A multilevel analysis of gross motor coordination of children and adolescents living at different altitudes: the Peruvian Health and Optimist Growth Study

Abstract

Background

Gross motor coordination (GMC) is a potential correlate of lifestyle behaviours and health outcomes in childhood and adolescence.

Aims

The aim of this study was to examine how sex, age, biological maturation, overweight, stunting, and physical fitness are associated with GMC in children and adolescents from Peru, and to examine associations between geographical area of residence, school-level characteristics, and GMC.

Subjects and methods

The sample included 7408 subjects, aged 6–14 years, from sea level, Amazon and high-altitude regions of Peru. A composite marker of total coordination was derived by the sum of scores from each test (GMC_T). Overweight was identified using BMI, and biological maturation, physical fitness, and stunting were assessed. School characteristics were obtained via an objective audit.

Results

Boys (β = 12.23 ± 0.90) and older children (β = 13.37 ± 0.64) had higher GMC_T than girls and younger children, respectively. Overweight was associated with lower GMC_T (β = −5.23 ± 0.80), whereas fitness was positively associated with GMC_T (β = 6.30 ± 0.25). Biological maturation was not a predictor; however, stunting was negatively associated with GMC_T (β = −3.71 ± 1.56). Subjects living in the Amazon had higher GMC_T than those at sea level (β = 16.57 ± 4.73). Five of nine school-level predictors (number of students, playground area with obstacles, multi-sports roofed, frequency and duration of Physical Education classes) were significant predictors of GMC_T.

Conclusions

Child- and school-level variables were significantly associated with GMC_T in this sample. These findings are important for the Peruvian community, especially school principals, councils and physical education teachers, helping them to define more efficient strategies and action plans to increase motor coordination in children.

Keywords:

• Children and adolescents
• gross motor coordination
• school context
• environment
• multilevel modelling

Acknowledgements

We would like to thank all schoolchildren from Barranco, Junín, San Ramon and La Merced for their participation in the study, as well as their parents. We also recognise UNE’s Physical Education students and teachers´ high dedication and professionalism in all steps related to the data collection. We remember the late Emeritus Professor Gaston Beunen, one of the prime movers of the Healthy and Optimistic Growth Study. Finally, we would also like to thank the anonymous reviewers for their suggestions that substantially improved the paper.

Author contributions

CS, DH, PTK, and JM analysed the data. CS, JM, AB, DH, and PTK drafted the manuscript. AB and JM designed the study and directed its implementation. AB and JM provided necessary logistical support. AB, DH, OV, RG, and PTK provided extensive critical comments and did the final editing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Foundation for Science and Technology Portugal [grant number SFRH/BD/141112/2018] and POCH of European Social Found (FSE).