{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:45:02Z","timestamp":1785775502551,"version":"3.56.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100022567","name":"Niche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022567","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001747","name":"Hong Kong Baptist University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001747","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Pediatr"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childhood obesity is associated with cardiometabolic and musculoskeletal health risks. Because fat reduction may be accompanied by loss of skeletal muscle, this trial aims to evaluate whether a plyometric-based high-intensity interval training (Plyo-HIIT) program improves muscle-to-fat ratio (MFR) in children aged 9\u201312\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This pragmatic, assessor-blinded, three-arm randomized controlled trial will recruit 210 children aged 9\u201312\u00a0years from primary schools in Hong Kong, China. Participants will be randomly assigned to Plyo-HIIT, structured fitness (SF) program, or the health education (HE) control group in a 1:1:1 ratio. Each group will engage in two 45-minute weekly sessions for 16\u00a0weeks. The Plyo-HIIT program involved developmentally appropriate plyometric exercise (e.g., jumping, skipping). The SF program includes moderate- to high-intensity activities maintaining 60%\u201380% of maximal heart rate. The HE group will receive weekly health education sessions. Outcomes will be assessed at baseline, post-intervention (16\u00a0weeks), and at 6-month follow-up. The primary outcome will be MFR measured using magnetic resonance imaging. Secondary outcomes will include body composition, muscular fitness, cardiorespiratory fitness, flexibility, body mass index, physical activity, and cortisol levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participant recruitment was conducted between September 26, 2024, and March 14, 2025. The 16-week intervention has been completed. However, as one participating cohort delayed the start date of the intervention, the 6-month follow-up assessments are still ongoing, with the final follow-up assessment scheduled for August 2026. No trial outcome data are reported in this protocol article.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is expected to provide evidence for the effectiveness of Plyo-HIIT in improving body composition by increasing the muscle-to-fat ratio among school-age children. This will support the integration of Plyo-HIIT training into school-based physical activity programs, offering a practical and time-efficient strategy to prevent early-onset obesity. By comparing Plyo-HIIT with the SF and HE groups, this study may further demonstrate the value of plyometric training for primary school settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12519-026-01064-z","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:01:06Z","timestamp":1784383266000},"page":"678-690","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of plyometric-based high-intensity interval training on muscle-to-fat ratio in children: protocol for a randomized controlled trial in primary school settings"],"prefix":"10.1007","volume":"22","author":[{"given":"Ying","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6740-8674","authenticated-orcid":false,"given":"Bjorn T.","family":"Tam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin-Yee","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke-Wen","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing-Lam","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asefa Adimasu","family":"Taddese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-Yin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"1064_CR1","unstructured":"World Health Organization. Obesity and overweight. 2022. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight. Accessed 5 Mar 2026."},{"key":"1064_CR2","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1080\/15374416.2016.1188703","volume":"46","author":"J Juvonen","year":"2017","unstructured":"Juvonen J, Lessard LM, Schacter HL, Suchilt L. Emotional implications of weight stigma across middle school: the role of weight-based peer discrimination. J Clin Child Adolesc Psychol. 2017;46:150\u20138. https:\/\/doi.org\/10.1080\/15374416.2016.1188703.","journal-title":"J Clin Child Adolesc Psychol"},{"key":"1064_CR3","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1111\/j.2047-6310.2012.00078.x","volume":"7","author":"J Madowitz","year":"2012","unstructured":"Madowitz J, Knatz S, Maginot T, Crow SJ, Boutelle KN. Teasing, depression and unhealthy weight control behaviour in obese children. Pediatr Obes. 2012;7:446\u201352. https:\/\/doi.org\/10.1111\/j.2047-6310.2012.00078.x.","journal-title":"Pediatr Obes"},{"key":"1064_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.13.1539","volume":"295","author":"LK Heilbronn","year":"2006","unstructured":"Heilbronn LK, de Jonge L, Frisard MI, DeLany JP, Larson-Meyer DE, Rood J, et al. Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals: a randomized controlled trial. JAMA. 2006;295:1539. https:\/\/doi.org\/10.1001\/jama.295.13.1539.","journal-title":"JAMA"},{"key":"1064_CR5","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/516576","volume":"2011","author":"AJ Santanasto","year":"2011","unstructured":"Santanasto AJ, Glynn NW, Newman MA, Taylor CA, Brooks MM, Goodpaster BH, et al. Impact of weight loss on physical function with changes in strength, muscle mass, and muscle fat infiltration in overweight to moderately obese older adults: a randomized clinical trial. J Obes. 2011;2011:516576. https:\/\/doi.org\/10.1155\/2011\/516576.","journal-title":"J Obes"},{"key":"1064_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3803\/EnM.2020.35.1.1","volume":"35","author":"G Kim","year":"2020","unstructured":"Kim G, Kim JH. Impact of skeletal muscle mass on metabolic health. Endocrinol Metab. 2020;35:1\u20136. https:\/\/doi.org\/10.3803\/EnM.2020.35.1.1.","journal-title":"Endocrinol Metab"},{"key":"1064_CR7","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1002\/cphy.c190029","volume":"10","author":"KE Merz","year":"2020","unstructured":"Merz KE, Thurmond DC. Role of skeletal muscle in insulin resistance and glucose uptake. Compr Physiol. 2020;10:785\u2013809. https:\/\/doi.org\/10.1002\/cphy.c190029.","journal-title":"Compr Physiol"},{"key":"1064_CR8","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1016\/j.jamda.2016.04.019","volume":"17","author":"JM Argil\u00e9s","year":"2016","unstructured":"Argil\u00e9s JM, Campos N, Lopez-Pedrosa JM, Rueda R, Rodriguez-Ma\u00f1as L. Skeletal muscle regulates metabolism via interorgan crosstalk: roles in health and disease. J Am Med Dir Assoc. 2016;17:789\u201396. https:\/\/doi.org\/10.1016\/j.jamda.2016.04.019.","journal-title":"J Am Med Dir Assoc"},{"key":"1064_CR9","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1172\/JCI114857","volume":"86","author":"F Zurlo","year":"1990","unstructured":"Zurlo F, Larson K, Bogardus C, Ravussin E. Skeletal muscle metabolism is a major determinant of resting energy expenditure. J Clin Investig. 1990;86:1423\u20137. https:\/\/doi.org\/10.1172\/JCI114857.","journal-title":"J Clin Investig"},{"key":"1064_CR10","doi-asserted-by":"publisher","first-page":"R581","DOI":"10.1152\/ajpregu.00755.2010","volume":"301","author":"PS MacLean","year":"2011","unstructured":"MacLean PS, Bergouignan A, Cornier MA, Jackman MR. Biology\u2019s response to dieting: the impetus for weight regain. Am J Physiol Regul Integr Comp Physiol. 2011;301:R581\u2013600. https:\/\/doi.org\/10.1152\/ajpregu.00755.2010.","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"1064_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20030647","volume":"20","author":"ME Rubio-Ruiz","year":"2019","unstructured":"Rubio-Ruiz ME, Guarner-Lans V, P\u00e9rez-Torres I, Soto ME. Mechanisms underlying metabolic syndrome-related sarcopenia and possible therapeutic measures. Int J Mol Sci. 2019;20:647. https:\/\/doi.org\/10.3390\/ijms20030647.","journal-title":"Int J Mol Sci"},{"key":"1064_CR12","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1002\/jcsm.12877","volume":"13","author":"PC Yu","year":"2022","unstructured":"Yu PC, Hsu CC, Lee WJ, Liang CK, Chou MY, Lin MH, et al. Muscle-to-fat ratio identifies functional impairments and cardiometabolic risk and predicts outcomes: biomarkers of sarcopenic obesity. J Cachexia Sarcopenia Muscle. 2022;13:368\u201376. https:\/\/doi.org\/10.1002\/jcsm.12877.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"1064_CR13","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1002\/jcsm.12548","volume":"11","author":"YG Seo","year":"2020","unstructured":"Seo YG, Song HJ, Song YR. Fat-to-muscle ratio as a predictor of insulin resistance and metabolic syndrome in Korean adults. J Cachexia Sarcopenia Muscle. 2020;11:710\u201325. https:\/\/doi.org\/10.1002\/jcsm.12548.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"1064_CR14","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1589\/jpts.28.1036","volume":"28","author":"J Park","year":"2016","unstructured":"Park J, Kim S. Validity of muscle-to-fat ratio as a predictor of adult metabolic syndrome. J Phys Ther Sci. 2016;28:1036\u201345. https:\/\/doi.org\/10.1589\/jpts.28.1036.","journal-title":"J Phys Ther Sci"},{"key":"1064_CR15","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.cmet.2021.03.020","volume":"33","author":"L Sylow","year":"2021","unstructured":"Sylow L, Tokarz VL, Richter EA, Klip A. The many actions of insulin in skeletal muscle, the paramount tissue determining glycemia. Cell Metab. 2021;33:758\u201380. https:\/\/doi.org\/10.1016\/j.cmet.2021.03.020.","journal-title":"Cell Metab"},{"key":"1064_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2024.116116","volume":"222","author":"MJ Lee","year":"2024","unstructured":"Lee MJ, Kim J. The pathophysiology of visceral adipose tissues in cardiometabolic diseases. Biochem Pharmacol. 2024;222:116116. https:\/\/doi.org\/10.1016\/j.bcp.2024.116116.","journal-title":"Biochem Pharmacol"},{"key":"1064_CR17","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1089\/chi.2021.0157","volume":"18","author":"N Salton","year":"2022","unstructured":"Salton N, Kern S, Interator H, Lopez A, Moran-Lev H, Lebenthal Y, et al. Muscle-to-fat ratio for predicting metabolic syndrome components in children with overweight and obesity. Child Obes. 2022;18:132\u201342. https:\/\/doi.org\/10.1089\/chi.2021.0157.","journal-title":"Child Obes"},{"key":"1064_CR18","doi-asserted-by":"publisher","DOI":"10.23751\/pn.v22i2-S.10441","volume":"22","author":"A Thaqi","year":"2020","unstructured":"Thaqi A, Berisha M, Hoxha S. The effect of plyometric training on the power-related factors of children aged 16\u00a0years-old. Prog Nutr. 2020;22:e2020004. https:\/\/doi.org\/10.23751\/pn.v22i2-S.10441.","journal-title":"Prog Nutr"},{"key":"1064_CR19","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.jsams.2015.01.011","volume":"19","author":"M Behrens","year":"2016","unstructured":"Behrens M, Mau-Moeller A, Mueller K, Heise S, Gube M, Beuster N, et al. Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions. J Sci Med Sport. 2016;19:170\u20136. https:\/\/doi.org\/10.1016\/j.jsams.2015.01.011.","journal-title":"J Sci Med Sport"},{"key":"1064_CR20","doi-asserted-by":"publisher","first-page":"137","DOI":"10.21037\/tp.2017.04.01","volume":"6","author":"AM Myers","year":"2017","unstructured":"Myers AM, Beam NW, Fakhoury JD. Resistance training for children and adolescents. Transl Pediatr. 2017;6:137\u201343. https:\/\/doi.org\/10.21037\/tp.2017.04.01.","journal-title":"Transl Pediatr"},{"key":"1064_CR21","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1080\/17461391.2021.1960426","volume":"22","author":"JB Mello","year":"2022","unstructured":"Mello JB, Pedretti A, Garc\u00eda-Hermoso A, Martins CML, Gaya AR, Duncan MJ, et al. Exercise in school Physical Education increase bone mineral content and density: systematic review and meta-analysis. Eur J Sport Sci. 2022;22:1618\u201329. https:\/\/doi.org\/10.1080\/17461391.2021.1960426.","journal-title":"Eur J Sport Sci"},{"key":"1064_CR22","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1097\/00005768-200006000-00003","volume":"32","author":"KA Witzke","year":"2000","unstructured":"Witzke KA, Snow CM. Effects of plyometric jump training on bone mass in adolescent girls. Med Sci Sports Exerc. 2000;32:1051\u20137. https:\/\/doi.org\/10.1097\/00005768-200006000-00003.","journal-title":"Med Sci Sports Exerc"},{"key":"1064_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-020-01037-z","volume":"17","author":"JP Chaput","year":"2020","unstructured":"Chaput JP, Willumsen J, Bull F, Chou R, Ekelund U, Firth J, et al. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5\u201317\u00a0years: summary of the evidence. Int J Behav Nutr Phys Act. 2020;17:141. https:\/\/doi.org\/10.1186\/s12966-020-01037-z.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"1064_CR24","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1519\/13643.1","volume":"19","author":"GD Myer","year":"2005","unstructured":"Myer GD, Ford KR, Palumbo JP, Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res. 2005;19:51. https:\/\/doi.org\/10.1519\/13643.1.","journal-title":"J Strength Cond Res"},{"key":"1064_CR25","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ejrad.2018.04.011","volume":"103","author":"A Grimm","year":"2018","unstructured":"Grimm A, Meyer H, Nickel MD, Nittka M, Raithel E, Chaudry O, et al. Evaluation of 2-point, 3-point, and 6-point Dixon magnetic resonance imaging with flexible echo timing for muscle fat quantification. Eur J Radiol. 2018;103:57\u201364. https:\/\/doi.org\/10.1016\/j.ejrad.2018.04.011.","journal-title":"Eur J Radiol"},{"key":"1064_CR26","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1093\/ajcn\/80.2.271","volume":"80","author":"W Shen","year":"2004","unstructured":"Shen W, Punyanitya M, Wang Z, Gallagher D, St-Onge MP, Albu J, et al. Visceral adipose tissue: relations between single-slice areas and total volume. Am J Clin Nutr. 2004;80:271\u20138. https:\/\/doi.org\/10.1093\/ajcn\/80.2.271.","journal-title":"Am J Clin Nutr"},{"key":"1064_CR27","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1002\/jmri.25031","volume":"43","author":"S Orgiu","year":"2016","unstructured":"Orgiu S, Lafortuna CL, Rastelli F, Cadioli M, Falini A, Rizzo G. Automatic muscle and fat segmentation in the thigh from T1-Weighted MRI. Magn Reson Imaging. 2016;43:601\u201310. https:\/\/doi.org\/10.1002\/jmri.25031.","journal-title":"Magn Reson Imaging"},{"key":"1064_CR28","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1491931","volume":"11","author":"DP Looney","year":"2024","unstructured":"Looney DP, Schafer EA, Chapman CL, Pryor RR, Potter AW, Roberts BM, et al. Reliability, biological variability, and accuracy of multi-frequency bioelectrical impedance analysis for measuring body composition components. Front Nutr. 2024;11:1491931. https:\/\/doi.org\/10.3389\/fnut.2024.1491931.","journal-title":"Front Nutr"},{"key":"1064_CR29","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1016\/j.jsams.2016.02.003","volume":"19","author":"C Cadenas-Sanchez","year":"2016","unstructured":"Cadenas-Sanchez C, Martinez-Tellez B, Sanchez-Delgado G, Mora-Gonzalez J, Castro-Pi\u00f1ero J, L\u00f6f M, et al. Assessing physical fitness in preschool children: feasibility, reliability and practical recommendations for the PREFIT battery. J Sci Med Sport. 2016;19:910\u20135. https:\/\/doi.org\/10.1016\/j.jsams.2016.02.003.","journal-title":"J Sci Med Sport"},{"key":"1064_CR30","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1177\/1753193415592328","volume":"40","author":"G Sanchez-Delgado","year":"2015","unstructured":"Sanchez-Delgado G, Cadenas-Sanchez C, Mora-Gonzalez J, Martinez-Tellez B, Chill\u00f3n P, L\u00f6f M, et al. Assessment of handgrip strength in preschool children aged 3 to 5\u00a0years. J Hand Surg Eur Vol. 2015;40:966\u201372. https:\/\/doi.org\/10.1177\/1753193415592328.","journal-title":"J Hand Surg Eur Vol"},{"key":"1064_CR31","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1123\/pes.25.3.407","volume":"25","author":"C Boyer","year":"2013","unstructured":"Boyer C, Tremblay M, Saunders T, McFarlane A, Borghese M, Lloyd M, et al. Feasibility, validity, and reliability of the plank isometric hold as a field-based assessment of torso muscular endurance for children 8\u201312\u00a0years of age. Pediatr Exerc Sci. 2013;25:407\u201322. https:\/\/doi.org\/10.1123\/pes.25.3.407.","journal-title":"Pediatr Exerc Sci"},{"key":"1064_CR32","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1007\/s42978-020-00073-2","volume":"3","author":"JJ Dawes","year":"2021","unstructured":"Dawes JJ, Stahl CA, Lockie RG, Redmond JE, Kornhauser CL, Holmes RJ, et al. Associations between two measures of trunk muscular endurance among male law enforcement officers. J Sci Sport Exerc. 2021;3:374\u20138. https:\/\/doi.org\/10.1007\/s42978-020-00073-2.","journal-title":"J Sci Sport Exerc"},{"key":"1064_CR33","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1080\/1091367X.2021.2016409","volume":"26","author":"KR Larson","year":"2022","unstructured":"Larson KR, Baptista F, Mahar MT, Welk GJ, Janz KF. Designing health-referenced standards for the plank test of core muscular endurance. Meas Phys Educ Exerc Sci. 2022;26:344\u201351. https:\/\/doi.org\/10.1080\/1091367X.2021.2016409.","journal-title":"Meas Phys Educ Exerc Sci"},{"key":"1064_CR34","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1080\/24733938.2017.1420208","volume":"2","author":"TWJ Lovell","year":"2018","unstructured":"Lovell TWJ, Bocking CJ, Fransen J, Coutts AJ. A multidimensional approach to factors influencing playing level and position in a school-based soccer programme. Sci Med Footb. 2018;2:237\u201345. https:\/\/doi.org\/10.1080\/24733938.2017.1420208.","journal-title":"Sci Med Footb"},{"key":"1064_CR35","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1519\/1533-4287(2004)18<551:RAFVOS>2.0.CO;2","volume":"18","author":"G Markovic","year":"2004","unstructured":"Markovic G, Dizdar D, Jukic I, Cardinale M. Reliability and factorial validity of squat and countermovement jump tests. J Strength Cond Res. 2004;18:551. https:\/\/doi.org\/10.1519\/1533-4287(2004)18%3c551:RAFVOS%3e2.0.CO;2.","journal-title":"J Strength Cond Res"},{"key":"1064_CR36","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1123\/ijspp.2016-0511","volume":"12","author":"B Pueo","year":"2017","unstructured":"Pueo B, Lipinska P, Jim\u00e9nez-Olmedo JM, Zmijewski P, Hopkins WG. Accuracy of jump-mat systems for measuring jump height. Int J Sports Physiol Perform. 2017;12:959\u201363. https:\/\/doi.org\/10.1123\/ijspp.2016-0511.","journal-title":"Int J Sports Physiol Perform"},{"key":"1064_CR37","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1519\/JSC.0000000000000864","volume":"29","author":"JR Fernandez-Santos","year":"2015","unstructured":"Fernandez-Santos JR, Ruiz JR, Cohen DD, Gonzalez-Montesinos JL, Castro-Pi\u00f1ero J. Reliability and validity of tests to assess lower-body muscular power in children. J Strength Cond Res. 2015;29:2277\u201385. https:\/\/doi.org\/10.1519\/JSC.0000000000000864.","journal-title":"J Strength Cond Res"},{"key":"1064_CR38","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1007\/s40279-016-0553-6","volume":"46","author":"S Domone","year":"2016","unstructured":"Domone S, Mann S, Sandercock G, Wade M, Beedie C. A method by which to assess the scalability of field-based fitness tests of cardiorespiratory fitness among schoolchildren. Phys Med. 2016;46:1819\u201331. https:\/\/doi.org\/10.1007\/s40279-016-0553-6.","journal-title":"Phys Med"},{"key":"1064_CR39","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.jsams.2023.03.005","volume":"26","author":"N Mar\u00edn-Jim\u00e9nez","year":"2023","unstructured":"Mar\u00edn-Jim\u00e9nez N, S\u00e1nchez-Parente S, Exp\u00f3sito-Carrillo P, Jim\u00e9nez-Iglesias J, \u00c1lvarez-Gallardo IC, Cuenca-Garc\u00eda M, et al. Criterion-related validity and reliability of the 2-km walk test and the 20-m shuttle run test in adults: the role of sex, age and physical activity level. J Sci Med Sport. 2023;26:267\u201376. https:\/\/doi.org\/10.1016\/j.jsams.2023.03.005.","journal-title":"J Sci Med Sport"},{"key":"1064_CR40","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1249\/MSS.0000000000002637","volume":"53","author":"AM Nevill","year":"2021","unstructured":"Nevill AM, De Menezes-Junior FJ, De Jesus \u00cdC, De Fatima Aguiar Lopes M, Corazza PRP, Tadiotto MC, et al. Predicting cardiorespiratory fitness using the 20-m shuttle run test: new insights using nonlinear allometry. Med Sci Sports Exerc. 2021;53:1624\u20139. https:\/\/doi.org\/10.1249\/MSS.0000000000002637.","journal-title":"Med Sci Sports Exerc"},{"key":"1064_CR41","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1519\/JSC.0000000000002886","volume":"34","author":"C Ay\u00e1n P\u00e9rez","year":"2020","unstructured":"Ay\u00e1n P\u00e9rez C, \u00c1lvarez P\u00e9rez S, Gonz\u00e1lez Baamonde S, Mart\u00ednez de Quel \u00d3. Influence of the box dimensions on the reliability and validity of the sit and reach in preschoolers. J Strength Cond Res. 2020;34:2683\u201392. https:\/\/doi.org\/10.1519\/JSC.0000000000002886.","journal-title":"J Strength Cond Res"},{"key":"1064_CR42","doi-asserted-by":"publisher","DOI":"10.3390\/sports13040109","volume":"13","author":"G De Castro-Maqueda","year":"2025","unstructured":"De Castro-Maqueda G, Rosety-Rodr\u00edguez M\u00c1, Fern\u00e1ndez-Santos JR. Body mass index and sedentary behaviour affect hamstring extensibility in primary education students. Sports. 2025;13:109. https:\/\/doi.org\/10.3390\/sports13040109.","journal-title":"Sports"},{"key":"1064_CR43","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1093\/ptj\/76.8.850","volume":"76","author":"SL Cornbleet","year":"1996","unstructured":"Cornbleet SL, Woolsey NB. Assessment of hamstring muscle length in school-aged children using the sit-and-reach test and the inclinometer measure of hip joint angle. Phys Ther. 1996;76:850\u20135. https:\/\/doi.org\/10.1093\/ptj\/76.8.850.","journal-title":"Phys Ther"},{"key":"1064_CR44","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3967\/bes2016.022","volume":"29","author":"JJ Wang","year":"2016","unstructured":"Wang JJ, Baranowski T, Lau WP, Chen TA, Pitkethly AJ. Validation of the physical activity questionnaire for older children (PAQ-C) among Chinese children. Biomed Environ Sci. 2016;29:177\u201386. https:\/\/doi.org\/10.3967\/bes2016.022.","journal-title":"Biomed Environ Sci"},{"key":"1064_CR45","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18073413","volume":"18","author":"D Marasso","year":"2021","unstructured":"Marasso D, Lupo C, Collura S, Rainoldi A, Brustio PR. Subjective versus objective measure of physical activity: a systematic review and meta-analysis of the convergent validity of the physical activity questionnaire for children (PAQ-C). Int J Environ Res Public Health. 2021;18:3413. https:\/\/doi.org\/10.3390\/ijerph18073413.","journal-title":"Int J Environ Res Public Health"},{"key":"1064_CR46","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.psychsport.2014.02.002","volume":"15","author":"EL Thomas","year":"2014","unstructured":"Thomas EL, Upton D. Psychometric properties of the physical activity questionnaire for older children (PAQ-C) in the UK. Psychol Sport Exerc. 2014;15:280\u20137. https:\/\/doi.org\/10.1016\/j.psychsport.2014.02.002.","journal-title":"Psychol Sport Exerc"},{"key":"1064_CR47","doi-asserted-by":"publisher","first-page":"E619","DOI":"10.1210\/jc.2012-3745","volume":"98","author":"S Martikainen","year":"2013","unstructured":"Martikainen S, Pesonen AK, Lahti J, Heinonen K, Feldt K, Pyh\u00e4l\u00e4 R, et al. Higher levels of physical activity are associated with lower hypothalamic-pituitary-adrenocortical axis reactivity to psychosocial stress in children. J Clin Endocrinol Metab. 2013;98:E619\u201327. https:\/\/doi.org\/10.1210\/jc.2012-3745.","journal-title":"J Clin Endocrinol Metab"},{"key":"1064_CR48","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jad.2023.02.123","volume":"329","author":"Y Li","year":"2023","unstructured":"Li Y, Jia W, Yan N, Hua Y, Han T, Yang J, et al. Associations between chronic stress and hair cortisol in children: a systematic review and meta-analysis. J Affect Disord. 2023;329:438\u201347. https:\/\/doi.org\/10.1016\/j.jad.2023.02.123.","journal-title":"J Affect Disord"},{"key":"1064_CR49","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.psyneuen.2016.12.017","volume":"77","author":"T Stalder","year":"2017","unstructured":"Stalder T, Steudte-Schmiedgen S, Alexander N, Klucken T, Vater A, Wichmann S, et al. Stress-related and basic determinants of hair cortisol in humans: a meta-analysis. Psychoneuroendocrinology. 2017;77:261\u201374. https:\/\/doi.org\/10.1016\/j.psyneuen.2016.12.017.","journal-title":"Psychoneuroendocrinology"},{"key":"1064_CR50","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3109\/10253890.2011.619239","volume":"15","author":"L Dettenborn","year":"2012","unstructured":"Dettenborn L, Muhtz C, Skoluda N, Stalder T, Steudte S, Hinkelmann K, et al. Introducing a novel method to assess cumulative steroid concentrations: increased hair cortisol concentrations over 6\u00a0months in medicated patients with depression. Stress. 2012;15:348\u201353. https:\/\/doi.org\/10.3109\/10253890.2011.619239.","journal-title":"Stress"},{"key":"1064_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.talanta.2020.121499","volume":"222","author":"CD Voegel","year":"2021","unstructured":"Voegel CD, Baumgartner MR, Kraemer T, W\u00fcst S, Binz TM. Simultaneous quantification of steroid hormones and endocannabinoids (ECs) in human hair using an automated supported liquid extraction (SLE) and LC-MS\/MS\u2014insights into EC baseline values and correlation to steroid concentrations. Talanta. 2021;222:121499. https:\/\/doi.org\/10.1016\/j.talanta.2020.121499.","journal-title":"Talanta"},{"key":"1064_CR52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jchromb.2013.03.008","volume":"928","author":"W Gao","year":"2013","unstructured":"Gao W, Stalder T, Foley P, Rauh M, Deng H, Kirschbaum C. Quantitative analysis of steroid hormones in human hair using a column-switching LC\u2013APCI\u2013MS\/MS assay. J Chromatogr B Biomed Sci Appl. 2013;928:1\u20138. https:\/\/doi.org\/10.1016\/j.jchromb.2013.03.008.","journal-title":"J Chromatogr B Biomed Sci Appl"},{"key":"1064_CR53","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1038\/s41366-024-01645-w","volume":"49","author":"CN Eggertsen","year":"2025","unstructured":"Eggertsen CN, Larsen RG, Duch K, Simonsen MB, Christensen CB, Warner TC, et al. Feasibility and efficacy of adding high-intensity interval training to a multidisciplinary lifestyle intervention in children with obesity\u2014a randomized controlled trial. Int J Obes (Lond). 2025;49:269\u201377. https:\/\/doi.org\/10.1038\/s41366-024-01645-w.","journal-title":"Int J Obes (Lond)"},{"key":"1064_CR54","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1139\/apnm-2015-0368","volume":"41","author":"J Ache-Dias","year":"2016","unstructured":"Ache-Dias J, Dellagrana RA, Teixeira AS, Dal Pupo J, Moro AR. Effect of jumping interval training on neuromuscular and physiological parameters: a randomized controlled study. Appl Physiol Nutr Metab. 2016;41:20\u20135. https:\/\/doi.org\/10.1139\/apnm-2015-0368.","journal-title":"Appl Physiol Nutr Metab"},{"key":"1064_CR55","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.01415","volume":"9","author":"DC Andrade","year":"2018","unstructured":"Andrade DC, Beltr\u00e1n AR, Labarca-Valenzuela C, Manzo-Botarelli O, Trujillo E, Otero-Farias P, et al. Effects of plyometric training on explosive and endurance performance at sea level and at high altitude. Front Physiol. 2018;9:1415. https:\/\/doi.org\/10.3389\/fphys.2018.01415.","journal-title":"Front Physiol"},{"key":"1064_CR56","doi-asserted-by":"publisher","first-page":"860","DOI":"10.5937\/jomb0-48461","volume":"43","author":"L Jiang","year":"2024","unstructured":"Jiang L, Xu L, Lu Y, Xu X. The correlation between insulin resistance and blood lipids in children. J Med Biochem. 2024;43:860\u20139. https:\/\/doi.org\/10.5937\/jomb0-48461.","journal-title":"J Med Biochem"},{"key":"1064_CR57","doi-asserted-by":"publisher","first-page":"310","DOI":"10.23736\/S0022-4707.18.08075-1","volume":"59","author":"D Thivel","year":"2019","unstructured":"Thivel D, Masurier J, Baquet G, Timmons BW, Pereira B, Berthoin S, et al. High-intensity interval training in overweight and obese children and adolescents: systematic review and meta-analysis. J Sports Med Phys Fit. 2019;59:310\u201324. https:\/\/doi.org\/10.23736\/S0022-4707.18.08075-1.","journal-title":"J Sports Med Phys Fit"},{"key":"1064_CR58","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1016\/S0022-2275(20)40090-2","volume":"35","author":"N Abate","year":"1994","unstructured":"Abate N, Burns D, Peshock RM, Garg A, Grundy SM. Estimation of adipose tissue mass by magnetic resonance imaging: validation against dissection in human cadavers. J Lipid Res. 1994;35:1490\u20136. https:\/\/doi.org\/10.1016\/S0022-2275(20)40090-2.","journal-title":"J Lipid Res"},{"key":"1064_CR59","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/MED.0000000000000360","volume":"24","author":"T Lemos","year":"2017","unstructured":"Lemos T, Gallagher D. Current body composition measurement techniques. Curr Opin Endocrinol Diabetes Obes. 2017;24:310\u20134. https:\/\/doi.org\/10.1097\/MED.0000000000000360.","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"1064_CR60","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/j.biopsych.2010.04.004","volume":"68","author":"BL Hankin","year":"2010","unstructured":"Hankin BL, Badanes LS, Abela JRZ, Watamura SE. Hypothalamic\u2013pituitary\u2013adrenal axis dysregulation in dysphoric children and adolescents: cortisol reactivity to psychosocial stress from preschool through middle adolescence. Biol Psychiatry. 2010;68:484\u201390. https:\/\/doi.org\/10.1016\/j.biopsych.2010.04.004.","journal-title":"Biol Psychiatry"},{"key":"1064_CR61","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.psyneuen.2015.08.014","volume":"62","author":"AC Incollingo Rodriguez","year":"2015","unstructured":"Incollingo Rodriguez AC, Epel ES, White ML, Standen EC, Seckl JR, Tomiyama AJ. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301\u201318. https:\/\/doi.org\/10.1016\/j.psyneuen.2015.08.014.","journal-title":"Psychoneuroendocrinology"}],"container-title":["World Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12519-026-01064-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12519-026-01064-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12519-026-01064-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:52:50Z","timestamp":1785772370000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12519-026-01064-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":61,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["1064"],"URL":"https:\/\/doi.org\/10.1007\/s12519-026-01064-z","relation":{},"ISSN":["1708-8569","1867-0687"],"issn-type":[{"value":"1708-8569","type":"print"},{"value":"1867-0687","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"12 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol has been reviewed and approved by the Research Ethics Committee of Hong Kong Baptist University (Ref. No.: REC\/22-23\/0536). Written informed consent was obtained from all participants and their parents or legal guardians prior to participation.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}