human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To prospect ively examine the effects of a r and omized school-based intervention on nutrition and physical activity knowledge and preferences , anthropometric measures , and fitness in low socioeconomic kindergarten children . STUDY DESIGN A total of 376 children completed a school-year combined dietary-behavioral-physical activity intervention  and were compared with 349 control subjects ( age 3.8 to 6.8 years ) . RESULTS The prevalence of overweight and obesity among the kindergarten children was 27.7 % . Even though the intervention was not associated with between group differences in body mass index changes , it was associated with significantly ( P < .05 ) greater increase in nutrition knowledge and preferences , physical activity knowledge and preferences , and improvement in fitness . There was a greater ( P < .05 ) decrease in the number of overweight children in the intervention group ( -31.9 % ) compared with the controls ( -17.5 % ) . CONCLUSIONS A kindergarten dietary-physical activity intervention applied by the kindergarten teachers , had no effect on body mass index changes between the groups , but improved nutrition and physical activity knowledge and preferences , improved fitness , and decreased the percent of overweight children . This intervention may play an important role in health promotion , prevention and treatment of childhood obesity Objective To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children . Design Cluster r and omised controlled single blinded trial ( Ballabeina study ) over one school year ; r and omisation was performed after stratification for linguistic region . Setting 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerl and . Participants 652 of the 727 preschool children had informed consent and were present for baseline measures ( mean age 5.1 years ( SD 0.7 ) , 72 % migrants of multicultural origins ) . No children withdrew , but 26 moved away . Intervention The multidimensional culturally tailored lifestyle intervention included a physical activity programme , lessons on nutrition , media use ( use of television and computers ) , and sleep and adaptation of the built environment of the preschool class . It lasted from August 2008 to June 2009 . Main outcome measures Primary outcomes were aerobic fitness ( 20 m shuttle run test ) and body mass index ( BMI ) . Secondary outcomes included motor agility , balance , percentage body fat , waist circumference , physical activity , eating habits , media use , sleep , psychological health , and cognitive abilities . Results Compared with controls , children in the intervention group had an increase in aerobic fitness at the end of the intervention ( adjusted mean difference : 0.32 stages ( 95 % confidence interval 0.07 to 0.57 ; P=0.01 ) but no difference in BMI ( −0.07 kg/m2 , −0.19 to 0.06 ; P=0.31 ) . Relative to controls , children in the intervention group had beneficial effects in motor agility ( −0.54 s , −0.90 to −0.17 ; P=0.004 ) , percentage body fat ( −1.1 % , −2.0 to −0.2 ; P=0.02 ) , and waist circumference ( −1.0 cm , −1.6 to −0.4 ; P=0.001 ) . There were also significant benefits in the intervention group in reported physical activity , media use , and eating habits , but not in the remaining secondary outcomes . Conclusions A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children . Trial registration Clinical Trials NCT00674544 PURPOSE To determine if there is an optimal grip span for determining the maximum h and grip strength in male and female teenagers , and if the optimal grip span was related to h and span . If they are related then the second aim was to derive a mathematic equation relating h and span and optimal grip span . METHODS One hundred healthy teenage boys ( 15.1 + /- 1.1 y ) and 106 girls ( 15.4 + /- 1.3 y ) were evaluated ( age range , 13 - 18 y ) . Each h and was r and omly tested on 10 occasions using 5 different grip spans , allowing a 1-minute rest between attempts . The  h and span  was measured from the tip of the thumb to the tip of the small finger with the h and opened as wide as possible . RESULTS The results showed that an optimal grip span to determine the maximum h and grip strength was identified for both genders , and the optimal grip span and h and span correlated in both genders . CONCLUSIONS The results suggest that there is an optimal grip span to which the dynamometer should be adjusted when measuring h and grip strength in teenagers . The optimal grip span was influenced by h and span in both genders . For males the optimal grip span can be derived from the equation y = x/7.2 + 3.1 cm , and for females from the equation y = x/4 + 1.1 cm . where y is the optimal grip span and x is the h and -span . These equations may improve the reliability and accuracy of the results and may guide clinicians and research ers in selecting the optimal grip span on the h and dynamometer when measuring h and grip strength in teenagers PURPOSE Information about factors related to overweight development in early stages of life is needed for design ing useful strategies to prevent overweight and related diseases . Longitudinal studies can contribute to this goal . The present study aim ed to identify factors in childhood that determine the development of overweight/obesity in adolescence . METHODS A prospect i ve study in 598 normal-weight Estonian and Swedish children age 9.5 ± 0.4 yr from the European Youth Heart Study , who were followed during 6 yr , was conducted . Weight and height were measured at baseline and follow-up , and weight status was ascertained according to the international criteria for body mass index . Cardiorespiratory fitness  ( expressed as  VO(2max ) ( mL·kg(-1)·min(-1 ) ) ) was assessed by a maximal bike test . Parents reported their weight , height , and educational level . RESULTS Being male ( vs female ) and Estonian ( vs Swedish ) was related to higher risk for incident overweight/obesity . Change in fitness was a stronger predictor of incident overweight/obesity than childhood fitness , parental overweight , or parental education . The risk of developing overweight/obesity was reduced 10 % every 1 mL·kg(-1)·min(-1 ) of VO(2max ) increase ( odds ratio = 0.90 and 95 % confidence interval = 0.84 - 0.95 ) after adjustment for a set of confounders including baseline body mass index and without differences by gender . CONCLUSIONS Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence . The current findings highlight the importance of promoting fitness through physical exercise from early stages in life , as a promising strategy to fight against overweight and obesity . Gender and country differences observed in this study require social and political attention To assess influence of age , sex , and lateral dominance on children 's unilateral stance , from 6 Houston area preschools and day-care centers , 121 subjects were r and omly selected and judged by teachers as normal 3- to 6-yr.-old children . The children were tested for eye , h and , and foot preference and were then classified on over-all dominance . Maximal duration of unilateral stance , or up to 60 sec. , was tested on each foot . Means over age groups show progressive increase in duration of unilateral stance with increasing age . No sex differences were found . A stepwise multiple correlation-regression showed stance on the nondominant foot and age as the only significant variables in stance on the dominant foot . Clinical ly , this study can help in evaluating children for neurodevelopmental disorders Objective : This study assesses differences in adiposity , aerobic fitness , and lifestyle characteristics in preschoolers according to their weight status and sports club ( SC ) participation . Method : As part of the Ballabeina study , 600 r and omly selected preschoolers ( mean age 5.1 ± 0.6 years ; 50.2 % girls ) were analyzed . Body composition was measured by bioelectrical impedance , aerobic fitness by the 20-meter shuttle run test , and physical activity by accelerometers . Eating habits , media use , and SC participation were assessed by question naires . Results : Overweight children ( Swiss national percentiles ) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts ( all p ≤ 0.028 ) . In addition , children not participating in SC were less physically active , had more media use , and ate less healthy compared to children participating in SC ( all p ≤ 0.023 ) . Controlling for parental sociocultural determinants attenuated differences in % body fat , in physical activity , and in eating habits . Conclusion : Aerobic fitness differs both according to weight status and SC participation in preschoolers . Furthermore , in view of the many differences in lifestyle behaviors , SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status The aim of this paper was to examine the validity and reliability of age b and 1 of the Movement Assessment Battery for Children-Second Edition ( MABC-2 ) in preparation for its st and ardization in mainl and China . Interrater and test-retest reliability of the MABC-2 was estimated using Intraclass Correlation Coefficient ( ICC ) . Cronbach 's alpha for each item and Item-total correlation were used to determine internal consistency . The content validity was determined by the Item-level content validity index ( I-CVI ) . Confirmatory factor analysis was used to examine the factorial validity of the MABC-2 test . The correlation coefficients between the MABC-2 and the Peabody Developmental Motor Scales-2 ( PDMS-2 ) were used to assess the criteria -related validity . The Cronbach 's alpha values of all eight items together were moderate but acceptable . The correlation coefficients between each test item and the total score were moderate except for two items . The ICC of interrater and test-retest reliability for each test items was good . The I-CVI of each item was excellent ( each above 0.78 ) . The result of confirmatory factor analysis showed that the goodness-of-fit indices of the adjusted model were good ( each above 0.9 ) , indicating a satisfactory fit of the data to the model . The total score on  MABC-2  and PDMS-2 was correlated well ( r=0.631 ) . It is concluded that the reliability and validity of age b and 1 of MABC-2 were fair in this study based on a large sample . However , there was a need to adjust part of items to improve the test 's psychometric properties when it is used in Chinese children The purpose of this study was to determine test-retest reliability for the 1-mile , 3/4-mile , and 1/2-mile distance run/alk tests for children in Grade s K-4 . Fifty-one intact physical education classes were r and omly assigned to one of the three distance run conditions . A total of 1,229 ( 621 boys , 608 girls ) completed the test-retests in the fall ( October ) , with 1,050 of these students ( 543 boys , 507 girls ) repeating the tests in the spring ( May ) . Results indicated that the 1-mile run/walk distance , as recommended for young children in most national test batteries , has acceptable intraclass reliability ( .83 less than R less than .90 ) for both boys and girls in Grade s 3 and 4 , has minimal ( fall ) to acceptable ( spring ) reliability for Grade 2 students ( .70 less than R less than .83 ) , but is not reliable for children in Grade s K and 1 ( .34 less than R less than .56 ) . The 1/2 mile was the only distance meeting minimal reliability st and ards for boys and girls in Grade s K and 1 ( .73 less than R less than .82 ) . Results also indicated that reliability estimates remained fairly stable across gender and age groups from the fall to spring testing periods , with the exception of the noticeably improved values for Grade 2 students on the 1-mile run/walk test . Criterion-referenced reliability ( P , percent agreement ) was also estimated relative to Physical Best and Fitnessgram run/walk st and ards . Reliability coefficients for all age group st and ards were acceptable to high ( .70 less than P less than .95 ) , except for Fitnessgram st and ards for 5-year-old girls on the 1-mile test for both fall and spring and for 6-year-old boys and girls on the 1-mile test administered in the spring Vicente-Rodríguez , G , Rey-López , JP , Ruíz , JR , Jiménez-Pavón , D , Bergman , P , Ciarapica , D , Heredia , JM , Molnar , D , Gutierrez , A , Moreno , LA , and Ortega , FB . Interrater reliability and time measurement validity of speed-agility field tests in adolescents . J Strength Cond Res 25(7 ) : 2059 - 2063 , 2011—The aim of this study was to examine the interrater reliability ( trained vs. untrained raters ) and criterion-related validity ( manual vs. automatic timing ) of the 4 × 10-m shuttle run and 30-m running speed tests ( times measured ) . The study comprised 85 adolescents ( 38 girls ) aged 13.0 - 16.9 years from the Healthy Lifestyle in Europe by Nutrition in Adolescence study . The time required to complete the 4 × 10-m shuttle run and 30-m 
    Output:
    
agent
Motor fitness , particularly balance , was the most studied fitness component , while cardiorespiratory fitness was the least studied .
While we wait for more evidence to be accumulated in preschool children , the PREFIT battery hereby proposed is a useful tool for assessing physical fitness in children aged 3–5 years
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To prospect ively examine the effects of a r and omized school-based intervention on nutrition and physical activity knowledge and preferences , anthropometric measures , and fitness in low socioeconomic kindergarten children . STUDY DESIGN A total of 376 children completed a school-year combined dietary-behavioral-physical activity intervention  and were compared with 349 control subjects ( age 3.8 to 6.8 years ) . RESULTS The prevalence of overweight and obesity among the kindergarten children was 27.7 % . Even though the intervention was not associated with between group differences in body mass index changes , it was associated with significantly ( P < .05 ) greater increase in nutrition knowledge and preferences , physical activity knowledge and preferences , and improvement in fitness . There was a greater ( P < .05 ) decrease in the number of overweight children in the intervention group ( -31.9 % ) compared with the controls ( -17.5 % ) . CONCLUSIONS A kindergarten dietary-physical activity intervention applied by the kindergarten teachers , had no effect on body mass index changes between the groups , but improved nutrition and physical activity knowledge and preferences , improved fitness , and decreased the percent of overweight children . This intervention may play an important role in health promotion , prevention and treatment of childhood obesity Objective To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children . Design Cluster r and omised controlled single blinded trial ( Ballabeina study ) over one school year ; r and omisation was performed after stratification for linguistic region . Setting 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerl and . Participants 652 of the 727 preschool children had informed consent and were present for baseline measures ( mean age 5.1 years ( SD 0.7 ) , 72 % migrants of multicultural origins ) . No children withdrew , but 26 moved away . Intervention The multidimensional culturally tailored lifestyle intervention included a physical activity programme , lessons on nutrition , media use ( use of television and computers ) , and sleep and adaptation of the built environment of the preschool class . It lasted from August 2008 to June 2009 . Main outcome measures Primary outcomes were aerobic fitness ( 20 m shuttle run test ) and body mass index ( BMI ) . Secondary outcomes included motor agility , balance , percentage body fat , waist circumference , physical activity , eating habits , media use , sleep , psychological health , and cognitive abilities . Results Compared with controls , children in the intervention group had an increase in aerobic fitness at the end of the intervention ( adjusted mean difference : 0.32 stages ( 95 % confidence interval 0.07 to 0.57 ; P=0.01 ) but no difference in BMI ( −0.07 kg/m2 , −0.19 to 0.06 ; P=0.31 ) . Relative to controls , children in the intervention group had beneficial effects in motor agility ( −0.54 s , −0.90 to −0.17 ; P=0.004 ) , percentage body fat ( −1.1 % , −2.0 to −0.2 ; P=0.02 ) , and waist circumference ( −1.0 cm , −1.6 to −0.4 ; P=0.001 ) . There were also significant benefits in the intervention group in reported physical activity , media use , and eating habits , but not in the remaining secondary outcomes . Conclusions A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children . Trial registration Clinical Trials NCT00674544 PURPOSE To determine if there is an optimal grip span for determining the maximum h and grip strength in male and female teenagers , and if the optimal grip span was related to h and span . If they are related then the second aim was to derive a mathematic equation relating h and span and optimal grip span . METHODS One hundred healthy teenage boys ( 15.1 + /- 1.1 y ) and 106 girls ( 15.4 + /- 1.3 y ) were evaluated ( age range , 13 - 18 y ) . Each h and was r and omly tested on 10 occasions using 5 different grip spans , allowing a 1-minute rest between attempts . The  h and span  was measured from the tip of the thumb to the tip of the small finger with the h and opened as wide as possible . RESULTS The results showed that an optimal grip span to determine the maximum h and grip strength was identified for both genders , and the optimal grip span and h and span correlated in both genders . CONCLUSIONS The results suggest that there is an optimal grip span to which the dynamometer should be adjusted when measuring h and grip strength in teenagers . The optimal grip span was influenced by h and span in both genders . For males the optimal grip span can be derived from the equation y = x/7.2 + 3.1 cm , and for females from the equation y = x/4 + 1.1 cm . where y is the optimal grip span and x is the h and -span . These equations may improve the reliability and accuracy of the results and may guide clinicians and research ers in selecting the optimal grip span on the h and dynamometer when measuring h and grip strength in teenagers PURPOSE Information about factors related to overweight development in early stages of life is needed for design ing useful strategies to prevent overweight and related diseases . Longitudinal studies can contribute to this goal . The present study aim ed to identify factors in childhood that determine the development of overweight/obesity in adolescence . METHODS A prospect i ve study in 598 normal-weight Estonian and Swedish children age 9.5 ± 0.4 yr from the European Youth Heart Study , who were followed during 6 yr , was conducted . Weight and height were measured at baseline and follow-up , and weight status was ascertained according to the international criteria for body mass index . Cardiorespiratory fitness  ( expressed as  VO(2max ) ( mL·kg(-1)·min(-1 ) ) ) was assessed by a maximal bike test . Parents reported their weight , height , and educational level . RESULTS Being male ( vs female ) and Estonian ( vs Swedish ) was related to higher risk for incident overweight/obesity . Change in fitness was a stronger predictor of incident overweight/obesity than childhood fitness , parental overweight , or parental education . The risk of developing overweight/obesity was reduced 10 % every 1 mL·kg(-1)·min(-1 ) of VO(2max ) increase ( odds ratio = 0.90 and 95 % confidence interval = 0.84 - 0.95 ) after adjustment for a set of confounders including baseline body mass index and without differences by gender . CONCLUSIONS Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence . The current findings highlight the importance of promoting fitness through physical exercise from early stages in life , as a promising strategy to fight against overweight and obesity . Gender and country differences observed in this study require social and political attention To assess influence of age , sex , and lateral dominance on children 's unilateral stance , from 6 Houston area preschools and day-care centers , 121 subjects were r and omly selected and judged by teachers as normal 3- to 6-yr.-old children . The children were tested for eye , h and , and foot preference and were then classified on over-all dominance . Maximal duration of unilateral stance , or up to 60 sec. , was tested on each foot . Means over age groups show progressive increase in duration of unilateral stance with increasing age . No sex differences were found . A stepwise multiple correlation-regression showed stance on the nondominant foot and age as the only significant variables in stance on the dominant foot . Clinical ly , this study can help in evaluating children for neurodevelopmental disorders Objective : This study assesses differences in adiposity , aerobic fitness , and lifestyle characteristics in preschoolers according to their weight status and sports club ( SC ) participation . Method : As part of the Ballabeina study , 600 r and omly selected preschoolers ( mean age 5.1 ± 0.6 years ; 50.2 % girls ) were analyzed . Body composition was measured by bioelectrical impedance , aerobic fitness by the 20-meter shuttle run test , and physical activity by accelerometers . Eating habits , media use , and SC participation were assessed by question naires . Results : Overweight children ( Swiss national percentiles ) and children not participating in SC had both lower aerobic fitness and higher % body fat compared to their respective counterparts ( all p ≤ 0.028 ) . In addition , children not participating in SC were less physically active , had more media use , and ate less healthy compared to children participating in SC ( all p ≤ 0.023 ) . Controlling for parental sociocultural determinants attenuated differences in % body fat , in physical activity , and in eating habits . Conclusion : Aerobic fitness differs both according to weight status and SC participation in preschoolers . Furthermore , in view of the many differences in lifestyle behaviors , SC participation at this age could represent a more discriminatory indicator of healthy lifestyle characteristics than weight status The aim of this paper was to examine the validity and reliability of age b and 1 of the Movement Assessment Battery for Children-Second Edition ( MABC-2 ) in preparation for its st and ardization in mainl and China . Interrater and test-retest reliability of the MABC-2 was estimated using Intraclass Correlation Coefficient ( ICC ) . Cronbach 's alpha for each item and Item-total correlation were used to determine internal consistency . The content validity was determined by the Item-level content validity index ( I-CVI ) . Confirmatory factor analysis was used to examine the factorial validity of the MABC-2 test . The correlation coefficients between the MABC-2 and the Peabody Developmental Motor Scales-2 ( PDMS-2 ) were used to assess the criteria -related validity . The Cronbach 's alpha values of all eight items together were moderate but acceptable . The correlation coefficients between each test item and the total score were moderate except for two items . The ICC of interrater and test-retest reliability for each test items was good . The I-CVI of each item was excellent ( each above 0.78 ) . The result of confirmatory factor analysis showed that the goodness-of-fit indices of the adjusted model were good ( each above 0.9 ) , indicating a satisfactory fit of the data to the model . The total score on  MABC-2  and PDMS-2 was correlated well ( r=0.631 ) . It is concluded that the reliability and validity of age b and 1 of MABC-2 were fair in this study based on a large sample . However , there was a need to adjust part of items to improve the test 's psychometric properties when it is used in Chinese children The purpose of this study was to determine test-retest reliability for the 1-mile , 3/4-mile , and 1/2-mile distance run/alk tests for children in Grade s K-4 . Fifty-one intact physical education classes were r and omly assigned to one of the three distance run conditions . A total of 1,229 ( 621 boys , 608 girls ) completed the test-retests in the fall ( October ) , with 1,050 of these students ( 543 boys , 507 girls ) repeating the tests in the spring ( May ) . Results indicated that the 1-mile run/walk distance , as recommended for young children in most national test batteries , has acceptable intraclass reliability ( .83 less than R less than .90 ) for both boys and girls in Grade s 3 and 4 , has minimal ( fall ) to acceptable ( spring ) reliability for Grade 2 students ( .70 less than R less than .83 ) , but is not reliable for children in Grade s K and 1 ( .34 less than R less than .56 ) . The 1/2 mile was the only distance meeting minimal reliability st and ards for boys and girls in Grade s K and 1 ( .73 less than R less than .82 ) . Results also indicated that reliability estimates remained fairly stable across gender and age groups from the fall to spring testing periods , with the exception of the noticeably improved values for Grade 2 students on the 1-mile run/walk test . Criterion-referenced reliability ( P , percent agreement ) was also estimated relative to Physical Best and Fitnessgram run/walk st and ards . Reliability coefficients for all age group st and ards were acceptable to high ( .70 less than P less than .95 ) , except for Fitnessgram st and ards for 5-year-old girls on the 1-mile test for both fall and spring and for 6-year-old boys and girls on the 1-mile test administered in the spring Vicente-Rodríguez , G , Rey-López , JP , Ruíz , JR , Jiménez-Pavón , D , Bergman , P , Ciarapica , D , Heredia , JM , Molnar , D , Gutierrez , A , Moreno , LA , and Ortega , FB . Interrater reliability and time measurement validity of speed-agility field tests in adolescents . J Strength Cond Res 25(7 ) : 2059 - 2063 , 2011—The aim of this study was to examine the interrater reliability ( trained vs. untrained raters ) and criterion-related validity ( manual vs. automatic timing ) of the 4 × 10-m shuttle run and 30-m running speed tests ( times measured ) . The study comprised 85 adolescents ( 38 girls ) aged 13.0 - 16.9 years from the Healthy Lifestyle in Europe by Nutrition in Adolescence study . The time required to complete the 4 × 10-m shuttle run and 30-m 
    Output:
    