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APPLIED SCIENCES

Motor Competence, Physical Activity, and Fitness across Early Childhood

KING-DOWLING, SARA1,2,3; PROUDFOOT, NICOLE A.1,3; CAIRNEY, JOHN2,4,5; TIMMONS, BRIAN W.1,2,3

Author Information

1Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA

2Infant and Child Health Lab, Department of Family Medicine, McMaster University, Hamilton, Ontario, CANADA

3Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, Ontario, CANADA

4Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, CANADA

5School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, AUSTRALIA

Address for correspondence: Brian W. Timmons, Ph.D., Health Sciences Centre, McMaster University, 1280 Main St. W, 3N27G, Hamilton, ON L8S 4M1, Canada; E-mail: [email protected].

Submitted for publication October 2019.

Accepted for publication February 2020.

Medicine & Science in Sports & Exercise: November 2020 - Volume 52 - Issue 11 - p 2342-2348
doi: 10.1249/MSS.0000000000002388
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Abstract

Motor competence describes one’s ability to execute goal-directed movement and is positively associated with physical activity and fitness levels in childhood and adolescence (1–3). In young children, motor competence shows low to moderate correlations with physical activity (4,5), which is hypothesized to strengthen over time (6), although few longitudinal studies exist to test this hypothesis. Typically, stronger associations are reported with moderate- to -vigorous intensity or vigorous intensity activities compared with total or light intensity activity (7,8). Furthermore, it is physical activities at these higher intensities that tend to be associated with positive health outcomes, including health-related fitness, with emerging evidence that vigorous activities provide additional benefits (9,10). The importance of motor competence to physical activity and fitness, and their trajectories, is further reinforced as children with low motor competence, such as those with developmental coordination disorder (DCD), are repeatedly found to have lower moderate-to-vigorous physical activity levels and lower aerobic and musculoskeletal fitness compared with typically developing children, and this gap tends to widen over time (11,12).

The current evidence linking motor competence to physical activity and fitness in childhood is strong; however, there are limited longitudinal studies examining how these relationships change over time and the mediating pathways among these constructs (3,5). These longitudinal associations have, however, been theoretically conceptualized in the literature, slightly differently, by Stodden and colleagues (6) and Hands and Larkin (13). In the developmental model by Stodden and colleagues (6), motor competence is central to health trajectories, as it is hypothesized to play an important emerging role in physical activity engagement and health-related fitness across developmental time. They describe this as a positive spiral of engagement whereby motor competence promotes engagement in physical activity through the mediating effects of health-related fitness and perceived motor competence (i.e., motor competence → health-related fitness → physical activity). Conversely, Hands and Larkin built their model on Bouffard and colleagues’ activity-deficit hypothesis that described children with low motor competence, such as children with DCD, to be in an activity deficit that would likely widen over time (14). This progressive withdrawal from physical activity is what Hands and Larkin (13) hypothesized would lead to less favorable health and fitness trajectories (i.e., motor competence → physical activity → health-related fitness). Although the models propose different primary mediating pathways and emerged separately in the literature, they are also quite complementary. Both models highlight that the relationships among motor competence, physical activity, and health-related fitness are likely reciprocal and mutually reinforcing, suggesting that in addition to influencing each other, the relationships among these constructs will also strengthen over time.

The existing longitudinal research examining these associations has focused primarily on the middle childhood to adolescent period, been limited by the measurement of motor competence at only one point in time, primarily relied on self-reported physical activity, and concentrated on cardiorespiratory fitness outcomes as indicators of overall fitness (e.g., [15–18]). The early years are a time when motor competencies are developed and reinforced, forming the foundation for future physical activity engagement (19) with more intense, vigorous physical activity (VPA) most strongly associated with health benefits, including health-related fitness (20). Therefore, it is important we understand how motor competence influences longitudinal changes in VPA and health-related fitness across this early childhood period. In addition, other components of fitness beyond cardiorespiratory fitness are important to examine in this context. Musculoskeletal fitness is an important indicator of health in childhood (21) and is particularly relevant in early childhood owing to the short, intermittent nature of their activity.

Therefore, the purposes of this study were to 1) examine the strength of the associations between motor competence and VPA and musculoskeletal fitness (short-term muscle power, or STMP) over time during early childhood, 2) examine the relationship between motor competence and trajectories of VPA and STMP over time, and 3) examine mediation pathways linking motor competence to VPA and STMP, through STMP and VPA, respectively, in this age group. We hypothesize that the strength of the associations between motor competence and VPA and STMP will increase over time and that children with greater motor competence will have the steepest increases in VPA and STMP. We further hypothesize that the positive effects of motor competence on STMP and VPA over time will be partially mediated by VPA and STMP, respectively, after controlling for age at baseline, sex, height, and weight.

This study aims to fill an important gap in the literature by examining the interrelationships among motor competence, physical activity and musculoskeletal fitness, and their trajectories, using objective, laboratory assessments across early childhood. By understanding the longitudinal relationships among these constructs, we will be better positioned to design and implement appropriate early interventions to target inactivity and poor fitness in childhood.

METHODS

Participants

Children 3, 4, or 5 yr of age were recruited and completed three assessments (12 ± 1 months apart) as part of the Health Outcomes and Physical activity in Preschoolers (HOPP) study. The HOPP study is a prospective cohort study in which participants were recruited from community-based organizations in south-central Ontario from 2010 to 2012. Further details on the study design are provided in a previous publication (22), and 1-yr tracking of VPA and STMP in this sample has been previously published (23). Children were ineligible if they had a diagnosed medical condition or a known physical impairment (e.g., epilepsy, cerebral palsy). Informed, written consent was given by parents/guardians of all participants. Ethical approval was obtained from the McMaster University Faculty of Health Science/Hamilton Health Sciences Research Ethics Board.

Motor competence

Motor competence was assessed using the Bruininks–Oseretsky Test of Motor Proficiency Second Edition—Short Form (BOT-SF [24]). This measure takes approximately 15 min to administer and contains 14 items covering all eight subdomains of the full version (fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper-limb coordination and strength). For each item, a raw score was obtained and converted into a point score. The point scores were totaled resulting in a total point score for each participant. This total point score was then converted into a standard score (M50, SD10) and corresponding percentile adjusted for the child’s chronological age. Evidence of reliability and validity of the test scores in studies that use similar populations has shown a strong correlation with the Peabody Developmental Motor Scales (r = 0.77) and high test–retest (r = 0.86) and interrater reliability (r = 0.97) (24). As this measure has only been validated in children 4 yr and older, motor competence for the 3-yr-old participants (n = 138) was not available at baseline, and therefore, these participants were only included in the analysis for the latter two time points. Children were also excluded if they refused/did not complete all of the BOT-SF items.

Physical activity

Physical activity was measured each year over 7 d using waist-worn accelerometers (ActiGraph GT3X models, Pensacola, FL). ActiGraph accelerometers have been validated for use in young children (25) and are capable of collecting data over short sampling intervals in order to accurately capture the short intermittent nature of children’s habitual physical activity (26). Parents were instructed to have their child wear the accelerometer over the right hip during all waking time and to remove only for water activities or sleep. Parents recorded the times the accelerometer was put on and taken off and the reason for removal in a log book. Each file was visually inspected, and periods of nonwear (i.e., when parent indicated the accelerometer was removed or when there were greater than 60 min of continuous 0 activity counts) were removed. Data were collected in 3-s epochs in order to accurately capture physical activity in this age group, as it approximates the average bout duration of vigorous activity observed in young children (26,27). In order to determine average daily minutes of VPA, each file was then analyzed using an established cut-point for preschoolers (25). As this cut-point was created for 15-s epochs, it was divided by 5 and applied to each 3-s epoch, with a threshold of ≥169 counts per 3 s considered VPA. Only children who wore the accelerometer ≥10 h on ≥3 d were included in the analyses. All accelerometer data were cleaned and processed using ActiLife software (ActiGraph).

Musculoskeletal fitness (STMP)

Musculoskeletal fitness was evaluated using a modified 10-s Wingate protocol on a pediatric cycle ergometer (LODE Corival Pediatric, Groningen, the Netherlands). Maximum pedaling cadence was determined by having the children sprint against only the internal resistance of the ergometer for approximately 20 s. After a short rest, children began the modified Wingate test where a load (0.55 N m·kg−1) was applied once the children reached 80% of their maximum pedaling cadence. Children pedaled against this resistance for 10 s and were instructed to keep pedaling as fast as they could. STMP was calculated as the average (mean) absolute power output (in watts) over the 10-s test. STMP was also expressed relative to body mass (in watts per kilogram). A modified 10-s test was used instead of the full 30-s Wingate, as young children tend to accumulate their physical activity in bouts shorter than 10 s (27). The Wingate test is considered the gold standard for assessing STMP, and this modified 10-s Wingate is feasible and has excellent test–retest reliability in preschoolers (intraclass correlations >0.9) (28). Children were excluded from all STMP analyses if they could not pedal >25 rpm or if they refused to continue pedaling for the entire test duration.

Statistical analyses

Pearson correlation coefficients between motor competence (BOT-SF standard score) and outcome measures (relative STMP (in watts per kilogram) and VPA) were calculated for each year to examine the strength of these relationships at each time point, with correlation coefficients ±0.1, ±0.3. and ±0.5 considered weak, moderate, and strong, respectively (29). Mixed-effects models using the restricted maximum likelihood method were chosen to examine the longitudinal relationships among motor competence, VPA, and absolute STMP (in watts) because of its ability to handle missing data, as estimates are created using all available time points for each child. Separate mixed-effects models including a random intercept for subject were tested for each outcome variable (STMP (in watts) and VPA). For each outcome variable, four separate models were examined to determine if motor competence (BOT-SF standard score) predicts STMP and VPA over time, controlling for age at baseline, sex, height, and weight (model 1). A motor competence–time interaction term was then added to determine if motor competence predicts changes in VPA or STMP over time (model 2). Sex–motor competence and sex–motor competence–time interaction terms were also tested to determine if these relationships and trajectories differed for girls and boys. The mediating effects of VPA and STMP were then examined by first testing the direct pathways between the potential mediator and the outcome (model 3) and then adding the potential mediator into model 1 (model 4). By examining the change in the motor competence estimate from model 1, we can determine if the mediator attenuates, and therefore mediates, the direct relationship between motor competence and STMP or VPA. Height, weight, motor competence, VPA, and STMP were all included as time-varying predictors, whereas age at baseline and sex were time independent. All analyses were conducted using SAS Studio 3.71.

RESULTS

Of the 691 parents assessed for eligibility, 143 declined participation and 77 were deemed ineligible because of the age of the child, a diagnosed medical condition, or developmental delay. The remaining 471 participants provided verbal consent and booked a baseline appointment. Of these, 43 did not attend their appointment and were unable to be rescheduled, and 6 additional children were found to be ineligible, leaving 422 children with written parental consent. Four children were unable to complete the first visit and withdrew, leaving 418 children (208 girls; age, 4.5 ± 0.9 yr) participating at baseline. Thirty-five children were lost to follow-up because of an inability to contact or withdrew from the study because of the time commitment, travel restrictions, or relocation. Total attrition over the study period was 8.4%. At baseline, 22 (5%) of children were excluded from the STMP analysis because of an inability/refusal to pedal over 25 rpm. Descriptive statistics for all of the participants and number of valid assessments at each year of the HOPP study are presented in Table 1. The 35 children who were lost to follow-up were similar in age (4.4 vs 4.5 yr), sex (46% vs 50% girls), height (105.2 vs 106.7 cm), weight (17.6 vs 18.0 kg), BOT-SF standard score (47.1 vs 47.9), VPA (42.7 vs 41.9 min), and STMP (74.0 vs 79.3 W) compared with those who remained in the cohort.

TABLE 1 - Participant characteristics.
Year 1 n Valid (%) Year 2 n Valid (%) Year 3 n Valid (%)
Total n (% male) 418 (50.2) 400 (50.2) 383 (49.9)
Age, yr 4.5 ± 0.9 418 (100) 5.5 ± 0.9 400 (100) 6.5 ± 0.9 383 (100)
Height, cm a 106.5 ± 7.7 418 (100) 113.5 ± 7.8 400 (100) 120.2 ± 7.9 383 (100)
Weight, kg b 17.9 ± 3.2 418 (100) 20.3 ± 3.8 400 (100) 22.9 ± 4.5 383 (100)
BMI, %ile c 52.4 ± 28.5 418 (100) 51.6 ± 28.1 400 (100) 50.2 ± 28.1 383 (100)
BOT-SF total point score 33.9 ± 11.7 268 (64) 40.4 ± 15.5 399 (99) 52.3 ± 12.4 383 (100)
BOT-SF standard score 47.8 ± 7.5 268 (64) 48.7 ± 8.8 399 (99) 49.7 ± 8.5 383 (100)
VPA, min·d−1 41.9 ± 12.6 365 (87) 45.0 ± 13.1 368 (92) 47.4 ± 14.8 358 (93)
STMP, W 78.8 ± 34.7 388 (93) 106.3 ± 32.9 398 (99) 129.4 ± 34.7 383 (100)
Values are presented as Mean ± SD.
aHeight was measured to the nearest 0.1 cm using a calibrated stadiometer.
bWeight was measured to the nearest 0.1 kg using a digital scale.
cBMI percentile was calculated using the US Centers for Disease Control and Prevention growth charts (30).
BMI = body mass index; STMP = short-term muscle power.

A significant, weak positive association between motor competence and VPA emerged over time (year 1, r = −0.02, P = 0.69; year 2 r = 0.13, P = 0.01; year 3 r = 0.21, P < 0.001). The positive relationship between motor competence and relative STMP (in watts per kilogram) was moderate and significant at each year (year 1, r = 0.32, P < 0.01; year 2 r = 0.35, P < 0.01; year 3 r = 0.39, P < 0.01).

Motor competence was a significant positive predictor of VPA (estimate = 0.20, P < 0.001) and absolute STMP (estimate = 0.61, P < 0.001) over time, and these relationships did not differ between boys and girls (i.e., no significant sex–motor competence interactions). A significant time–motor competence interaction was found for VPA, indicating that motor competence influenced trajectories of VPA across time, with higher levels of motor competence associated with a greater increase in VPA (Fig. 1). No significant time–motor competence interaction was found for STMP, indicating that the positive effect of motor competence was consistent across time (Fig. 2). In addition, three-way interactions (i.e., sex–motor competence–time) were not significant, indicating that sex did not moderate these trajectories.

F1
FIGURE 1:
Trajectories of VPA (in minutes per day) for children with varying levels of motor competence, adjusting for age at baseline, sex, height, and weight. Gray lines represent the model-predicted trajectory of VPA for a child with average (mean) motor competence, dashed lines represent low motor competence (mean − 1 SD), and solid black lines represent high motor competence (mean + 1 SD).
F2
FIGURE 2:
Trajectories of STMP (in watts) for children with varying levels of motor competence, adjusting for age at baseline, sex, height, and weight. Gray lines represent the model-predicted trajectory of STMP for a child with average (mean) motor competence, dashed lines represent low motor competence (mean − 1 SD), and solid black lines represent high motor competence (mean + 1 SD).

Although VPA was a significant predictor of STMP (estimate = 0.17, P < 0.001), it did not attenuate the direct effects of motor competence on STMP and was therefore not a meaningful mediator. Likewise, STMP predicted VPA (estimate = 0.10, P < 0.01), but it did not attenuate the direct effects of motor competence on VPA. See Tables 2 and 3 for a detailed breakdown of each mixed-effects model predicting VPA (Table 2) and STMP (Table 3).

TABLE 2 - Mixed-effects models of motor competence and STMP on VPA over time adjusting for age at baseline, sex, height, weight.
Model 1 Model 2 Model 3 Model 4
Est SE P Est SE P Est SE P Est SE P
Initial age −0.91 0.97 0.35 −0.98 0.97 0.31 −1.39 0.96 0.15 −1.41 0.97 0.15
Sex (male) 7.58 1.13 <0.01 7.54 1.12 <0.01 6.47 1.07 <0.01 7.15 1.13 <0.01
Height 0.27 0.17 0.11 0.27 0.17 0.11 0.29 0.16 0.08 0.19 0.17 0.27
Weight −0.10 0.24 0.67 −0.09 0.24 0.70 −0.69 0.25 <0.01 −0.46 0.27 0.08
Time 0.55 0.84 0.51 −6.5 2.60 0.01 0.06 0.84 0.95 0.06 0.86 0.94
Motor competence 0.20 0.05 <0.01 −0.11 0.12 0.36 0.16 0.06 <0.01
Motor competence × time 0.14 0.05 <0.01
STMP 0.10 0.02 <0.01 0.08 0.03 <0.01
Intercept 6.31 11.60 0.59 21.78 12.75 0.09 18.43 11.52 0.11 19.16 12.37 0.12
Random effects
 var(intercept) 83.65 8.82 <0.01 83.02 8.75 <0.01 78.50 8.07 <0.01 81.41 8.64 <0.01
 var(Residual) 82.70 4.86 <0.01 82.09 4.83 <0.01 83.60 4.54 <0.01 82.09 4.83 <0.01
Est, estimate.

TABLE 3 - Mixed-effects models of motor competence and VPA on STMP over time adjusting for age at baseline, sex, height, and weight.
Model 1 Model 2 Model 3 Model 4
Est SE P Est SE P Est SE P Est SE P
Initial age 6.64 1.21 <0.01 6.68 1.21 <0.01 7.11 1.35 <0.01 6.31 1.23 <0.01
Sex (male) 5.89 1.41 <0.01 5.91 1.41 <0.01 2.33 1.56 0.14 4.71 1.46 <0.01
Height 0.94 0.21 <0.01 0.94 0.21 <0.01 1.41 0.22 <0.01 0.96 0.21 <0.01
Weight 4.32 0.29 <0.01 4.31 0.29 <0.01 3.64 0.32 <0.01 4.32 0.30 <0.01
Time 6.41 1.04 <0.01 9.20 3.13 <0.01 7.13 1.15 <0.01 6.09 1.06 <0.01
Motor competence 0.61 0.07 <0.01 0.73 0.15 <0.01 0.57 0.07 <0.01
Motor competence × time −0.06 0.06 0.34
VPA 0.17 0.04 <0.01 0.12 0.04 <0.01
Intercept −164.40 14.28 <0.01 −170.40 15.63 <0.01 −184.50 15.14 <0.01 −167.01 14.69 <0.01
Random effects
 var(intercept) 141.83 14.09 <0.01 142.04 14.11 <0.01 175.35 16.75 <0.01 141.32 14.27 <0.01
 var(Residual) 123.00 6.96 <0.01 122.94 6.97 <0.01 138.51 7.57 <0.01 118.05 6.98 <0.01
Est, estimate.

DISCUSSION

This study examined the longitudinal relationships between motor competence and physical activity and musculoskeletal fitness in a large sample of young children across early childhood. In line with our hypotheses, a weak, a positive association between motor competence and physical activity emerged over the 3-yr study period. Results from the mixed-effects models supported that motor competence was a positive predictor of both VPA and STMP over time, independent of age at baseline, sex, height, and weight, and children with higher levels of motor competence had the greatest increases in VPA.

Consistent with previous cross-sectional literature, we found weak and moderate associations between motor competence and physical activity and fitness, respectively, during early childhood (1,4). Although the relationship between motor competence and fitness was consistent across the 3 yr, an association between motor competence and physical activity emerged over this time frame, providing longitudinal evidence in early childhood to support the emerging relationship proposed by Stodden and colleagues (6). In line with this, our findings also demonstrate a widening gap in VPA engagement as the children got older, as children with higher motor competence scores had a greater increase in VPA over the study period. Children who are more motorically competent may begin to self-select or are chosen into more physically engaging activities and sports as they get older, whereas children with motor difficulties may begin to withdraw more and more from active pursuits because of a myriad of potential factors including low self-efficacy in their physical capabilities (31). This highlights the importance of motor competence on future physical activity engagement and suggests that the early years is a key time to promote motor skill development in order for children to increase participation in physical activity as they transition to school age. In contrast to our hypothesis, the relationship between motor competence and fitness remained moderate over the study period (increasing only slightly from r = 0.32 to r = 0.39). Findings from a recent meta-analysis found a small positive moderating role of age on the relationship between motor competence and musculoskeletal fitness; however, there were very few studies included with samples younger than 7–8 yr, and most were cross-sectional designs (32). The consistency in the strength of the association between motor competence and fitness found in the current study suggests that these variables will continue to be associated over a longer follow-up period and may only become strong once children reach middle to late childhood.

Contrary to both of the aforementioned theoretical mediation models, neither VPA nor STMP acted as meaningful mediators, and these relationships seem to be relatively independent in this early childhood period (i.e., the relationship between motor competence and VPA was not mediated by STMP and, the relationship between motor competence and STMP was not mediated by VPA). Although this was one of the first longitudinal studies to examine these mediating pathways during early childhood, the insignificant mediating effect of physical activity is in line with work by Cairney and colleagues (12), who found that self-reported physical activity did not explain the widening gap in cardiorespiratory fitness (predicted peak V̇O2 on the 20-m shuttle run) between children age 9–14 yr with and without motor impairment. However, the current findings are contrary to studies that have found significant mediating effects of physical activity (33,34) and health-related fitness (18,35) in school-age children. These discrepancies may be due to different measurement techniques (e.g., field vs laboratory assessed fitness, cardiorespiratory vs musculoskeletal fitness, self-reported vs objectively-measured physical activity), study designs (e.g., cross-sectional vs longitudinal), or the varying ages and characteristics of the samples (e.g., early vs late childhood; DCD vs typically developing samples) found in the current literature.

The weak associations between motor competence and physical activity in early childhood along with the low skill and fitness demands of play may explain the insignificant mediating pathways in this age group. The gap in skills between children with high and low motor competence is likely less apparent at this young age because skill demands of play are low (36). Low skill demands, combined with the short, intermittent nature of young children’s active play, will potentially increase the likelihood that children with lower motor competence will engage in physical activity despite their lower fitness levels. As children get older and play becomes more challenging (skill based), sport related, and physically demanding, the mediating aspects of musculoskeletal fitness may emerge.

The lack of mediating effects in the current study may also be explained by the coordinative demands of the physical fitness test itself. In general, many musculoskeletal fitness and motor coordination tasks require a high degree of neuromuscular control (e.g., motor unit recruitment, firing rate, optimal coactivation), with both requiring well-timed muscle contractions in order to move efficiently and economically (1,37). It is possible that concurrent improvements in motor competence and musculoskeletal fitness may occur primarily through neural maturation and practice, as a child’s ability to control force in a given task improves (38), and that this may occur independently of VPA engagement during this early developmental period.

Importantly, motor competence itself is a general construct that has been assessed throughout the literature using different standardized tools and techniques. For example, the BOT-2 used in the current study assesses outcome performance from a range of fine motor and gross motor subdomains, whereas other studies have used tools that assess movement quality (process) and/or only include object control and locomotor domains. By in large, the findings from this study and others demonstrate that motor competence, regardless of how it is measured, is positively associated with physical activity and health-related fitness in childhood, with our findings further highlighting that the effect on physical activity becomes more pronounced over time during the early years.

Limitations

Because of the young age of the sample and the time commitment for other assessments being conducted as part of the HOPP study (22), it was not feasible to conduct a full motor competence battery; therefore, the short-form of the BOT was used. Although this test correlates well with the full motor assessment, it does not allow for examination of the separate subdomains (e.g., fine motor vs gross motor items, object control vs locomotor). As previous research has found that object manipulation skills may be more predictive of future physical activity levels compared with other motor skills (15), it will be important for future longitudinal research to examine the relative importance of each component of motor competence, and how they are measured, on future health-related fitness and physical activity in this age group. As mentioned previously, the use of the BOT also limited our ability to include the children who were 3 yr old at baseline testing (n = 138); however, these children were able to be included in the analyses at the last two times points and removing these children from the analysis entirely did not significantly affect the overall results. In addition, although continuous verbal encouragement was provided during fitness testing, we recognize that motivation and attention may have influenced test performance. Lastly, we did not use imputation strategies or full-information maximum likelihood to handle missing data, and our statistical methodology is somewhat limited in its ability to test the significance of the indirect mediating effects. However, most participants were included in the statistical models (>94%), and the reported direct effects are small enough to conclude there was not meaningful mediation.

Future directions

Because motor competence was independently associated with musculoskeletal fitness and physical activity in early childhood, further research examining the underlying mechanisms linking these constructs is needed. We need further longitudinal studies to examine how these relationships change over time in typically developing children from early childhood through middle childhood and adolescence that include additional indicators of health-related fitness, such as aerobic fitness and body composition, in order to determine if and when these mediating pathways emerge. Although we do recognize that these are complex, dynamic associations influenced by many other individual and environmental factors such as growth, maturation, and practice (6,19), future randomized controlled trials targeting motor competence would provide further evidence to support the positive influence motor competence has on long-term physical activity and health-related fitness outcomes. Determining how to best design and tailor motor interventions (i.e., what assessments we should use and what motor components we should target) in order to have the greatest impact on future physical activity health outcomes will be a key area for future investigation.

CONCLUSIONS

Motor competence is an important predictor of VPA and STMP during early childhood. Children who are more motor competent had higher musculoskeletal fitness and a greater increase in VPA over the study period. Targeting and developing appropriate motor skill interventions at an early age may help to improve trajectories of both physical activity and health-related fitness.

The authors would like to thank all of the participants and their families as well as all of the research staff and trainees who participated in data collection. Funding for this project was provided by the Canadian Institutes of Health Research (CIHR; MOP 102560). B. W. T. was supported by a CIHR New Investigator Award. S. K. D. was supported by a CIHR Master’s Award and an Ontario Women’s Health Scholar Doctoral Award.

The authors have no conflicts of interest to declare. The results of the present study do not constitute endorsement by the American College of Sports Medicine and are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation.

REFERENCES

1. Cattuzzo MT, dos Santos Henrique R, Ré AHN, et al. Motor competence and health related physical fitness in youth: a systematic review. J Sci Med Sport. 2016;19(2):123–9.
2. Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills in children and adolescents. Sports Med. 2010;40(12):1019–35.
3. Robinson LE, Stodden DF, Barnett LM, et al. Motor competence and its effect on positive developmental trajectories of health. Sports Med. 2015;45(9):1273–84.
4. Logan SW, Kipling Webster E, Getchell N, Pfeiffer KA, Robinson LE. Relationship between fundamental motor skill competence and physical activity during childhood and adolescence: a systematic review. Kinesiol Rev. 2015;4(4):416–26.
5. Jones D, Innerd A, Giles EL, Azevedo LB. Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis. J Sport Health Sci. 2020; [cited 2020 Mar 12]. Available from: http://www.sciencedirect.com/science/article/pii/S2095254620300296. doi:10.1016/j.jshs.2020.03.001.
6. Stodden DF, Goodway JD, Langendorfer SJ, et al. A developmental perspective on the role of motor skill competence in physical activity: an emergent relationship. Quest. 2008;60(2):290–306.
7. Williams HG, Pfeiffer KA, O’Neill JR, et al. Motor skill performance and physical activity in preschool children. Obesity (Silver Spring). 2008;16(6):1421–6.
8. Nilsen AKO, Anderssen SA, Loftesnes JM, Johannessen K, Ylvisaaker E, Aadland E. The multivariate physical activity signature associated with fundamental motor skills in preschoolers. J Sports Sci. 2020;38(3):264–72.
9. Janssen I, LeBlanc AG. Systematic review of the health benefits of physical activity and fitness in school-age children and youth. Int J Behav Nutr Phys Act. 2010;7:40.
10. Poitras VJ, Gray CE, Borghese MM, et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-age children and youth. Appl Physiol Nutr Metab. 2016;41(6 Suppl 3):S197–239.
11. Rivilis I, Hay J, Cairney J, Klentrou P, Liu J, Faught BE. Physical activity and fitness in children with developmental coordination disorder: a systematic review. Res Dev Disabil. 2011;32(3):894–910.
12. Cairney J, Veldhuizen S, King-Dowling S, Faught BE, Hay J. Tracking cardiorespiratory fitness and physical activity in children with and without motor coordination problems. J Sci Med Sport. 2017;20(4):380–5.
13. Hands B, Larkin D. Physical fitness and developmental coordination disorder. In: Cermak S, Larkin D, editors. Developmental Coordination Disorder. Albany (NY): Delmar; 2002. pp. 172–84.
14. Bouffard M, Watkinson EJ, Thompson LP, Causgrove Dunn J, Romanow SK. A test of the activity deficit hypothesis with children with movement difficulties. Adapt Phys Activ Q. 1996;13(1):61–73.
15. Barnett LM, Van Beurden E, Morgan PJ, Brooks LO, Beard JR. Childhood motor skill proficiency as a predictor of adolescent physical activity. J Adolesc Health. 2009;44(3):252–9.
16. Barnett LM, Morgan PJ, van Beurden E, Beard JR. Perceived sports competence mediates the relationship between childhood motor skill proficiency and adolescent physical activity and fitness: a longitudinal assessment. Int J Behav Nutr Phys Act. 2008;5(1):40.
17. Lopes VP, Rodrigues LP, Maia JA, Malina RM. Motor coordination as predictor of physical activity in childhood. Scand J Med Sci Sports. 2011;21(5):663–9.
18. Lima RA, Pfeiffer K, Larsen LR, et al. Physical activity and motor competence present a positive reciprocal longitudinal relationship across childhood and early adolescence. J Phys Act Health. 2017;14:440–7.
19. Clark JE, Metcalfe JS. The mountain of motor development: a metaphor. In: Clark JE, Humphrey J, editors. Motor Development: Research and Reviews. Reston (VA): NASPE Publications; 2002. pp. 163–90.
20. Leppänen MH, Nyström CD, Henriksson P, et al. Physical activity intensity, sedentary behavior, body composition and physical fitness in 4-year-old children: results from the MINISTOP trial. Int J Obes (Lond). 2016;40:1126–33.
21. Ortega FB, Ruiz JR, Castillo MJ, Sjöström M. Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes (Lond). 2008;32(1):1–11.
22. Timmons BW, Proudfoot NA, MacDonald MJ, Bray SR, Cairney J. The health outcomes and physical activity in preschoolers (HOPP) study: rationale and design. BMC Public Health. 2012;12:284.
23. Caldwell HA, Proudfoot NA, King-Dowling S, Di Cristofaro NA, Cairney J, Timmons BW. Tracking of physical activity and fitness during the early years. Appl Physiol Nutr Metab. 2016;41(5):504–10.
24. Bruininks RH, Bruininks BD. Bruininks–Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Minneapolis (MN): Pearson Assessment; 2005.
25. Pate RR, Almeida MJ, McIver KL, Pfeiffer KA, Dowda M. Validation and calibration of an accelerometer in preschool children. Obesity (Silver Spring). 2006;14(11):2000–6.
26. Obeid J, Nguyen T, Gabel L, Timmons BW. Physical activity in Ontario preschoolers: prevalence and measurement issues. Appl Physiol Nutr Metab. 2011;36(2):291–7.
27. Baquet G, Stratton G, Van Praagh E, Berthoin S. Improving physical activity assessment in prepubertal children with high-frequency accelerometry monitoring: a methodological issue. Prev Med. 2007;44(2):143–7.
28. Nguyen T, Obeid J, Timmons BW. Reliability of fitness measures in 3- to 5-year-old children. Pediatr Exerc Sci. 2011;23(2):250–60.
29. Field A. Discovering Statistics Using IBM SPSS Statistics. London: Sage; 2013. 954 p.
30. Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: methods and development. Vital and health statistics. Series 11, Data from the National Health Survey. 2002;(246):1–190.
    31. Cairney J, Hay JA, Faught BE, Wade TJ, Corna L, Flouris A. Developmental coordination disorder, generalized self-efficacy toward physical activity, and participation in organized and free play activities. J Pediatr. 2005;147(4):515–20.
    32. Utesch T, Bardid F, Büsch D, Strauss B. The relationship between motor competence and physical fitness from early childhood to early adulthood: a meta-analysis. Sports Med. 2019;49:541–51.
    33. Silman A, Cairney J, Hay J, Klentrou P, Faught BE. Role of physical activity and perceived adequacy on peak aerobic power in children with developmental coordination disorder. Hum Mov Sci. 2011;30(3):672–81.
    34. Faught BE, Hay JA, Cairney J, Flouris A. Increased risk for coronary vascular disease in children with developmental coordination disorder. J Adolesc Health. 2005;37(5):376–80.
    35. Britton Ú, Belton S, Issartel J. Small fish, big pond: the role of health-related fitness and perceived athletic competence in mediating the physical activity-motor competence relationship during the transition from primary to secondary school. J Sports Sci. 2019;37:2538–48.
    36. Wall AET. The developmental skill-learning gap hypothesis: implications for children with movement difficulties. Adapt Phys Activ Q. 2004;21(3):197–218.
    37. Ferguson GD, Aertssen WF, Rameckers EA, Jelsma J, Smits-Engelsman BC. Physical fitness in children with developmental coordination disorder: measurement matters. Res Dev Disabil. 2014;35(5):1087–97.
    38. Kellis E, Hatzitaki V. Development of neuromuscular coordination with implications in motor control. In: De Ste Croix M, Korff T, editors. Paediatric Biomechanics and Motor Control: Theory and Application. New York (NY): Routledge, Taylor & Francis Group; 2012. pp. 50–70.
    Keywords:

    MOTOR PROFICIENCY; MUSCLE POWER; MUSCULOSKELETAL FITNESS; ACCELEROMETRY; PRESCHOOL; LONGITUDINAL

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