ADAPTED PHYSICAL ACTIVITY QUARTERLY, 1994,11,297-305
O 1994 Human Kinetics Publishers, Inc.
Obesity and Movement Competency in Children
J. Dru Marshall and Marcel Bouffard
University of Alberta
The primary purpose of this study was to document the actual gross movement
competencies, as measured by the Test of Gross Motor Development, in obese versus
nonobese children. A 2 Gender (male, female) x 2 Groups (obese, nonobese) x 2
Age Categories (Grade 1, Grade 4) x 2 Programs (quality daily physical education
[QDPE], non-QDPE) completely randomized factorial design was used. A significant
three-way interaction effect (Group x Age x Program) was found for the Locomotor
Skills subscale, such that the differencein movement competency in locomotor skills
between obese and nonobese children increased as children got older if they did not
receive QPDE. A significant main program effect was also found for the Object
Control Skills subscale, with the QDPE children scoring higher than the non-QDPE
children. It appears, then, that QDPE programs offer a "protective" effect for the
development of locomotor skills in obese children. Implications of these findings
are discussed.
Several research studies have concluded that obese children are less active than
nonobese children (Berkowitz, Agras, Komer, Kraemer, & Zeanah, 1985; Dumin, Lonergan, Good, & Ewan, 1974; Mayer, 1965; Thompson, Jarvie, Lahey, & Cureton, 1982).
Consequently, physical activity/exercise forms one of the comerstones of obesity treatment regimes. The exercise component of an overall treatment program is often directed
towards measurable outcomes such as improvement in client fitness, a decrease in
weight and fat mass, and an increase in muscle mass. Typically, these programs involve
structured or "active lifestyle" activities (Epstein, Wing, & Valoski, 1985; Thompson
et al., 1982) and are rarely successful over the long term. This lack of success has been
attributed to a number of factors, ranging from low adherence to program regime to the
fact that the multifaceted nature of obesity makes it difficult to treat (Bamstuble,
Klesges, & Terbizan, 1986; Brownell, 1984). Given the recent evidence linking a sedentary lifestyle to movement competency (Magill, 1993) and to coronary heart disease
(Blair et al., 1989), it is important to investigate some of the underlying reasons for
inactivity in obesity, particularly in young children, for whom early prevention would
seem prudent.
It is well known that practice is one of the most important motor learning variables
(Magill, 1993; Schmidt, 1988). If obese youngsters are inactive, they lack practice and,
thus, potentially may have impaired the development of motor skills. Further, children
J. Dru Marshall and Marcel Bouffard are with the Department of Physical Education and
Sport Studies at the University of Alberta, P-421 Van Vliet Physical Education Centre, Edmonton,
AB Canada T6G 2H9.
Marshall and Bouffard
298
who are less movement competent are more frequently socially rejected by their peers
than those who are movement competent would be (Evans & Roberts, 1987). Inept
children, on the average, may have less opportunities to interact in movement situations.
Hence, inadequate motor performance may lead obese children to withdraw from participation in physical activity. Consequently, a potentially dangerous cycle may develop.
Withdrawal from activity results in the lack of practice of the very skills these children
need for positive participation. Lack of practice, in turn, inhibits further movement skill
development and increases the existing performance differences between obese children
and their nonobese peers.
Children often rely on physical education programs in schools to provide them
with activity learning situations. Unfortunately, elementary school children often are
not given the opportunity to learn and to develop motor skills, in part because the schools
typically do not place sufficient emphasis on physical education (Malina, 1988). In
Canada, the movement towards increased time allotment to physical education occurred
in the 1970s with the advent of the quality daily physical education (QDPE) movement.
After a comprehensive study of elementary school programs across Canada, the following
elements of a quality program were outlined in 1976: daily instruction, maximum active
participation, a wide range of movement experiences, fitness activities in each lesson,
qualified competent teachers, adequate and appropriate facilities and equipment, a program based on child growth and development characteristics, an opportunity to develop
positive attitudes toward physical activity, and the provision of suitable competition
(Turkington, 1987). Benefits attributed to these types of programs include: better health,
improved fitness, less susceptibility to stress, increased independence, improved academic performance, improved self-esteem, increased knowledge and understanding of
a healthy lifestyle, and more positive attitudes toward physical activity, school, and
themselves (Canadian Association for Health, Physical Education, and Recreation, 1988;
Robbins, 1987). The development of motor skill in QDPE programs has not been well
studied.
Although numerous studies have demonstrated that obese children are relatively
inactive, their motor performance of culturally normative movement skills has not been
adequately documented. Thus, the primary purpose of this study was to document the
actual movement performance of obese versus nonobese children. Second, because the
literature suggests that when children are inactive their motor performance, compared
to that of active children, becomes worse over time, age was included as a factor. Third,
because a good physical activity program may alleviate the effects on inactivity, the
type of school physical education program received by the children was also included
as a factor. Finally, because gender differences are frequently observed on motor performance tests (Thomas & French, 1985), gender was included as a factor.
Methods
Subjects
A total of 130 students were selected to participate in this study. Sixty-five obese children
were identified using anthropometric screening tools. Each obese child was matched
with a nonobese child of the same age, gender, and school. For each obese child, the
following matching strategy was used. In each class, the list of nonobese children that
were the same age as the obese child k6 months was generated. The nonobese children
were randomly selected from this list. The number of subjects in each group is presented
in Table 1.
Obesity and Movement Competency
299
Table 1 Number of Subjects in Each Group
Obese
Group
Boys
Girls
Nonobese
Boys
Girls
Grade 1
QDPE
Non-QDPE
Grade 4
QDPE
Non-QDPE
Note. QDPE = quality daily physical education.
Procedure
The study consisted of two phases. The initial obesity screening phase involved the
anthropometric measurement of 342 students from nine schools within a major Canadian
city. These schools, two of which were offering QDPE programs, were chosen on the
basis of convenience and obtained permission. Sixty-five children were age-, gender-,
and school-matched with 65 nonobese controls. The second phase of the study involved
the administration of the two subscales (Locomotor and Object Control) of the Test of
Gross Motor Development (TGMD; Ulrich, 1985) to the 130 subjects.
Informed consent was obtained for each subject, and all were briefed and familiarized with the procedures prior to any measurements being taken. All measures were
conducted in the school setting. All aspects of this research were reviewed and approved
by an ethics review panel.
Measures
Initial anthropometric screening for this study occurred in school physical education
classes. The body composition of all students was assessed by two methods: (a) visually,
with the Marshall Visual Rating Scale (Marshall, Hazlett, Spady, & Quinney, 1990)
and (b) via the sum of five skinfolds used in the Canadian Standardized Test of Fitness
(CSTF; Canadian Standardized Test of Fitness Operations Manual, 1986).
The Marshall Visual Rating Scale was used to subjectively classify adiposity
before the collection of all other measures. This test is a simple 4-point scale, with a
rating of 1 corresponding to slim (thin, anorexic-like), 2 to ideal (optimal weight to
height), 3 to overweight (pleasantly plump but not indicative of a health risk), and 4 to
obese (grossly overweight, at perceived health risk). An interrater reliability study of
this scale, using 75 subjects, established an unadjusted reliability estimate of 0.95
(Marshall et al., 1990), indicating that an unusually high degree of consistency across
raters was attainable by visual inspection.
Skinfolds (triceps, biceps, subscapular, suprailiac, and medial calf) were measured
according to the procedures outlined in the CSTF Operations Manual (1986). Each
skinfold was measured once, followed by a second set of measures completed in the
same order. If the two measures were within .4 mm, the average of the two values was
taken as the final score for that skinfold. If the two measures varied by more than .4
Marshall and Bouffard
300
mm, a thud measure was taken. The final score in this instance was the mean of the
closest two values. The five final skinfold values were then added. For the CSTF skinfold
test, a sum greater than or equal to the normative 85th percentile for age and gender
was defined as obese (Canada Fitness Survey, 1985). The visual diagnosis of obesity
(or in some cases of being overweight) was used to confirm the skinfold diagnosis of
obesity. The use of two measures to classify obesity helped to increase the validity of
this classification (Marshall et al., 1990).
The TGMD was administered to all 130 (65 obese; 65 nonobese) subjects to
determine their level of motor performance. The TGMD has two subscales: Locomotor
Skills and Object Control Skills. The Locomotor Skills subscale contains seven items:
run, gallop, hop, leap, horizontal jump, skip, and slide. The Object Control Skill subscale
has five items: two-hand strike, stationary bounce, catch, kick, and overhand throw.
Three trials of each skill were performed and videotaped. Skills were scored according
to the procedure outlined in the TGMD manual. That is, if a critical feature was observed
on two of three trials, a score of 1 was given, otherwise 0 was awarded. Composite
scores were developed for the Object Control subscale and the Locomotor subscale.
Coding
The coders were two graduate students in physical education. The videotaped performance of each child was independently coded by each coder according to the procedure
outlined by Ulrich (1985). Using a relative decision model (see Shavelson & Webb,
1991, pp. 13-14), the reliability of the total score for each subscale was calculated. The
reliability of the average of the scores of both coders was 0.89 for the locomotor skills
subscale and 0.93 for the object control subscale. This average score was used for data
analysis because the reliability of two scores is higher than the reliability of a single
score.
Design
A 2 Gender (males, females) x 2 Groups (obese, nonobese) x 2 Age Categories (Grade
1, Grade 4) x 2 Programs (QDPE, non-QDPE) completely randomized factorial design
(Kirk, 1982) was used in this study.
Results
The data for each subscale were analyzed with 2 x 2 x 2 x 2 (Group x Gender x Age
x Program) analyses of variance (ANOVA). We decided to use univariate analyses
instead of a multivariate analysis because the subscales had little common variance (i.e.,
.12). Due to the small variance in common, these variables were viewed as "conceptually
independent" (for a discussion of this issue see Huberty & Moms, 1989). The SPSS/
PC+ software was used for analysis of the data (Norusis, 1990). Due to unequal sample
size in each cell, a regression solution was selected. This method may be viewed as
conservative because it extracts the sum of squares that is unique to each main effect
or interaction effect. It is evident from the anthropometric results presented in Table 2
that the obese subjects in this study scored higher than the nonobese subjects (and were
therefore fatter) in both the CSTF sum of skinfold test and the subjective visual rating.
Descriptive motor performance results for each subscale are presented in Table 3.
The ANOVA conducted on the Locomotor Skills subscale scores revealed a
significant three-way interaction of Group x Age x Program, F(l, 114) = 4.65, p < .05
(see Figure 1). This interaction was followed up by simple Group x Age interactions
Obesity and Movement Competency
301
Table 2 Anthropometric Results of Subjects
Nonobese
Obese
Group
Boys
SD
M
M
Girls
SD
Canadian Standardized Test of Fitness sum of
Grade 1
92.0 4.5
QDPE
93.0 3.5
90.8 3.8
89.4 4.2
Non-QDPE
Grade 4
92.2 4.4
91.7 4.3
QDPE
92.2 3.6
Non-QDPE
93.3 2.5
M
Boys
SD
M
Girls
SD
skinfolds (percentile scores)
46.0
37.5
19.8
23.5
29.4
23.3
28.3
9.3
49.4
21.1
8.8
14.1
42.2
31.7
17.5
23.6
Visual ratings
Grade 1
QDPE
Non-QDPE
Grade 4
QDPE
Non-QDPE
2.4
2.0
.70
.00
3.2
2.8
.84
.75
1.8
1.9
.42
.64
1.4
1.3
.55
.52
2.7
3.2
.87
.67
3.1
2.8
.78
.67
1.8
1.7
.44
.50
1.6
1.4
.53
.53
Note. QDPE = quality daily physical education.
at each level of the Program factor (Keppel, 1991, pp. 447-450). This interaction was
not significant for children receiving QDPE. However, it was significant for children
who did not receive QDPE, F(1, 56) = 10.39, p < .01. This Group x Age interaction
means that the difference in movement competency between obese and nonobese children
becomes larger as children get older if they do not receive QDPE.
The ANOVA for the Object Control Skills subscale scores did not reveal any
significant effect involving the Group factor. However, a significant Program main effect
was found, F ( l , 114) = 6.77, p < .02, with the QDPE children scoring higher (M =
13.2, SD = 2.7) than the non-QDPE children (M = 12.1, SD = 3.0).
Discussion
The significant Group x Age x Program interaction found for the Locomotor Skills
subscale demonstrated that the difference in movement competency in locomotor skills
between obese and nonobese children increases as children age if they do not receive
QDPE programs. Thus, a dangerous pattern is established for obese children in nonQDPE programs. In the long term, lack of movement competency in locomotor skills
can be a major obstacle to successful integration into society (Henderson, 1986). Individuals who are movement incompetent more often experience negative affective outcomes
and are less likely to participate in movement situations (Craft & Hogan, 1985; Roberts,
Kleiber, & Duda, 1981). Due to a lack of movement competencies, a child may be
ridiculed by his or her peers (Gordon & McKinlay, 1980), experience frustration when
learning movement skills, and be excluded from participation (Evans & Roberts, 1987).
The exclusion from peer groups can only impair the normal development of knowledge
Marshall and Bouffard
302
Table 3
Object Control Subscale and the Locomotor Subscale Scores
Nonobese
Obese
Boys
SD
M
Group
Girls
M
Boys
SD
M
SD
Girls
M
SD
Object control subscale
Grade I
QDPE
Non-QDPE
Grade 4
QDPE
Non-QDPE
12.65
12.75
2.22
2.33
11.20 3.09
7.58 2.96
12.65 2.60
11.19 3.08
9.70 1.64
9.17 2.26
15.72
14.17
2.46
0.75
13.56 1.29
11.56 1.94
15.61 1.64
15.33 1.37
12.22 2.12
12.83 2.25
Locomotor subscale
Grade 1
QDPE
Non-QDPE
Grade 4
QDPE
Non-QDPE
16.10
18.06
2.26
1.45
17.90 3.71
16.83 2.32
17.40 2.07
16.56 2.54
19.20 1.89
17.33 2.16
18.61
17.55
3.57
2.23
19.83 2.47
18.00 2.32
20.11 2.25
21.72 2.29
20.67 1.22
19.72 1.33
Note. QDPE = quality daily physical education.
No-Quality Daily
Physical Education
Quality Daily
Physical Education
x-x Non-obese
Obese
Grade 1
Figure 1 -Locomotor
education program.
Grade 4
Grade 1
Grade 4
scores obtained by nonobese and obese children in each physical
Obesity and Movement Competency
303
and skills essential to cope with everyday life situations (Wall, McClements, Bouffard,
Findlay, & Taylor, 1985).
Conversely, because the difference between obese and nonobese children did not
increase over time, QDPE programs appeared to offer a "protective" effect for the
development of locomotor skills in obese children. Many benefits have been reported
previously with QDPE programs, including increased sociability and improved fimess,
skill, and attitude (Martens, 1982; Siedentop & Siedentop, 1985). Our research supports
an improvement in object control skills for children enrolled in QDPE versus non-QDPE
programs, as demonstrated by the main effect of Program. Additionally, it appears that
an improvement in movement competency in locomotor skills, particularly in those
children who need this type of improvement (i.e., fat and potentially lower fimess level
children), is also a benefit of QDPE programs, one that has been previously unexplored.
It is interesting that a significant three-way Group x Age x Program interaction
was found for locomotor skills, but not for object control skills. We can only speculate
about the nature of this difference. The locomotor skills tests may involve a cardiovascular
fitness component, as all tests require three trials of movement, whereas the object
control skills tests are relatively stationary, discrete tasks. There is little difference in
movement competency in obese and nonobese children in Grade 1. However, after 3
years of potential inactivity, the physiological task demands for the Locomotor Skills
subscale for an obese child in Grade 4, who may be at a lower functional fimess level,
may be higher than that for a nonobese child, and thus, the interaction effects that were
found in this study may be partially a result of fimess levels, as opposed to actual
movement competency. On the other hand, since the object control skills are relatively
stationary, there is probably less cardiovascular fitness involved, and the physiological
task demands for obese and nonobese children are likely to be equal.
This explanation is based on changes in fitness level over time. Just as we
hypothesized about the decrease in movement competency over time, a similar argument
can be made for decreasing fitness levels following years of inactivity or withdrawal
from activity. Unfortunately, fimess levels were not measured in this study, and little
empirical evidence exists with regards to the changing fimess levels of children below
10 years of age. Thus, these hypotheses cannot be confirmed at this time.
Although this preliminary work suggests that obese children have inferior movement competencies in locomotor skills, it appears that if they are fortunate to attend a
school that offers a QDPE program, they will not experience a further reduction in
motor skill competency over time. Thus, an important remedial avenue in terms of the
physical activity component for obesity treatment may be the teaching of motor skills.
This approach would allow youngsters to experience success in a movement environment,
and thus, they would be more motivated to participate in further activity situations. As
a result of increased participation, one would expect to see an increase in fimess. This
is in contrast to the traditional exercise components of obesity treatment programs,
which tend to focus on fitness and weight loss or maintenance and which provide only
transient benefits.
In future studies, researchers should attempt to replicate the findings of this study
(Lindsay & Ehrenberg, 1993). Additionally, future studies should determine the impact
of QDPE in both obese and nonobese children on other variables, such as fimess,
perceptions of physical and social competence, self-esteem, and body image. The results
of these future studies should be shared with both physical educators and program
administrators to improve current physical education curricula.
Marshall and Bouffard
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First International Conference
"Prevention: The Key to Health for Life"
October 27-30, 1994, Charleston, West Virginia
Sponsored by the Lawrence Frankel Foundation and the Center for
the Study of Aging of Albany, NY. Plenary sessions, symposia, paper
presentations, posters, workshops, and demonstrations will relate to people
of all ages, races, and nationalities. Interdisciplinary topics to include medicine, health promotion and education, public policy, ethics, fitness, wellness, lifestyle, environment, and mofe.
For further information, contact Nancy Peoples, the Arnold Agency,
#10 Hale St., Charleston, WV (Tel. 3041342-1200). For information about
program content, speakers, etc., contact Sara Harris, Center for the Study
of Aging, 706 Madison Ave., Albany, NY.
Tel. 5 1814656927; Fax 5181462-1339.