Background

Musculoskeletal fitness is an excellent functional measure that is significantly related to health among youth.

Objective

Our objective was to identify health-related criterion-referenced cut-points for musculoskeletal fitness (MSF) among youth.

Methods

A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for MSF among youth were eligible provided they included (1) youth aged 5–17 years from the general population, (2) at least one quantitative assessment of MSF (e.g., muscular strength), (3) at least one quantitative assessment of health (e.g., cardiometabolic risk), (4) a criterion for health, and (5) a quantitative analysis [e.g., receiver operating characteristic (ROC) curve] of at least one health-related cut-point for MSF. A narrative synthesis was used to describe the results of included studies.

Results

Collectively, 13 studies that developed health-related criterion-referenced cut-points for MSF among 14,476 youth from 15 countries were included. Muscular strength demonstrated high discriminatory ability [median area under the curve (AUC) ≥ 0.71] for cardiometabolic risk/metabolic syndrome, sarcopenic obesity risk and bone health, and moderate discriminatory ability (median AUC 0.64–0.70) for asthma. Muscular power also demonstrated high discriminatory ability for bone health but only moderate discriminatory ability for cardiometabolic risk/metabolic syndrome and low discriminatory ability (median AUC 0.56–0.63) for cognition/academic performance. Both muscular endurance and flexibility demonstrated low discriminatory ability for musculoskeletal pain. Health-related cut-points for MSF that demonstrated significant discriminatory ability were generally higher for boys than for girls (for muscular strength and power) and generally increased with age for muscular strength and power but remained stable for flexibility.

Conclusions

Data remain insufficient to establish universal health-related cut-points for MSF among youth. Despite variations in the health-related discriminatory ability of different MSF tests, handgrip strength and standing broad jump emerged as the two tests with the highest discriminatory ability. More research, using standardized testing protocols and health-risk definitions, is required to better triangulate universal health-related cut-points for MSF among youth.

PROSPERO registration number

CRD42020207458.

中文翻译：

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青少年肌肉骨骼健康的健康相关标准参考切点：系统评价

背景

肌肉骨骼健康是一项与青少年健康显着相关的出色功能指标。

客观的

我们的目标是确定青少年肌肉骨骼健康 (MSF) 的健康相关标准参考切点。

方法

2020 年 9 月对两个电子数据库（MEDLINE 和 SPORTDiscus）进行了系统搜索。只有在青年中为无国界医生制定了与健康相关的标准参考切点的同行评审研究才符合条件，前提是它们包括 (1) 5 岁至17 岁的普通人群，(2) 至少一项 MSF 定量评估（例如，肌肉力量），(3) 至少一项健康定量评估（例如，心脏代谢风险），(4) 健康标准，以及(5) 对 MSF 的至少一个与健康相关的切点进行定量分析 [例如，受试者工作特征 (ROC) 曲线]。叙述性综合用于描述纳入研究的结果。

结果

总共纳入了 13 项研究，这些研究为来自 15 个国家的 14,476 名青年制定了无国界医生的健康相关标准参考切点。肌肉力量表现出对心脏代谢风险/代谢综合征、肌肉减少性肥胖风险和骨骼健康的高辨别能力[曲线下面积中位数 (AUC) ≥ 0.71]，以及对哮喘的中等辨别能力（中位数 AUC 0.64–0.70）。肌肉力量也表现出对骨骼健康的高辨别能力，但对心脏代谢风险/代谢综合征的辨别能力只有中等，而对认知/学业表现的辨别能力低（中位 AUC 0.56-0.63）。肌肉耐力和柔韧性都表现出对肌肉骨骼疼痛的低辨别能力。

结论

数据仍然不足以确定青年无国界医生的普遍健康相关临界点。尽管不同 MSF 测试的健康相关辨别能力存在差异，但握力和立定跳远成为辨别能力最高的两项测试。需要使用标准化测试协议和健康风险定义进行更多研究，以更好地确定青年中无国界医生的普遍健康相关切点。

PROSPERO 注册号

CRD42020207458。