1

Physical Fitness
Monika Haga 1 , Eero A. Haapala 2 , and Hermundur Sigmundsson 1,3
1
Norwegian University of Science and Technology, Norway
2 University of Jyväskylä, Finland, and University of Eastern Finland, Finland
3
Reykjavik University, Iceland

Childhood is an important time for structural and functional changes. This period is
characterized by essential processes in brain development and opportunities to learn
and develop different motor skills and physical fitness (PF) characteristics through func-
tional activities and play. Physical fitness is an important factor in child development
because it is regarded as a predictor of central health outcomes and is positively asso-
ciated with cognition and brain health. Broadly defined, PF represents a set of inherent
or achieved personal attributes that relate to the capacity to perform physical activity
(Caspersen, Powell, & Christenson, 1985). Children who have high levels of PF can carry
out the daily tasks without extensive fatigue. In children, these daily tasks include inac-
tive or sedentary play, physical activity games and play, and tasks related to education
and school. PF is a multifaceted concept, and of particular interest are the physical and
physiological components that are more directly affected by physical activity habits and
that are usually associated with health status, disease prevention, and health promotion.
The fitness components that seem to be especially important markers of various health
outcomes in young people include cardiorespiratory fitness, flexibility, muscular fitness,
speed/agility, and body composition. Muscular fitness is the capacity to perform work
against resistance, while speed and agility imply the ability to move quickly and to change
the direction of the body rapidly and in a controlled way. Cardiorespiratory fitness is
the overall capacity of the cardiovascular, respiratory, and skeletal muscle system to use
oxygen for energy production. Body composition is used to describe the percentages of
fat, bone, water, and muscle. Although PF components are partly genetic in origin, they
are also partly a reflection of the physical activity pattern over recent weeks, months, and
years. In this way, physical activity or exercise can be seen as the health-related behavior
or processes that help achieve PF.
Physical activity and PF are associated with numerous health benefits and behav-
ioral outcomes. There is still insufficient evidence about the type and amount of phys-
ical activity required for some health benefit; however, both physical activity and PF
have been identified as factors that affect overweight and obesity, cardiovascular dis-
ease risk factors, skeletal health, mental health, and cognitive performance in young
people (Janssen & LeBlanc, 2010). Accordingly, guidelines recommend that toddlers and
preschoolers accumulate at least 180 minutes of daily physical activity at any intensity,

The Encyclopedia of Child and Adolescent Development. Edited by Stephen Hupp and Jeremy D. Jewell.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
DOI 10.1002/9781119171492.wecad032
2 Growth in Childhood

progressing by the age of 5 toward at least 60 minutes of energetic play (e.g., moderate-
to vigorous-intensity physical activity). In addition, the goal of minimizing the amount
of time spent being sedentary for extended periods should also be pursued. Even so,
there is a common concern that children do not participate in a sufficient amount of
physical activity and that engagement in sedentary behavior is increasing. An increase
in unhealthy weight and obesity in childhood and a decline in both motor competence
and components of PF indirectly indicate such a trend. Unfortunately, the complex inter-
actions between the variety of factors and mechanisms that determine participation in
physical activity and thereby a sufficient fitness level in childhood are not fully under-
stood. In this respect, motor competence is suggested as one possible determinant of
children’s physical activity behavior and PF.

1 The Association Between Physical Fitness and Motor

Competence in Children
The everyday activities require that children master different motor skills. Among these
are the skills that are essential to biological functioning such as crawling, walking, and
running, as well as those required for adequate social functioning, such as dressing
and playing. Motor competence can be conceptualized as a person’s ability to execute
different motor acts, including coordination of both fine (e.g., manual dexterity) and
gross motor skills (e.g., static and dynamic balance). Some children experience consid-
erable difficulties in coordinating and controlling their body movements and are often
described as having low motor competence or poor motor proficiency. These children
often experience a marked impairment in the performance of motor skills that has
adverse effects on the activities of daily living, leisure activities, sports, and academic
achievement. The constructs of physical activity, PF, and motor competence are inter-
related. Varying degrees of these components are required whenever movement activi-
ties are performed. Motor competence has been seen as a possible determinant of young
people’s PF and physical activity levels (Stodden et al., 2008). Individuals who master dif-
ferent movements and have a comprehensive motor repertoire tend to have an improved
basis for participation in various physical activity play, sports, and games, and as a conse-
quence increase their fitness levels. Additionally, physically fit children are more likely to
be more physically active and to continue to develop their motor competence. Therefore,
a better understanding of the nature of the relationship between physical fitness and
motor competence across childhood could be usefully applied to initiate health-related
behaviors and to develop appropriate strategies for promoting an active lifestyle.
There is strong evidence of a positive association between motor competence and
cardiovascular fitness among children and adolescents (Cattuzzo et al., 2016). Similarly,
children with developmental coordination disorder or poor motor proficiency tend to
have lower cardiorespiratory fitness measured using both laboratory- and field-based
methods, compared to typically developing children or children with high motor com-
petence (Luz, Cordovil, Almeida, & Rodrigues, 2017; Rivilis et al., 2011). Longitudinal
studies also confirm that these relative differences in cardiorespiratory fitness between
children with high or low motor competence tend to persist as children grow older
(Haga, 2009).
 Physical Fitness 3

Strong evidence of a positive association between motor competence and muscular

fitness (muscle strength and endurance) among children and adolescents is found
in the majority of the studies (Cattuzzo et al., 2016). Likewise, the literature that
examined muscle strength and endurance are consonant in reporting a negative effect
of low motor competence on this PF component. For example, children with low
motor competence had significantly poorer performance in test items such as sit-ups,
push-ups, hand grip force, ball-throw distance (Rivilis et al., 2011), standing broad
jump, and the 20-meter sprint than those with better motor competence (Gísladóttir,
Haga, & Sigmundsson, 2013).
There is also strong evidence of an inverse association between motor competence and
weight status among children and adolescents (Cattuzzo et al., 2016). A majority of the
studies reveal that children with poor motor proficiency scored significantly differently
on anthropometric variables displayed as higher BMI scores, greater waist girth, and
greater percentage of body fat compared to their peers (Rivilis et al., 2011). No clear
gender effect on the association between motor competence and body composition is
reported in the literature.
There is mixed and conflicting evidence of an association between motor competence
and flexibility among children and adolescents (Cattuzzo et al., 2016). The same has been
found in regard to the effect of low motor competence on flexibility (Rivilis et al., 2011).
According to the review by Rivilis et al. (2011), children with poor motor proficiency
demonstrate that range of motion varies within the group from extreme flexibility to
rigidity, thus reflecting the heterogeneous fitness profiles in these children.
There is an overall positive association between motor competence and physical activ-
ity among children. These associations are reported to be low and due mainly to the
cross-sectional design of the studies conducted, therefore it was not possible to establish
a causal relationship (Holfelder & Schott, 2014). Likewise, these associations seem to be
stronger at the extremes of the distributions (well coordinated vs. poorly coordinated),
as children with poor motor proficiency clearly display a reduced physical activity level
compared to their more coordinated peers (Rivilis et al., 2011). A recent longitudinal
study indicated a positive reciprocal relationship between motor competence and phys-
ical activity across childhood through early adolescence, and cardiorespiratory fitness
was found to mediate the association in both directions (Lima et al., 2017). One can
therefore assume that spending time in physical activities will influence the development
of motor competence and vice versa, that is, a sufficient level of motor competence will
influence time spent in physical activity. Children with high PF levels tend to partici-
pate in a wider variety of activities, and in turn they develop different motor skills. At
the same time, children with low motor competence tend to be less engaged in vigorous
activities and participate in fewer unstructured and structured physical activities. Poor
coordination and the accompanying feeling of inadequacy in motor activities will lead
to lower motivation to participate in physical activity.
It is hypothesized that the association between motor competence and PF will be
stronger in older than in younger children. Over time the relationship between motor
skill competence and physical activity is predicted to improve, that is, higher levels of
motor skill competence will provide a greater motor repertoire for participating in var-
ious physical activities, sports, and games (Stodden et al., 2008). Although the existing
empirical literature related to the association across time is scarce, it can be argued that
it contradicts this hypothesis. Association between motor competence and PF in the age
4 Growth in Childhood

groups was statistically higher for the youngest age groups (4–6 years and 11–12 years)
than for the adolescent group (15–16 years). The differences between the two youngest
age groups were not statistically significant, and the results demonstrate that the cor-
relation between motor competence and PF decreases with age (Haga, Gísladóttir, &
Sigmundsson, 2015). Other findings reveal that the relationship remains strong and sta-
ble across childhood and early adolescence, but, in line with Haga et al. (2015), they
also fail to support the hypothesis that this relationship gets stronger as children grow
older (Luz, Rodrigues, De Meester, & Cordovil, 2017). The different domains of motor
competence (such as locomotor, mobility, and manipulative skills) are also found to be
differently associated with PF components across age groups.
In general, the association between different PF components and motor compe-
tence can potentially be explained by physical activity patterns and levels; the type,
amount, and intensity of physical activity impact upon aspects of PF and motor
development/learning. Different activities promote different physiological adaptations,
that is, changes in the various PF components depend on the type of activity performed.
Therefore, a possible explanation of the findings that the association between different
PF components and motor competence is higher at a younger age may be linked to the
type of physical activities different age groups engage in. The types of activities in which
individuals engage in will change with age, evolving from play-oriented activities during
childhood to more organized sports activities in adolescence and adulthood. Typically,
young children mainly develop their fitness level by unstructured activities. Preschool-
ers are found to engage in different forms of energetic play, such that metabolic activity
is well above the resting metabolic rate. Forms of physical activity play in preschoolers
include gross locomotor movements such as running, climbing, and chasing, which can
be categorized as aerobic activities involving large muscle groups, depending on their
intensity. These activities require good motor competence to participate in successfully.
All together, these activities enhance PF components such as muscle strength and
endurance and cardiorespiratory fitness. The more time a child spends in such physically
active play the more opportunity they have to increase their fitness and to gain experi-
ence and practice that influences the rate and direction of their motor development.
The lower association between the two variables in adolescents may suggest that this
group is not so dependent on motor competence to engage in physical activities, and
hence maintain their PF. In adolescence the amount of play-oriented activities decreases
and adolescents may choose to participate in specific sports or physical activities that
are less comprehensive in nature. For example, the performance of running may give
restricted motor experiences in terms of manual dexterity or eye–hand coordination,
but promotes merely the development of motor skills that are directly related to the
specific activity performed, in this case dynamic balance. The intensity and duration
of the physical activity may also be sufficient to promote PF (such as cardiorespiratory
fitness and muscle fitness). In this way, some physical activities could enhance PF but
may not be important for the further development of motor competence in adolescents
(Gísladóttir et al., 2013).
Children with a poor motor proficiency may tend to avoid or withdraw from
activities that require a considerable extent of motor performance. Because of this, the
skill–learning gap will further increase between children with low motor competence
and their peers as the latter group will generally achieve a higher level of motor com-
petence and begin to participate in even more demanding physical activity tasks. Given
 Physical Fitness 5

that the activity deficit gap between children with low and high motor competence
apparently widens with age, children with low motor competence continue to be more
physically inactive compared to the latter group as they age. Indeed, longitudinal studies
confirm that these relative differences in fitness components between children with
high and low motor competence tend to persist as children grow older (Haga, 2009).
There are also measurement issues that confuse our understanding about the interac-
tion between motor competence and PF. Some assessment of motor competence focuses
on aspects such as balance/postural control, sureness, accuracy, and coordination of
movements. Other studies use maximum kicking, throwing speed, and maximum jump-
ing distance to measure motor skill competence. It can be argued that some of these
motor assessment tools are more closely related to the test items used to assess PF. This
could explain the strong association between those variables. In this way, movement
tests do not always discriminate well between motor competence and PF, and the corre-
lation between the two variables may depend on the specific content of the fitness test
battery and the tasks used to measure motor competence.
The literature leads to a conclusion that it is important to improve both PF and motor
competence from early childhood in order to promote the development of appropriate
PF levels, motor competence, and physical activity patterns. In terms of health promo-
tion and an active lifestyle this could lead to lasting activity habits across lifespan.
Both growth- and maturation-related changes and practice/learning are contrib-
utors to variance in and between these variables. In this way, their potential role as
confounding variables complicates understanding of the relationships between motor
competence and PF. There is clear and strong evidence that PF is associated with
motor competence but there is still uncertainty with regard to how these associations
develop during childhood and into adolescence. Associations seem to be stronger at
the extremes of the distributions (well coordinated vs. poorly coordinated). A clear
understanding of these relationships is complicated by the variety of constructs and
methods used to measure PF, motor competence, and physical activity. Additionally,
changes in associations are dependent on growth- and maturation-related changes as
well as on practice/learning.

2 The Association Between Physical Fitness and Brain Health,

Cognition, and Academic Achievement in Children
The possible associations of physical activity and fitness with cognitive functioning and
brain health have been increasingly investigated in recent years (Donnelly et al., 2016).
The increased interest in this topic may be caused by concern that children today are
not maintaining appropriate levels of physical activity, PF, and motor competence.
The central nervous system and the brain undergo a rapid structural and functional
development during childhood and adolescence (Lenroot & Giedd, 2006). For example,
total white matter continues to increase linearly from early childhood to the early
twenties. Similarly, gray-matter volume increases but the increase is nonlinear. Frontal
gray-matter volume reaches its peak toward the end of prepubertal years at the age
of 10–12 years, while temporal gray-matter volume peaks during adolescence at the
age of 16–17 years. There is also evidence that subcortical structures, such as the
hippocampus, amygdala, and putamen, continue to grow in volume during the pubertal
period (Lenroot & Giedd, 2006). During its growth and development, the brain appears
6 Growth in Childhood

to be particularly responsive to exercise. Studies using animal and human models

have shown that physical activity can improve synaptic plasticity, cerebral blood flow,
vasculature, and neurogenesis in the brain (Hillman, Erickson, & Kramer, 2008).
Most published studies on children and adolescents suggest that those with bet-
ter cardiorespiratory fitness outperform their peers with poorer cardiorespiratory
fitness in cognitive and academic tests (Donnelly et al., 2016; Santana et al., 2017).
Furthermore, children with higher cardiorespiratory fitness, as measured by maximal
oxygen uptake (VO2 max mL⋅kg−1 ⋅min−1 ) and by 20-meter endurance shuttle run test,
demonstrate larger frontal lobe gray-matter volume, larger hippocampal and caudate
nucleus volumes, and more efficient neuroelectric processing during cognitive tasks
than their peers with lower fitness (Donnelly et al., 2016). These size differences in
brain architecture and function are accompanied by differences in executive functions
including working memory, cognitive control and attention, and academic achieve-
ment. Longitudinal data also demonstrate that children who have consistently higher
cardiorespiratory fitness also have consistently better academic performance than those
with lower cardiorespiratory fitness (Donnelly et al., 2016; Santana et al., 2017). The
evidence on sex differences in the associations of cardiorespiratory fitness with brain
functions, cognition, and academic achievement is not consistent. While some studies
have found stronger associations between cardiorespiratory fitness and academic
achievement in boys, others suggest that the corresponding associations are stronger
in girls (Santana et al., 2017).
The bidirectional link between motor competence and cognitive skills is already
present in early childhood. While brain maturation allows children to perform many
new motor skills, newly developed motor skills enable them to be involved in new expe-
riences and exploration which have an effect on their brain development and cognitive
skills (Thelen, 1995). Accordingly, motor competence, particularly fine motor skills
and bilateral motor competence, has been directly related to cognition in prepubertal
children (van der Fels et al., 2014). Furthermore, emerging evidence suggests that better
speed/agility performance as a measure of gross motor competence is strongly related
to larger gray-matter volumes in the frontal, temporal, and cerebellar regions of the
brain as well as to cognition and academic achievement in children (Esteban-Cornejo
et al., 2017; Haapala et al., 2014). Evidence suggests that the associations of motor
competence with cognition and academic achievement are stronger in boys than in girls.
Although muscle strength is an essential component of PF, determining children’s abil-
ity to carry out the tasks of daily life, the measures of muscle strength have weak, if any,
associations with cognition or academic achievement (Santana et al., 2017). A z-score
created from hand grip strength and standing long jump performance as an indicator of
muscle strength has been directly related to larger cerebellar gray-matter volumes, but
these associations were largely modified by the measures of cardiorespiratory fitness
and motor competences (Esteban-Cornejo et al., 2017).
Given the interrelationship between the different measures of PF and the difficulty
of clearly separating one measure from another, some studies have investigated the
associations of fitness scores that have been created by combining different measures
of PF. Most of these studies indicate that children and adolescents with higher overall
PF have better academic achievement than those with poorer levels of PF, and that
better overall PF is also linked to better academic achievement longitudinally (Santana
et al., 2017). There is sufficient evidence to conclude that physical activity supports
 Physical Fitness 7

normal brain, cognitive, and academic development in youth (Donnelly et al., 2016). As
stated earlier, PF is a product of growth, maturation, and physical activity. Few studies
in children and adolescents have investigated whether improvements in PF mediate the
positive effects of physical activity on brain health, cognition, and academic achieve-
ment. The results of a metaregression study indicated that cardiorespiratory fitness
does not mediate the effects of exercise on cognition in adults (Etnier, Nowell, Landers,
& Sibley, 2006). Similarly, some intervention studies among children suggest that
physical activity can improve academic achievement without improving PF. However,
studies that have observed positive effects of exercise interventions on cognition or
academic achievement have also reported improvements in cardiorespiratory fitness
or motor competence.
These results together suggest that children and adolescents with better PF, including
high levels of cardiorespiratory fitness and motor competence, outperform their peers
with lower levels of fitness in cognitive and academic tasks. There is also evidence that
physical activity may have positive effects on cognition and academic achievement and
that the effects of physical activity may be independent of changes in PF. The results
showing a weak relationship of muscle strength to brain and cognition do not imply the
irrelevance of muscular fitness development during childhood. Rather, children who
participate in structured and well-designed strength-training programs can improve
their cardiorespiratory endurance, motor competence, and cardiometabolic risk factors,
all of which have been linked to cognition and academic achievement. Furthermore,
there is evidence that children with better motor competence and higher levels of mus-
cle strength are more likely to grow into physically active adolescents and adults, and
are thus more likely to improve their brain health in the long term. Therefore, children
should be allowed to practice and rehearse different components of PF through versatile
physical activities stressing cardiorespiratory and neuromuscular systems through early
and middle childhood to develop their physical fitness which will in turn contribute to
better cognition and academic achievement.

3 Future Directions in Research, Theory, and Methodology

Physical fitness is a complex entity composed of numerous and varied components that
present a challenge in terms of precise and reliable assessment. Field-based tests of
fitness provide a reasonable alternative as they are time efficient, low in cost and equip-
ment requirements, and easy to administer to a large number of individuals simultane-
ously. If a field-based test assessment is to be considered “good,” it must be valid, reliable,
and feasible. Yet there is limited evidence for most field-based tests of PF components
in very young children when it comes to reliability and validity.
Existing physical fitness tests have been criticized for their attempt to split up a com-
plex attribute into constituent components and to measure each of these components
separately. It is difficult, if not impossible, to obtain a pure measure of basic components
in physical fitness, even in test and laboratory settings; only an indirect indication of
the basic components is possible. The constituent components of a skill, it may be
argued, are not known, nor is it known how they combine to make up the complex skill,
which means that it is hard to find an isolated measure of basic components. Speed
and agility, for example, are closely related to muscular fitness in terms of the need for
8 Growth in Childhood

explosive strength to move the body/body part, in addition to moving quickly and/or
changing direction. Consequently, test items measuring agility (tested by the shuttle
sprint and the 20-meter sprint test in young people) are also measuring components
of muscular fitness. Therefore, caution should be exercised when interpreting the
associations of one component of physical fitness with brain structures and functions,
cognition, and academic achievement in children and adolescents. Furthermore, all
of these characteristics are largely determined by genetic background, growth, and
maturation, but physical activity and exercise training have been found to improve
cardiorespiratory fitness, motor competence, and muscle strength more than can be
explained by growth and maturation.
According to a dynamic systems approach our movements emerge from the interact-
ing of three factors: the individual, the task, and the environment. A unilateral focus on
individual constraints such as anthropometric factors, experience, endurance, strength,
and concentration without taking into account the environment or the task that is being
performed will give an incomplete picture. On the basis of such a perspective, it is
suggested that children’s PF should be measured according to the performance of move-
ments that are naturally included in most children’s everyday play activities.
On the basis of the existing evidence, it is important to ensure children’s access to
activities and environments that promote physically active play and motor development
and that reduce sedentary behavior. Children’s motor competence and physical fitness
should also be encouraged, as they may serve as positive and sustainable trajectories of
health behavior and lead to positive long-term health outcomes.

SEE ALSO: Bone and Skeletal Development; Fine Motor Development; Gross Motor
Development; Height and Weight; Obesity in Children

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10 Growth in Childhood

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Monika Haga (PhD, Norwegian University of Science and Technology, 2011) is a Profes-
sor at the Faculty of Social and Educational Sciences, Norwegian University of Science
and Technology, Norway. Her research interests include exploring the associations of
physical fitness, physical activity, and motor competence in children and adolescents.
She is also engaged in projects, and has published, in the field of human movement
science and health promotion with a special focus on children, adolescents, and older
adults. She has authored several peer-reviewed original articles and book chapters on
motor development, motor competence, and physical activity.
Eero A. Haapala (PhD, University of Eastern Finland, 2015) is a Postdoctoral Research
Fellow at the Faculty of Sport and Health Sciences, University of Jyväskylä, Finland,
and at the Institute of Biomedicine, University of Eastern Finland. His research inter-
ests include examining the associations of cardiometabolic health and health behaviors
on brain, cognition, and academic achievement in children and adolescents. He has
authored several peer-reviewed original and review articles on the associations of phys-
ical activity, physical fitness, adiposity, and diet quality with cognition and academic
achievement and other fields of pediatric exercise science and physiology.
Hermundur Sigmundsson (PhD, Norwegian University of Science and Technol-
ogy, 1998) is a Professor in Biological Psychology at the Department of Psychology,
Norwegian University of Science and Technology, Norway. He is also a Professor in
Sport Science at Reykjavik University, Iceland. His research interests include exploring
learning and skill development with a focus on a better understanding of the learning
process. He leads the research group on Mind, Brain, and Education at the Norwegian
University of Science and Technology, and has published over 70 articles and seven
books.