Dong, Y. et al. Trends in physical fitness, growth, and nutritional status of Chinese children and adolescents: A retrospective analysis of 1.5 million students from six successive National surveys between 1985 and 2014. Lancet Child. Adolesc. Health. 3, 871–880 (2019).
Google Scholar
Lang, J. J. et al. Top 10 international priorities for physical fitness research and surveillance among children and adolescents: A Twin-Panel Delphi study. Sports Med. 53, 549–564 (2023).
Google Scholar
Fühner, T., Kliegl, R., Arntz, F., Kriemler, S. & Granacher, U. An update on secular trends in physical fitness of children and adolescents from 1972 to 2015: A systematic review. Sports Med. 51, 303–320 (2021).
Google Scholar
Ortega-Gómez, S., Adelantado-Renau, M., Carbonell-Baeza, A. & Moliner-Urdiales, D. Jiménez-Pavón, D. Role of physical activity and health-related fitness on self-confidence and interpersonal relations in 14-year-old adolescents from secondary school settings: DADOS study. Scand. J. Med. Sci. Sports. 33, 2068–2078 (2023).
Google Scholar
Sember, V. et al. Secular trends in skill-related physical fitness among Slovenian children and adolescents from 1983 to 2014. Scand. J. Med. Sci. Sports. 33, 2323–2339 (2023).
Google Scholar
Nuzzo, J. L. The case for retiring flexibility as a major component of physical fitness. Sports Med. 50, 853–870 (2020).
Google Scholar
Raghuveer, G. et al. Cardiorespiratory fitness in youth: an important marker of health: a scientific statement from the American heart association. Circulation 142, e101–e118 (2020).
Google Scholar
García-Hermoso, A., Ramírez-Campillo, R. & Izquierdo, M. Is muscular fitness associated with future health benefits in children and adolescents? A systematic review and meta-analysis of longitudinal studies. Sports Med. 49, 1079–1094 (2019).
Google Scholar
Lang, J. J. et al. Systematic review of the relationship between 20m shuttle run performance and health indicators among children and youth. J. Sci. Med. Sport. 21, 383–397 (2018).
Google Scholar
Guan, S. Y. et al. Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019. Autoimmun. Rev. 22, 103361 (2023).
Google Scholar
Chong, K. H. et al. Pooled analysis of physical activity, sedentary behavior, and sleep among children from 33 countries. JAMA Pediatr. 178, 1199–1207 (2024).
Google Scholar
Kasović, M., Štefan, L., Piler, P. & Zvonar, M. Longitudinal associations between sport participation and fat mass with body posture in children: A 5-year follow-up from the Czech ELSPAC study. PLoS One. 17, e0266903 (2022).
Google Scholar
Bokaee, F. et al. Comparison of isometric force of the craniocervical flexor and extensor muscles between women with and without forward head posture. Cranio 34, 286–290 (2016).
Google Scholar
Molina-Garcia, P. et al. Role of physical fitness and functional movement in the body posture of children with overweight/obesity. Gait Posture. 80, 331–338 (2020).
Google Scholar
Maciałczyk-Paprocka, K. et al. Prevalence of incorrect body posture in children and adolescents with overweight and obesity. Eur. J. Pediatr. 176, 563–572 (2017).
Google Scholar
Sepehri, S., Sheikhhoseini, R., Piri, H. & Sayyadi, P. The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: A systematic review and meta-analysis. BMC Musculoskelet. Disord. 25, 105 (2024).
Google Scholar
Koseki, T., Kakizaki, F., Hayashi, S., Nishida, N. & Itoh, M. Effect of forward head posture on thoracic shape and respiratory function. J. Phys. Ther. Sci. 31, 63–68 (2019).
Google Scholar
Wen, L. et al. Sagittal imbalance of the spine is associated with poor sitting posture among primary and secondary school students in china: A cross-sectional study. BMC Musculoskelet. Disord. 23, 98 (2022).
Google Scholar
Piercy, K. L. et al. The physical activity guidelines for Americans. JAMA 320, 2020–2028 (2018).
Google Scholar
Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P. & Khaleghi Tazji, M. Efficacy of abdominal control feedback and scapula stabilization exercises in participants with forward Head, round shoulder postures and neck movement impairment. Sports Health. 11, 272–279 (2019).
Google Scholar
van Sluijs, E. M. F. et al. Physical activity behaviours in adolescence: current evidence and opportunities for intervention. Lancet 398, 429–442 (2021).
Google Scholar
Pereira, H. V. et al. International consensus on the definition of functional training: modified e-Delphi method. J. Sports Sci. 43, 767–775 (2025).
Google Scholar
Crawford, D. A., Drake, N. B., Carper, M. J., DeBlauw, J. & Heinrich, K. M. Are changes in physical work capacity induced by High-Intensity functional training related to changes in associated physiologic measures? Sports (Basel). 6, 26 (2018).
Google Scholar
Deng, B. et al. Effects of unilateral and bilateral complex-contrast training on lower limb strength and jump performance in collegiate female volleyball players. PLoS One. 20, e0327237 (2025).
Google Scholar
Weston, K. L. et al. Effect of novel, school-based high-intensity interval training (HIT) on cardiometabolic health in adolescents: project FFAB (fun fast activity blasts) – an exploratory controlled before-and-after trial. PLoS One. 11, e0159116 (2016).
Google Scholar
Gao, Y., Yang, Y., Xian, C. & Wang, Z. Comparative study of functional training and traditional resistance training on lower-limb strength performance in male adolescent volleyball players: a randomized controlled trial. Front. Physiol. 16, 1629055 (2025).
Google Scholar
Xiao, W. et al. Effect of functional training on physical fitness among athletes: A systematic review. Front. Physiol. 12, 738878 (2021).
Google Scholar
Wan, K., Dai, Z., Wong, P., Ho, R. S. & Tam, B. T. Comparing the effects of integrative neuromuscular training and traditional physical fitness training on physical performance outcomes in young athletes: A systematic review and Meta-Analysis. Sports Med. Open. 11, 15 (2025).
Google Scholar
van Dillen, L. R. et al. Effect of motor skill training in functional activities vs strength and flexibility exercise on function in people with chronic low back pain: A randomized clinical trial. JAMA Neurol. 78, 385–395 (2021).
Google Scholar
Yildiz, S., Pinar, S. & Gelen, E. Effects of 8-Week functional vs. Traditional training on athletic performance and functional movement on prepubertal tennis players. J. Strength. Cond Res. 33, 651–661 (2019).
Google Scholar
Lu, Y., Wiltshire, H. D., Baker, J. S. & Wang, Q. The effects of running compared with functional High-Intensity interval training on body composition and aerobic fitness in female university students. Int. J. Environ. Res. Public. Health. 18, 11312 (2021).
Google Scholar
Wang, X. et al. Effects of high-intensity functional training on physical fitness and sport-specific performance among the athletes: A systematic review with meta-analysis. PLoS One. 18, e0295531 (2023).
Google Scholar
Leahy, A. A. et al. Feasibility of a school-based physical activity intervention for adolescents with disability. Pilot Feasibility Stud. 7, 120 (2021).
Google Scholar
Leahy, A. A. et al. Review of high-intensity interval training for cognitive and mental health in youth. Med. Sci. Sports Exerc. 52, 2224 (2020).
Google Scholar
Kennedy, S. G. et al. Implementing resistance training in secondary schools: A cluster randomized controlled trial. Med. Sci. Sports Exerc. 50, 62–72 (2018).
Google Scholar
Lubans, D. R. et al. Time-efficient intervention to improve older adolescents’ cardiorespiratory fitness: findings from the ‘burn 2 learn’ cluster randomised controlled trial. Br. J. Sports Med. 55, 751–758 (2021).
Google Scholar
Fairclough, S. J. et al. Move well, feel good: feasibility and acceptability of a school-based motor competence intervention to promote positive mental health. PLoS One. 19, e0303033 (2024).
Google Scholar
Neil-Sztramko, S. E., Caldwell, H. & Dobbins, M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst. Rev. 9, CD007651 (2021).
Google Scholar
Schmidt, S. A. J., Lo, S. & Hollestein, L. M. Research techniques made simple: sample size Estimation and power calculation. J. Invest. Dermatol. 138, 1678–1682 (2018).
Google Scholar
Lubans, D. R. et al. Framework for the design and delivery of organized physical activity sessions for children and adolescents: rationale and description of the ‘SAAFE’ teaching principles. Int. J. Behav. Nutr. Phys. Act. 14, 24 (2017).
Google Scholar
Deci, E. L. & Ryan, R. M. Intrinsic Motivation and Self-Determination in Human Behavior (Plenum, 1985).
National Health Commission of the People’s Republic of China. Screening for Overweight and Obesity Among School-Age Children and Adolescents (2018).
Abd El-Azeim, A. S., Mahmoud, A. G., Mohamed, M. T. & El-Khateeb, Y. S. Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: A randomized controlled trial. Eur. J. Phys. Rehabil Med. 58, 757–766 (2022).
Google Scholar
Xing, Q., Hong, R., Shen, Y. & Shen, Y. Design and validation of depth camera-based static posture assessment system. iScience 26, 107974 (2023).
Google Scholar
Cai, S. et al. Secular trends in physical fitness and cardiovascular risks among Chinese college students: an analysis of five successive National surveys between 2000 and 2019. The Lancet Reg. Health – Western Pacific 58 (2025).
Xi, Y. et al. Validity and reliability of Chinese physical activity questionnaire for children aged 10–17 years. BES 32, 647–658 (2019).
Vandekar, S., Tao, R. & Blume, J. A. Robust. Effect Size Index. Psychometrika 85, 232–246 (2020).
Google Scholar
García-Hermoso, A., Alonso-Martinez, A. M., Ramírez-Vélez, R. & Izquierdo, M. Effects of exercise intervention on health-related physical fitness and blood pressure in preschool children: A systematic review and meta-analysis of randomized controlled trials. Sports Med. 50, 187–203 (2020).
Google Scholar
Oliveira, A., Monteiro, Â., Jácome, C., Afreixo, V. & Marques, A. Effects of group sports on health-related physical fitness of overweight youth: A systematic review and meta-analysis. Scand. J. Med. Sci. Sports. 27, 604–611 (2017).
Google Scholar
Ruivo, R. M., Pezarat-Correia, P. & Carita, A. I. Effects of a resistance and stretching training program on forward head and protracted shoulder posture in adolescents. J. Manipulative Physiol. Ther. 40, 1–10 (2017).
Google Scholar
Ruivo, R. M., Carita, A. I. & Pezarat-Correia, P. The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: randomised controlled study. Man. Ther. 21, 76–82 (2016).
Google Scholar
Peng, Y., Wang, S. R., Qiu, G. X., Zhang, J. G. & Zhuang Q.-Y. Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis. Chin. Med. J. (Engl). 133, 483–493 (2020).
Google Scholar
Bortz, C. et al. The prevalence of hip pathologies in adolescent idiopathic scoliosis. J. Orthop. 31, 29–32 (2022).
Google Scholar
Sung, Y. H. & Suboccipital Muscles Forward head Posture, and cervicogenic Dizziness. Med. (Kaunas). 58, 1791 (2022).
Calcaterra, V. et al. Childhood obesity and incorrect body posture: impact on physical activity and the therapeutic role of exercise. Int. J. Environ. Res. Public. Health. 19, 16728 (2022).
Google Scholar
Lubans, D. R., Sheaman, C. & Callister, R. Exercise adherence and intervention effects of two school-based resistance training programs for adolescents. Prev. Med. 50, 56–62 (2010).
Google Scholar
Molina-Garcia, P. et al. Effects of exercise on body posture, functional movement, and physical fitness in children with overweight/obesity. J. Strength. Cond Res. 34, 2146–2155 (2020).
Google Scholar
Poon, E. T. C., Li, H. Y., Gibala, M. J., Wong, S. H. S. & Ho, R. S. T. High-intensity interval training and cardiorespiratory fitness in adults: an umbrella review of systematic reviews and meta-analyses. Scand. J. Med. Sci. Sports. 34, e14652 (2024).
Google Scholar
Graham, M., Azevedo, L., Wright, M. & Innerd, A. L. The effectiveness of fundamental movement skill interventions on moderate to vigorous physical activity levels in 5- to 11-year-old children: A systematic review and meta-analysis. Sports Med. 52, 1067–1090 (2022).
Google Scholar
Dobbins, M., Husson, H., DeCorby, K. & LaRocca, R. L. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst. Rev. 2013, CD007651 (2013).
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