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Physical Fitness and Health in Adolescents

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A Special Issue of Children (ISSN 2227-9067) belonging to the section "Pediatric Orthopedics & Sports Medicine".

Deadline for manuscript submissions: 1 February 2027 | Viewed by 12161

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Editors

Dr. María Mendoza Muñoz

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Guest Editor

Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
Interests: health; children; chronic disease; physical condition; physical literacy; obesity; well-being
Special Issues, Collections and Topics in MDPI journals

Dr. Raquel Pastor-Cisneros

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Guest Editor

Physical Activity for Education, Performance and Health (PAEPH) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
Interests: physical literacy; exercise; health-related quality of life; paediatric obesity; body composition; body mass index; adolescence; anthropometric; BMI; growth table; pediatrics; youth; adolescent; childhood obesity; classification systems; percentiles; children’s health; growth; lMS method; percentile; sex; size; weight

Special Issue Information

Dear Colleagues,

Adolescence represents a crucial stage in human development, marked by rapid physical, emotional, and social changes. In this context, physical fitness emerges not only as a key indicator of current health status, but also as a powerful predictor of future health outcomes. The alarming increase in sedentary lifestyles, obesity rates, and mental health disorders among adolescents underscores the urgent need to examine and promote physical fitness from a comprehensive, evidence-based perspective.

This Special Issue of Children seeks to bring together cutting-edge research focused on physical fitness and its interrelation with adolescent health. Contributions from diverse disciplines, such as kinesiology, sports science, public health, psychology, and pedagogy, will be welcomed. This Special Issue aims to explore the different components of physical fitness—including cardiorespiratory endurance, muscular strength, flexibility, body composition—and their associations with physical, mental, and social well-being.

Key topics will include the development of reliable assessment tools, longitudinal studies that track fitness changes and their health implications, and interventions designed to improve fitness levels in various settings (schools, communities, clinical environments). Special attention will be given to socio-environmental factors that facilitate or hinder active lifestyles, as well as to gender and socioeconomic disparities in access to physical activity opportunities.

We also encourage submissions that examine innovative approaches to promoting adolescent fitness, such as the use of digital technologies, school-based physical education reforms, and community health initiatives. Furthermore, papers investigating the bidirectional relationships between fitness and psychological variables, such as motivation, self-esteem, and resilience, will be highly valued.

We invite researchers, educators, clinicians, and policymakers to contribute papers to this Special Issue that will lead to a healthier and more active youth.

Dr. María Mendoza Muñoz
Dr. Raquel Pastor-Cisneros
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

physical fitness
adolescent health
cardiorespiratory endurance
muscular strength
physical activity promotion
mental well-being
exercise interventions
public health
school-based programmes.

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Published Papers (7 papers)

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Research

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15 pages, 277 KB

Open AccessArticle

Physical Development and Postural Behaviors in Children and Adolescents: A Cross-Sectional Study

by Francesca D’Elia, Rosario Ceruso, Giuseppe Giardullo, Angelica Delfina Picone, Vera Simoes, Tiziana D’Isanto and Giovanni Esposito

Children 2026, 13(5), 698; https://doi.org/10.3390/children13050698 - 19 May 2026

Viewed by 708

Abstract

Background/Objectives: Musculoskeletal pain represents a frequent and increasingly recognized health issue during adolescence. During this developmental phase, daily habits such as prolonged sitting, sedentary behaviors and the adoption of non-neutral postures may contribute to spinal overload and pain symptoms. This study contributes to the existing literature by focusing on concrete postural behaviors in real-life daily situations, an aspect that is still underexplored despite its relevance for musculoskeletal health. The aim of this study was to investigate the associations between daily habits, postural behaviors and the presence of back and neck pain. Methods: A cross-sectional study was conducted on a sample of 70 adolescents aged 10–20 years. Data were collected using the Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA), administered online. Descriptive statistics and chi-square tests with effect sizes (Cramer’s V) were used to examine associations between postural behaviors, lifestyle factors, and pain outcomes, providing an inferential assessment beyond simple descriptive analysis. Results: Significant associations were found between gender and back pain, sitting posture during daily activities (writing at the desk and talking with friends) and back pain, with flexed or asymmetrical postures more frequently reported among participants with pain, and between back and neck pain (p < 0.05). Conclusions: The findings highlight the relevance of gender and daily postural behaviors as factors associated with musculoskeletal pain in adolescents. By identifying posture-specific behaviors linked to pain, this study provides preliminary evidence that can inform targeted preventive strategies and guide future research on modifiable daily habits in youth. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

21 pages, 1509 KB

Open AccessArticle

Cross-Sectional Associations of Sport Participation, Academic Performance, and Psychological Well-Being Among Rural Romanian Adolescent Boys in the Context of Family Background

by Filoména Dávid, Krisztina Rácz and Pál Salamon

Children 2026, 13(1), 135; https://doi.org/10.3390/children13010135 - 16 Jan 2026

Viewed by 1485

Abstract

Background: Adolescence is a sensitive period for psychological, academic, and social development, and sports participation has been described as a potential protective factor for academic performance and psychological well-being. However, limited research has examined the combined influence of sports involvement, sport type, and family background on adolescents’ academic and psychological outcomes. This study aimed to investigate the associations between organized sport participation, sport type (football vs. judo), psychological well-being, psychosomatic symptoms, academic performance, and family socioeconomic background among adolescent boys. Methods: The sample consisted of 52 boys aged 11–14 years from a rural school, divided into football players (n = 13), judo athletes (n = 13), non-athletes (n = 13), and a contextual subgroup of students with special educational needs (SEN; n = 13), with the latter included for exploratory purposes only. Data included school-record-based academic performance and validated self-report measures of life satisfaction, depressive symptoms, psychosomatic complaints, perceived physical fitness, and socioeconomic background. Results: Athletes demonstrated significantly higher academic achievement than non-athletes in overall grade point average (p < 0.001), mathematics (p < 0.001), Romanian (p < 0.001), English (p = 0.03), and Hungarian (p < 0.001). They also reported higher life satisfaction (p < 0.001) but simultaneously showed slightly elevated depressive symptom scores (p < 0.001), indicating a paradoxical pattern of concurrent psychosocial benefits and psychological strain. Parental education (p < 0.001), parental occupational status (p = 0.01), and fathers’ occupational position (p = 0.02) were significantly higher among athletes’ families. Perceived physical fitness was also rated higher by athletes (p < 0.001). No significant differences were found in body mass index, family structure, or most psychosomatic symptoms. Conclusions: Sport participation was associated with more favorable academic and psychological indicators, yet also with elevated depressive symptoms, highlighting the dual nature of organized sport during adolescence. Future research should apply longitudinal designs, include female participants, and incorporate objective indicators of training load. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

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14 pages, 285 KB

Open AccessArticle

Association Between Physical Fitness and Quality of Life in Children and Adolescents with Down Syndrome

by Osama Aljuhani, Shomokh Alharbi, Raghad Hakami, Deema Alsaeedi, Wejdan Alqadheb, Najla Al-sadaawi and Fouz Alosaimi

Children 2025, 12(12), 1611; https://doi.org/10.3390/children12121611 - 26 Nov 2025

Cited by 2 | Viewed by 1647

Abstract

Background/Objectives: Multiple studies have reported that the quality of life (QoL) among children and adolescents with Down syndrome (DS) is lower than that among typically developing children. Meanwhile, physical fitness is crucial for improving QoL throughout childhood and adolescence. Combining these insights, this cross-sectional study aimed to examine the association between physical fitness and QoL in children and adolescents with DS. Methods: Participants were 56 children and adolescents (aged 8–16 years) enrolled in one DS center in Saudi Arabia. Cardiorespiratory fitness, muscular strength, and muscular power were measured to assess physical fitness. The PedsQL^TM (parents’ proxy scale) was used to measure participants’ QoL. Multiple linear regression with pooled analysis was used to examine the association between physical fitness and QoL. Results: Boys showed higher muscular power than girls (p = 0.024). Weak to moderate correlations were observed between muscular power, muscular strength, and QoL domains. Regression results suggested that children and adolescents with high muscular power had better scores in social functioning (B = 0.693, R² = 0.22, p = 0.013). Children and adolescents with high muscular strength had better scores in overall QoL (B = 2.665, R² = 0.21, p = 0.027). Conclusions: Children and adolescents with DS who have higher muscular fitness had better scores in social functioning and overall QoL. Increasing muscular fitness in children and adolescents with DS appears to be particularly important for improving QoL. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

11 pages, 692 KB

Open AccessArticle

High-Intensity Physical Activity During Late Adolescence Predicts Young Adult CT-Based Finite Element Bone Strength in Emerging Adulthood: Iowa Bone Development Study

by Soyang Kwon, Kathleen F. Janz, Indranil Guha, Alex V. Rowlands, Oscar Rysavy, Punam K. Saha, Chandler Pendleton, Euisung D. Shin and Steven M. Levy

Children 2025, 12(9), 1204; https://doi.org/10.3390/children12091204 - 9 Sep 2025

Cited by 1 | Viewed by 1874

Abstract

Objective: This study investigated associations between physical activity (PA) during late adolescence and emerging adulthood and bone strength in emerging adulthood by utilizing advanced finite element analysis of computed tomography (CT/FEA) technology beyond the traditional dual-energy X-ray absorptiometry (DXA) method. Methods: This study included 266 participants (152 females) from the Iowa Bone Development Study. PA volume (average acceleration) and intensity (intensity gradient) metrics were calculated from ActiGraph accelerometer data collected at ages 17, 19, 21, and 23 years. Compressive modulus and compressive stiffness of the tibia were estimated at age 23 via CT/FEA of the tibia. Sex-specific linear regression models were used to evaluate associations between PA metrics and bone outcomes, adjusting for age, height, weight, musculoskeletal fitness, and calcium intake. Results: Intensity gradient averaged over 17–23 years of age was positively associated with compressive stiffness at age 23 years in both females and males (p < 0.01). Intensity gradient was positively associated with compressive modulus in females (p < 0.01), but not in males. No significant associations were found between average acceleration and either compressive stiffness or modulus in either sex (p > 0.05). Conclusions: Using a state-of-the-art CT/FEA method, this study suggests that high-intensity PA during late adolescence and emerging adulthood improves bone strength. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

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14 pages, 549 KB

Open AccessArticle

Impact of a Strength Training Program on Physical Performance in U10 Soccer Players: A Quasi-Experimental Trial

by Adrián Torregrosa-Domínguez, Iván Moreno-Camacho, Eduardo José Fernández-Ozcorta and Rafael Ramos-Véliz

Children 2025, 12(9), 1200; https://doi.org/10.3390/children12091200 - 8 Sep 2025

Viewed by 2814

Abstract

Background/Objectives: The integration of strength training in grassroots youth soccer remains limited, often due to persistent myths regarding its safety and utility. This study evaluated the effectiveness of a tailored, playful strength training program in young players and analyzed the influence of the Relative Age Effect (RAE) on physical development and training response. Methods: A 14-week quasi-experimental pretest–posttest design was conducted with 27 federated male soccer players aged 9–10 years (experimental: n = 15; control: n = 12). The intervention consisted of twice-weekly, game-based strength training sessions integrated into the regular team routine. Outcomes included validated anthropometric (BMI) and functional (handgrip strength, standing long jump, Illinois agility test) indicators. RAE was analyzed according to birth quartile. Non-parametric statistical analyses and effect size (r) calculations were used. Results: The experimental group achieved significantly greater pre–post gains in handgrip strength than controls (right and left). Agility and standing long jump improved within the experimental group, but between-group differences were not significant. BMI decreased within the experimental group, yet the net between-group difference in BMI change was not significant in the context of a higher baseline BMI (p = 0.047). Although the Relative Age Effect (RAE) influenced baseline BMI, no moderating effect was detected on performance variables or training-induced changes in this sample. Conclusions: In U10 soccer players, a playful, context-integrated strength program produced superior gains in handgrip strength compared with usual practice. Improvements in agility and standing long jump were observed within the intervention group, but did not exceed those of the controls. BMI changes were not different between the groups and must be interpreted with caution, given baseline imbalances. In this sample, RAE did not moderate training response. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

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13 pages, 657 KB

Open AccessArticle

Physical Fitness, Experiential Avoidance, and Psychological Inflexibility Among Adolescents: Results from the EHDLA Study

by Maria Mendoza-Muñoz, José Francisco López-Gil, Damián Pereira-Payo and Raquel Pastor-Cisneros

Children 2025, 12(8), 1032; https://doi.org/10.3390/children12081032 - 6 Aug 2025

Cited by 2 | Viewed by 2071

Abstract

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

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Review

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25 pages, 359 KB

Open AccessReview

Longitudinal Change and Tracking of Health-Related Physical Fitness in Adolescents Aged 12–16 Years: A Structured Narrative Review

by Souhail Bchini, Dhouha Moussaoui, Abedelmalek Kalefh Tabnjh, Anissa Bouassida, Nadhir Hammami and Fatma Hilal Yagin

Children 2026, 13(9), 1208; https://doi.org/10.3390/children13091208 - 7 Sep 2026

Viewed by 306

Abstract

Background/Objectives: The period between 12 and 16 years of age coincides with peak pubertal change, declining habitual physical activity, and the consolidation of lifelong behavioral patterns, making it a critical window for understanding how fitness develops and how stable (or unstable) it is over time. This review aims to synthesize longitudinal evidence addressing how HRPF changes and tracks in adolescents aged approximately 12 to 16 years, the sex- and maturation-related modifiers of these patterns, the methodological approaches used to assess them, and the secular and behavioral context within which they occur. Methods: A structured narrative review was conducted searching four electronic databases—Google Scholar, PubMed, Web of Science, and Scopus—using terms combining concepts of adolescence, health-related physical fitness, and longitudinal study design published up to April 2026. Reference lists of retrieved systematic reviews and meta-analyses were snowball-searched. Eligible studies employed longitudinal or repeated-measures designs in samples overlapping the 12–16-year age range; no formal risk-of-bias appraisal or quantitative pooling was undertaken, consistent with the narrative-review design. Findings were synthesized narratively by HRPF component and thematic domain. Results: Cardiorespiratory fitness rises through early adolescence before plateauing or declining from approximately age 15 in one longitudinal cohort, more markedly in boys; muscular power and strength diverge increasingly by sex, a pattern consistent with androgen-mediated gains in lean mass in boys, although this mechanism was not directly tested here; flexibility remains the most stable component; and body composition acts as both an outcome and a determinant of other fitness test performance. Within-adolescence tracking is moderate-to-high for most components in the single available 3-year cohort of adolescent girls that reported component-specific tracking coefficients (e.g., lower-limb power β = 0.98, aerobic endurance β = 0.75, trunk muscular endurance β = 0.51), and substantially stronger than tracking from childhood into adolescence. Secular trends indicate population-level fitness has declined in many countries over recent decades, with adolescents showing greater decline than children. Conclusions: Early-to-mid adolescence appears to be a critical and time-limited opportunity to consider for fitness-promoting intervention: fitness rank is still somewhat malleable, but shows progressively stronger tracking with age—a pattern of rank stability that should not itself be read as evidence about responsiveness to intervention. Methodological heterogeneity in test batteries, follow-up duration, and tracking statistics limits direct comparability across studies. Future research should incorporate maturity-status indicators, multi-wave designs, and harmonized assessment protocols. Full article

(This article belongs to the Special Issue Physical Fitness and Health in Adolescents)

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