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Centile curves and normative values for the twenty

metre shuttle-run test in English schoolchildren
a a b a
Gavin Sandercock , Christine Voss , Daniel Cohen , Matthew Taylor & D. M.
b
Stasinopoulos
a
University of Essex, UK
b
London Metropolitan University, UK
Published online: 17 Feb 2012.

To cite this article: Gavin Sandercock , Christine Voss , Daniel Cohen , Matthew Taylor & D. M. Stasinopoulos (2012): Centile
curves and normative values for the twenty metre shuttle-run test in English schoolchildren, Journal of Sports Sciences, 30:7,
679-687

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 Journal of Sports Sciences, April 2012; 30(7): 679–687

Centile curves and normative values for the twenty metre shuttle-run
test in English schoolchildren

GAVIN SANDERCOCK,1 CHRISTINE VOSS,1 DANIEL COHEN,2 MATTHEW TAYLOR,1 &

D. M. STASINOPOULOS2
1
University of Essex, UK, and 2London Metropolitan University, UK

(Accepted 19 January 2012)

Downloaded by [Western Kentucky University] at 02:40 01 May 2013

Abstract
The aim of this study was to provide normative data for performance on the 20 m shuttle-run test of cardiorespiratory fitness
in English schoolchildren. A total of 7366 10–16 year olds completed the 20 m shuttle-run test. We expressed performance as
the number of shuttles completed, test score (shuttles and levels) and estimated peak oxygen consumption (V_ O2peak). We
calculated descriptive statistics for each age-sex group to construct percentile curves and tables. To assess the cardiorespiratory
fitness of our sample, we calculated the number of participants who fell below proposed cut-offs for low cardiorespiratory
fitness based on either completed shuttles or V_ O2peak. These cut-offs did not agree in terms of frequency of classification. The
classification based on estimated V_ O2peak suggested low fitness was more prevalent in males and that the incidence of low
fitness increased with age in both sexes. These are the first normative data for shuttle-run performance in English youth and
can now be used to interpret data from this cardiorespiratory fitness test. The two cut-offs used for low fitness did not agree
and future research should establish a cut-off for test performance which can predict present or future ill-health

Keywords: cardiorespiratory fitness, children, centiles, normative data, GAMLSS

Cardiorespiratory fitness is the product of com-

Introduction
Low cardiorespiratory fitness is independently asso-
ciated with morbidity and mortality from chronic
disease in adults (Wei et al., 1999; Williams, 2001),
as well as adverse metabolic conditions in children
(Lobelo, Pate, Dowda, Liese, and Ruiz, 2009; Mesa
et al., 2006). Conversely, good cardiorespiratory
fitness is moderately associated with metabolic,
musculoskeletal and psychological health (Ortega,
Ruiz, Castillo, and Sjostrom, 2008; Ruiz, Ortega,
Warnberg, and Sjostrom, 2007), and even attenuates
much of the adverse health risk associated with
obesity (Lee, Sui, and Blair, 2008). Recent evidence
suggests that UK children’s cardiorespiratory fitness
is declining by around 8% per decade (Sandercock,
Voss, McConnell, and Rayner, 2010; Stratton et al.,
2007), twice the rate observed in other developed
nations (Tomkinson and Olds, 2007). Such findings
have lead to a call from the UK’s Chief Medical
Officer for ‘comprehensive fitness testing’ in schools
including the use of the 20 m shuttle-run test to
assess cardiorespiratory fitness (Donaldson, 2010).
bined efforts of the respiratory and cardiovascular
systems and represents the body’s overall capacity to
perform prolonged, strenuous exercise. The World
Health Organization recommends graded exercise
testing to exhaustion as the ‘gold standard’ measure-
ment technique (Shephard et al., 1968). Maximal
individual testing is impractical in epidemiological
studies or for assessing large population groups and
the most commonly used method to estimate
cardiorespiratory fitness in young people is the
20 m shuttle-run test (Leger, Mercier, Gadoury,
and Lambert, 1988). Global normative data derived
from data simulation are available and show large
international variation (Olds, Tomkinson, Leger,
and Cazorla, 2006). Recent data suggest that UK
children are less fit than those from most other
European countries (Sandercock, Voss, and
Gladwell, 2008). One advantage of any UK-derived
normative values however, is 10–15.9 year old
English children’s shuttle-run performance is still
within + 0.5 SD of the global average (Olds et al.,
2006).

Correspondence: Gavin Sandercock, University of Essex, Centre for Sports and Exercise Science, School of Biological Sciences, Wivenhoe Park, Colchester
CO4 3SQ, UK. E-mail: gavins@essex.ac.uk
ISSN 0264-0414 print/ISSN 1466-447X online Ó 2012 Taylor & Francis
http://dx.doi.org/10.1080/02640414.2012.660185
 680 G. Sandercock et al.

Performance on the 20 m shuttle-run differs Table I. Sample characteristics (mean (SD) or frequencies (%)).
according to the age and sex of the participant and
Boys Girls National
should only be interpreted when expressed relative (n ¼ 3896) (n ¼ 3497) Value
to these measures. The aims of this study are
threefold. First, to produce cross-sectional reference Age (years) 13.1 (1.5) 13.0 (1.4)** –
data for 20 m shuttle-run test performance in Ethnic Mix n ¼ 3603 (92%) n ¼ 2990 (86%) –
English schoolchildren; this will aid interpretation White 93% 92% 91%
Mixed 3%* 3%* 1%
of future test results. Second, to provide a critical
Asian 2%* 3%* 5%
discussion of currently recommended cut-offs used Black 2% 2% 2%
to describe paediatric cardiorespiratory fitness. Other/Chinese 0.4% 0.5% 1%
Third, this paper will also provide a brief introduc- Area Deprivation n ¼ 3536 (91%) n ¼ 3208 (92%)
tion to some of the intricacies of the 20 m shuttle- IMD2007 Score 12 (7) 12 (7) 19 (7)
run for those who may not have administered or % England’s least 32% 32% 20%
participated in the test. deprived LSOA
% England’s most 1% 1% 20%
deprived LSOA
Urban/Rural Index n ¼ 3536 (91%) n ¼ 3208 (92%)
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Methods Urban 63%* 62%* 80%

Fringe 19%* 20%* 9%
Sample
Village 13%* 14%* 7%
There are a number of recent UK studies which have Isolated dwelling 4% 4% 4%
produced data for the 20 m shuttle-run test (Boddy, Body Mass Index n ¼ 3859 (99%) n ¼ 3390 (97%)
Hackett, and Stratton, 2010; Sandercock et al., BMI z-score 0.72 (1.14) 0.56 (1.11)**
Underweight 4% 5% –
2008; Stratton et al., 2007) but the raw data are Normal 68% 68% –
not all publicly available. A search of survey variables Overweight 22% 22% –
on the UK data archive using the search terms: Obese 6% 5% –
‘fitness’ ‘aerobic’ ‘shuttle’ ‘test’ ‘capacity’ ‘run’ and
Note: Frequencies in brackets represent the proportion of the total
‘running’ produced no results relating to the 20 m
sample with data for each variable.
shuttle-run test. We therefore used data from our *significantly different from National Census Data (w2; p 5 0.05).
own East of England Healthy Hearts Study (Voss **significant between-sex differences (independent t-test;
and Sandercock, 2010). This sample has the p 5 0.05).
disadvantage of not being nationally representative
but is broadly similar to the English population of
Description of the 20 m shuttle-run test
this age in terms of a number of descriptive
characteristics which we sampled (Table I). The participants were required to run 20 m shuttles,
The University of Essex Research Ethics Com- in time with an audible signal. After one minute of
mittee approved the study. The sample was drawn shuttles run at this pace the audible signal changes to
from an opportunity sample of 26 schools; 18 in alert participants to an increase in pace and the
urban areas and eight from rural areas. The varied beginning of what is termed the next level. Alternative
geography of the East of England allowed us to nomenclature such as laps (in place of shuttle) and
sample from schools in relatively remote rural areas stages (in terms of levels) are sometimes used but
and large suburban centres and areas of north east herein we will use shuttles and levels only. Initial
London. The sample was less deprived than running speed was 8.5 km  h71 in the original
most of England according to the English Indices methodology, with increases in running speed of
of Deprivation (Office For National Statistics, 0.5 km  h71 at each level thereafter (Leger et al.,
2007). 1988). The initial speed requires the participant to
complete each 20 m shuttle in 8.5 s, a brisk walk or
slow jog for most children and adults. Several
Procedure
analogues of the original protocol (Leger et al.,
After gaining consent, participants’ mass was re- 1988) are available, differences between which have
corded, their stature was measured and body mass been described in detail previously (Tomkinson,
index (BMI) was calculated (kg  m72). Ethnicity Leger, Olds, and Cazorla, 2003). Tests are broadly
was self-reported by choosing the most appropriate comparable in terms of the number of shuttles the
category from the UK 2001 census ethnic groups. participant completes and running speed at each
Each participant then completed the 20 m shuttle- level. One exception is the running speed during the
run test as described below. All procedures were first level. For this study we used the FITNESS-
carried out during scheduled physical education GRAM PACER test (Meredith and Welk, 2007a),
lessons between 2006 and 2010. which starts at 8.0 kmh71 and increases to
 Centile curves for 20 m shuttle-run in schoolchildren
9.0 km  h71 at level 2. We favour this version of the
test as the scoring system comprises shuttle numbers
only. These simple integers are easy to remember and
do not require the researchers to count unnumbered
shuttles between level changes as in other test
versions (Brewer, Ramsbottom, and Williams, 1988).
Participants were encouraged to run for as long as
possible and were instructed that their test would be
over when they failed to maintain the designated pace
(miss the bleeps) for two consecutive shuttles. If the
participant missed one shuttle they were allowed to
speed up to finish the next shuttle within the allotted
time. Participants were allowed to ‘drop out’ of the
test at any time if they felt unable to maintain the test
pace. This volitional test termination was the more
commonly observed of the two criteria. A team of
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researchers acted as ‘spotters’ and recorded the final
shuttle count at either the point of volitional exhaus-
tion or when the participant failed to maintain the
required running speed twice. We have previously
compared (unpublished) the performance and heart
rate responses of participants who drop out volition-
ally (196 + 11 bpm) and those who have to be
stopped but are trying to continue (194 + 12 bpm)
and found no significant differences between these
groups for either measure (Effect size, d ¼ 0.17).
We expressed shuttle run performance as the com-
mon metric of running speed at last completed level
(km  h71), as well as predicted V_ O2peak (ml  kg71 
min71). A number of equations (Barnett, Chan, and
Bruce, 1993; Leger et al., 1988; Mahar, Welk, Rowe,
Crotts, and McIver 2006; Ruiz et al., 2008; Takahashi,
Kumakura, Matsuzaka, Yamazoe, and Ikeda, 2004)
are available by which test performance can be
converted to predicted V_ O2peak (ml  kg71  min71);
the most commonly used is that of the test originator
(Leger et al., 1988), which uses running speed at the
last completed level (km  h71) and age (years).
Finally, we created percentile curves for perfor-
mance expressed as shuttle count and as test score,
expressed as level reached plus shuttles run within
that level (e.g. 77 shuttles or a test score 9:5). Both
are potentially meaningful indices for instructors and
test participants. Shuttle count and test score are
useful metrics by which to rank participants’
performance and are comparable between the
various shuttle-test protocols after completing level
two. There is, however, a methodological problem in
analysing these types of data. Neither represents
interval level data as the changes in performance are
not equal between each shuttle. For instance,
shuttles 1–7 require the participant to run at
8.0 km  h71, the performance interval between each
shuttle is equal as it is equally difficult for a
participant to progress from shuttle 1–2 as its from
shuttle 6–7. However, to reach shuttle 8, the
participant must accelerate to 9.0 km  h71. In the
681
later levels, where there are up to 16 shuttles per
level, and a participant can improve their shuttle
count by 15 with no increment in running speed. At
the beginning of the test such an improvement in
shuttle count would require an improvement in
running speed of 1 km  h71 (2 levels). For statistical
analysis, we recommend the use of final running
speed. For the reasons outlined above, however, this
metric may prove insensitive to small changes in
performance, particularly in participants with high
levels of cardiorespiratory fitness.
Data treatment
Body mass index was converted to age- and sex-
specific z-scores based on UK reference data (Cole,
Freeman, and Preece, 1995). Each participant was
classified as: underweight, normal weight, overweight
or obese (Cole, Bellizzi, Flegal, and Dietz, 2000). We
calculated means and standard deviations for shuttle
count, as well as for final running speed and predicted
V_ O2peak at both the final completed shuttle and the
final completed level in each age group and by sex
(Table II). We also calculated the number of
participants in each age-sex group who might be
considered to have low cardiorespiratory fitness levels
according to two criteria. Low cardiorespiratory
fitness was defined using the cut-offs for V_ O2peak
(ml  kg71  min71) based on the expert opinion of
the European Group of Paediatric Work Physiology
(Bell, Macek, Rutenfranz, and Saris, 1986) with
V_ O2peak estimated by Leger’s (1988) equation. The
second method was based on age- and sex-specific
test performance (shuttles run) and was based on the
FITNESSGRAM lower healthy fitness zone cut-offs
(Meredith and Welk, 2007b). The FITNESSGRAM
cut-offs represent a retro-extrapolated value equiva-
lent to the lowest quintile of adult fitness levels, giving
an expected frequency of 20% in each age group
(Cureton and Plowman, 2008). Information regard-
ing the development and relative merits of each
method is given in the discussion.
Statistical analysis
Between-sex differences were assessed by indepen-
dent t-test for continuous variables. To assess the
representativeness of our sample we used Chi-square
to compare our sample with expected cell frequency
values derived from the 2001 UK census data.
Where appropriate, standardised effect sizes (Co-
hen’s d) were calculated.
Creation of Centile curves
Centile curves for completed shuttles and final
running speed were constructed for boys and girls
 682 G. Sandercock et al.

Table II. Descriptive statistics for 20 m shuttle run performance in 10–16 year old English Schoolchildren.

Shuttles Running speed at last V_ O2peak % Low Fitness % Low Fitness

n (count) completed level (km  h71) (ml  kg71  min71)a (Bell et al. 1986)b (FITNESSGRAM 2007)c

Males
10 299 40.6 (21.7) 10.2 (1.17) 47.1 (5.61) 7.0% 25.1%
11 688 42.9 (20.8) 10.3 (1.11) 45.9 (5.49) 17.6% 17.6%
12 933 46.7 (22.0) 10.5 (1.15) 45.3 (5.86) 13.8% 28.8%
13 835 52.4 (23.6) 10.8 (1.19) 45.2 (6.23) 20.7% 34.5%
14 673 62.8 (26.8) 11.3 (1.30) 46.3 (6.99) 22.4% 22.4%
15 408 65.9 (26.7) 11.4 (1.29) 45.7 (7.16) 18.9% 33.1%
16 60 74.1 (21.4) 11.8 (1.02) 46.4 (5.79) 13.3% 26.7%
Total 3896 52.0 (25.1) 10.7 (1.27) 45.8 (6.23) 17.5% 27.1%
Females
10 293 31.9 (15.8) 9.7 (0.97) 44.7 (4.62) 0.0% 11.6%
11 663 31.4 (14.7) 9.7 (0.88) 43.0 (4.33) 8.1% 8.1%
12 912 33.8 (15.5) 9.8 (0.88) 41.9 (4.49) 5.4% 26.1%
13 754 35.3 (16.2) 9.9 (0.90) 40.7 (4.72) 4.6% 22.5%
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14 569 36.6 (17.1) 10.0 (0.95) 39.2 (5.08) 21.4% 21.4%

15 267 35.2 (15.8) 9.9 (0.85) 37.2 (4.73) 49.8% 22.8%
16 39 42.8 (21.4) 10.3 (1.03) 37.8 (5.86) 38.5% 38.5%
Total 3497 34.2 (16.0) 9.8 (0.91) 41.2 (5.05) 11.7% 19.8%

Note: Data are mean (+SD) for continuous variables or %.

a _
V O2peak (ml  kg71  min71) predicted using the equation of Leger et al. (1988).
b
Females: 5 35 ml  kg71  min71; Males: 5 40 ml  kg71  min71.
c
FITNESSGRAM PACER cut-offs (expected cell value: 20%).

separately using the Generalized Additive Models for
Location, Scale and Shape (GAMLSS) (Rigby and
Stasinopoulos, 2006). GAMLSS models are imple-
mented as a package in the statistical software R (R-
Development Core Team 2011) and have previously
been used by the World Health Organisation Multi-
centre Growth Reference Study Group (WHO,
2006) to construct centile curves for child growth
standards. The GAMLSS are regression-type models
in which the response variable (e.g. shuttles) has a
distribution depending on parameters which de-
scribe its properties. Standard regression only allows
estimation of the location (mean). GAMLSS, how-
ever, allows the user to model all the parameters of
the distribution as a function of the explanatory
variable (e.g. age), including the scale parameter
(standard deviation), as well as skewness and
kurtosis.
The particular distributions used in the construc-
tion of our centiles for the shuttle data was the Box-
Cox Power Exponential (BCPE) distribution (Rigby
and Stasinopoulos, 2006) for the male participants,
as used in the Child growth curves (WHO, 2006).
The BCPE is a four parameter distribution made up
of; the median, an approximation of the coefficient of
variation, skewness and kurtosis. The kurtosis was
not needed to analyse the females’ data. Such as
case, where kurtosis is not needed, corresponds to
the lambda mu and sigma (LMS) method (Cole and
Green, 1992).
Results
Table I shows small differences in self-reported ethnic
background between our sample and data from the
2001 Census. The mean Index of Deprivation (2007)
score was significantly lower than the English average
and the Lower Super Output Areas represented in the
present study were less likely to represent England’s
most deprived areas. Compared with national census
data, the present sample also comprised significantly
fewer schoolchildren from urban areas, but more from
town and fringe areas and villages. Table I also shows
that BMI z-scores were higher than the 1990 UK
Reference data in both sexes. Boys were also slightly
older than girls (d ¼ 0.13).
The age-sex distribution of 20 m shuttle-run
performance is given in Table II. Performance is
expressed as number of shuttles completed, running
speed at final completed level and predicted V_ O2peak.
When low fitness was defined using The European
Group of Paediatric Work Physiology cut-offs (Bell
et al., 1986) and the V_ O2peak prediction equation
(Leger et al., 1988) using age and running speed at
final completed level, 17.5% of males were classified
as having low fitness. Using the same method, 11.7%
of females had low fitness including some from all age
categories except 10–10.9 years. Again, the frequency
of low fitness increased across the age range studied.
The FITNESSGRAM PACER cut-offs (Meredith
and Welk, 2007a) classified 17.4% of boys as having
low cardiorespiratory fitness, but there was no
 Centile curves for 20 m shuttle-run in schoolchildren 683

meaningful relationship between this frequency and
age. The FITNESSGRAM cut-offs classified 20% of
female participants as having low fitness. The
prevalence of low fitness was lower than the expected
value of 20% in 10 and 11 year olds but was higher
than expected in all other age groups.
Centile curves for male and female performance
(shuttles completed and levels plus shuttles) are
given in Figures 1 and 2. Equivalent numerical
values are available in Tables III and IV. These figures
contain curves approximating the 2nd, 10th, 25th,
50th, 75th, 90th and 98th centiles. Together, these
data show that males performed better on the test at all
ages compared with females. In males there was an
improvement in performance across the age range with
performance improving most rapidly between 12–13
years and 13–14 years. In females, performance also
increased between the ages of 12 and 14 years but this

Table III. Centile values for total shuttles run and test score expressed
as level reached and shuttles (level:shuttle) for males age 10–16 years.

Total Shuttles Completed: Males

Percentiles 2nd 10th 25th 50th 75th 90th 98th

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10 10 15 22 34 52 68 90
11 11 17 24 37 55 70 90
12 12 19 27 41 59 74 92
13 13 22 32 47 66 81 99
14 16 26 38 55 76 92 110
15 19 31 44 64 85 102 122
16 21 35 49 69 90 108 126
Test Score (Levels:Shuttles): Males
10 2:3 2:8 3:7 5:2 7:1 8:7 10:7
11 2:4 3:2 4:1 5:5 7:4 8:9 10:7
12 2:5 3:4 4:4 5:9 7:8 9:2 10:9
13 2:6 3:7 4:9 6:6 8:5 9:9 11:5
14 3:1 4:3 5:6 7:4 9:4 10:9 12:4
15 3:4 4:8 6:3 8:3 10:2 11:8 13:4
Figure 1. Centile curves for 20 m shuttle-run performance in 16 3:6 5:3 6:8 8:8 10:7 12:2 13:8
males age 10–16 years. Note: Shuttles completed starts from a
score of 1 (first shuttle). For test score in levels:shuttles, there is no Note: Shuttles completed starts from a score of 1 (first shuttle). For
level zero, scores start from level one. test score in levels: shuttles, there is no level zero, scores start from
level 1:1.

Table IV. Centile values for total shuttles run and test score
expressed as level reached and shuttles (level:shuttle) for females
age 10–16 years.

Total Shuttles Completed: Females

Percentiles 2nd 10th 25th 50th 75th 90th 98th

10 10 15 20 28 38 50 72
11 10 15 21 28 39 51 71
12 10 16 22 30 41 53 73
13 11 18 23 32 43 56 76
14 12 18 24 33 45 58 79
15 12 18 24 33 45 58 79
16 12 18 23 32 43 56 76
Test Score (Levels:Shuttles): Females
10 2:3 2:8 3:5 4:5 5:6 9:9 8:11
11 2:3 2:8 3:6 4:5 5:7 6:10 8:10
12 2:3 3:1 3:7 4:7 5:9 7:2 9:1
13 2:4 3:3 3:8 4:9 6:2 7:5 9:4
14 2:5 3:3 3:9 5:1 6:4 7:7 9:7
15 2:5 3:3 3:9 5:1 6:4 7:7 9:7
16 2:5 3:3 3:8 4:9 6:2 7:5 9:4
Figure 2. Centile curves for 20 m shuttle-run performance in
females age 10–16 years. Note: Shuttles completed starts from a Note: Shuttles completed starts from a score of 1 (first shuttle). For
score of 1 (first shuttle). For test score in levels:shuttles, there is no test score in levels: shuttles, there is no level zero, scores start from
level zero, scores start from level one. level 1:1.
 684 G. Sandercock et al.
increase was more modest. From 14.5 years onwards,
test performance decreased slightly in females.
Discussion
These are the first data to provide normative centile
values for shuttle-run performance in English
schoolchildren. While the sample may not be truly
representative of the diversity of English school-
children, this regional sample provides contemporary
reference data with which future individual or group
test scores may be compared. These data may also be
used in countries with similar global normative data
to the UK (Olds et al., 2006). Such norm-referenced
testing is commonly used to assess and interpret
BMI and blood pressure when measurements are
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made in children and adolescents.
The present data show the well documented
between-sex differences and typical maturational
changes in aerobic test performance (Malina and
Bouchard, 1991). Males’ test performance was
higher than that of females at all ages. Male
performance increased across the ages represented
here, but was steepest between 12–14 years due to
physiological changes associated with puberty. In
females there were only modest increases in perfor-
mance from 10–14 years, after which median
performance actually declined slightly.
These data provide a normative reference against
which 20 m shuttle-run test performance can be
compared. The curves allow easy interpretation
without the need to convert shuttles or run time to
V_ O2peak using the various available equations. Such
age- and sex-related normative data are useful as they
show how test performance changes during matura-
tion. We envisage the future use of these curves for
quick, simple interpretation of 20 m shuttle-run test
performance in a manner similar to reference data
for other health indicators measured in school-
children/young adults such as BMI (Cole et al.,
1995) or blood pressure (Jackson, Thalange, and
Cole, 2007).
As with blood pressure and BMI, normative age-
and sex-specific reference data are needed as the use
of adult reference data to make normative compar-
isons with children’s fitness would be inadequate.
Unlike BMI, we cannot yet offer criterion-referenced
cut-offs for low cardiorespiratory fitness. Despite a
wealth of evidence demonstrating that cardiorespira-
tory fitness is a powerful marker of health which
tracks from childhood into adulthood (Andersen and
Haraldsdottir, 1993; Boreham et al., 2004;
Kristensen et al., 2006), there is no universally
agreed definition for low cardiorespiratory fitness in
youth.
In adults, low cardiorespiratory fitness is indepen-
dently associated with morbidity from chronic disease
and mortality (Sui, Laditka, Hardin, and Blair, 2007;
Wei et al., 1999; Williams, 2001). Conversely, good
cardiorespiratory fitness is already associated with
myriad health benefits in youth (Ortega et al., 2008)
and is able to attenuate much of the adverse health
risk associated with obesity in adults (Lee et al.,
2008). The heterogeneity of methodologies used to
measure fitness (cycle ergometry, treadmill exercise),
the units of expression (ml  kg71  min71 or
l  min71) and the statistical treatment of data as
continuous or division into tertiles, quartiles or
quintiles make generalisations difficult. There is
certainly a positive dose-response between cardior-
espiratory fitness and health in adults but it is not a
linear relationship. Individuals appear to gain the
largest benefits to their health by moving out of the
lowest category (usually quartile or quintile) for
cardiorespiratory fitness. Additional health gains
achieved by moving between categories representing
higher fitness (e.g. third to fourth quintile) are more
modest (Sui et al., 2007; Wei et al., 1999).
Minimum fitness standards in youth
Several groups have attempted to create cut-offs using
a variety of methodologies and referencing against a
diverse range of health criteria. The European Group
of Paediatric Work Physiology proposed a V_ O2peak cut
point of 40 ml  kg71  min71 for boys and
35 ml  kg71  min71 for girls as a health indicator
based on expert opinion (Bell et al., 1986). The
Cooper Institute for Aerobics Research provides
higher cut-offs (42 and 38 ml  kg71  min71 for boys
and girls, respectively) based on retro-extrapolation
from the association between aerobic capacity and
cardiovascular disease risk in adults (Blair et al. 1989).
Approximations of these values are supported by
data linking (low) cardiorespiratory fitness to adverse
metabolic profiles in children, where metabolic risk
acts as a proxy measure for development of cardio-
vascular disease and diabetes. Data from the Eur-
opean Youth Heart Study (Andersen, Wedderkopp,
Hansen, Cooper, and Froberg, 2003) showed sig-
nificant clustering of metabolic risk factors in 9 and
15 year olds who were 1.2 SD below the population
mean for cardiorespiratory fitness assessed by cycle
ergometry. Using ROC analysis, Ruiz et al. (2007)
found clustered cardiovascular disease risk at
V_ O2peak 42 ml  kg71  min71 and 37 ml  kg71 
min71 in 9–10 boys and girls, respectively. Lobelo
et al. (2009) found cut-offs for cardiovascular disease
risk of 44 ml  kg71  min71 for 12–15 year-old
males; 40 ml  kg71  min71 for 16–19 year-old
males, and approximately 36 ml  kg71  min71 for
12–19 year-old females. As the cut-offs proposed in
both these studies (Lobelo et al., 2009; Ruiz et al.,
2007) were very similar to the FITNESSGRAM
 Centile curves for 20 m shuttle-run in schoolchildren
cut-offs, we did not additionally assess our sample
against either.
Mesa et al. (2006) tested cardiorespiratory fitness
using the 20 m shuttle-run and used ROC analyses to
determine the cut-point for cardiorespiratory fitness
and adverse blood lipid profile in adolescents (13–18
years). Expressed as performance, the values for
males are as follows: age 13–14, 45 shuttles; age 14–
15, 52 shuttles; age 15–16, 59 shuttles; age 16–18.5,
59 shuttles. The authors were unable to create cut-
offs for females due to the low association between
test performance and plasma lipid profile. Interest-
ingly, when expressed as V_ O2peak, these values are
approximately 42+1 ml  kg71  min71 for all ages.
Together, data from these studies suggest theore-
tical cut-offs around 35 ml  kg71  min71 for girls
Downloaded by [Western Kentucky University] at 02:40 01 May 2013
and 42 ml  kg71  min71 for boys may be associated
with adverse metabolic health in children. Table II
shows the number of participants in the present
sample who might be at metabolic risk. These values
should be interpreted with caution as the data have
been converted to predicted V_ O2peak based on one of
a number of available reference equations which has
obvious limitations (Barnett et al., 1993; Leger et al.,
1988; Takahashi et al., 2004). Low cardiorespiratory
fitness was more prevalent in males than females and
the likelihood of having low cardiorespiratory fitness
increased with age.
In males overall, the cut-off for low fitness accord-
ing to V_ O2peak predicted from age and speed at final
completed level agreed very closely with the FIT-
NESSGRAM cut-offs. This was surprising, as unlike
final completed level, the FITNESSGRAM values
are based on total shuttles completed. In males, they
also correspond to a predicted V_ O2peak of 42 ml 
kg71  min71 not 40 ml  kg71  min71 as in the
former method (Bell et al., 1986). Closer examina-
tion of the values in each age group shows some large
disparities between different age groups suggesting
agreement of the total value may be coincidental.
The retro-extrapolated values for number of
shuttles completed provided in the FITNESSGRAM
approximate the lowest quintile of fitness giving an
expected frequency of 20% in each age-sex group.
Compared with the classification of fitness based on
the calculation of V_ O2peak the FITNESSGRAM cut-
offs produced much higher frequencies for low
fitness in females, particularly in the younger age
range. It seems unlikely that our younger (10–13.9
years) female sample contains the very low frequen-
cies of individuals with low fitness suggested using
the V_ O2peak cut-offs (Bell, et al., 1986) when this is
untrue of all other age and sex categories. It seems
more likely therefore, that the V_ O2peak prediction
equation performs poorly in younger females.
Certainly, validity coefficients between 20 m shut-
tle-run test performance and direct measures of
685
V_ O2peak via expired gas analysis tend to increase with
participant age (Tomkinson and Olds, 2007). Using
Leger’s equation to reference shuttle-run test per-
formance against a 35 ml  kg71  min71 cut-off for
low fitness should be employed with great caution in
young females.
Limitations
Area level deprivation was not associated with CRF
in this study, but the relative affluence of the sample
may limit the generalisability of these data to children
from very deprived areas. The sample of 16 year olds
was small and is unlikely to be representative. We
used only two of the many cut-offs available to define
cardiorespiratory fitness. It would also be of interest
to make further classifications using cut-offs derived
from shuttle-running (Lobelo et al., 2009; Ruiz et al.,
2007) or other exercise modalities (Adegboye,
Andersen, Froberg, Sardinha, and Heitmann, 2010).
Conclusions
These are the first centile curves to describe 20 m
shuttle-run test performance in schoolchildren and
can be used as a reference with which to compare the
performance of individuals of a corresponding age.
Using existing cut-offs for low cardiorespiratory
fitness based on V_ O2peak we found low fitness was
more prevalent in males than females in this age
range. The FITNESSGRAM cut-offs gave similar
overall values in boys but indicated much higher
prevalence of low fitness in girls than that observed
using V_ O2peak . All classification methods produced
different frequencies within age groups.
The use of centile curves has a number of advantages
over simple numerical reporting of descriptive statistics.
Centiles can be applied to asymmetrical distributions
(as they are here) and are able to account for skewness
which simple reporting of means and standard devia-
tions cannot do. More importantly, the continuous
curves allow accurate age-related assessment which is a
major advantage over age-related mean and standard
deviation values in whole years. This feature is
particularly important when large age-related increases
in performance are evident as in pubertal boys.
If the 20 m shuttle-run test is to be used to
monitor population health in children and adoles-
cents, there is a clear need to establish the levels of
test performance which are associated with potential
markers of ill-health such as hypertension and
adverse metabolic risk profile.
Acknowledgements
This research is supported by the University of Essex
Research Promotion Fund.
 686 G. Sandercock et al.
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