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TheALPHAHealthRelatedFitnessTestBatteryfor

ChildrenandAdolescents

TestManual

www.thealphaproject.eu
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CONTENTS

1.WHATISHEALTHRELATEDFITNESS?............................................................................................4

2.THEALPHAFITNESSTESTBATTERYFORCHILDRENANDADOLESCENTS.....................................4
2.1.Developmentofthetestbattery.........................................................................................4

2.2.Descriptionofthetestbattery...........................................................................................4

3.HOWTOCONDUCTTHETESTS?....................................................................................................5

3.1.Generalinstructions............................................................................................................5

3.2.Standardization....................................................................................................................7

3.3.Recommendedsequence....................................................................................................7

3.4.Instructionsfortheparticipants..........................................................................................7

4.SAFETYMODEL...............................................................................................................................8

4.1.Pretestinghealthscreening................................................................................................8

4.2.Recommendationforsafetesting.......................................................................................8

5.TESTS...............................................................................................................................................9

5.1.Pubertaldevelopment.........................................................................................................9

5.1.1.Girls................................................................................................................................9

5.1.2.Boys..............................................................................................................................11

5.2.Bodycomposition..............................................................................................................13

5.2.1.BodyMassIndex(BMI)...............................................................................................13

5.2.2.Waistcircumference...................................................................................................14

5.2.3.Tricepsskinfoldthickness............................................................................................15

5.2.4.Subscapularskinfoldthickness...................................................................................16

5.3.Musculoskeletalfitness......................................................................................................17

5.3.1.Handgrip......................................................................................................................17

5.3.2.Standinglongjump......................................................................................................20

5.4.Motorfitness......................................................................................................................21

5.4.1.4x10shuttleruntest...................................................................................................21

5.5.Cardiorespiratoryfitness...................................................................................................23

6.REFERENCEVALUES......................................................................................................................24

7.MEASUREMENTSSHEET...............................................................................................................33

8.WORKINGGROUP.........................................................................................................................34

FOREWORD

ALPHAisthefirstletteroftheGreekalphabet.Asanadjective,thetermALPHAiscommonlyused
to designate the first in an order of precedence. In our case, ALPHA is the acronym of the first
European collaborative project designed to be the first European approach to provide a set of
evidencebasedinstrumentsforassessinglevelsofphysicalactivityandfitnessinacomparableway
within the EU. The acronym ALPHA corresponds to Assessing the Levels of Physical Activity and
Fitness,aprojectcoordinatedbyDr.MichaelSjstrmfromtheKarolinskaInstitutetandfundedby
the Directorate General for Health and Consumers Affairs (DG SANCO) of the EU. A part of the
result of the activity of the ALPHA Consortium, and its external advisors, is the ALPHA Fitness
(ALPHAFIT)TestBatteryforChildrenandAdolescentswhichagainisthefirstEuropeanapproach
to provide evidencebased recommendations and operating instructions to assess the health
relatedfitnessstatusinchildrenandadolescentsonapopulationbaseintheEU.Inthefollowing
pagesthisinformationisprovided.

The question now is whether the ALPHAFIT Test Battery applied to Children and Adolescents
should also appear within the first positions in an order of precedence in relation to health. My
answerisyes.

In fact, physical fitness refers to a physiologic state of wellbeing and functional capacity that
allows adequately meeting the multiple demands of daily living including those coming from a
physicaloverload,suchasexerciseordisease.Thehigherthefitnesslevelsofaperson,thehigher
his/her ability to meet the demands of a functional overload. This overload may come not only
from exercise but also from any other physical stress. Sensu strictu, physical fitness makes
referencetothefullrangeofphysicalqualities,i.e.,aerobiccapacity,strength,endurance,speed,
agility, coordination, flexibility Nevertheless, other qualities, such as body composition or
metabolism also play an important role in meeting the demands of any physical overload.
Consequently, they all can also be considered as components of physical fitness. Healthrelated
physicalfitnessincludesthosecomponentsofphysicalfitnessthathaveshowntobemoreclearly
related to health status and it could also relate to wellbeing and happiness although data are
lackinginthisregard.

Iencouragenotonlytoreadthefollowingpagesbuttoputthemintopracticeasafirstpriorityin
relation to health and wellbeing both at individual and population levels. ALPHAFIT individuals
andgroupscanbeahealthygoalforEurope.

Granada,December19th,2009

ManuelJCastilloGarzn,MD,PhD
ProfessorofMedicalPhysiology
SchoolofMedicine,UniversityofGranada

1.WHATISHEALTHRELATEDFITNESS?

Physicalfitnessistypicallydefinedwithfocusontwogoals:performanceorhealth.Healthrelated
physicalfitnesscanbedefinedastheabilityofapersontoperformdailyactivitieswithvigour,and
bytraitsandcapacitiesthatareassociatedwithalowriskforthedevelopmentofchronicdiseases
and premature death. Despite chronic diseases and cardiovascular disease events occur most
frequentlyduringorafterthefifthdecadeoflife,thereisevidenceindicatingthattheprecursorsof
cardiovasculardiseasehavetheirorigininchildhoodandadolescence.Therefore,theassessment
of healthrelated fitness at childhood and adolescence is of public health and clinical interest.
Healthrelatedfitnesscomponentsincludecardiorespiratoryfitness,musculoskeletalfitness,motor
fitnessandbodycomposition.

2.THEALPHAHEALTHRELATEDFITNESSTESTBATTERYFORCHILDRENAND
ADOLESCENTS

2.1.Developmentofthetestbattery
TheALPHAfitnesstestbatterywasdevelopedtoprovideasetofvalid,reliable,feasibleandsafe
fieldbased fitness tests for the assessment of healthrelated physical fitness in children and
adolescents, to be used in the public health monitoring system in a comparable way within the
EuropeanUnion.

2.2.Descriptionofthetestbattery
ALPHAfitnesstestbatteryistimeefficient,lowincostandequipmentrequirements,andcanbe
easilyadministeredtoalargenumberofpeoplesimultaneously.

We propose a valid, reliable, feasible and safe test battery for the assessment of healthrelated
physical fitness in children and adolescents to be used for health monitoring purposes at
populationlevel.

3.HOWTOCONDUCTTHETESTS?

3.1.Generalinstructions
TheALPHAhealthrelatedfitnesstestbatterypresentsthreeslightlydifferentversionsdepending
ontheavailabletimetoadministerthetests.

a) Evidencebased ALPHA healthrelated fitness test battery. This version of the battery
includes weight and height (BMI), waist circumference, skinfolds thickness (triceps and
subscapular), handgrip strength, standing long jump, and 20m shuttle run tests. All these
measurementshaveshowntobestronglyrelatedwiththecurrentandfuturehealthstatus
ofthechildren/adolescent.

The time needed to administer this battery to a group of 20 individuals by one tester is
around2hoursand30minutes.

Evidence Based Health-Related Fitness Test Battery


for Children and Adolescents

Cardiorespiratory
fitness

Musculoskeletal
fitness

Body composition

20m shuttle run test

Handgrip strength

Weight & Height (BMI)

Standing long jump

Waist circumference

Triceps & Subscapular


skinfold thickness

Figure1.EvidencebasedHealthRelatedFitnessTestBatteryforChildrenandAdolescents.BMI
indicatesbodymassindex(weightinkgdividedbyheightinmeterssquared,kg/m2).

b) High priority ALPHA healthrelated fitness test battery (Figure 2). When there are time
constraints, as it can be the case in the school setting, we recommend omitting the
assessmentoftheskinfoldthickness.Thismeasurementisthemostskilldemanding,soin
thesecasesBMIandwaistcircumferencecanbeenoughtoassessbodycomposition.

The time required to administer this battery to a group of 20 children by one trained
physical education (PE) teacher or a healthprofessional is less than 2 hours (i.e. 2 PE
sessionsof~55minutes).
5

High Priority ALPHA Health-Related Fitness Test Battery


for Children and Adolescents

Cardiorespiratory
fitness

Musculoskeletal
fitness

Body composition

20m shuttle run test

Handgrip strength

Weight & Height (BMI)

Standing long jump

Waist circumference

Figure 2. High priority ALPHA HealthRelated Fitness Test Battery for Children and Adolescents.
BMIindicatesbodymassindex(weightinkgdividedbyheightinmeterssquared,kg/m2).

c) Extended ALPHA healthrelated fitness test battery (Figure 3). In those cases where there
arenotimelimitations,werecommendusingallthetestsincludedintheevidencebased
batterytogetherwithoneadditionaltest(4x10mshuttlerun)toassessmotorfitness.This
test has shown a poorer health and criterionrelated validity, but only because of a low
numberofstudies.

Extended ALPHA Health-Related Fitness Test Battery


for Children and Adolescents

Cardiorespiratory
fitness

Musculoskeletal
fitness

Body composition

20m shuttle run test

Handgrip strength

Weight & Height (BMI)

Standing long jump

Waist circumference

Triceps & Subscapular


skinfold thickness

Motor fitness

4x10m shuttle run test

Figure 3. Extended ALPHA HealthRelated Fitness Test Battery for Children andAdolescents. BMI
indicatesbodymassindex(weightinkgdividedbyheightinmeterssquared,kg/m2).

3.2.Standardization
A strict standardization of the field work precludes to a great extent the confounding bias that
often interferes when comparing results from isolated studies. This manual, which includes not
onlythedescriptionofthetestsbutalsothemostappropriatesequence,andtheinstructionsfor
thetesterandparticipants,willenableahigheraccuracyintheassessmentofphysicalfitnessand
itsrelationshipwithhealthinyoungpeople.

3.3.Therecommendedsequence
Therecommendedsequencetoadministerthisbatterywouldbe:

1. Pubertalstatus.
2. Weightandheight(BMI).
3. Waistcircumference.
4. Skinfoldthickness(tricepsandsubscapular).
5. Handgripstrength,standinglongjumpand4x10mshuttleruntest.Thesecouldbecarried
outalternativelyorsimultaneitywhentherearetwoormoretesters.
6. 20mshuttleruntest.

3.4.Instructionsfortheparticipants
Childmustbeinstructedtoabstainfromstrenuousexerciseinthe48hprecedingthetesting.To
wearcomfortablesportclothesandshoesisvitalfortheappropriateadministrationofthebattery.
A notable and constant level of encouragement is recommended to guarantee the maximum
performancefromtheparticipantsthroughoutthetests.

4.SAFETYMODEL

4.1.Pretestinghealthscreening
Knowledgeofthecurrentandformerhealthstatusofthechildrenandadolescentsisimportantin
order to enhance safe testing. A pretesting screening should identify young people at high risk,
andshouldbesimilartotheonetypicallyusedtoallowthechildrenandadolescentstotakeactive
partinthePElessons. Forthispurpose,inmost/manyEuropeancountries,childrenhaveannual
physical examinations by the schooldoctors who provide detailed information regarding the
skeletomuscular, cardiorespiratory, haematocirculatory, psychoneurological and endocrine
metabolic systems. When this service is not available, it is recommendable that the parents or
guardians complete at least a pretesting/preparticipation screening questionnaire before the
childstartswiththePElessonsand/orthefitnesstesting.Agoodexampleofsuchquestionnaireis
theExerciseandPhysicalActivityReadinessAssessmentquestionnaire.Inanycase,itisimportant
to be alert to the subjective symptoms such as skin pallor, dizziness, syncope and dyspnea. The
tests should be immediately interrupted if there is any sign of problem or risk (see the standard
operatingprocedureforspecification).Anychildabletotakepartinphysicaleducationclassescan
performtheALPHAhealthrelatedfitnesstestbattery.

4.2.Recommendationforsafetesting
A small and comfortable chamber, but warm and ventilated at the same time, is highly
recommendedforthebodycompositionmeasurements.Ideally,nobodyelseapartfromthetester,
anassistant,andamaximumof2participantsshouldbepresentinthechamberatthesametime.
Anonslipperysurfaceisnecessaryforthestandinglongjumpand4x10mshuttleruntests.Finally,
aspaceofatleast25mlengthisrequiredforasafeadministrationofthe20mshuttleruntest.

Immediately after the body composition measurements (BMI, waist circumference and skinfold
thickness),andbeforecontinuingwiththerestofthetests(handgripstrength,standinglongjump,
4x10m shuttle run, and 20m shuttle run), it is necessary to carry out a 510 minutes warm up
composedofjoggingandstretchingexercises.

5.TESTS

5.1.Pubertalstatus(Tannerstage)

Anevaluationofthepubertalstatusofchildrenandadolescentsisofimportanceduetothefact
that childhood and adolescence is a period of life where many changes occur. Though pubertal
development should be ideally evaluated by a paediatrician or trained physician through direct
observation,thisisnotfeasibleinmostsettings.Instead,trainedinterviewerscanaskthechildren
and adolescents to classify themselves in one of the five stages of pubertal maturity defined by
TannerandWhitehouse.

5.1.1.Girls

In girls, Tanner Stage should be assessed by the stage of breast development and public hair
distributionasdenotedintable1.

Table1.GirlsTannerStagesbybreastdevelopment,andbyhairdistribution.

Stage BreastDevelopment
Hairdistribution
1
The infantile stage persists from the immediate Nohair.
postnatal period until the onset of puberty. The
breast has no glandular tissue and the areola and
papillaconformtothechestline.
2

This is the bud stage, during which the breast and Smallamountoflong,slightly
papilla are elevated as a small mound, and the pigmented,downyhair.
diameter of the areola is increased. The
developmentofthebreast.

The breast and areola are further enlarged and Moderate amounts of more
present an appearance rather like that of a small curly, pigmented hair: more
adult mammary gland with a continuous rounded lateral.
contour.

The areola and papilla are further enlarged and Resembles adult public hair
form a secondary mound projecting above the in coarseness and curliness,
corpusofthebreast.
but does not extend to the
medialsurfacesofthethighs.

This is the typical adult stage with a smooth Adultpatter.


rounded contour, the secondary mound present in
Stage4havingdisappeared.

Images.

Stage

Breastdevelopment

Hairdistribution

10


5.1.2.Boys

In boys, Tanner Stage should be assessed by the stage of genitalia development (penis size and
testicularvolume)andpubichairdistributionasdenotedintable2.

Table2.BoysTannerStagesbypenisandscrotumdevelopment,andbyhairdistribution.

Stage PenisandScrotumDevelopment
HairDistribution
1

During this time the genitalia increase in overall Nohair.


size, but there is little change in general
appearance. Testes volume 1.5 cc. Phallus is
childlike.

The scrotum has begun to enlarge, and there is Smallamountoflong,slightly


some reddening and change in texture of the pigmented,downyhair,along
scrotalskin.Testesvolume1.66cc.Thescrotumis thebaseofthescrotum.
reddened, thinner and lager. The phallus is
childlike.

The penis has increased in length, and there is a Moderate amount of more
small increase in breadth. There has been further curly,pigmented,andcoarser
growthofthescrotum.Testesvolume6to12cc.
hair;morelateralextension.

The length and breadth of the penis has increased


further and the glands have developed. The
scrotumisfurtherenlarged,andthescrotalskinhas
becomedarker.Testesvolume12to20cc.

The genitalia are adult in size and shape. Tests Adultpatter.


volume20cc.

Resembles adult hair in


coarseness and curliness, but
does not extend to the
medialsurfacesofthethighs.

11


Images.
Stage

PenisandScrotumDevelopment

Hairdistribution

12

5.2.Bodycomposition

5.2.1.BodyMassIndex(BMI)

Purpose
Tomeasurebodysize.

Healthrelation
HigherBMIisassociatedwithaworsecardiovascularprofile.
Equipment
Anelectronicscaleandatelescopicheightmeasuringinstrument.
Performance
Bodyweightinkilogramsdividedbythesquareofheightinmeters(kg/m2).


Bodyweight

Thechildmuststandontheplatformofthescalewithoutsupport.Thechild
stands still over the centre of the platform with the body weight evenly
distributed between both feet. Light underclothes can be worn, excluding
shoes,longtrousersandsweater.
Bodyheight

Hair ornaments must be removed and braids must be undone. The child
standsonthestadiometerwithbarefeetplacedslightlyapartandtheback
of the head, shoulder blades, buttocks, calves, and heels touching the
verticalboard.Legsmustbekeptstraightandthefeetflat.Thetestermust
positionthechildsheadsothatahorizontallinedrawnfromtheearcanalto
the lower edge of the eye socket runs parallel to the baseboard (i.e., the
Frankfortplanepositionshorizontally).Theheadboardmustbepulleddown
torestfirmlyontopoftheheadandcompresshair.

Practiceandnumberoftesttrials:Twomeasurementsofbothbodyweight
andbodyheightareperformedandthemeanofeachoneisretained.
Measurement
Itstartswhenthechildhasreachedthecorrecttestposition.
Scoring
Weight is recorded to the nearest 100 g. Example: a result of 58 kg scores
58.0. In height the reading must be taken to the last completed 1 mm.
Example:aresultof157.3cmscores157.3.

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5.2.2.Waistcircumference

Purpose
Toestimatecentralbodyfat.
Healthrelation
Ahigherwaistcircumferenceisariskfactorforcardiovasculardisease.
Equipment
Nonelastictape.
Performance
Thechildwearslittleclothingsothatthetapemaybecorrectlypositioned.
Thechildstandserectwiththeabdomenrelaxed,thearmsatthesidesand
the feet together. The tester faces the child and places an inelastic tape
aroundhim/her,inahorizontalplane,atthelevelofthenaturalwaist,which
isthenarrowestpartofthetorso,asseenfromtheanterioraspect.Insome
obese children, it may be difficult to identify a waist narrowing. In such
cases,thesmallesthorizontalcircumferenceshouldbemeasuredinthearea
betweenthespinailiacasuperiorandthecostaledgeinthemidaxillaryline.

Practice and number of test trials: Two measurements are performed not
consecutivelyandthemeanisusedintheanalyses.
It starts when the child has reached the correct test position. The
Measurement
measurementshouldnotbemadeoverclothing,shouldbetakenattheend
of a normal expiration without the tape compressing the skin and with
childsarmsattheside.
Scoring
Itisrecordedtothenearest0.1cm.Example:aresultof60.7cmscores60.7.

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5.2.3.Tricepsskinfoldthickness

Purpose
Tomeasuresubcutaneousfatandtoestimatepercentagebodyfat.
Healthrelation
Ahigheradiposityisariskfactorforcardiovasculardisease.
Equipment
Skinfoldcalliper,nonelastictapeandpen.
Performance
Themidupperarmpointishalfthedistancebetweentheacromionprocess
(the most lateral bony protuberance of the back of the shoulder) and the
olecranon(thebonystructurethatstandsoutwhentheelbowisbent).The
tester stands behind the child and picks up the skinfold about 1 cm above
themidpointmarkoverthebicepsmuscle,withthefoldrunningdownward
alongthemidlineofthebackupperarm.Thecaliperjawsmustbeappliedat
rightanglestotheneckofthefoldjustbelowthefingerandthumbover
the midpoint mark. While maintaining a grip on the skinfold, the tester
gently releases the caliper handles and allows the jaws to close on the fat
foldfortwosecondsbeforetakingthereading.

Practice and number of test trials: Two measurements are performed not
consecutivelyandthemeanisusedintheanalyses.
Measurement
Child starts when he/she has reached the correct test position. Skinfolds
must be measured not on the dominant side of the adolescent (it means
that,whensomeoneisrighthandedthanskinfoldsmustbemeasuredonthe
lefthandside).Themeasurementshouldnotbemadeoverclothing.
Scoring
It is recorded to the nearest 0.1 mm. Example: a result of 21.2 mm scores
21.2.

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5.2.4.Subscapularskinfoldthickness

Purpose
Tomeasuresubcutaneousfatandtoestimatepercentagebodyfat.
Healthrelation
Ahigheradiposityisariskfactorforcardiovasculardisease.
Equipment
Skinfoldcalliper,nonelastictapeandpen.
Performance
Thesubscapularskinfoldispickeduponadiagonal,inclinedinferolaterally
approximately45tothehorizontalplaneinthenaturalcleavagelinesofthe
skin. The site is just inferior to the lower angle of the scapula. The child
standscomfortablyerect,withtheupperextremitiesrelaxedatthesidesof
the body. To locate the site, the tester palpates the scapula, running the
fingers inferiorly and laterally, along its vertebral border until the inferior
angleisidentified.Forsomechildren,especiallytheobese,gentleplacement
of the childs arm behind the back aids in identifying the site. The caliper
jawsareapplied1cminferolateraltothethumbandfingerraisingthefold.

Practice and number of test trials: Two measurements are performed not
consecutivelyandthemeanisusedintheanalyses.
Measurement
Child starts when he/she has reached the correct test position. Skinfolds
must be measured not on the dominant side of the adolescent (it means
that,whensomeoneisrighthandedthanskinfoldsmustbemeasuredonthe
lefthandside).Themeasurementshouldnotbemadeoverclothing.
Scoring
It is recorded to the nearest 0.1 mm. Example: a result of 33.4 mm scores
33.4.

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5.3.Musculoskeletalfitness

5.3.1.Handgripstrength

Purpose
Tomeasureupperbodyisometricstrength.
Healthrelation
Musculoskeletalfitnessisinverselyassociatedwithestablishedandemerging
cardiovasculardiseaseriskfactors,backpainandwithbonemineralcontent
and density. Musculoskeletal improvements from childhood to adolescence
arenegativelyassociatedwithchangesinoveralladiposity.
Equipment
A hand dynamometer with adjustable grip (TKK 5101 Grip D; Takey, Tokio
Japan)andatablerule.
Performance
Childsqueezesgraduallyandcontinuouslyforatleast2seconds,performing
the test twice (alternately with both hands) with the optimal gripspan
(previously calculated, according to the hand size) and allowing short rest
betweenmeasures.Foreachmeasure,thehandtobetestedfirstlyischosen
randomly.Theelbowmustbeinfullextensionandavoidingcontactingwith
any other part of the body with the dynamometer, except the hand being
measured.
Instructions:"Takethedynamometerwithonehand.Squeezeitforcefullyas
you can while holding the dynamometer away from your body. Don't let it
touchyouduringthetest.Squeezegraduallyandcontinuouslyforatleast2
seconds.Dothetesttwiceperhand:thebestresultscores."
Practiceandnumberoftesttrials:Thetestershowstherightperformance.
Bothhandsaretobetestedtwice,andthebestresult(ofeachhand)scored.
Adjustthehandgripspanaccordingtothehandsize(seenextpage).
Measurement
The maximal duration of the test is 35 seconds. Hand size should be
measured in right hand at maximal width and by measuring the distance
separating distal extremes of the first and fifth digits. The precision of the
measureis0.5cm.Theresultsofhandsizeshouldberoundedtothenearest
whole centimetre. If you prefer, you can put the childrens hand over the
rulertable to see the optimal grip span according to hand size (see ruler
table).Duringthetest,thearmandhandholdingthedynamometershould
not touch the body. The instrument is held in line with the forearm and
hangs down at the side. After a short rest, a second attempt is made. The
indicatorneedstobereturnedtozeroafterthefirstattempt.
Scoring
Theresultisexpressedinkilograms,accurateto0.1kg.Example:aresultof
24kgscores24.0.

17

Rulertable.Optimalgripspanforchildren(612years)accordingtohandsize.ThegripspaniscalculatedfromtheequationbyEspaaRomeroetal.
(JHandSurgery[Am],2008Mar;33(3):37884.):y=x/4+0.44forboysandy=0.3x0.52forgirls,wherexisthehandsize,andyisthegripspan.

GRIP SPAN (cm) for FEMALES (Mark it with a circle)

3
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5

3
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7

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1

GRIP SPAN (cm) for MALES (Mark it with a circle)

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HAND SIZE (real cm)

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Rulertable.Optimalgripspanforadolescents(1318years)accordingtohandsize.ThegripspaniscalculatedfromtheequationbyRuizetal.(J
HandSurg,[Am].2006Oct;31(8):136772):y=x/7.2+3.1formalesandy=x/4+1.1forfemales,wherexisthehandsize,andyisthegripspan.

GRIP SPAN (cm) for FEMALES (Mark it with a circle)

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GRIP SPAN (cm) for MALES (Mark it with a circle)

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HAND SIZE (real cm)

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5
.
5

1
6

1
6
.
5

1
7

1
7
.
5

1
8

1
8
.
5

1
9

1
9
.
5

2
0

2
0
.
5

2
1

2
1
.
5

2
2

2
2
.
5

2
3

2
3
.
5

2
4

2
4
.
5

2
5

19

5.3.2.Standinglongjump

Purpose
Tomeasurelowerbodyexplosivestrength.
Healthrelation
Musculoskeletalfitnessisinverselyassociatedwithestablishedandemerging
cardiovasculardiseaseriskfactors,backpainandwithbonemineralcontent
anddensity.Musculoskeletalimprovementsfromchildhoodtoadolescence
arenegativelyassociatedwithchangesinoveralladiposity.
Equipment
Nonslipperyhardsurface,stick,tapemeasure,adhesivetape,andcones.
Performance
Jumpingfordistancefromastandingstartandwithfeettogether.

Instructions: Stand with your feet at the shoulders width, and toes just
behindtheline.Bendyourkneeswithyourarmsinfrontofyou,parallelto
theground.Asyouswingbotharms,pushoffvigorouslyandjumpasfaras
possible.Trytolandwithyourfeettogetherandtostayupright.Thetestis
donetwiceandthebestattemptisrecorded.

Practiceandnumberoftesttrials:Thetestershowstherightperformance.
Twotrialsarecarriedoutandthebestresultisscored.
Measurement
Horizontallinesaredrawnonthelandingregion10cmapart,paralleltoand
starting 1 m from the takeoff line. A tape measure perpendicular to these
lines gives accurate measurements. Stand on one side and record the
distances jumped. The distance is measured from the takeoff line to the
point where the back of the heel nearest to the takeoff line lands on the
ground.Afurtherattemptisallowedifthechildfallsbackwardsortouches
thematwithanotherpartofthebody.
Scoring
Theresultisgivenincm.
Example:ajumpof1m56cmscores156.

20

ALPHAFitnessTestBatteryforChildrenandAdolescents

5.4.Motorfitness

5.4.1.4x10mshuttleruntest

Purpose
Tomeasurespeedofmovement,agilityandcoordination.
Healthrelation
Improvements in speed/agility seem to have a positive effect on skeletal
health.
Equipment
Clean, nonslippery floor. Stopwatch, adhesive tape, tape measure, three
spongesofdifferentcoloursandfourcones.
Performance
A running and turning (shuttle) test at maximum speed (4x10 m). Two
parallellinesaredrawnonthefloor(withtape)10mapart.Inthestartline
thereisonesponge(B)andintheoppositelinetherearetwosponges(A,C).
Whenthestartisgiven,thechild(withoutsponge)runsasfastaspossibleto
theotherlineandreturnstothestartinglinewiththesponge(A),crossing
both lines with both feet. The sponge (A) is changed by the sponge B in
starting line. Then go back running as fast as possible to the opposite line
andchangethespongeBbytheConeandrunbacktothestartingline(see
figure,nextpage).

Instructions:Getreadybehindtheline.Onefootshouldbejustbehindthe
line.Whenthestartisgiven,runasfastaspossibletotheotherlinewithout
spongeandreturntothestartinglinewiththespongeA,crossingbothlines
with both feet. Thereafter, change the sponge A by sponge B and go back
runningasfastaspossibletotheoppositeline,wherethespongeBmustbe
changed bythe C one. Finally, runback to thestarting line without getting
down speed before crossing it. Do the test twice: the best result is the
score.

Practiceandnumberoftesttrials:Thetestershowstherightperformance.
Twotrialsareperformedandthebesttimescored.
Measurement
Makesurethatbothfeetcrossthelineeachtime,thathe/sheremainsinthe
requiredpathandthattheturnsaremadeasquicklyaspossible.Calloutthe
number of cycles completed after each one. The test stops when the child
crosses the finishing line with one foot. The child should not slip or slide
duringthetest,soaslipprooffloorisnecessary.
Scoring
Theresultisscoredinsecondswithonedecimal.Example:atimeof21.6sec
isexpressedas21.6.

21

ALPHAFitnessTestBatteryforChildrenandAdolescents

Graphicdescription.

1m

10 m

Sponge A
Sponge B
Sponge C

22

ALPHAFitnessTestBatteryforChildrenandAdolescents

5.5.Cardiorespiratoryfitness

5.5.1.20mshuttleruntest

Purpose

Toassesscardiorespiratoryfitness.
Healthrelation
High cardiorespiratory fitness during childhood and adolescence is strongly
associatedwithahealthiercurrentandfuturecardiovascularhealth.
Equipment
A gymnasium or space large enough to mark out a 20m track, four cones,
tapemeasure,CDplayerandaprerecordedCDofthetestprotocol.
Performance
Childrenarerequiredtorunbetween2lines20mapartintimewithanaudio
signal. The initial speed of the signal is 8.5 km/h and is increased by 0.5
km/h/min(1minuteequalto1step).Thetestfinisheswhenthechildfailsto
reach the end lines concurrent with the audio signals on 2 consecutive
occasions.Otherwise,thetestendswhenthechildstopsbecauseoffatigue.
Thistestisdoneonce.

Instructions: The shuttle run test gives an indication of your maximal


aerobic capacity, i.e. the endurance, and involves running there and back
along a 20m track. Speed will be controlled by means of a tape emitting
buzzingsoundsatregularintervals.Paceyourselvessoastobeatoneendof
the20mtrackortheotherwhenyouhearasound.Accuracytowithinoneor
twometresisenough.Touchthelineattheendofthetrackwithyourfoot,
turnsharplyandrunintheoppositedirection.Atfirst,thespeedislowbutit
will increase slowly and steadily every minute. Your aim in the test is to
followthesetrhythmforaslongasyoucan.Youshouldthereforestopwhen
youcannolongerkeepupwiththesetrhythmorfeelunabletocomplete
theoneminuteperiod.Rememberthenumberannouncedbytherecording
whenyoustop,thatisyourscore.Thelengthofthetestvariesaccordingto
theindividual:thefitteryouare,thelongerthetestlasts.Tosumup,thetest
is maximal and progressive, in other words easy at the beginning and hard
towardstheend.GoodLuck!

Practiceandnumberoftesttrials:Onlyonetrialisperformed.
Measurement
Selecttestsite,preferablyina25mlonggym.Allowforaspaceofatleast
onemetreateitherendofthetrack.Thewidertheareaused,themorethe
number of children that can be tested simultaneously: one metre between
eachchildisrecommended.Thesurfaceshouldbeuniformbutthematerial
of which it is made is not specifically important. The two ends of the 20m
trackshouldbeclearlymarked.

Check the functioning of the sound track and CD player. Ensure that the
device is powerful enough for group testing. Listen to the contents of the
sound track. Note the numbers on the CD player timer so as to be able to
locatethekeysectionsofthetrackquickly.
Scoring
After the child has stopped, the last completed halfstep is retained.
Example:a score of 6.5 stages. If a higher precision is required (eg.
interventionstudiesaimingtodetectsmallchanges),thefinaltimespentin
thetestexpressedinseconds,insteadofhalfstages,canberetained.

23

ALPHAFitnessTestBatteryforChildrenandAdolescents
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6.REFERENCEVALUES

BodyMassIndex(weightinkg/heightinm2)
Verylow

Low

Average

High

Veryhigh

13y

16.7

16.818.0

18.122.2

22.325.7

25.8

14y

17.5

17.619.0

19.123.3

23.426.5

26.6

15y

17.9

18.119.5

19.623.8

23.926.7

26.8

16y

18.0

18.119.6

19.723.7

23.826.4

26.5

17y

19.0

19.120.5

20.624.6

24.727.5

27.6

Girls

13y

17.5

17.619.0

19.123.2

23.326.4

26.5

14y

17.6

17.718.9

19.022.8

22.925.6

25.7

15y

18.1

18.219.4

19.523.0

23.125.6

25.7

16y

18.3

18.419.6

19.723.1

23.225.8

25.9

17y

18.2

18.319.5

19.623.2

23.225.8

25.9

Boys

AdaptedfromMorenoetal.Anthropometricbodyfatcompositionreferencevalues
inSpanishadolescents.TheAVENAStudy.EurJClinNutr2006;60:191196.

24

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Waistcircumference(cm)
Verylow

Low

Average

High

Veryhigh

13y

62

6366

6778

7987

88

14y

65

6669

7080

8188

89

15y

67

6771

7281

8289

90

16y

67

6871

7281

8288

88

17y

70

7173

7483

8491

92

Girls

13y

61

6265

6675

7683

84

14y

61

6264

6573

7480

81

15y

63

6466

6775

7681

82

16y

63

6466

6775

7681

82

17y

62

6365

6674

7580

81

Boys

AdaptedfromMorenoetal.BodyfatdistributionreferencestandardsinSpanish
adolescents:theAVENAStudy.IntJObes2007;31:17981805.

25

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Tricepsskinfoldthickness(mm)
Verylow

Low

Average

High

Veryhigh

13y

78

915

16.23

24

14y

78

915

1621

22

15y

78

914

1519

20

16y

67

813

1318

19

17y

78

914

1519

20

Girls

13y

10

1112

1320

2125

26

14y

10

1112

1319

2023

24

15y

10

1112

1319

2023

24

16y

11

1213

1420

2124

25

17y

10

1113

1420

2125

26

Boys

AdaptedfromMorenoetal.BodyfatdistributionreferencestandardsinSpanish
adolescents:theAVENAStudy.IntJObes2007;31:17981805.

26

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Subscapularskinfoldthickness(mm)
Verylow

Low

Average

High

Veryhigh

13y

67

812

1319

20

14y

78

912

1319

20

15y

78

912

1317

18

16y

78

912

1316

17

17y

89

1013

1418

19

Girls

13y

89

1016

1722

23

14y

89

1014

1520

21

15y

910

1114

1519

20

16y

910

1115

1620

21

17y

910

1115

1621

22

Boys

AdaptedfromMorenoetal.BodyfatdistributionreferencestandardsinSpanish
adolescents:theAVENAStudy.IntJObes2007;31:17981805.

27

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Bodyfat(%)

Verylow

Low

Average

High

Veryhigh

13y

10.0

10.112.9

13.024.3

24.436.4

36.5

14y

10.1

10.213.0

13.124.0

24.135.1

35.2

15y

9.6

9.712.2

12.322.0

22.131.4

31.5

16y

9.9

10.112.5

12.621.8

21.930.4

30.5

17y

11.3

11.414.1

14.224.0

24.132.9

33.0

Girls

13y

17.8

17.921.0

21.129.5

29.635.3

35.4

14y

17.6

17.720.4

20.528.1

28.233.3

33.4

15y

18.3

18.421.0

21.128.1

28.232.9

33.0

16y

19.0

19.121.8

21.929.2

29.334.1

34.2

Boys

17y
18.721.7
21.829.7
29.835.1
35.2
18.6
AdaptedfromMorenoetal.Anthropometricbodyfatcompositionreferencevalues
inSpanishadolescents.TheAVENAStudy.EurJClinNutr2006;60:191196.

Equationstoestimatebodyfat(%)
Females:
Bodyfat(%)=1.33(tric+subsc)0.013(tric+subsc)22.5

Femaleswhentric+subsc>35mm:
Bodyfat(%)=0.546(tric+subsc)+9.7

Malesprepubertal(Tannerstage1):
Bodyfat(%)=1.21(tric+subsc)0.008(tric+subsc)21.7
Malespubertal(Tannerstage2,3y4):
Bodyfat(%)=1.21(tric+subsc)0.008(tric+subsc)23.4
Malespostpubertal(Tannerstage5):
Bodyfat(%)=1.21(tric+subsc)0.008(tric+subsc)25.5

Maleswhentric+subsc>35mm:
Bodyfat(%)=0.783(tric+subsc)+1.7

Bodyfat(%)estimatedfromequationsreportedbySlaughteretal.(HumBiol1988:
60:709723)usingtricepsandsubscapularskinfolds.
28

ALPHAFitnessTestBatteryforChildrenandAdolescents
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Cardiorespiratoryfitness:20mshuttleruntest(stages)

Verylow

Low

Average

High

Veryhigh

13y

3.0

3.54.5

5.06.0

6.57.5

8.0

14y

3.5

4.05.5

6.06.5

7.08.5

9.0

15y

4.0

4.55.5

6.07.0

7.58.5

9.0

16y

4.0

4.5.5.5

6.07.0

7.58.5

9.0

17y

4.5

5.06.0

6.57.5

8.09.0

9.5

Girls

13y

2.0

2.52.5

3.03.5

4.04.5

5.0

14y

2.0

2.53.0

3.54.0

4.55.0

5.5

15y

2.0

2.53.0

3.54.0

4.55.0

5.5

16y

2.0

2.53.0

3.54.0

4.55.0

5.5

17y

2.0

2.53.0

3.54.0

4.55.0

5.5

Boys

AdaptedfromOrtegaetal.PhysicalfitnesslevelsamongEuropeanadolescents:The
HELENAstudy.BrJSportsMed.2010Jun11.[Epubaheadofprint].

29

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Upperlimbmaximalstrength:handgripstrengthtest(kg)

Verylow

Low

Average

High

Veryhigh

13y

21.4

21.524.7

24.827.8

27.931.8

31.9

14y

26.3

26.430.4

30.534.0

34.138.5

38.6

15y

31.3

31.435.7

35.839.7

39.844.3

44.4

16y

35.9

36.040.0

40.143.7

43.848.1

48.2

17y

39.9

40.043.5

43.646.7

46.850.6

50.7

Girls

13y

19.9

20.022.5

22.624.8

24.927.6

27.7

14y

21.5

21.624.1

24.226.4

26.529.2

29.3

15y

22.5

22.625.1

25.227.4

27.530.3

30.4

16y

22.9

23.025.4

25.527.8

27.930.8

30.9

17y

23.9

24.026.4

26.528.9

29.032.1

32.2

Boys

Valuesexpressedasaverageofrightandlefthands.

AdaptedfromOrtegaetal.PhysicalfitnesslevelsamongEuropeanadolescents:The
HELENAstudy.BrJSportsMed.2010Jun11.[Epubaheadofprint].

30

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Lowerlimbexplosivestrength:standingbroadjumptest(cm)

Verylow

Low

Average

High

Veryhigh

13y

135

136152

153167

168184

185

14y

151

152169

170183

184200

201

15y

165

166182

183196

197212

213

16y

175

176192

193206

207221

222

17y

184

185201

202215

216229

230

Girls

13y

118

119133

134147

148163

164

14y

121

122137

138151

152167

168

15y

123

124138

139151

152167

168

16y

126

127141

142154

155169

170

17y

129

130144

145157

158172

173

Boys

AdaptedfromOrtegaetal.PhysicalfitnesslevelsamongEuropeanadolescents:The
HELENAstudy.BrJSportsMed.2010Jun11.[Epubaheadofprint].

31

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

Speed/agility:4x10mshuttleruntest(sec)

Verylow

Low

Average

High

Veryhigh

13y

13.0

12.312.9

11.812.2

11.211.7

11.1

14y

12.6

11.912.5

11.411.8

10.911.3

10.8

15y

12.1

11.512.0

11.011.4

10.510.9

10.4

16y

11.8

11.111.7

10.711.0

10.210.6

10.1

17y

11.8

11.111.7

10.711.0

10.210.6

10.1

Girls

13y

13.9

13.113.8

12.513.0

11.912.4

11.8

14y

13.8

13.013.7

12.412.9

11.812.3

11.7

15y

13.7

13.013.6

12.412.9

11.812.3

11.7

16y

13.6

12.913.5

12.312.8

11.712.2

11.6

Boys

17y
12.913.4
12.412.8
11.812.3
13.5
11.7

Lowerscoresindicatebetterperformance.
AdaptedfromOrtegaetal.PhysicalfitnesslevelsamongEuropeanadolescents:The
HELENAstudy.BrJSportsMed.2010Jun11.[Epubaheadofprint].

32

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

ALPHAHealthRelatedFitnessTestBattery
forChildrenandAdolescents
Measurements

Nameofthechild:

Sex:Male/Female

Dateofbirth:

Tannerstage

Breastdevelopment

Hairdistribution

Hairdistribution

PenisandScrotumDevelopment

Bodycomposition

Weight(kg)

Weight(kg)

Height(cm)

Height(cm)

Waistcircumference(cm)

Tricepsskinfoldthickness(mm)

Tricepsskinfoldthickness(mm)

Subscapularskinfoldthickness(mm)

Subscapularskinfoldthickness(mm)

Handgripstrengthrighthand(kg)

Handgripstrengthrighthand(kg)

Handgripstrengthlefthand(kg)

Handgripstrengthlefthand(kg)

Standinglongjump(cm)

Standinglongjump(cm)

Motorfitness

4x10mshuttleruntest(sec)

Waistcircumference(cm)

Musculoskeletalfitness

4x10mshuttleruntest(sec)

Cardiorespiratoryfitness

20mshuttleruntest(stage)


Notes:(e.g.reasonsforexclusion,problemsoccurringduringthetest)

Nameofthetester:

Date:
33

ALPHAFitnessTestBatteryforChildrenandAdolescents
www.thealphaproject.eu

7.WORKINGGROUP

TheALPHAhealthrelatedfitnesstestbatterywasdevelopedundertheframeworkofthe
ALPHAstudythankstotheteamworkofthefollowinggroupofexperts:

1. JonatanRRuiz,UniversityofGranada,Spain,andKarolinskaInstitutet,Sweden
2. VanesaEspaaRomero,UniversityofGranada,Spain,andKarolinskaInstitutet,Sweden
3. JosCastroPiero,UniversityofCdiz,Spain
4. EnriqueGArtero,UniversityofGranada,Spain
5. FranciscoBOrtega,UniversityofGranada,Spain,andKarolinskaInstitutet,Sweden
6. DavidJimnezPavn,UniversityofGranada,Spain
7. MagdalenaCuenca,UniversityofGranada,Spain
8. PalmaChillnGarzn,UniversityofGranada,Spain
9. MJosGirelaRejn,UniversityofGranada,Spain
10. JessMora,UniversityofCdiz,Spain
11. ngelGutirrez,UniversityofGranada,Spain
12. JaanaSuni,UKKInsitute,Finland
13. MichaelSjstrm,KarolinskaInstitutet,Sweden
14. ManuelJCastillo,UniversityofGranada,Spain

We would like to thank our group of international experts Prof. Pekka Oja, Prof. Han CG
Kemper,Prof.JorgeMota,Prof.KariB,Prof.WillemvanMechelen,andProf.RobertM.Malina
fortheirvaluablecontributiontotheconceptionandstrategyofthedevelopmentoftheALPHA
healthrelatedfitnesstestbatteryforchildrenandadolescents.

E.U.DGSANCOfundedprojectintheframeworkofthePublicHealthProgramme,ref:2006120

34