Health-related quality of life in childhoodThe importance of physical activity, fitness and motor competence

Resumen

Health-related quality of life (HRQOL) in childhood can be defined as a child’s subjective perception of the impact of health status on physical, psychological, and social functioning, also considering the ability to perform activities appropriate to the age of the child. HRQOL emerged at the beginning of the 21st century as an essential health outcome that provides scientific evidence for health care prevention, health promotion and clinical decision-making. International interest in HRQOL has continued to increase, generating a large and growing body of research literature. Thus, evaluation of HRQOL is particularly important for improving health, especially in childhood, as it is a critical period for introducing prevention strategies and healthy habits that might be related to HRQOL. It is known that optimal physical activity levels can improve HRQOL, but only a few studies have investigated the association between physical fitness (a construct closely related to physical activity, but different) and HRQOL in children under 7 years. In addition, on the one hand, motor competence is known to be associated with HRQOL of children with clinical conditions, there are no studies investigating the association between motor competence and HRQOL in typically developing children though. What is more, cardiorespiratory fitness has a strong influence on motor competence, and this in turn, on HRQOL but this association has not yet been studied. On the other hand, children with very low levels of motor competence can be associated with developmental motor coordination disorder, who tend to have poorer HRQOL scores and whose parents underestimate one’s HRQOL. However, only two studies have examined differences in HRQOL between children with this health condition and typically developing ones, and just one has examined parent-child differences. Finally, although a positive relationship between physical activity and biopsychosocial health has been evidenced in children, school-based physical activity interventions including HRQOL as an end-point are scarce and their results inconclusive. Four original articles addressing several questions are included in this doctoral thesis, which the main objective was to study the association between HRQOL with fitness and motor competence, analyse the differences in HRQOL between children with developmental motor coordination disorder and typically development ones and also analyse the differences between parents and children’s perceptions, and examine the effectiveness of a school-based physical activity programme on improving HRQOL in children. The main details of the articles are presented in the summary table. Andrés Redondo Tébar has completed this doctoral thesis in the framework of two predoctoral fellowships (J.I-JCCMREDONDOTEBAR, 2018-CPUCLM-7813), mentioned earlier. The research was designed by Mr Andrés Redondo Tebar, Dr Mairena Sánchez López and Dr Vicente Martínez-Vizcaíno, whose data are derived from the MOVI-KIDS study. The MOVI-KIDS study was funded by the Ministry of Economy and Competitiveness Carlos III Health Institute and FEDER funds (FIS PI12/00761 and FIS PI12/02400), whose principal investigators are Dr Mairena Sánchez López and Dr Vicente Martínez Vizcaíno, and the Research Network on Preventative Activities and Health Promotion (RD12/0005/0009). The analyses of the data, the writing of the articles and the peer-review process were performed by Andrés Redondo Tébar and supervised by the principal investigators of the project and the respective co-authors of the articles.