School based physical fitness testing: challenges and opportunities

The key message of this Commentary is to highlight the potential value of school-based physical fitness testing (SB-PFT) as a useful and predictive biomarker of pediatric health. To achieve its potential as one of the most dynamic and inclusive pediatric real-world health data collections available, SB-PFT must incorporate advances in data analytics and quality procedures, human-centered design concepts, new technologies such as wearable monitors of physiological responses to exercise, and newer insights into developmental aspects of physical fitness. A re-imagined implementation of SB-PFT is consistent with recent NIH and national emphasis on the seemingly intractable rise of chronic diseases in children and adolescents.