COSMIN database

Clinical outcome measures for monitoring physical function in pediatric obesity: An integrative review

Mahaffey, R., Morrison, S. C., Stephensen, D., and Drechsler, W. I.
OBJECTIVE: Measuring physical function in children with obesity is important to provide targets for clinical intervention to reduce impairments and increase participation in activities. The objective of this integrative review was to evaluate measurement properties of performance-based measures of physical function in children with overweight and obesity.

DESIGN AND METHODS: An integrative review of literature published in Cochrane Reviews, SPORTDiscus, CINAHL, PLoS, Medline, and Scopus was conducted.

RESULTS: Twenty-eight studies were eligible and represented 66 performance-based measures of physical function. Assessments of repeatability and feasibility were not conducted in the majority of performance measures reported; only 6-min-timed walk (6MTW) was examined for test-retest repeatability. Measures of flexibility, strength, aerobic performance, anaerobic performance, coordination, and balance demonstrated construct validity and responsiveness; however, findings were inconsistent across all performance-based measures. Multi-item tests of physical function demonstrated acceptable construct validity and responsiveness; however, internal consistency was not determined.

CONCLUSIONS: There is moderate evidence that 6MTW is suitable for the measurement of physical function in children with obesity. However, evidence is low for the use of aerobic and anaerobic performance, muscle strength, Movement Assessment Battery for Children, and Bruininks-Oseretsky Test of Motor Proficiency multi-item performance instruments and very low for flexibility, coordination, and balance tests. Based on this review, measurement of physical function using 6MTW is recommended.
Obesity (Silver Spring)
Publication year:
Functional status:
Physical functioning
Children (0-18)
Endocrine, nutritional and metabolic diseases and related symptoms
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
6MWT - 6-Minute Walk Test [see: reference, pubmed, proqolid, ZUID (NL)]
TUG - Timed Up and Go test [see: reference, ]
Sit-and-reach [see: reference, ]
Shoulder stretches
Partial sit-ups
Bent-leg sit-up
Horizontal jump
Vertical jump
Right-angle push-ups
Bent-arm hang
Trunk lifts
Strength (BOT2)
Small ball throw
Basketball throw
1 kg ball throw
9-minutes run/walk
Multistage/Leger/shuttle run
6-Minute RunTest [see: reference, ]
1/4-, 1/2-, or 1-mile run
800/1,600 m run/walk
8/12 run
1-mile run
10x 5 m shuttle run [see: reference, ]
4 m x 5 m shuttle run
Running speed/agility (BOT2)
Sprint 40 m
Sprint 20 m
Sprint 50 m
Sprint ~32 m
Margaria step climbing test
Plate tapping
Jumping side-to-side
One-leg standing balance [see: reference, doi: 10.1302/0301-620X.47B4.678, pubmed, ZUID (NL)]
Walking backward
One-leg hop
Moving sideways
TUDS - Timed Up-and-Down Stairs
Bilateral coordination
Upper limb coordination
Unilateral stance (L and R)
Tandem walking
180 degrees tandem pivot
Lateral foot scooting (L and R)
Hopping forward (L and R)
Crouch and walk
Lateral dodging
Forward to backward walking
Walk, look, and carry (L and R)
Descending stairs
Step-ups x 1 step (L and R)
KTK - Körperkoordinationstest für Kinder
MABC - Movement Assessment Battery for Children
PPF Awards - President’s Physical Fitness Awards
Fitnessgram: Healthy Fitness Zones
BOT2-SF - Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form
CB&M - Community Balance and Mobility Scale
PACER (Fitnessgram)