{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:22:25Z","timestamp":1788888145528,"version":"build-2803163510"},"reference-count":63,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Multiple studies have reported that the quality of life (QoL) among children and adolescents with Down syndrome (DS) is lower than that among typically developing children. Meanwhile, physical fitness is crucial for improving QoL throughout childhood and adolescence. Combining these insights, this cross-sectional study aimed to examine the association between physical fitness and QoL in children and adolescents with DS. Methods: Participants were 56 children and adolescents (aged 8\u201316 years) enrolled in one DS center in Saudi Arabia. Cardiorespiratory fitness, muscular strength, and muscular power were measured to assess physical fitness. The PedsQLTM (parents\u2019 proxy scale) was used to measure participants\u2019 QoL. Multiple linear regression with pooled analysis was used to examine the association between physical fitness and QoL. Results: Boys showed higher muscular power than girls (p = 0.024). Weak to moderate correlations were observed between muscular power, muscular strength, and QoL domains. Regression results suggested that children and adolescents with high muscular power had better scores in social functioning (B = 0.693, R2 = 0.22, p = 0.013). Children and adolescents with high muscular strength had better scores in overall QoL (B = 2.665, R2 = 0.21, p = 0.027). Conclusions: Children and adolescents with DS who have higher muscular fitness had better scores in social functioning and overall QoL. Increasing muscular fitness in children and adolescents with DS appears to be particularly important for improving QoL.<\/jats:p>","DOI":"10.3390\/children12121611","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:43:22Z","timestamp":1764157402000},"page":"1611","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Physical Fitness and Quality of Life in Children and Adolescents with Down Syndrome"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5336-1721","authenticated-orcid":false,"given":"Osama","family":"Aljuhani","sequence":"first","affiliation":[{"name":"Department of Physical Education, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shomokh","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Hakami","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deema","family":"Alsaeedi","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wejdan","family":"Alqadheb","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najla","family":"Al-sadaawi","sequence":"additional","affiliation":[{"name":"Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouz","family":"Alosaimi","sequence":"additional","affiliation":[{"name":"Department of Physical Education, College of Sport Sciences and Physical Activity, King Saud University, P. O. Box 2454, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Melo, G.L.R., Neto, I.V.S., da Fonseca, E.F., Stone, W., and Nascimento, D.D.C. (2022). Resistance training and Down Syndrome: A narrative review on considerations for exercise prescription and safety. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.948439"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.5582\/irdr.2021.01016","article-title":"The prevalence and patterns of chromosome abnormalities in newborns with major congenital anomalies: A retrospective study from Saudi Arabia","volume":"10","author":"Bahashwan","year":"2021","journal-title":"Intractable Rare Dis. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1159\/000154261","article-title":"Down\u2019s syndrome in Saudi Arabia: Incidence and cytogenetics","volume":"45","author":"Niazi","year":"1995","journal-title":"Hum. Hered."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.15537\/smj.2025.46.4.20241117","article-title":"Prevalence and impact of endocrinopathies on growth in pediatric down syndrome patients: A retrospective analysis","volume":"46","author":"Alfaraj","year":"2025","journal-title":"Saudi Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1542\/peds.2011-1605","article-title":"Health supervision for children with Down syndrome","volume":"128","author":"Bull","year":"2011","journal-title":"Pediatrics"},{"key":"ref_6","first-page":"43","article-title":"A new age for childhood diseases. Down syndrome","volume":"65","author":"Finesilver","year":"2002","journal-title":"Rn"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1542\/peds.2012-1616","article-title":"Trends in survival among children with Down syndrome in 10 regions of the United States","volume":"131","author":"Kucik","year":"2013","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1469-8749.2004.tb00483.x","article-title":"Clinical, social, and ethical implications of changing life expectancy in Down syndrome","volume":"46","author":"Bittles","year":"2004","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.4103\/jdmimsu.jdmimsu_433_22","article-title":"Down syndrome and its oral effects in Saudi Arabian region: A review of literature","volume":"17","author":"Alkahtani","year":"2022","journal-title":"J. Datta Meghe Inst. Med. Sci. Univ."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Fuc\u00e0, E., Galassi, P., Costanzo, F., and Vicari, S. (2022). Parental perspectives on the quality of life of children with Down syndrome. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.957876"},{"key":"ref_11","unstructured":"World HealthOrganization (2012). The World Health Organization Quality of Life (WHOQOL), WHO."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"AbuAlhommos, A.K., Al Hawaj, M.A., Alanazi, A.A., Alrashidi, H.H., Aldawsari, M.F., and Alajmi, R.A. (2025). Quality of Life for Patients with Down Syndrome and Their Caregivers: A Cross-Sectional Study from a Parental Perspective in Saudi Arabia. Healthcare, 13.","DOI":"10.3390\/healthcare13131614"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"502","DOI":"10.47102\/annals-acadmedsg.2023415","article-title":"Quality of life of children and young adults with Down syndrome from caregivers\u2019 perspective: A systematic review and meta-analysis","volume":"53","author":"Chan","year":"2024","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Alhammad, S.A., Alqahtani, A.S., Alwadeai, K.S., Algabbani, M.F., and Alhusaini, A.A. (2024). Walking capacity and its association with quality of life among children with down syndrome in Saudi Arabia. BMC Pediatr., 24.","DOI":"10.1186\/s12887-023-04519-8"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Alqahtani, A.S., Algabbani, M.F., Alhammad, S.A., Alwadeai, K.S., and Alhusaini, A. (2024). Physical activity status and its association with quality of life among children with down syndrome in Saudi Arabia: A comparative cross-sectional study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0297111"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/sj.ijo.0803774","article-title":"Physical fitness in childhood and adolescence: A powerful marker of health","volume":"32","author":"Ortega","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1016\/j.ridd.2011.04.003","article-title":"(Instrumental) activities of daily living in older adults with intellectual disabilities","volume":"32","author":"Hilgenkamp","year":"2011","journal-title":"Res. Dev. Disabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1016\/j.ridd.2014.05.027","article-title":"Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: Results of the HA-ID study","volume":"35","author":"Oppewal","year":"2014","journal-title":"Res. Dev. Disabil."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1089\/chi.2018.0198","article-title":"Changes in body composition and physical fitness in adolescents with Down syndrome: The UP&DOWN Longitudinal study","volume":"15","author":"Veiga","year":"2019","journal-title":"Child. Obes."},{"key":"ref_20","first-page":"1348","article-title":"Are poor physical fitness and obesity two features of the adolescent with Down syndrome?","volume":"28","author":"Ruiz","year":"2013","journal-title":"Nutr. Hosp."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"601","DOI":"10.2147\/TCRM.S10235","article-title":"Reduced exercise capacity in persons with Down syndrome: Cause, effect, and management","volume":"6","author":"Mendonca","year":"2010","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5521","DOI":"10.3390\/ijerph18115521","article-title":"Prospective associations of physical activity and health-related physical fitness in adolescents with down syndrome: The UP&DOWN longitudinal study","volume":"18","author":"Villagra","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Binsaddiq, D.W., Ibrahim, A.I., and Abualait, T.S. (2025). Body Composition and Adiposity in Children with Down Syndrome Compared to Typically Developing Children: The Association with Their Motor Performance. Children, 12.","DOI":"10.3390\/children12101298"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1080\/20473869.2022.2162627","article-title":"Strength versus aerobic program: Effects on body composition and health-related physical fitness levels of youths with Down syndrome","volume":"70","author":"Corredeira","year":"2024","journal-title":"Int. J. Dev. Disabil."},{"key":"ref_25","first-page":"534","article-title":"Swim, strength, or combined programs: Effect on health-related physical fitness in adolescents with Down syndrome","volume":"41","author":"Sadarangani","year":"2024","journal-title":"Adapt. Phys. Act. Q."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1123\/jtpe.2015-0110","article-title":"Physical activity, physical fitness, and health-related quality of life in school-aged children","volume":"35","author":"Gu","year":"2016","journal-title":"J. Teach. Phys. Educ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1007\/s11136-015-0917-7","article-title":"Independent and combined association of overall physical fitness and subjective well-being with fibromyalgia severity: The al-\u00c1ndalus project","volume":"24","author":"Gray","year":"2015","journal-title":"Qual. Life Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Medrano-Ure\u00f1a, M.d.R., Ortega-Ruiz, R., and Ben\u00edtez-Sillero, J.d.D. (2020). Physical fitness, exercise self-efficacy, and quality of life in adulthood: A systematic review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.20944\/preprints202007.0700.v1"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s11136-019-02136-6","article-title":"Associations between health-related quality of life and physical fitness in 4\u20137-year-old Spanish children: The MOVIKIDS study","volume":"28","year":"2019","journal-title":"Qual. Life Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12955-021-01766-0","article-title":"Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: A systematic review and meta-analysis of observational studies","volume":"19","year":"2021","journal-title":"Health Qual Life Outcomes"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Supramaniam, N., Zanudin, A., and Azmi, N.A. (2023). Body Mass Index, Physical Activity, Cardiorespiratory Endurance and Quality of Life among Children with Physical Disabilities. Children, 10.","DOI":"10.3390\/children10091465"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"959","DOI":"10.4236\/ce.2012.326146","article-title":"Measurement properties of the Arabic Lebanon version of the Pediatric Quality of Life Inventory 4.0 generic core scales for young child (5\u20137 years), and child aged 8\u201312 years: Quality of Life of in Urban and Rural Children in Lebanon","volume":"3","author":"Sabbah","year":"2012","journal-title":"Creat. Educ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/00005650-199902000-00003","article-title":"The PedsQL: Measurement model for the pediatric quality of life inventory","volume":"37","author":"Varni","year":"1999","journal-title":"Med. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1111\/j.1471-6712.2011.00889.x","article-title":"Cross-cultural validation of the Pediatric Quality of Life Inventory\u2122 4.0 (PedsQL\u2122) generic core scale into Arabic language","volume":"25","author":"Arabiat","year":"2011","journal-title":"Scand. J. Caring. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Cabeza-Ruiz, R., Alc\u00e1ntara-Cordero, F.J., Ruiz-Gavil\u00e1n, I., and S\u00e1nchez-L\u00f3pez, A.M. (2019). Feasibility and reliability of a physical fitness test battery in individuals with Down syndrome. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16152685"},{"key":"ref_36","unstructured":"ACSM (2013). ACSM\u2019s Guidelines for Exercise Testing and Prescription, Lippincott Williams & Wilkins."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.apmr.2012.04.022","article-title":"Test-retest reliability of the 6-minute walk test in individuals with Down syndrome","volume":"93","author":"Casey","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/adc.73.1.25","article-title":"Body mass index reference curves for the UK, 1990","volume":"73","author":"Cole","year":"1995","journal-title":"Arch. Dis. Child."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1027\/1614-2241\/a000141","article-title":"Multiple imputation by predictive mean matching when sample size is small","volume":"14","author":"Kleinke","year":"2018","journal-title":"Methodology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/01621459.1996.10476908","article-title":"Multiple imputation after 18+ years","volume":"91","author":"Rubin","year":"1996","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: Appropriate use and interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/cch.12019","article-title":"Functioning and post-school transition outcomes for young people with D own syndrome","volume":"39","author":"Foley","year":"2013","journal-title":"Child Care Health Dev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3109\/17518423.2015.1077901","article-title":"An exploratory study of the association between physical activity, cardiovascular fitness and body size in children with Down syndrome","volume":"20","author":"Shields","year":"2017","journal-title":"Dev. Neurorehabilit."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/cch.12815","article-title":"Quality of life in individuals with Down syndrome aged 4 to 21 years","volume":"47","author":"Lee","year":"2021","journal-title":"Child: Care Health Dev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1080\/09638288.2016.1194901","article-title":"The profile of social functioning in children with Down syndrome","volume":"39","author":"Nygaard","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9992595","DOI":"10.1155\/2024\/9992595","article-title":"Family self-support in managing Down syndrome children: A qualitative study","volume":"2024","author":"Noroozi","year":"2024","journal-title":"Sci. World J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jshs.2012.10.004","article-title":"Children and adolescents with Down syndrome, physical fitness and physical activity","volume":"2","author":"Pitetti","year":"2013","journal-title":"J. Sport Health Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0003-9993(96)90086-6","article-title":"Peak torque, average power, and hamstring\/quadriceps ratios in nondisabled adults and adults with mental retardation","volume":"77","author":"Croce","year":"1996","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","first-page":"847","article-title":"Isokinetic arm and leg strength of adults with Down syndrome: A comparative study","volume":"73","author":"Pitetti","year":"1992","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.3109\/09638288.2011.563820","article-title":"The effect of progressive resistance training on leg strength, aerobic capacity and functional tasks of daily living in persons with Down syndrome","volume":"33","author":"Cowley","year":"2011","journal-title":"Disabil. Rehabil."},{"key":"ref_51","first-page":"343","article-title":"Effect of training on the muscle strength and dynamic balance ability of adults with Down syndrome","volume":"18","author":"Tsimaras","year":"2004","journal-title":"J. Strength Cond. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.ridd.2014.10.022","article-title":"Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study","volume":"36","author":"Villagra","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e2337","DOI":"10.1002\/mgg3.2337","article-title":"Quality of life in children with Down syndrome and its association with parent and child demographic characteristics: Parent-reported measures","volume":"12","author":"Alrayes","year":"2024","journal-title":"Mol. Genet. Genom. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/jir.12142","article-title":"Development of physical fitness in children with intellectual disabilities","volume":"59","author":"Hartman","year":"2015","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1111\/jir.12580","article-title":"A schedule of gross motor development for children with Down syndrome","volume":"63","author":"Winders","year":"2019","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Grande, E.-I., Vargas-Pinilla, O.-C., Torres-Narvaez, M.-R., and Rodr\u00edguez-Malag\u00f3n, N. (2022). Neuromuscular exercise in children with Down Syndrome: A systematic review. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-19086-8"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Llerena, A., Ladr\u00f3n-de-Guevara, L., Medina-Rebollo, D., and Alcaraz-Rodr\u00edguez, V. (2024). Impact of Physical Activity on Autonomy and Quality of Life in Individuals with Down Syndrome: A Systematic Review. Healthcare, 12.","DOI":"10.3390\/healthcare12020181"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ejmhg.2017.07.006","article-title":"Correlation between cognitive function, gross motor skills and health\u2014Related quality of life in children with Down syndrome","volume":"19","year":"2018","journal-title":"Egypt. J. Med. Hum. Genet."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1108\/AMHID-03-2021-0014","article-title":"Relationship between quality of life and physical fitness in adults with intellectual disabilities","volume":"16","year":"2022","journal-title":"Adv. Ment. Health Intellect. Disabil."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Shen, X., Huang, P., Nie, B., Su, M., Liu, D., Guo, Y., and Zheng, L. (2024). An Adapted Physical Activity Program for Adolescents with an Intellectual Disability: An International Classification of Functioning, Disability, and Health Perspective. Life, 14.","DOI":"10.3390\/life14101314"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"357","DOI":"10.5935\/1984-0063.20200125","article-title":"Sleep and health-related physical fitness in children and adolescents: A systematic review","volume":"14","author":"Fonseca","year":"2021","journal-title":"Sleep Sci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jsams.2017.09.019","article-title":"Physical fitness and psychological health in overweight\/obese children: A cross-sectional study from the ActiveBrains project","volume":"21","author":"Migueles","year":"2018","journal-title":"J. Sci. Med. Sport"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"\u015ali\u017c, D., Wiecha, S., G\u0105sior, J.S., Kasiak, P.S., Ulaszewska, K., Lewandowski, M., Barylski, M., and Mamcarz, A. (2023). Impact of COVID-19 infection on cardiorespiratory fitness, sleep, and psychology of endurance athletes\u2014CAESAR study. J. Clin. Med., 12.","DOI":"10.20944\/preprints202303.0430.v1"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/12\/1611\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:24:01Z","timestamp":1764159841000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/12\/1611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":63,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["children12121611"],"URL":"https:\/\/doi.org\/10.3390\/children12121611","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]}}}