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The Measurement and Interpretation of Aerobic Fitness in Children: Current Issues

Generation of energy from aerobic metabolism is largely dependent upon the ability of the pulmonary, cardiovascular, haematological and cellular systems to transport oxygen from the atmosphere to the contracting muscles and the ability of the tissues to use oxygen to catabolize fuels1. Maximal aerobic power or maximum oxygen uptake (V0 2max) refers to the maximum rate of oxygen consumption during exercise with large muscle groups of increasing intensity continued to exhaustion. As V0 2max limits an individual's capacity for aerobic exercise it is widely accepted as the single best indicator of aerobic fitness". Protocols for the measurement of V0 2max and its interpretation in the context of health or training status in adults are well established. Children, however, are not mini adults and the variability of physiological responses to maximal exercise observed during growth and maturation confound and complicate these processes. Interest has recently been focused on the determination of maximal effort in children and adolescents and whether the peak levels of oxygen uptake measured during incremental exercise truly represent a maximal index of aerobic fitness. The interpretation of aerobic fitness in young people is confounded by the need to appropriately partition out body size differences from group comparisons, e.g. by age or sex. Renewed interest in the merits and pitfalls of various scaling techniques has produced some interesting findings which challenge conventional interpretation of changes in aerobic fitness with growth and maturation. This paper addresses some of these issues currently engaging the interest of paediatric exercise physiologists with an emphasis on the recent work of the Children's Health and Exercise Research Centre at the University of Exeter.