{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:26Z","timestamp":1783318526704,"version":"3.54.6"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to examine the detection rate of chronic fatigue syndrome (CFS) in secondary school students in Shaanxi Province and its association with their physical fitness test outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey involving the distribution of CFS questionnaires and collection of physical fitness test data was carried out among students from 25 secondary schools in Shaanxi Province. A total of 8,840 valid questionnaires and datasets were analyzed. Detection rates for CFS and chronic fatigue (CF) were determined based on screening criteria and severity levels. Gender and year group distribution variances for CFS and CF were assessed using chi-square tests, while correlation analyses were performed to evaluate the relationship between CFS and physical fitness test scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results showed an overall CFS detection rate of 2.059% among students, with rates of 1.903% for males and 2.234% for females. There was no significant difference in CFS detection rates between genders (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20091.210,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.546). The CFS detection rate increased from 1.012% in grade 7 to 3.728% in the Cram school, with significant differences across grade groups (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200924.082,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020). Correlation analysis revealed a weak to moderate negative correlation between CFS severity and performance grades in the 1,000-meter run for boys (\n                      <jats:italic>\u03c4<\/jats:italic>\n                      \u2009=\u2009\u22120.261,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and the 800-meter run for girls (\n                      <jats:italic>\u03c4<\/jats:italic>\n                      \u2009=\u2009\u22120.385,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Among female students in cram schools, those in the CFS group had significantly lower vital capacity than the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), whereas no significant difference was found between the CF group and the control group. Both the CF and CFS groups exhibited significantly lower 800\u2005m or 1,000\u2005m running test results than control group students to varying degrees.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CFS-like symptoms among secondary school students in Shaanxi Province warrant attention. The screening detection rate tended to increase with grade level and was highest among students in cram schools. Higher CFS levels were associated with poorer physical fitness achievement, particularly endurance running performance, suggesting that students with CFS-like symptoms may require additional attention in school health monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1821254","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:38:40Z","timestamp":1783316320000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution characteristics of chronic fatigue syndrome among secondary school students and its association with physical health: a case study in Shaanxi Province"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuan","family":"Yuan","sequence":"first","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University","place":["Xi'an, Shaanxi, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Liu","sequence":"additional","affiliation":[{"name":"Weinan Jicai Middle School","place":["Weinan, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Chen","sequence":"additional","affiliation":[{"name":"Yankou Town Nine-Year Compulsory Education School","place":["Hanzhong, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimei","family":"Shen","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shaanxi Normal University","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Shaanxi University of Technology","place":["Hanzhong, Shaanxi, 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