Scandinavian Journal of Public Health, 2011; 39: 35–43

ORIGINAL ARTICLE

Physical fitness in northern European youth: Reference values from the

Latvian Physical Health in Youth Study

MELITA SAUKA1, ILGA S. PRIEDITE1, LUDMILA ARTJUHOVA1, VIESTURS LARINS2,

GUNTARS SELGA3, ÖRJAN DAHLSTRÖM4 & TOOMAS TIMPKA4
1
Sports Medicine State Agency, Riga, Latvia, 2Latvian Academy of Sport Education, Riga, Latvia, 3Riga Stradins
University, Riga, Latvia, and 4Section of Social Medicine and Public Health, Linköping University, Sweden

Abstract
Aims: Physical fitness has the potential to be used as a key health determinant in youth. The aim of this study was to establish
age- and sex-stratified reference values for health-related physical fitness in Latvian school-age children and to identify
notable sex differences. Methods: Physical fitness was assessed using the EUROFIT test battery. Data were gathered from
schoolchildren aged between 6 and 17 years (n ¼ 10,464) by a medical team using standardised methods (EUROFIT
battery). Fitness levels, stratified by chronological age and sex, were computed as mean  SD. Each test was also analysed for
differences between males and females in each age group. Results: Boys performed better than girls in muscular endurance
and strength, cardiorespiratory endurance, and speed–agility fitness tests. Girls had better flexibility than boys (p < 0.001).
There was also a more pronounced improvement in physical fitness scores with age in boys compared with girls.
Conclusions: Physical fitness reference values were developed for Latvian children and adolescents. These
reference values will permit comparisons between students during physical education lessons and provide a
baseline against which progress in physical fitness among northern European youths can be compared.

Key Words: Cardiorespiratory endurance, EUROFIT, flexibility, muscular endurance

that a low-level physical fitness in youth predisposes

Background
Physical fitness is a set of attributes that people have
or achieve that relate to their ability to perform
physical activity [1]. Health-related physical fitness
consists of those components of physical fitness that
are associated with health. Health-related fitness is
demonstrated by being able to perform daily activi-
ties with vigour and by traits and capacities associated
with a low risk for the development of chronic
diseases and premature death [2]. Health-related
fitness is commonly measured by physiological fac-
tors such as cardiorespiratory endurance, muscular
strength, balance, and flexibility [3].
Health-related fitness has been established as a key
health determinant that can be measured more
reliably than physical activity in adulthood [4],
childhood, and adolescence [5–9]. There is evidence
Correspondence: Melita Sauka, PhD, Sports Medicine State Agency, Ministry of Health, Raina bulvaris 27, Riga, LV- 1050, Latvia. Fax: þ371 67227306.
E-mail: melita@latnet.lv
individuals to health problems in adult life. In a
recent systematic review, it was concluded that there
is strong evidence that high cardiorespiratory endur-
ance is associated with a healthier cardiovascular
profile later in life and that muscular strength
improvements from childhood to adolescence are
negatively associated with changes in overall adipos-
ity [10]. In addition to a healthier cardiovascular
profile, it has been shown that the physical fitness
aspects related to speed and dynamic strength in
adolescence are associated with bone mineral density
and the accumulation of bone mass later in life
[11,12].
The possible uses of standardised measurement of
physical fitness in childhood include assessment of
opportunities for promotion of physical activity at the
population level and evidence-based individual

(Accepted 11 July 2010)

ß 2011 the Nordic Societies of Public Health
DOI: 10.1177/1403494810380298

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36 M. Sauka et al.
counselling and prescription of exercise [4,13,14].
However, these uses of health-related fitness testing
require that the assessments are based on up-to-date
reference values. The positioning of individuals and
groups in percentiles allows not only straightforward
interpretation of the progression of physical fitness
over time but also identification of cross-sectional
deviations in need of immediate investigation and
intervention. The method is thereby applicable in
educational and health-care settings.
Aims
The aim of this study was to establish age- and sex-
stratified reference values for health-related physical
fitness in Latvian school-aged children and to identify
notable sex differences.
Methods
The European Physical Fitness Test battery
EUROFIT [15] was used to assess physical fitness.
The nine tests in the battery cover cardiorespiratory
endurance, muscular endurance, muscular strength,
flexibility, balance, and speed and agility. The mea-
surement protocols for the EUROFIT battery were
approved by the Health Statistics and Medical
Technologies State Agency of Latvia. The study
was conducted in accordance with the ethical stan-
dards laid down in the 1964 Declaration of Helsinki.
Participants
Over a 5-year study period, pupils aged between 6
and 17 years were recruited to the study from public
schools throughout Latvia. Information about the
study was presented annually at regional meetings for
principals. All study participation was voluntary. A
total of approximately 2000 pupils from a represen-
tative mix of urban and rural schools were accepted
into the study each year. To avoid test learning bias
among the participants, each school participated only
once. Written informed consent was sought from
parents before the tests. Only those children who had
obtained parental approval were approached about
participation. Final informed consent was obtained
from the children before starting data collection.
Data collection
The data were gathered by a specially trained medical
team from the Sports Medicine State Agency from
April 2004 to July 2009. The data collection
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consisted of physical fitness testing and anthropo-
metric measurements.
Cardiorespiratory endurance was evaluated by
means of a 20-m endurance shuttle run (ESR) test,
with the test subject running back and forth over a
distance of 20 m. The initial speed was 8.5 km/h,
which was increased by 0.5 km/h every minute (1 min
is equal to one stage). The time at which a child
dropped out was the indicator of his or her cardio-
respiratory endurance.
Muscular endurance is the ability of a muscle
group to execute repeated contractions over time or
to maintain a maximal voluntary contraction for a
prolonged period of time. The endurance strength
(functional strength) of the upper body was mea-
sured using a bent arm hang (BAH) test, which
determines the maximum length of time a subject can
remain suspended by the arms from a bar. Trunk
strength (i.e. abdominal muscular endurance) was
assessed using a sit-ups (SUP) test completed within
half a minute. The total number of completed sit-ups
performed within 30 s was counted.
We assessed static and explosive strength.
Handgrip strength refers to the maximal isometric
force that can be generated mainly by the hand and a
forehand muscle (upper limb) involved in performing
the handgrip, and was assessed with a handgrip
(HGR) test. Lower limb explosive strength was
assessed using a standing broad jump (SBJ) test.
The explosive strength developed by the legs from a
standing position was recorded as the maximum
horizontal distance covered by jumping with the feet
together.
Mobility of the trunk and hips assessed using the
sit-and-reach (SAR) test, which is a reflection of
overall flexibility. Flexibility was measured in a sitting
position with feet placed flat against a box and the
fingertips placed on the edge of the top plate. The
subject attempted to reach forward as far as possible,
keeping his or her knees straight, without jerking and
with hands stretched out. The maximum distance
reached with the fingers when bending forward while
sitting on the floor was recorded.
Speed covered assessment of speed of movement/
agility and speed of limb movement. Speed of
movement/agility was assessed using a 10  5 m
shuttle run (SHR) test. This test assessed the
subjects’ speed of movement, agility and coordina-
tion in an integrated fashion. The subjects ran back
and forth five times along a 10-m track at the highest
speed possible. At the end of each track section, the
subjects deposited or picked up a sponge from a line
on the floor. Therefore, the test permitted measure-
ment not only of speed of displacement, but also of
agility and coordination.

The plate tapping test (PLT) assessed the speed
and the coordination of limb movement. Two discs
are placed with their centres 60 cm apart on the table.
The subject moved the preferred hand back and forth
between the discs over the hand in the middle as
quickly as possible. This action was repeated for 25
full cycles (50 taps).
The flamingo balance test assessed the ability to
balance successfully on one leg. The subject stood on
a beam (metal beam 50 cm long, 5 cm high, and 3 cm
wide) with shoes removed. The number of falls in
60 s of balancing was recorded.
Statistical analysis
Physical fitness levels, stratified by chronological age
groups, were computed as the mean  SD. Eleven
chronological age groups were used for the analyses,
ranging from 6 years (6.0–6.9 years) to 17 years
(17.0–17.9 years). The physical fitness variables were
also subjected to an analysis of differences (one-way
ANOVA) between males and females within each age
group. All calculations were performed using SPSS
v.14.0 software for Windows. The significance level
was set at p < 0.05.
Results
Data from 10,464 children and adolescents (5507
males and 4957 females) were analysed. The overall
rate of participation in the tests was 95%. In the
oldest age groups (16–17 years), where the motiva-
tion for participating in physical education classes
was lower, the drop-out rates were higher than in the
younger age groups. In schools where medical staff
worked in a space smaller than 20 m in length, the
20-m ESR test was not done. These circumstances
led to a high proportion of non-participation
(60–70%) in this test.
The mean physical fitness scores for Latvian
school-age children were grouped according to
chronological age and sex from 6 to 17 years of age
(Table I). Sex differences (favouring boys) in mus-
cular endurance, as measured by the BAH and SUP
tests, were statistically significant from 8 to 17 years
of age. Analysis of strength (HGR and SBJ tests)
revealed similar statistically significant differences in
all age groups. However, girls had better flexibility
(SAR test) than boys, with statistically significant
differences in all age groups. Boys had better cardio-
respiratory endurance (ESR test) compared with girls
from the age of 9 years, and better speed-agility (SHR
test) from the age of 7 years.
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Physical fitness: Composition of reference values 37
The computed reference values stratified by age
and sex and expressed in percentiles from P5 to P95
for trunk strength (SUP test), cardiorespiratory
endurance (ESR test), and speed/agility (SHR test)
are displayed in Tables II–IV. Aptitude for muscular
endurance, strength, and cardiorespiratory endur-
ance was higher for boys than for girls (Figure 1). The
P95 percentile line in girls was equivalent to the P50
percentile line in boys. There was also a more
pronounced improvement in physical fitness scores
for boys than for girls with increasing age.
Discussion
We have developed population-based reference
values for physical fitness in northern European
(Baltic States and Scandinavia) schoolchildren and
adolescents of varying age. To be able to compare the
physical fitness level between countries, we used a
randomised subject selection procedure, standar-
dised measurements, and test methods that have
been assessed for reliability [16]. In a recent review, it
was concluded that the ESR test in particular is a
valid measure of cardiorespiratory endurance, the
SBJ test is a valid test for lower body muscular
strength, and the HGR test is a valid measure of
upper body muscular strength [17]. Nevertheless, it
still must be remembered that the percentile lines
identified in this study do not represent cut-off
thresholds for pathological test results predictive for
disease in adulthood, and that the associations
between physical fitness and health are complex.
For instance, improvements in muscular endurance,
speed, and agility rather than cardiorespiratory
endurance have a positive effect on skeletal health
[18].
In our Latvian data, we found that boys performed
better than girls in tests for muscular endurance and
strength, cardiorespiratory endurance, and speed of
movement/agility, whereas girls performed better in
the flexibility tests. These observations correspond to
the results of the HELENA study performed in
2006–08, using pooled data from children aged
13–17 years in 10 European countries [19].
Comparing our data with the results from the
HELENA study, we found compelling similarities
between functional strength (Figure 1a) and static
strength (Figure 1b). The differences in mean BAH
test scores between the current study and the
HELENA study were only 2.64 s for boys and
2.62 s for girls, and only 1.4 kg for boys and
0.30 kg for girls for the HGR test. However, other
reference values, such as for explosive strength
(Figure 1c) and flexibility (Figure 1d), showed
 38

Table I. Physical fitness scores (mean  SD) by age and gender of Latvian school-age children from EUROFIT battery.

Muscular endurance Muscular strength Flexibility Cardio-respiratory endurance Speed Total body balance
M. Sauka et al.

Bent arm Sit-ups Handgrip Broad jump Sit and reach Endurance shuttle Shuttle Plate tapping Flamingo
Age hang (BAH) (SUP) test (HGR) (SBJ) (SAR) run (ESR) run test (PLT) test
(years) test (s) (repeats) test (kg) test (cm) test (cm) test (min)a (10  5) (SHR) (s) test (s) (no instabilities)
Boys (n ¼ 5507)
6 5.6  6.1 12.2  5.4 8.6  2.6b 107.3  25.0b 16.5  5.0b – 26.0  2.7c 23.4  3.8 12.05  4.5
7 7.2  6.9c 15.1  4.7 10.8  3.2b 120.3  21.3b 15.6  5.6b 1.9  1.0 24.6  2.8b 21.0  10.1 13.8  2.2
8 8.7  8.0b 17.1  4.8b 12.7  3.3b 132.2  22.6b 15.8  5.8b 2.2  1.2c 23.7  2.8b 18.4  6.3 13.5  2.5c
9 10.1  9.5b 18.7  4.9b 14.4  3.7b 138.8  22.8b 14.6  6.2b 2.6  1.5b 22.9  2.6b 16.7  7.8 12.6  3.0
10 11.6  9.9b 20.2  4.8b 16.4  4.1b 147.3  24.1b 14.5  6.2b 3.2  1.7b 22.2  2.8b 15.4  7.4 12.2  3.3
11 12.4  10.6b 21.3  4.5b 18.5  5.1b 152.0  24.9b 13.7  6.6b 3.7  1.9b 21.8  2.5b 14.4  8.2 11.6  3.6
12 12.7  11.1b 21.8  4.7c 21.8  5.4b 160.7  26.2b 13.3  6.7b 3.9  1.9b 21.4  2.6b 14.2  11.2 11.1  3.9c
13 15.8  11.8b 23.2  4.7b 26.0  7.0b 174.6  29.8b 14.1  7.0b 4.5  2.2b 20.5  2.5b 12.6  2.3 10.4  4.0
14 20.0  14.0b 24.1  4.4b 31.3  8.3b 189.7  33.3b 16.1  8.1b 5.3  2.0b 19.9  2.4b 12.2  6.7 10.1  3.7
15 25.0  15.2b 25.1  4.4b 36.4  7.6b 200.0  35.2b 17.1  8.1b 5.5  2.1b 19.5  2.5b 11.4  2.2 8.8  4.2
16 28.2  15.7b 25.5  4.7c 40.5  7.5b 212.4  34.1b 19.2  9.4b 6.5  2.3b 19.1  3.1b 10.9  2.5 9.2  4.3
17 30.8  15.4b 25.8  4.5b 41.0  7.5b 220.5  28.7b 20.0  9.4b 5.8  2.4b 18.7  2.6b 11.3  3.0 9.2  4.3
Girls (n ¼ 4957)
6 5.6.  6.2 11.8  5.2 8.0  2.4 100.1  19.7 18.3  5.1 – 26.7  2.8 22.8  4.3 14.5  3.0
7 5.6  6.3 14.3  4.7 9.4  3.0 108.3  23.5 17.8  5.7 1.6  0.8 25.5  2.7 20.3  3.7 13.4  2.5
8 6.5  6.8 15.6  4.8 11.4  3.1 121.6  19.7 17.4  6.5 1.8  0.9 24.4  2.6 18.0  3.0 13.1  2.9
9 6.6  6.5 17.0  4.7 12.8  3.4 129.3  22.4 16.5  6.4 1.9  0.9 23.9  2.5 16.2  2.8 12.4  3.2
10 7.8  7.4 18.4  4.6 14.8  3.9 135.7  25.5 16.3  6.7 2.6  1.3 22.9  2.5 14.9  4.7 11.9  3.5

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11 7.6  7.6 18.7  4.4 17.2  4.8 142.7  23.1 16.6  6.9 2.7  1.4 22.5  2.4 14.2  8.4 11.1  3.8
12 7.6  7.6 19.1  4.3 19.9  5.5 147.4  25.5 17.4  7.1 2.9  1.5 22.3  2.5 13.3  2.6 11.1  5.1
13 8.2  8.8 20.3  4.5 23.1  5.3 154.1  27.6 19.5  8.3 3.3  1.7 21.8  2.6 12.7  2.3 10.1  3.8
14 9.1  9.1 20.0  4.4 26.1  5.6 159.8  30.3 21.0  8.0 3.3  1.5 21.2  2.2 12.7  7.8 9.7  4.1
15 9.6  8.9 20.6  4.9 27.0  5.1 161.7  26.3 22.2  8.3 3.3  1.6 21.2  2.1 11.9  2.6 8.7  4.5
16 11.5  11.1 20.9  4.6 27.8  5.5 164.4  26.9 23.5  9.5 3.9  1.4 21.0  2.4 12.0  9.3 8.4  4.2
17 11.6  11.0 21.9  4.3 28.5  6.2 170.0  23.6 24.2  8.3 3.6  1.4 20.6  2.4 12.1  8.1 8.4  4.2
a
Boys, n ¼ 2348; girls, n ¼ 2011.
b
Statistical differences between the sexes at the level p  0.001.
c
Statistical differences between the sexes at the level p  0.05.
 Physical fitness: Composition of reference values 39
Table II. Normal values (in repeats) of the physical fitness of Latvian school-age children: trunk strength – sit-ups (SUP) test.

Percentiles
Age
(years) 5 10 20 30 40 50 60 70 80 90 95
Boys (n ¼ 5507)
6 2.0 5.0 7.0 10.0 11.0 12.0 13.0 15.0 17.0 20.0 21.0
7 7.0 9.0 12.0 13.0 14.0 15.0 17.0 18.0 19.0 20.0 22.0
8 8.0 11.0 14.0 15.0 16.0 17.0 18.0 20.0 21.0 23.0 24.0
9 10.0 13.0 15.0 17.0 18.0 19.0 20.0 21.0 23.0 24.0 26.0
10 12.0 14.0 17.0 18.0 19.0 20.0 21.0 23.0 24.0 26.0 27.0
11 14.0 16.0 18.0 19.0 20.0 21.0 22.0 24.0 25.0 27.0 28.0
12 15.0 16.0 18.0 20.0 21.0 22.0 23.0 24.0 25.0 28.0 29.0
13 16.0 18.0 20.0 21.0 22.0 23.0 24.0 26.0 27.0 29.0 30.0
14 17.0 19.0 20.0 22.0 23.0 24.0 25.0 26.0 28.0 30.0 32.0
15 18.0 20.0 21.0 22.0 24.0 25.0 26.0 28.0 29.0 30.0 32.0
16 18.0 20.0 22.0 23.0 25.0 26.0 27.0 28.0 29.0 31.0 32.0
17 19.0 20.0 22.0 24.0 25.0 26.0 27.0 28.0 30.0 31.0 32.0
Girls (n ¼ 4957)
6 1.0 4.0 7.0 10.0 11.0 12.0 13.0 14.0 15.0 18.0 20.0
7 6.0 8.0 11.0 12.0 14.0 15.0 16.0 17.0 18.0 20.0 21.0
8 7.0 9.0 12.0 14.0 15.0 16.0 17.0 18.0 19.0 21.0 23.0
9 8.0 11.0 14.0 15.0 16.0 17.0 18.0 19.0 20.0 23.0 24.0
10 11.0 13.0 15.0 16.0 18.0 19.0 20.0 21.0 22.0 24.0 25.0
11 11.0 13.0 15.0 17.0 18.0 19.0 20.0 21.0 22.0 24.0 26.0
12 12.0 13.0 16.0 17.0 19.0 20.0 20.0 22.0 23.0 24.0 26.0
13 13.0 15.0 17.0 18.0 19.0 20.0 21.0 22.0 24.0 26.0 28.0
14 14.0 15.0 17.0 18.0 19.0 20.0 21.0 22.0 23.0 25.0 27.0
15 13.0 15.0 17.0 18.0 20.0 21.0 22.0 23.0 25.0 26.0 29.0
16 13.0 15.0 17.0 19.0 20.0 21.0 22.0 23.0 25.0 27.0 28.0
17 14.0 18.0 19.0 20.0 21.0 22.0 23.0 24.0 25.0 27.0 28.0

Table III. Normal values (in min) of the physical fitness of Latvian school-age children: cardiorespiratory endurance – endurance shuttle
run (ESR) test.

Percentiles
Age
(years) 5 10 20 30 40 50 60 70 80 90 95
Boys (n ¼ 2348)
7 0.5 1.1 1.1 1.2 1.3 1.5 2.0 2.3 2.6 3.2 4.0
8 1.0 1.1 1.2 1.3 1.5 2.0 2.3 3.0 3.3 4.1 4.5
9 0.6 1.1 1.3 1.4 2.1 2.3 2.5 3.2 4.0 5.0 5.3
10 1.0 1.2 1.4 2.1 2.4 3.1 3.5 4.1 5.0 5.5 6.4
11 1.1 1.4 2.0 2.3 3.0 3.4 4.1 4.6 5.3 6.4 7.1
12 1.3 1.5 2.2 2.5 3.2 3.4 4.3 5.1 5.6 6.5 7.8
13 1.2 1.4 2.3 3.2 3.6 4.4 5.1 5.5 6.4 7.4 8.2
14 2.3 3.0 3.4 4.2 4.5 5.2 5.5 6.3 7.1 8.1 9.1
15 2.4 3.1 3.5 4.1 4.6 5.3 6.1 6.5 7.3 8.2 9.3
16 2.5 3.2 4.4 5.4 6.1 6.4 7.2 7.5 8.4 10.0 10.5
17 2.3 3.1 4.1 4.5 5.2 6.1 6.4 7.2 7.5 8.2 9.5
Girls (n ¼ 2011)
7 0.5 1.0 1.1 1.2 1.3 1.4 1.5 2.0 2.2 3.0 3.2
8 0.9 1.0 1.1 1.2 1.3 1.4 2.0 2.2 2.4 3.3 3.5
9 1.0 1.1 1.2 1.3 1.4 1.5 2.1 2.3 2.6 3.3 4.1
10 1.0 1.2 1.3 1.5 2.1 2.3 2.6 3.2 4.0 4.5 5.2
11 1.1 1.2 1.4 1.7 2.2 2.4 3.0 3.3 4.1 4.9 5.3
12 1.1 1.2 1.4 2.1 2.2 2.5 3.2 3.5 4.2 5.1 5.5
13 1.2 1.3 1.6 2.2 2.5 3.2 3.5 4.2 4.5 5.9 6.3
14 1.3 1.5 2.1 2.4 2.6 3.3 3.4 4.2 4.5 5.3 6.1
15 1.1 1.4 1.5 2.2 2.4 3.1 3.3 4.1 5.0 5.3 6.2
16 1.5 2.1 2.4 3.1 3.3 3.5 4.1 4.5 5.2 6.3 7.1
17 1.8 2.2 2.3 2.5 3.2 3.3 4.1 4.3 5.0 5.2 6.6

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40 M. Sauka et al.
Table IV. Normal values (in s) of the physical fitness of Latvian school-age children: speed of movement/agility – shuttle run test
10  5 m (SHR).

Percentiles
Age
(years) 5 10 20 30 40 50 60 70 80 90 95

Boys (n ¼ 5507)
6 21.7 22.8 23.7 24.3 25.1 25.7 26.4 27.1 28.5 30.1 31.4
7 20.5 21.2 22.3 23.1 23.7 24.4 25.0 25.8 27.0 28.2 29.1
8 19.8 20.4 21.5 22.1 22.8 23.5 24.2 24.9 25.8 27.3 29.1
9 19.4 20.0 20.8 21.5 22.1 22.8 23.2 24.0 24.8 26.3 27.8
10 18.6 19.4 20.2 20.7 21.3 22.1 22.7 23.2 24.0 25.5 26.8
11 18.4 19.0 19.7 20.4 21.1 21.5 22.1 22.6 23.8 25.1 26.5
12 17.5 18.2 19.3 20.0 20.7 21.2 21.8 22.5 23.5 24.7 26.4
13 16.8 17.7 18.3 19.0 19.7 20.3 20.9 21.5 22.3 23.7 25.0
14 16.1 16.8 17.9 18.7 19.3 20.0 20.5 21.2 21.9 22.9 24.0
15 15.8 16.5 17.7 18.4 18.8 19.4 19.8 20.3 21.1 22.6 23.8
16 15.2 15.6 16.7 17.6 18.1 18.8 19.4 20.0 20.8 22.7 24.4
17 15.2 15.5 16.4 17.2 18.1 18.7 19.1 19.7 20.4 21.6 23.8
Girls (n ¼ 4957)
6 22.4 23.4 24.5 25.2 25.6 26.4 27.1 27.9 28.6 30.6 32.1
7 21.2 22.8 23.9 24.6 25.3 26.1 26.9 27.8 29.4 29.3 30.5
8 20.5 21.3 22.3 23.1 23.7 24.3 24.9 25.5 26.5 27.9 28.9
9 20.3 21.0 21.9 22.3 23.0 23.6 24.4 25.2 25.9 27.1 28.6
10 19.2 20.0 21.2 21.8 22.3 22.8 23.4 24.0 24.8 25.9 27.5
11 18.6 19.6 20.6 21.3 21.9 22.4 23.0 23.6 24.3 25.4 26.7
12 18.6 19.8 20.4 21.1 21.7 22.2 22.8 23.4 24.1 25.2 26.2
13 18.2 19.1 20.0 20.5 21.0 21.5 22.3 22.8 23.5 24.8 25.9
14 17.7 18.4 19.4 19.9 20.5 21.1 21.6 22.2 22.9 24.2 25.0
15 18.0 18.9 19.6 20.1 20.6 21.6 21.6 22.1 22.9 24.0 25.2
16 17.1 18.2 19.0 19.9 20.6 21.1 21.5 22.1 22.6 23.9 24.9
17 17.1 17.9 18.6 19.4 19.9 20.6 21.0 21.7 22.2 23.2 24.0

considerable differences. The mean SBJ test score
difference between our study and the HELENA
study was 17.5 cm for boys and 21.8 cm for girls.
Comparing our study with the HELENA study for
the SAR test, the mean score difference was 5.2 cm
for boys and 10.9 cm for girls. The mean score
difference for the cardiorespiratory endurance test
(Figure 1e) was 0.8 min for boys and 0.16 min for
girls. The running distance used for the speed test
differed between the studies, but the trends in the
performances were similar (Figure 1f). The values
from our study should therefore be appropriate for
application by those practitioners and researchers
who implement the 10  5 m version of the SHR test
instead of the 10  4 m version. These comparative
observations imply that the transfer of reference
values for physical fitness between populations and
geographic regions is not straightforward, and sug-
gest that specific norms need to be developed for each
population in which testing is to be performed.
Comparing the current data with other studies
involving homogeneous populations of European
youth, we find that adolescents from Spain [16]
performed better on the cardiorespiratory endurance
test than the Latvian adolescents. The authors from
Spain also analysed the results of 15 studies from
different countries and concluded that the perfor-
mance of Spanish adolescents was worse than the
performances reported from 11 of the 15 studies.
Our study population thus showed a lower level of
cardiorespiratory endurance compared with homo-
geneous populations of adolescents investigated in
previous studies. This can be explained by an insuf-
ficient infrastructure for participation in sports and
spontaneous physical activities, and a lack of policies
for promotion of habitual physical activity among
school-aged children. Children from lower social
classes are not always able to participate in organised
sports activities because of lack of financial recourses.
One similarity to a Swiss study performed in 1996–
1997 [20] is that the performance among boys
improved with age for all tests except for the flexibil-
ity test, whereas improvement among girls decreased
after the onset of menstruation. Comparing the mean
SAR test scores from Latvian and Swiss [20] pupils
between 9 and 17 years of age, and between Latvia

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 Physical fitness: Composition of reference values 41
(a) Functional strength – bent arm hang test (b) Muscular strength – handgrip test
50
P10 Lat 60
P10 EU P10 Lat
45 P50 Lat P10 EU
P50 EU P80 P50 Lat
40 P80 Lat 50 P50 EU
P80 P80 EU Boys Girls P80 Lat
P50 P80 EU
35
Boys Girls 40
30
P80
P10
Time (sec)

25

kg
30
P50
20 P50
P80
20
15 P10

10
10
P50
5
P10
P10
0 0
6 7 8 9 1011121314151617 6 7 8 9 1011121314151617 6 7 8 9 10 11 12 13 14 15 16 17 6 7 8 9 10 11 12 13 14 15 16 17
Age Age
(c) Muscular strength – standing broad jump) test
300 (d) Flexibility – sit-and-reach test
P10 Lat 35
P10 EU P10 Lat
P10 EU
P50 Lat
30 P80
250 P50 Lat
P80 P50 EU
P50 EU
Boys Girls P80 Lat
P80 Lat P80
P80 EU 25
200 P80 EU P50
cm

20
cm

150
P50
15

100
10
P10 P10
50 5

0 0
6 7 8 9 10 11 12 13 14 15 16 17 6 7 8 9 10 11 12 13 14 15 16 17 6 7 8 9 10 11 12 13 14 15 16 17 6 7 8 9 10111213141516 17
Age Age

(f) Speed – 10 x 5 m shuttle run test (PLat) and 10 x 4m shuttle run test (PEU) .
(e) Cardiorespiratory endurance – endurance shuttle run test
10 35 P10 Lat
P10 Lat P10 EU
9 P10 EU P50 Lat
30
P80 P50 Lat P50 EU
8 Boys Girls
P50 EU P80 Lat
Boys Girls P80 EU
P80 Lat 25
7
P80 EU P80
6 20
P50 P80 P80
sec

5
min

15
4 P50
P50
3 10 P10
P10 P10
2
5
1

0
7 8 9 10 11 12 13 14 15 16 17 7 8 9 1011121314151617 0
6 7 8 9 10 11 12 13 14 15 16 17 6 7 8 9 1011121314151617
Age Age

Figure 1. Physical fitness percentile curves (P10, P50, P80) of six EUROFIT tests from the present study (PLat) and from 10 European
countries (PEU) [19]. (a) Functional strength – bent arm hang test; (b) Muscular strength – handgrip test; (c) Muscular strength –
standing broad jump) test; (d) Flexibility – sit-and-reach test; (e) Cardiorespiratory endurance – endurance shuttle run test; (f) Speed –
10x5 m shuttle run test (PLat) and 10x4 m shuttle run test (PEU).

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42 M. Sauka et al.
and Spanish pupils [21] between 13 and 17 years of
age, the adolescents from Switzerland scored better
in all age groups and both genders. Compared with
mean scores from the trunk strength (SUP) test for
13-year-old boys reported from Greece [22], Latvian
boys showed worse results. Comparing our data on
muscular strength with data from Lithuania collected
in 2002, the Latvian adolescents aged 12, 14, and 16
years showed slightly worse results among both boys
and girls [23]. Even though these observations may
seem discouraging for Latvian adolescents, it must be
remembered that our study data were collected from
a common population of school-aged children and
adolescents with a low level of non-participation in
the study (5%). More studies of physical fitness
involving representative populations of children and
adolescents are therefore warranted before conclu-
sions can be drawn about country-level differences.
Conclusions
Planning of evidence-based programs for promotion
of physical activity among the young requires refer-
ence values for physical fitness in different age
groups. We have established standardised values for
health-related physical fitness among northern
European youth based on data from Latvian children
and adolescents aged between 6 and 17 years.
Bearing in mind that the objective for physical
education is not physical fitness per se, the reference
values can be used as a part of individual-level
assessments of students. Maybe even more impor-
tantly, they allow monitoring of population-based
trends at regional and national levels. More research
is needed to establish validated cut-off values for
pathological cardiorespiratory endurance and mus-
cular strength tests.
Declaration on conflict of interest
This research received no specific grant from any
funding agency in the public, commercial, or not-for-
profit sectors.
Acknowledgements
The study was financed by regular funding to the
Sports Medicine State Agency from the Latvian
Ministry of Health. Reference value tables for all
tests are available upon request from the correspond-
ing author.
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