@phdthesis{Golle2015,
  author    = {Golle, Kathleen},
  title     = {Physical fitness in school-aged children},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-85949},
  school      = {Universit{\"a}t Potsdam},
  pages     = {xi, 147, xii},
  year      = {2015},
  abstract  = {Physical fitness is an important marker of health that enables people to carry out activities of daily living with vigour and alertness but without undue fatigue and with sufficient reserve to enjoy active leisure pursuits and to meet unforeseen emergencies. Especially, due to scientific findings that the onset of civilization diseases (e.g., obesity, cardiovascular disease) begins in childhood and that physical fitness tracks (at least) into young adulthood, the regular monitoring and promotion of physical fitness in children is risen up to a public health issue. In relation to the evaluation of a child's physical fitness over time (i.e., development) the use of longitudinally-based percentile values is of particular interest due to their underlined dedication of true physical fitness development within subjects (i.e., individual changes in timing and tempo of growth and maturation). Besides its genetic determination (e.g., sex, body height), physical fitness is influenced by factors that refer to children's environment and behaviour. For instance, disparities in physical fitness according to children's living area are frequently reported concerning the fact that living in rural areas as compared to urban areas seems to be more favourable for children's physical fitness. In addition, cross-sectional studies found higher fitness values in children participating in sports clubs as compared to non-participants. However, up to date, the observed associations between both (i.e., living area and sports club participating) and children's physical fitness are unresolved concerning a long-term effect. In addition, social inequality as determined by the socioeconomic status (SES) extends through many areas of children's life. While evidence indicates that the SES is inversely related to various indices of child's daily life and behaviour like educational success, nutritional habits, and sedentary- and physical activity behaviour, a potential relationship between child's physical fitness and the SES is hardly investigated and indicated inconsistent results. The present thesis addressed three objectives: (1) to generate physical fitness percentiles for 9- to 12- year-old boys and girls using a longitudinal approach and to analyse the age- and sex-specific development of physical fitness, (2) to investigate the long-term effect of living area and sports club participation on physical fitness in third- to sixth-grade primary school students, and (3) to examine associations between the SES and physical fitness in a large and representative (i.e., for a German federal state) sample of third grade primary school students. Methods (i/ii) Healthy third graders were followed over four consecutive years (up to grade 6), including annually assessment of physical fitness and parental questionnaire (i.e., status of sports club participation and living area). Six tests were conducted to estimate various components of physical fitness: speed (50-m sprint test), upper body muscular power (1-kg ball push test), lower body muscular power (triple hop test), flexibility (stand-and-reach test), agility (star agility run test), and cardiorespiratory fitness (CRF) (9-min run test). (iii) Within a cross-sectional study (i.e., third objective), physical fitness of third graders was assessed by six physical fitness tests including: speed (20-m sprint test), upper body muscular power (1-kg ball push test), lower body muscular power (standing long jump [SLJ] test), flexibility (stand-and-reach test), agility (star agility run test), and CRF (6-min run test). By means of questionnaire, students reported their status of organized sports participation (OSP). Results (i) With respect to percentiles of physical fitness development, test performances increased in boys and girls from age 9 to 12, except for males' flexibility (i.e., stable performance over time). Girls revealed significantly better performance in flexibility, whereas boys scored significantly higher in the remaining physical fitness tests. In girls as compared to boys, physical fitness development was slightly faster for upper body muscular power but substantially faster for flexibility. Generated physical fitness percentile curves indicated a timed and capacity-specific physical fitness development (curvilinear) for upper body muscular power, agility, and CRF. (ii) Concerning the effect of living area and sports club participation on physical fitness development, children living in urban areas showed a significantly faster performance development in physical fitness components of upper and lower body muscular power as compared to peers from rural areas. The same direction was noted as a trend in CRF. Additionally, children that regularly participated in a sports club, when compared to those that not continuously participated in a sports club demonstrated a significantly faster performance development in lower body muscular power. A trend of faster performance development in sports club participants occurred in CRF too. (iii) Regarding the association of SES with physical fitness, the percentage of third graders that achieved a high physical fitness level in lower body muscular power and CRF was significantly higher in students attending schools in communities with high SES as compared to middle and low SES, irrespective of sex. Similar, students from the high SES-group performed significantly better in lower body muscular power and CRF than students from the middle and/or the low SES-group. Conclusion (i) The generated percentile values provide an objective tool to estimate childrenʼs physical fitness within the frame of physical education (e.g., age- and sex-specific grading of motor performance) and further to detect children with specific fitness characteristics (low fit or high fit) that may be indicative for the necessity of preventive health promotion or long term athlete development. (ii) It is essential to consider variables of different domains (e.g., environment and behavior) in order to improve knowledge of potential factors which influence physical fitness during childhood. In this regard, the present thesis provide a first input to clarify the causality of living area and sports club participation on physical fitness development in school-aged children. Living in urban areas as well as a regular participation in sports clubs positively affected children´s physical fitness development (i.e., muscular power and CRF). Herein, sports club participation seems to be a key factor within the relationship between living area and physical fitness. (iii) The findings of the present thesis imply that attending schools in communities with high SES refers to better performance in specific physical fitness test items (i.e., muscular power, CRF) in third graders. Extra-curricular physical education classes may represent an important equalizing factor for physical activity opportunities in children of different SES backgrounds. In regard to strong evidence of a positive relationship between physical fitness - in particular muscular fitness/ CRF - and health, more emphasis should be laid on establishing sports clubs and extra-curricular physical education classes as an easy and attractive means to promote fitness-, and hence health- enhancing daily physical activity for all children (i.e. public health approach).},
  language  = {en}
}
@phdthesis{Fliesser2018,
  author    = {Fließer, Michael},
  title     = {Der Einfluss unterschiedlicher Indikatoren des sozio{\"o}konomischen Status auf R{\"u}ckenschmerz},
  doi       = {10.25932/publishup-42345},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-423455},
  school      = {Universit{\"a}t Potsdam},
  pages     = {84},
  year      = {2018},
  abstract  = {Obwohl der sozio{\"o}konomische Status (SES) eine in der Sozialepidemiologie h{\"a}ufig gebrauchte Variable darstellt, ist seine Verwendung mit methodischen Problemen verkn{\"u}pft: Seine latente Struktur f{\"u}hrt dazu, dass sich verschiedene M{\"o}glichkeiten der Operationalisierung er{\"o}ffnen. Diese reichen von klassischen Ungleichheitsindikatoren wie Bildung, Einkommen oder Berufsposition, {\"u}ber multidimensionale oder {\"u}ber Nachbarschaftsmerkmale konstruierte Indizes, bis hin zu subjektiven Statuseinsch{\"a}tzungen. Problematisch ist dies insofern, als verschiedene Indikatoren auf unterschiedlichen theoretischen Konstrukten beruhen und unterschiedliche Schlussfolgerungen erlauben. In dieser Arbeit wird deshalb in einem ersten Schritt anhand eines systematischen Reviews zum Zusammenhang von SES und R{\"u}ckenschmerzen {\"u}berpr{\"u}ft, welche Indikatoren in wissenschaftlichen Publikationen eingesetzt werden und wie die Auswahl begr{\"u}ndet wird. Das Ergebnis zeigt eine klare Pr{\"a}ferenz f{\"u}r klassische Indikatoren (Bildung, Einkommen und Berufsposition). Erl{\"a}utert wurde die jeweilige Auswahl allerdings nur in einem geringen Prozentsatz der untersuchten Artikel, obwohl die unterschiedlichen Studienergebnisse nahelegen, dass der gew{\"a}hlte Indikator einen Einfluss auf den gefundenen Zusammenhang aus{\"u}ben k{\"o}nnte. Deshalb wurde in einem weiteren Schritt {\"u}berpr{\"u}ft, wie unterschiedliche SES-Indikatoren mit der Verbesserung von R{\"u}ckenschmerzen nach einer Rehabilitation (Studie 1) und der Neuentstehung von R{\"u}ckenschmerzen (Studie 2) zusammenh{\"a}ngen. Außerdem wurde untersucht, ob ein einfaches Modell den Zusammenhang von SES und Gesundheit so darstellen kann, dass a priori abzusch{\"a}tzen ist, wie hoch der Einfluss unterschiedlicher Indikatoren auf einen bestimmten Gesundheitsoutput sein k{\"o}nnte. Es zeigt sich, dass sich der errechnete Zusammenhang zwischen den verschiedenen Indikatoren und chronischen R{\"u}ckenschmerzen erheblich unterscheidet: F{\"u}r Menschen, die bereits wegen R{\"u}ckenschmerzen in Rehabilitation waren, erwiesen sich Bildung und Berufsposition als {\"a}hnlich einflussreiche Einflussfaktoren, w{\"a}hrend f{\"u}r das Einkommen kein bedeutender Zusammenhang festgestellt werden konnte. F{\"u}r die Neuentstehung chronischer R{\"u}ckenschmerzen zeigte sich die Berufsposition als wichtigster Indikator, gefolgt von Bildung, w{\"a}hrend f{\"u}r Einkommen kein signifikanter Zusammenhang gefunden werden konnte. Folglich bestimmt die Wahl des Indikators die H{\"o}he des festgestellten Zusammenhangs stark mit. Unterschiedliche Indikatoren d{\"u}rfen deshalb nicht als austauschbar betrachtet werden und es muss bei jeder Forschungsfrage genau {\"u}berlegt werden, welcher Indikator f{\"u}r die jeweilige Fragestellung am besten verwendet werden kann. Das vorgeschlagene theoretische Modell kann dabei als Unterst{\"u}tzung dienen.},
  language  = {de}
}