{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:00:00Z","timestamp":1792512000163,"version":"4.5.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country\u2019s absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12\u201316 in Pakistan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study was conducted among 2,970 school adolescents aged 12\u201316\u2009years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study\u2019s results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1212396","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T13:59:22Z","timestamp":1695823162000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Establishment of health related physical fitness evaluation system for school adolescents aged 12\u201316 in Pakistan: a cross-sectional study"],"prefix":"10.3389","volume":"11","author":[{"given":"Syed Muhammad Zeeshan Haider","family":"Hamdani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Ghufran","family":"Hadier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Khurram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Danish Haider","family":"Hamdani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaista Shireen","family":"Danish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Urooj","family":"Fatima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1038\/s41591-019-0644-7","article-title":"Understanding the rise of cardiometabolic diseases in low-and middle-income countries","volume":"25","author":"Miranda","year":"2019","journal-title":"Nat Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1016\/S0140-6736(18)32822-8","article-title":"The global Syndemic of obesity, undernutrition, and climate change: the lancet commission report","volume":"393","author":"Swinburn","year":"2019","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"598499","DOI":"10.3389\/fped.2020.598499","article-title":"Development of LMS and Z score growth references for Egyptian children from birth up to 5 years","volume":"8","author":"El Shafie","year":"2021","journal-title":"Front Pediatr"},{"key":"ref4","volume-title":"Foundations of Physical Activity and Public Health","author":"Kohl","year":"2019"},{"key":"ref5","year":"2010"},{"key":"ref6","volume-title":"ACSM's Health-Related Physical Fitness Assessment Manual","author":"Medicine","year":"2013"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"873141","DOI":"10.3389\/fpubh.2022.873141","article-title":"Associations of sport participation, muscle-strengthening exercise and active commuting with self-reported physical fitness in school-aged children","volume":"10","author":"Shi","year":"2022","journal-title":"Front Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.adolescence.2010.05.019","article-title":"Adolescents and youth in developing countries: health and development issues in context","volume":"33","author":"Fatusi","year":"2010","journal-title":"J Adolesc"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e4032","DOI":"10.7717\/peerj.4032","article-title":"Reference standards to assess physical fitness of children and adolescents of Brazil: an approach to the students of the Lake Itaip\u00fa region\u2014Brazil","volume":"5","author":"Hobold","year":"2017","journal-title":"PeerJ"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.jsams.2018.09.227","article-title":"Physical fitness reference standards for preschool children: the PREFIT project","volume":"22","author":"Cadenas-Sanchez","year":"2019","journal-title":"J Sci Med Sport"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.apmr.2017.06.021","article-title":"Do trials of resistance training to improve mobility after stroke adhere to the American College of Sports Medicine guidelines? 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