PURPOSE: To develop sex- and age-specific international normative 20 m shuttle run test (20mSRT) values for children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM® criterion-referenced standards for healthy cardiorespiratory endurance. METHODS: A systematic literature search was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1-minute stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 year-olds. Following corrections for methodological differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex- and age-specific normative centile values generated using the LMS method. Sex- and age-related differences were expressed as percent and standardized differences in means. The prevalence of children and youth with healthy cardiorespiratory endurance was estimated using the age- and sex-specific FITNESSGRAM® criterion-referenced standards. RESULTS: Normative values were displayed as tabulated centiles for the 20mSRT using four common metrics (speed [km/h] at the last completed stage, completed stages, laps, and mass-specific peak oxygen uptake) on a dataset comprising 850,036 test performance scores from 48 countries extracted from 159 reports. Boys consistently outperformed girls at each age group (mean difference ±95%CI: 0.99 ±0.35 km/h or 0.81 ±0.21 standardized units), with the magnitude of age-related increases larger for boys than for girls. Boys (mean ±95%CI: 68 ±13%) had healthier cardiorespiratory endurance than girls (mean ±95%CI: 52 ±18%), with the prevalence of healthy cardiorespiratory endurance decreasing systematically with age. CONCLUSION: This study provides the most comprehensive and up-to-date set of international sex- and age-specific normative 20mSRT values for children and youth. We envision these results as a useful tool for coaches, physical educators, health practitioners, and public health workers as a surveillance, profiling, and/or screening instrument to help identify over- and under-performing children and youth.
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