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Validation of a VO(2)max Z-score model for fitness assessment in a healthy Spanish pediatric population.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Gavotto A
  • Robert J
  • Andrianoely M
  • Rezola E
  • Manso B
  • Ferrer-Sargues FJ
  • Matecki S
  • Hager A
  • Gauthier N
  • Yin SM
  • Guillaumont S
  • Mura T
  • Borreguero JMB
  • Amedro P
  • QUALIREHAB study group

Grupos

Abstract

INTRODUCTION AND OBJECTIVES: Maximal oxygen uptake is the gold standard for assessing aerobic capacity in children and adolescents. Its interpretation requires robust reference models. A pediatric Z-score model has recently been developed, but external validation in independent cohorts is essential to confirm its applicability. METHODS: We conducted a multicenter validation study including a total of 1046 healthy participants (mean age, 12.0 ± 2.6 years), composed of 2 cohorts: a prospective Spanish validation cohort (n = 175) and a previously published reference cohort (n = 871). The Z-score model was compared with historical weight- and height-based linear equations in terms of correlation, prediction error, and classification of impaired aerobic fitness. Subgroup analyses were performed by sex and body mass index. RESULTS: The Z-score model showed the strongest correlation between predicted and observed maximal oxygen uptake (R(2) = 0.70), outperforming weight-based (R(2) = 0.64) and height-based (R(2) = 0.66) equations. It yielded smaller prediction errors among body mass index groups and identified 14% of participants as having impaired aerobic fitness, compared with 20% and 23% using weight- and height-based reference models, respectively. The Z-score model showed improved consistency and reduced bias, particularly in overweight participants. CONCLUSIONS: The pediatric Z-score model demonstrated superior accuracy, consistency, and classification reliability compared with linear equations in a large, independent Spanish cohort. Its adoption may enhance the interpretation of pediatric cardiopulmonary exercise testing, support early identification of reduced aerobic fitness, and guide prevention strategies and tailored interventions. Registered on ClinicalTrials.gov (NCT04876209).

Copyright © 2026 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
1885-5857, 1885-5857

REVISTA ESPANOLA DE CARDIOLOGIA  EDICIONES DOYMA S A

Tipo:
Article
Páginas:
680-690
PubMed:
41785991
Factor de Impacto:
0,385 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 1

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Keywords

  • Condición física; Consumo de oxígeno; Exercise test; Oxygen consumption; Pediatrics; Pediatría; Physical fitness; Prueba de esfuerzo cardiopulmonar; Puntuación Z; Reference values; Valores de referencia; Z-scores

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