The criterion-referenced validity of the FITNESSGRAM Trunk-Extension test.

Area of Science:

• Sports Medicine
• Pediatric Health
• Musculoskeletal Fitness

Background:

• Low-back pain (LBP) is a prevalent issue among youth, impacting their physical activity and well-being.
• Current fitness assessments may not adequately predict LBP risk in this demographic.
• Identifying reliable predictors of LBP is crucial for targeted interventions in school-aged populations.

Purpose of the Study:

• To evaluate the predictive utility of various fitness field tests for self-reported LBP in school-aged children and adolescents.
• To compare the effectiveness of different muscular fitness tests, including the FITNESSGRAM trunk extension test, in identifying youth with LBP.
• To determine the accuracy of single and combined fitness test scores in predicting LBP.

Main Methods:

• A cohort of 376 students (grades 4-10) completed a survey on LBP history.
• Participants underwent a battery of muscular fitness tests, including the FITNESSGRAM trunk extension test.
• Receiver operator characteristic (ROC) curve analysis was employed to assess predictive accuracy (Area Under the Curve - AUC, Sensitivity - Se, Specificity - Sp).

Main Results:

• The FITNESSGRAM trunk extension test demonstrated poor predictive utility for LBP in both genders.
• In girls, the sit-and-reach test (AUC=0.71) and composite curl-up scores (AUC=0.79) were significant predictors.
• For boys, the dynamic curl-up test showed the best prediction (AUC=0.75) for LBP.

Conclusions:

• Musculoskeletal fitness indicators, particularly in girls, show potential for identifying past LBP, but low specificity may lead to misclassification.
• The current FITNESSGRAM trunk extension test is inadequate for discriminating between students with and without LBP.
• Revisiting the utility of the trunk extension test in youth fitness assessments is recommended.