Criterion-Related Validity of the 20-M Shuttle Run Test for Estimating Cardiorespiratory Fitness: A Meta-Analysis
The main purpose of the present meta-analysis was to examine the criterion-related validity of the 20-m shuttle run test for estimating cardiorespiratory fitness. Relevant studies were searched from twelve electronic databases up to December 2014, as well as from several alternative modes of searching. The Hunter-Schmidt’s psychometric meta-analysis approach was conducted to estimate the population criterion-related validity of the 20-m shuttle run test. From 57 studies that were included in the present meta-analysis, a total of 78 correlation values were analyzed. The overall results showed that the performance score of the 20-m shuttle run test had a moderate-to-high criterion-related validity for estimating maximum oxygen uptake (rp = 0.66-0.84), being higher when other variables (e.g. sex, age or body mass) were used (rp = 0.78-0.95). The present meta-analysis also showed that the criterion-related validity of Leger’s protocol was statistically higher for adults (rp = 0.94, 0.87-1.00) than for children (rp = 0.78, 0.72-0.85). However, sex and maximum oxygen uptake level do not seem to affect the criterion-related validity values. When an individual’s maximum oxygen uptake attained during a laboratory-based test is not feasible, the 20-m shuttle run test seems to be a useful alternative for estimating cardiorespiratory fitness. In adults the performance score only seems to be a strong estimator of cardiorespiratory fitness, in contrast among children the performance score should be combined with other variables. Nevertheless, as in the application of any physical fitness field test, evaluators must be aware that the performance score of the 20-m shuttle run test is simply an estimation and not a direct measure of cardiorespiratory fitness. Key points Overall the 20-m shuttle run test has a moderate-to-high mean criterion-related validity for estimating cardiorespiratory fitness. The criterion-related validity of the 20-m shuttle run test is significantly higher for adults than for children. However, when the performance score is combined with other variables, the criterion-related validity value increases considerably among children. Sex and maximum oxygen uptake level of individuals seem not to affect the criterion-related validity of the 20-m shuttle run test. When individuals’ maximum oxygen uptake attained during a laboratory-based test is not feasible, the 20-m shuttle run test seems to be a useful alternative for estimating cardiorespiratory fitness. Key words: Maximum oxygen uptake, peak oxygen uptake, PACER, Multistage fitness test, Leger test Introduction Nowadays, cardiorespiratory fitness is considered one of the most powerful markers of health, even above other traditional markers such as weight status, blood pressure or cholesterol level (Blair, 2009). Current evidence has shown how cardiorespiratory fitness status is an important quantitative predictor of cardiovascular events and all-cause mortality in healthy adults (Kodama et al., 2009). Additionally, during childhood higher cardiorespiratory fitness levels have been associated with a healthier cardiovascular profile in adulthood (Ruiz et al., 2009). Therefore, cardiorespiratory fitness testing may help to identify a target population for primary prevention both in children and adults, as well as for health promotion policies (Ruiz et al., 2009). Different kinds of tests are commonly used to assess cardiorespiratory fitness. Cardiorespiratory fitness is typically identified as the maximal oxygen uptake (VO2max) reached by an individual (Pescatello et al., 2014). Specifically, the VO2max attained during a laboratory-based and graded maximal exercise test is widely considered the criterion measure (also called “gold standard”) of cardiorespiratory fitness (Pescatello et al., 2014). Alternatively, due to advances in technology, today a portable gas analyzer can also be worn during a field-based graded maximal exercise test (Castagna et al., 2010; Silva et al., 2012). Due to the necessity of sophisticated and costly instrumentation, qualified technicians, and time constraints, the use of the directly measured VO2max is limited in several settings such as in sports clubs, schools, or in large scale research studies (Pescatello et al., 2014). Unlike the direct methods to determine VO2max, in the above mentioned settings the performance score attained during cardiorespiratory fitness field tests could be a useful alternative. The 20-m shuttle run (20MSR) test, also called the ‘‘Course Navette’’, “PACER”, or “Multistage fitness test”, is probably the most widely used field test for estimating cardiorespiratory fitness (Castro-Pinero et al., 2010). The 20MSR test is simple, easy to administer and not too time-consuming, it requires minimal equipment, and a large number of individuals can be tested simultaneously. The 20MSR test consists of one-minute stages of continuous, incremental speed running. The initial speed is 8.5 km/h, and increases by 0.5 km/h per minute (Leger et al., 1984). The individual is required to run between two lines 20-m apart, while keeping pace with audio signals emitted from a pre-recorded cassette or compact disk. The test ends when the individual fails to reach the end lines concurrent with the audio signals on two consecutive occasions. Although in the original protocol the stages lasted two minutes (Leger and Lambert, 1982), later it was modified to one minute stages which were considered more motivating (Leger et al., 1984). Additionally, later different combinations of starting speed and speed increase have been proposed (e.g. Cadenas-Sanchez et al., 2014; Dong-Ho et al., 2014). Each primary study that is published about criterion-related validity of the 20MSR test only constitutes a single piece of a constantly growing body of evidence (Cooper et al., 2009). For instance, in some studies the correlation coefficient is high (Chatterjee et al., 2006c), while in others the association is moderate or even low (Von Haaren et al., 2011). To make sense of the often conflicting results found in the scientific literature, researchers have to conduct meta-analyses (Cooper et al., 2009; Hunter and Schmidt, 2004; Lipsey and Wilson, 2001). Thus meta-analyses remain a useful tool for the evaluation of evidence (Cooper et al., 2009), forming a critical process for the development of theory in science (Hunter and Schmidt, 2004). Previous studies have carried out meta-analyses on the validity of different field-based tests widely used in sports sciences such as the Borg’s perceived exertion scale (Chen et al., 2002), the International Physical Activity Questionnaire (Kim et al., 2012), or the flexibility tests sit-and-reach (Mayorga-Vega et al., 2014a) and toe-touch (Mayorga-Vega et al., 2014b). To our knowledge there are not any meta-analyses addressing the criterion-related validity of the 20MSR test. Therefore, the purposes of the present meta-analysis were: (a) to estimate and compare the overall population mean of the criterion-related validity coefficients of the 20MSR test for estimating cardiorespiratory fitness; (b) to examine the influence of some study features (sex, age, and level of VO2max of the participants) in criterion-related validity coefficients of the 20MSR test (between-study analyses); and (c) to compare the values of the criterion-related validity coefficients between the performance score only and the performance score combined with other variables (within-study analyses).