Cardio-respiratory FitnessIn a research conducted by the National Center for Health Statistics (NCHS), it was found that the percentage of adolescents aged 12 to 15 years with adequate cardio-respiratory fitness (CRF) level has reduced significantly in 2012 compared to the statistics of 1999-2000. The data obtained from the National Health and Nutrition Examination Survey (NHANES), 1999-2004 and the NHANES National Youth Fitness Survey, 2012 showed CRF levels have declined among U.S. teens. Cardio-respiratory fitness, an important component of physical fitness is the ability of the circulatory and respiratory systems to supply fuel (oxygen) at the time of sustained physical activity and eliminate fatigue products once the fuel is supplied. As the CRF levels continue to fall among adolescents, the need for physical rehabilitation is gaining importance.

The major findings of this study related to pediatric healthcare are as follows.

  • The number of adolescents aged 12 to 15 years with adequate CRF levels fell from 52.4% in 1999–2000 to 42.2% in 2012.
  • The percentage of boys with adequate CRF levels decreased from 64.8% in 1999–2000 to 50.2% in 2012 while the percentage of girls decreased from 40.5% to 33.8%.
  • The percentage of adolescents aged 12 to 15 years with adequate CRF levels did not differ by race and Hispanic origin or by family income-to-poverty ratio.
  • A higher percentage (54.1%) of normal weight teens had adequate CRF levels compared to overweight (29.9%) or obese (20%) teens in the age group 12 to 15 years.

Adequate CRF levels are very important for fitness. Several studies have shown that a low fitness level is closely associated with the risk for cardiovascular diseases including coronary artery disease, stroke and more. It is evident from these findings that obesity/overweight and low fitness levels are correlated. Therefore, physical activities are essential to improve the CRL levels in adolescents. A 2013 study by American researchers suggest adolescents require higher intensity physical activity to maintain or improve cardiorespiratory fitness.

Comprehensive and accurate documentation of the symptoms, medications, past and current illness, usual level of physical activity and other personal details of patients has to be made to determine whether the cardio-respiratory fitness levels are adequate. Adequate levels of cardio-respiratory fitness are based on age and sex specific standards and established according to how fit children or adolescents need to be for good health. Once the pediatricians confirm the CRF levels from the clinical documentation, they can conduct screening (for example, obesity screening) and recommend preventive measures to reduce weight or they can refer them to rehabilitation physicians for advice regarding a good diet and effective exercises. The Affordable Care Act (ACA) considers screening under preventive care services which is among the ten essential health benefits that must be covered by insurance policies.