Abdominal muscular endurance in Brazilian children and adolescents: systematic review of cross-sectional studies

Davoli, Gabriela Barroso de Queiroz; Lima, Luiz Rodrigo Augustemak de; Silva, Diego Augusto Santos

doi:10.5007/1980-0037.2018v20n4p483

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Revista Brasileira de Cineantropometria & Desempenho Humano

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original article • Rev. bras. cineantropom. desempenho hum 20 (4) • Jul-Aug 2018 • https://doi.org/10.5007/1980-0037.2018v20n4p483 copy

Abdominal muscular endurance in Brazilian children and adolescents: systematic review of cross-sectional studies

Resistência muscular abdominal em crianças e adolescentes do Brasil: revisão sistemática dos estudos transversais

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The literature has demonstrated the importance of musculoskeletal fitness in the prevention of chronic noncommunicable diseases. Although current recommendations of physical activities include strengthening and muscular endurance aspects, little is known about the muscular endurance levels of children and adolescents in a national scope. The aim of this study was to systematically review the literature to identify the prevalence of Brazilian children and adolescents who meet health criteria for muscular endurance. A hierarchical search was conducted in four databases (MEDLINE; Scopus; SciELO; LILACS) using the following terms: “muscular endurance”, “muscle endurance”, “physical fitness”, “child”, “adolescent”, “adults” “school” and correspondents in the Portuguese language. Overall, 2,652 articles (2,269 had their title and abstract read) were found and 70 were eligible for reading in full. Seventeen studies were reviewed and evaluated for risk of bias. Among 32,661 children and adolescents, only 40.2% of boys and 31.9% of girls presented abdominal muscular endurance adequate for health, and most studies were conducted in the southern region of Brazil. The variability in procedures for evaluating abdominal muscular endurance and cut-points used for interpretation occurred due to the use of different standardizations (PROESP/BR®, FITNESSGRAM® and AAHPERD®). Less than half of Brazilian adolescents of both sexes have adequate abdominal muscular endurance for health. Studies investigating the causes and consequences of inadequate abdominal muscular endurance may contribute to strategies for disease prevention and health promotion of children and adolescents.

Key words
Adolescent; Child; Physical fitness

Author	Region	City	State	M%	Age(years)	Muscular endurance measurement	Aim
Bergman et al.²⁰20 Bergmann GG; Araújo MLB; Garlipp DC; Lorenzi TDC; Gaya A. Alteração anual no crescimento e na aptidão física relacionada à saúde de escolares. Rev Bras Cineantropom Desempenho Hum 2005;7(2):55-61.	Southern	Canoas	RS	M: 50.8%	7 to 17	Curl-up (60s)	To analyze the development of health-related physical fitness of children and adolescents, verifying the differences between sexes and determining the occurrence of children and adolescents who are respectively below, within or above the healthy physical fitness zones.
Burgos et al.²¹21 Burgos MS, Reuter CP, Tornquist L, Piccin AS, Reckziegel MB, Poh HH, et al. Perfil de aptidão física relacionada à saúde de crianças e adolescentes de 7 a 17 anos. Health Sci Inst 2012;30(2):171-175.	Southern	Santa Cruz do Sul	RS	M: 52.3%	7 to 17	Curl-up (60s)	To evaluate and characterize the profile of health-related physical fitness of children and adolescents of Santa Cruz do Sul-RS
Castro et al.²⁷27 Castro FJS, Oliveira ACC. Associação entre a aptidão física relacionada à saúde e o desempenho acadêmico em adolescentes. Rev Bras Cineantropom Desempenho Hum 2016;18(4):441-449.	Northeastern	Aracaju	SE	M: 56.1%	15 to 18	Curl-up (60s)	To verify the association between health-related physical fitness components and academic performance in adolescents
Dórea et al.²⁸28 Dórea V, Ronque ERV, Cyrino ES, Serassuelo Junior H, Gobbo LA, Carvalho FO, et al. Aptidão física relacionada à saúde em escolares de Jequié, BA, Brasil. Rev Bras Med Esporte 2008;14(6):494-499.	Northeastern	Jequié	BA	M: 53.2%	7 to 12	Curl-up mod. (60s)	To analyze health-related physical fitness in schoolchildren from Jequié, BA, Brazil
Glaner et al.¹⁴14 Glaner MF. Aptidão física relacionada à saúde de adolescentes rurais e urbanos em relação a critérios de referência. Rev Bras Educ Fís Esporte 2005;19(1):13-24.	Southern	Porto Alegre	RS	M:100%	10 to 18	Curl-up	To compare health-related physical fit-ness among male adolescents residing in rural and urban areas and to analyze it in relation to the referenced criteria established by AAHPERD (1988).
Guedes et al.³³33 Guedes DP, Guedes JERP. Aptidão física relacionda à saúde de crianças e adolescentes: avaliação referenciada por critério. Rev Bras Ativ Fis Saúde 1995;1(2):27-28.	Southern	Londrina	PR	M: 49%	7 to 17	Curl-up mod.	To identify the proportion of children and adolescents belonging to the school population of the city of Londrina-Paraná who meet criteria related to health, based on information on physical fitness indexes
Guedes et al.¹³13 Guedes DP, Miranda Neto JT, Germano JM, Lopes V, Silva AJRM. Aptidão físicarelacionada à saúde de escolares: programa fitnessgram. Rev Bras Med Esporte 2012;18(2):72-76.	Southeastern	Montes Claros	MG	M:48.8%	6 to 18	Curl-up mod.; push-up	To investigate the association between socio-demographic and behavioral behavior factors and health patterns based on scores of physical fitness components in a sample of Brazilian schoolchildren
Luguetti et al.¹⁵15 Luguetti CN, Ré AHN, Böhme MTS. Indicadores de aptidão física de escolares daregião centro-oeste da cidade de São Paulo. Rev Bras Cineantropom Desempenho Hum 2010;12(5):331-337.	Southeastern	São Paulo	SP	M: 50.5%	7 to 16	Curl-up (60s)	To measure physical fitness indicators in children and adolescents according to chronological age and sex and to classify their performance through normative tables of PROESP / BR
Minatto et al.³¹31 Minatto G, Petroski EL, Silva DAS. Health-related physical fitness in Brazilian adolescents from a small town of German colonization. Rev Andal Med Deporte 2016;9(2):67-74.	Southern	São Bonifácio	SC	M:52.3%	10 to 17	Curl-up	To identify the physical fitness and health profile of Brazilian adolescents from a small German colonization city, as well as to describe the prevalence of adolescents with low physical fitness according to sex and age
Pelegrini et al.¹²12 Pelegrini A, Silva DAS, Petroski EL, Glaner MF. Aptidão física relacionadaà saúde de escolares brasileiros: dados do projeto esporte Brasil. Rev Bras Med Esporte 2011;17(2):92-96.	All regions	-	-	M: 54.8%	7 to 10	Curl-up mod. (60s)	To analyze the physical fitness of Brazilian schoolchildren, according to an evaluation referenced by health criteria.
Pereira et al.22	Southern	Uruguaiana	RS	M: 49.1	10 to 17	Curl-up (60s)	To identify the prevalence and factors associated with low physical fitness in adolescents.
Petroski et al.¹⁶16 Petroski EL; Silva AF; Rodrigues AB; Pelegrini A. Aptidão física relacionada a saúde em adolescentes brasileiros residentes em áreas de médio/baixo índice de desenvolvimento humano. Rev Salud Pública 2011;13(2):219-228.	Southeastern	Januária	MG	M: 42.4	14 to 17	Curl-up mod. (60s)	Assessing health-related physical fitness in adolescents of a city with me-dium / low human development index.
Ronque et al.²⁹29 Ronque ERV, Cyrino ES, Dórea V, Serassuelo Junior H, Galdi EHG, Arruda M. Diagnóstico da aptidão física em escolares de alto nível socioeconômico: avaliação referenciada por critérios de saúde. Rev Bras Med Esporte 2007;13(2):71-76.	Southern	Londrina	PR	M: 53.6	7 to 10	Curl-up mod. (60s)	To analyze body adiposity and motor performance in children of high socio-economic level, according to an evaluation referenced by health criteria.
Sehn et al.²³23 Sehn AP, Reuter CP, Kern DG, da Silva CF, Barbian CD, Welser L, et al. Perfil sociodemográfico associado em nível de aptidão física relacionada à saúde emescolares. Saude Pesqui 2017;10(1):75-82.	Southern	Santa Cruz do Sul	RS	M: 46.1%	7 to 17	Curl-up (60s)	To verify the existence of association between socio-demographic factors and health-related physical fitness levels in schoolchildren.
Serassuelo Junior et al.¹¹11 Serassuelo Junior H, Rodrigues AR, Cyrino ES, Ronque EV, Oliveira SRS, SimõesAC. Aptidão física relacionada à saúde em escolares de baixo nível socioeconômicodo município de cambé/PR. Rev Educ Fís/UEM 2005;16(1):5-11.	Southern	Cambé	PR	M: 45.9%	11 to 12	Curl-up mod. (60s)	To analyze the health-related physical fitness in schoolchildren of low socio-economic level in the city of Cambé / PR
Tornquist et al.²⁴24 Tornquist D, Tornquist L, Reuter CP, Reckziegel MB, Burgos LT, Burgos MS. Aptidão física relacionada à saúde de escolares das séries iniciais: um estudo entre turmas assistidas e não assistidas pelo profissional de Educação Física. Rev Bras Ativ Fis Saúde 2013;18(3):298-300.	Southern	Santa Cruz do Sul	RS	M: 53.1	9.07 (dp1.54)	Curl-up	To verify possible differences in health-related physical fitness levels among students in the initial grades who participate in Physical Education classes taught by a qualified professional (municipal and private schools) and students in which classes are taught by a single teacher (state schools).
Werk et al.²⁵25 Werk R, Vieira AZ, Nuñez PRM, Habitante CA, Silva JVP. Aptidão física relacionada à saúde de crianças de uma escola estadual de campo grande/MS. Cienc Cuid Saude 2009; 8(1):42-47.	Midwestern	Campo Grande	MT	M: 43.9%	7 to 10	Curl-up (60s)	To analyze the health-related physical fitness level of children aged 7-10 years and the differences between sexes.

Author	Age range/Sample that performed the muscle endurance test		Percentage of subjects classified as having adequate abdominal muscular endurance	Reference for the classification of curl-up test
Bergman et al.²⁰	7-17 years (n=3447 boys; n=3347 girls)		47% of boys (n=1620) and 34% of girls (n=1138)	FITNESSGRAM
Burgos et al.²¹	7-17 years (n=871 boys; n=793 girls)		63.3% of boys (n=543) and 71.2% of girls (n=06)	PROESP/BR
Castro et al.²⁷	15-18 years (n=183 boys; n=143 girls)		9.8% of boys (n=18) and 4.2% of girls (n=11)	AAHPERD
Dórea et al.²⁸	7-12 years (n=182 boys; n= 160 girls)		11.0% of boys (n=20) and 7.0% of girls (n=04)	AAHPERD
Glaner et al.¹⁴	10.50 to 17.49 years (n=721 boys)		24.8% of boys (n=179)	AAHPERD
Guedes et al.³³	7-17 years (n=21ü3 boys; n=2189 girls)		39.5% of boys (n=831) and 31.0% of girls (n=679)	AAHPERD
Guedes et al.¹³	6-18 years (n=1,392 boys; n=1,457 girls)		Abdominal: 33.2% of boys (n=462) and 21.8% of girls (n=318);Arm flexion: 48.7% of boys (n=678); 30.7% of girls (n=447).	FITNESSGRAM
Luguetti et al.¹⁵	7-16 years(n=1,590 boys; n=1555 girls)		64% of boys (n=1,018) and 57% of girls (n=886)	PROESP/BR
Minatto et al.³¹	10-17 years (n=145 boys; n=132 girls)		62.1% of boys (n=90) and 54.5% of girls (n=72)	FITNESSGRAM
Pelegrini et al.¹²	7-10 years (n=4,114 boys; n=3,393 girls)		30% of boys (n=1,243); 30% of girls (n=1,018)	AAHPERD
Pereira et al.²²	10-17 years(n=714 boys; n=741 girls)		71.7% of boys (n=523); 73.5% of girls (n=563)	PROESP/BR
Petroski et al.¹⁶	14-17 years (n=266 boys; n=361 girls)		2.3% of boys (n=06); 1.0% of girls (n=03)	AAHPERD
Ronque et al.²⁹	7-10 years (n=274 boys and n=237 girls)		67% of boys (n= 184) and 64% of girls (n= 152)	AAHPERD
Sehn et al.²³	7-17 years (n=461 boys; n=539 girls).		51.5% (n=567) (did not present stratifica-tion by sex)	PROESP/BR
Serassuelo Junior et al.¹¹	11-12 years (n=108 boys; n=127 girls)		10.2% of boys (n=11) and 8.0% of girls (n=10)	AAHPERD
Tornquist et al.²⁴	7-17 years (n=333 boys; n=293 girls)		43.0% (n=269) (did not present stratifica-tion by sex)	PROESP/BR
Werk et al.²⁵	7-10 years (n=129 boys; n=161 girls)		72% of boys (n=93); 78% of girls (n=126)	PROESP/BR
Total^* * for the calculation of the percentage of subjects with adequate muscular endurance, the following equation was considered: (number of subjects classified as having adequate muscular endurance/total number of subjects in the studies considered) * 100; ^† † : the calculation only considered the information of the abdominal muscular endurance test of the studies found; ^§ § : the calculation for sex-stratified information only considered studies that presented information stratified by sex, thus, two studies were not included for this calculation (e.g., Sehn et al., and Tornquist et al.).	6-18 years (n=32661) (n=17,033 boys; n=15,628 girls)	40.2% of boys (n=6,841) and 31.9% of girls (n=4,986)

Author	Q1	Q2	Q3	Q4	Q5	Q7	Q8	Q9	Q10	Q11	Q13	Q14	Final score^* * to determine the total score, we considered the following equation: (total of positive answers / total of questions considered for that study).	Classification
Bergman et al.²⁰20 Bergmann GG; Araújo MLB; Garlipp DC; Lorenzi TDC; Gaya A. Alteração anual no crescimento e na aptidão física relacionada à saúde de escolares. Rev Bras Cineantropom Desempenho Hum 2005;7(2):55-61.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias
Burgos et al.²¹21 Burgos MS, Reuter CP, Tornquist L, Piccin AS, Reckziegel MB, Poh HH, et al. Perfil de aptidão física relacionada à saúde de crianças e adolescentes de 7 a 17 anos. Health Sci Inst 2012;30(2):171-175.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias
Castro et al.²⁷27 Castro FJS, Oliveira ACC. Associação entre a aptidão física relacionada à saúde e o desempenho acadêmico em adolescentes. Rev Bras Cineantropom Desempenho Hum 2016;18(4):441-449.	1	1	1	1	1	NA	NA	1	NA	1	NA	0	0,70	Low risk of bias
Dórea et al.²⁸28 Dórea V, Ronque ERV, Cyrino ES, Serassuelo Junior H, Gobbo LA, Carvalho FO, et al. Aptidão física relacionada à saúde em escolares de Jequié, BA, Brasil. Rev Bras Med Esporte 2008;14(6):494-499.	1	1	1	1	1	NA	NA	1	NA	1	NA	0	0,70	Low risk of bias
Glaner et al.¹⁴14 Glaner MF. Aptidão física relacionada à saúde de adolescentes rurais e urbanos em relação a critérios de referência. Rev Bras Educ Fís Esporte 2005;19(1):13-24.	1	1	1	1	1	NA	NA	1	NA	1	NA	0	0,70	Low risk of bias
Guedes et al.³³33 Guedes DP, Guedes JERP. Aptidão física relacionda à saúde de crianças e adolescentes: avaliação referenciada por critério. Rev Bras Ativ Fis Saúde 1995;1(2):27-28.	1	1	ND	1	1	NA	NA	1	NA	1	NA	1	0,77	Low risk of bias
Guedes et al.¹³13 Guedes DP, Miranda Neto JT, Germano JM, Lopes V, Silva AJRM. Aptidão físicarelacionada à saúde de escolares: programa fitnessgram. Rev Bras Med Esporte 2012;18(2):72-76.	1	1	1	1	1	NA	NA	1	NA	1	NA	1	0,80	Low risk of bias
Luguetti et al.¹⁵15 Luguetti CN, Ré AHN, Böhme MTS. Indicadores de aptidão física de escolares daregião centro-oeste da cidade de São Paulo. Rev Bras Cineantropom Desempenho Hum 2010;12(5):331-337.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias
Minatto et al.³¹31 Minatto G, Petroski EL, Silva DAS. Health-related physical fitness in Brazilian adolescents from a small town of German colonization. Rev Andal Med Deporte 2016;9(2):67-74.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias
Pelegrini et al.¹²12 Pelegrini A, Silva DAS, Petroski EL, Glaner MF. Aptidão física relacionadaà saúde de escolares brasileiros: dados do projeto esporte Brasil. Rev Bras Med Esporte 2011;17(2):92-96.	1	1	ND	ND	0	NA	NA	1	NA	1	NA	0	0,50	Moderate risk of bias
Pereira et al.²²22 Pereira TA, Bergmann MLA, Bergmann GG. Fatores associados à baixa aptidão física de adolescentes. Rev Bras Med Esporte 2016;22(3):176-181.	1	1	1	ND	1	NA	NA	1	NA	1	NA	1	0,77	Low risk of bias
Petroski et al.¹⁶16 Petroski EL; Silva AF; Rodrigues AB; Pelegrini A. Aptidão física relacionada a saúde em adolescentes brasileiros residentes em áreas de médio/baixo índice de desenvolvimento humano. Rev Salud Pública 2011;13(2):219-228.	1	1	1	1	1	NA	NA	1	NA	1	NA	0	0,70	Low risk of bias
Ronque et al.²⁹29 Ronque ERV, Cyrino ES, Dórea V, Serassuelo Junior H, Galdi EHG, Arruda M. Diagnóstico da aptidão física em escolares de alto nível socioeconômico: avaliação referenciada por critérios de saúde. Rev Bras Med Esporte 2007;13(2):71-76.	1	1	0	1	0	NA	NA	1	NA	1	NA	0	0,50	Moderate risk of bias
Sehn et al.²³23 Sehn AP, Reuter CP, Kern DG, da Silva CF, Barbian CD, Welser L, et al. Perfil sociodemográfico associado em nível de aptidão física relacionada à saúde emescolares. Saude Pesqui 2017;10(1):75-82.	1	1	0	1	0	NA	NA	1	NA	1	NA	0	0,50	Moderate risk of bias
Serassuelo Junior et al.¹¹11 Serassuelo Junior H, Rodrigues AR, Cyrino ES, Ronque EV, Oliveira SRS, SimõesAC. Aptidão física relacionada à saúde em escolares de baixo nível socioeconômicodo município de cambé/PR. Rev Educ Fís/UEM 2005;16(1):5-11.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias
Tornquist et al.²⁴24 Tornquist D, Tornquist L, Reuter CP, Reckziegel MB, Burgos LT, Burgos MS. Aptidão física relacionada à saúde de escolares das séries iniciais: um estudo entre turmas assistidas e não assistidas pelo profissional de Educação Física. Rev Bras Ativ Fis Saúde 2013;18(3):298-300.	1	1	1	1	1	NA	NA	1	NA	1	NA	0	0,70	Low risk of bias
Werk et al.²⁵25 Werk R, Vieira AZ, Nuñez PRM, Habitante CA, Silva JVP. Aptidão física relacionada à saúde de crianças de uma escola estadual de campo grande/MS. Cienc Cuid Saude 2009; 8(1):42-47.	1	1	ND	1	0	NA	NA	1	NA	1	NA	0	0,55	Low risk of bias

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[1] Author Contributions

DASS is the principal investigator and conceived the idea of the manuscript. GBQD and LRAL draft of the first version of the paper and made the extractions of the data. All authors read and approved the final manuscript.