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Bidi ec ional Rela ionship O e Time Be ween Body Mass Index and Fundamen al
Mo emen Skill Domains Measu ed by a P ocess-O ien ed Me hod in Childhood : A 3-
Yea Longi udinal S udy
© 2024 The Au ho s. Published by Human Kine ics, Inc.
Published e sion
Kasanen, Ma ia; Laukkanen, A o; Niemis ö, Donna; Tol anen, Asko; O ega,
F ancisco; Sääkslah i, A ja
Kasanen, M., Laukkanen, A., Niemis ö, D., Tol anen, A., O ega, F., & Sääkslah i, A. (2024).
Bidi ec ional Rela ionship O e Time Be ween Body Mass Index and Fundamen al Mo emen
Skill Domains Measu ed by a P ocess-O ien ed Me hod in Childhood : A 3-Yea Longi udinal
S udy. Jou nal o Mo o Lea ning and De elopmen , Ea ly online.
h ps://doi.o g/10.1123/jmld.2023-0044
2024
Jou nal o Mo o Lea ning and De elopmen , (Ahead o P in )
h ps://doi.o g/10.1123/jmld.2023-0044 ORIGINAL RESEARCH
Fi s Published Online: June 14, 2024
Bidi ec ional Rela ionship O e Time
Be ween Body Mass Index and
Fundamen al Mo emen Skill Domains
Measu ed by a P ocess-O ien ed Me hod
in Childhood: A 3-Yea Longi udinal S udy
Ma ia Kasanen, A o Laukkanen, Donna Niemis ö,
Asko Tol anen, F ancisco O ega, and A ja Sääkslah i
Facul y o Spo and Heal h Sciences, Uni e si y o Jy äskylä, Jy äskylä, Finland
The wo ldwide inc ease in childhood o e weigh and obesi y unde sco es he
need o s udy a iables like undamen al mo emen skill (FMS) le els om ea ly
childhood. This s udy in es iga ed he bidi ec ional longi udinal ela ionship
be ween body mass index (BMI) and p ocess-o ien ed FMSs, including locomo-
o skills and objec con ol skills in 675 Finnish child en, aged 3–8 yea s a
baseline (50.5% emale, mean age 5.5 yea s) o e 3 yea s. S anda dized BMI- o -
age SD sco es (BMI SDS z-sco es) ollowed Finnish na ional s anda ds. The FMS
assessmen comp ised ou sub es s om he Tes o G oss Mo o De elopmen ,
hi d edi ion. Age-adjus ed s anda dized esiduals o FMS o skill domains and
BMI SDS z-sco es we e used in a wo-le el, c oss-classified, c oss-lagged
eg ession analysis, accoun ing o gende , and baseline alue o he dependen
a iables. The esul s showed no s a is ically significan longi udinal ela ionship
be ween BMI and FMS o i s skill domains o ei he gende in ei he di ec ion.
This sugges s ha BMI and p ocess-o ien ed FMS, encompassing locomo o skill
and objec con ol skill, de elop independen ly, possibly influenced by unex-
plo ed a iables. These findings con adic ea lie esul s based on p oduc -
o ien ed measu emen s, which may include a physical capaci y componen . The
© 2024 The Au ho s. Published by Human Kine ics, Inc. This is an Open Access a icle dis ibu ed
unde he e ms o he C ea i e Commons A ibu ion 4.0 In e na ional License, CC BY 4.0, which
pe mi s un es ic ed noncomme cial and comme cial use, dis ibu ion, and ep oduc ion in any medium,
p o ided he o iginal wo k is p ope ly ci ed, he new use includes a link o he license, and any changes
a e indica ed. See h p://c ea i ecommons.o g/licenses/by/4.0. This license does no co e any hi d-
pa y ma e ial ha may appea wi h pe mission in he a icle.
Laukkanen h ps://o cid.o g/0000-0002-9722-0258
Niemis ö h ps://o cid.o g/0000-0002-9198-9437
Tol anen h ps://o cid.o g/0000-0001-6430-8897
O ega h ps://o cid.o g/0000-0003-2001-1121
Sääkslah i h ps://o cid.o g/0000-0003-4354-0990
Kasanen (ma [email protected]) is co esponding au ho , h ps://o cid.o g/0000-0003-
0057-3610
1
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ou comes u he unde sco e he impo ance o moni o ing weigh s a us om
ea ly childhood, gi en i s significan associa ion wi h la e -li e weigh condi ions.
Keywo ds:child en, ea ly childhood, mo o de elopmen
Childhood o e weigh and obesi y ha e eme ged as significan global issues due
o hei high p e alence (NCD Risk Fac o Collabo a ion, 2017). The Wo ld Heal h
O ganiza ion (2021) cha ac e izes o e weigh and obesi y as “abno mal o excessi e
a accumula ion ha may impai heal h.”The body mass index (BMI) se es as a
p ac ical me hod o iden i ying child en who a e o e weigh and obese, al hough
he BMI does no di ec ly measu e body a le els (Ma in-Cal o e al., 2016).
E idence shows a s ong longi udinal ela ionship be ween obesi y in childhood
and adul hood, s a ing in ea ly childhood (Rooney e al., 2011) wi h child en aged
8 yea s o younge (UNICEF, 2022). Thus, unde s anding he ac o s unde lying
o e weigh and obesi y in childhood is impo an . Fundamen al mo emen skills
(FMSs), which ep esen he pe o mance le el o ounda ional mechanisms (neu al,
muscula , biomechanical, and pe cep ual) ha d i e g oss mo o mo emen s
(Goodway e al., 2019), a e conside ed o sha e an in e se bidi ec ional ela ionship
wi h o e weigh and obesi y du ing childhood (Robinson e al., 2015). Hence,
imp o ed FMSs may help p e en he condi ions o obesi y and being o e weigh
h ough physical ac i i y, while a highe weigh s a us migh be associa ed wi h
poo e FMSs, especially o asks equi ing manipula ion o o al body mass
(Robinson e al., 2015). A sys ema ic e iew (Ba ne e al., 2021)suppo s his
in e se bidi ec ional ela ionship be ween weigh s a us and FMS le el in childhood.
E idence sugges s ha BMI may di e en ially a ec he mul iple FMS
domains, such as locomo o skills (LMSs) and objec con ol skills (OCSs; Ba ne
e al., 2016). A highe BMI can impac LMSs due o mo emen agains g a i y,
while he ela ionship be ween BMI and OCSs, which a e mo e s a ic, emains
unclea (Okely e al., 2004). Acco ding o he same sys ema ic e iew, highe BMI
o body a le els nega i ely a ec LMSs, bu a e e se pa hway om LMS le el o
weigh s a us and ela ionships be ween OCS le el and weigh s a us is inde e -
mina e because longi udinal esea ch is limi ed (Ba ne e al., 2021). The e o e,
mo e longi udinal s udies ocusing on hese skill domains a e needed.
FMS can be measu ed using di e en me ics and app oaches (Hul een e al.,
2020) such as p ocess- o p oduc -o ien ed me ics. P ocess-o ien ed es s assess
he quali y o mo emen h ough specific pe o mance c i e ia, ocusing on
pa e ns and echniques, whe eas p oduc -o ien ed es s measu e ou comes such
as speed, dis ance, heigh , o he numbe o epe i ions wi hou conside ing he
me hod o execu ion (Williams & Monsma, 2006). These measu es co ela e o
some ex en , anging om low o mode a e (Rée al., 2018), and e alua e di e en
aspec s o FMS (Palme e al., 2021;Rée al., 2018).
To ou knowledge, ou s is he fi s s udy o in es iga e he bidi ec ional
longi udinal ela ionship ha BMI has wi h FMS le el o , sepa a ely, wi h LMS
and OCS le els, measu ed ia a p ocess-o ien ed app oach om ea ly childhood.
P e ious s udies (D’Hond e al., 2014;Lima e al., 2019) ha e in es iga ed he
bidi ec ional longi udinal ela ionship be ween FMSs, measu ed ia he p oduc -
o ien ed Kö pe koo dina ions es ü Kinde assessmen , and BMI (D’Hond
e al., 2014) o body a ness (Lima e al., 2019) om ea ly childhood. Bo h
(Ahead o P in )
2KASANEN ET AL.
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s udies (D’Hond e al., 2014;Lima e al., 2019) epo ed significan in e se
bidi ec ional longi udinal ela ionships be ween FMS and bo h BMI and body
a ness, espec i ely.
Howe e , i is c ucial o epo esea ch findings on he bidi ec ional longi u-
dinal ela ionship o FMS and BMI using p ocess-o ien ed measu es as well
because his app oach may po en ially o e a mo e accu a e pic u e o he
longi udinal ela ionship be ween FMS and BMI. Few s udies ha e examined
he longi udinal ela ionship om p ocess-o ien ed FMSs o skill domains o
weigh s a us (Duncan e al., 2021;Foulkes e al., 2021;Vlaho e al., 2014) o he
e e se (Lopes e al., 2020) s a ing in ea ly childhood, and he findings o hose
s udies ha e been inconsis en . The p ocess-o ien ed Tes o G oss Mo o De el-
opmen , second edi ion (TGMD-2), was used in hese s udies. While Duncan e al.
(2021) and Vlaho e al. (2014) iden ified in e se ela ionships be ween FMS and
BMI o body a ness, Foulkes e al. (2021) and Lopes e al. (2020) ound no
significan ela ionship be ween FMS, LMS, o OCS and an indi idual’s likelihood
o becoming o e weigh o obese.
The pa ially con adic o y findings and limi ed p io esea ch highligh he need
o addi ional esea ch in o he bidi ec ional longi udinal ela ionship be ween
weigh s a us and bo h FMS le els and skill le els in he composi e domains
sepa a ely, pa icula ly om he pe spec i e o p ocess-o ien ed me hods o mea-
su ing FMS. The p esen s udy examined his ela ionship using s anda dized BMI-
o -age SD sco es (BMI SDS z-sco es) and p ocess-o ien ed age- esidualized FMS
le els s a ing om ea ly childhood in Finnish child en aged 3–8 yea s a baseline
o e a 3-yea ollow-up pe iod. Addi ionally, he s udy conside ed he ela ionships
be ween BMI SDS z-sco es and age- esidualized skill domains— ha is, LMS and
OCS—as dis inc ela ionships ha may exis (Ba ne e al., 2016;Okely e al.,
2004).D awingonexis ing heo y(Robinson e al., 2015) and p e ious sys ema ic
e iews (Ba ne e al., 2021), we hypo hesize a bidi ec ional ela ionship be ween
BMI and FMSs o e ime. Specifically, we expec ha highe baseline BMI le els
will p edic lowe FMSs a ollow-up, while p oficien baseline FMSs will p edic
lowe subsequen BMI le els. This bidi ec ional influence sugges s ha ele a ed
BMI in ea ly childhood may impac de elopmen o FMSs nega i ely in la e
childhood and, con e sely, ha p oficien FMSs in ea ly childhood may be
associa ed wi h a educ ion in BMI 3 yea s la e . In pa icula , we an icipa e a
nega i e bidi ec ional ela ionship be ween BMI and LMS, as he li e a u e has
indica ed (Ba ne e al., 2016;D’Hond e al., 2014;Lima e al., 2019;Okely e al.,
2004). Gi en ha FMS de elopmen exhibi s gende di e ences (Ba ne e al.,
2016) and ha BMI may also be influenced by gende (Shah e al., 2020), ou
analysis specifically in es iga ed gende di e ences by examining he in e ac ions
be ween gende and FMS o skill domains, and be ween gende and BMI.
Ma e ials and Me hods
The longi udinal da a used in his s udy we e collec ed a wo measu emen poin s
om 950 Finnish child en who pa icipa ed in he geog aphical clus e - andomized
Skilled Kids s udy (2015–2016) and o whom comp ehensi e da a we e a ailable
on he main s udy a iables (pa en al suppo o child physical ac i i y and
(Ahead o P in )
LONGITUDINAL RELATIONSHIP BETWEEN FMS AND BMI 3
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ou doo ime) o he ollow-up esea ch, e e ed o as he Ac i e Family s udy
(2018–2020). O hese 950 child en, 675 pa icipa ed in he measu emen s
app oxima ely 3 yea s la e (mean =3.23 yea s, ange =2.39–4.55 yea s), and
hese 675 ul ima ely we e included in he s udy. F om a bias pe spec i e, he a e o
loss o ollow-up (29%) was conside ed accep able (K is man e al., 2004), and he
missing da a we e ound o be missing comple ely a andom (Li le’s MCAR es
chi-squa e =118.773, deg ees o eedom =141, p=.913), conside ing all model-
in ol ed a iables. Pa icipan s we e nes ed wi hin 36 childca e cen e s and 97
schools.
Be o e da a collec ion was ini ia ed, pa icipan s’pa en s p o ided w i en
in o med consen o hei own and hei child en’s olun a y pa icipa ion in he
s udy and o da a me ging. The E hics Commi ee o he Uni e si y o Jy äskylä
g an ed e hical app o al o he baseline on Oc obe 30, 2015, and o he ollow-
up on June 28, 2018.
Measu emen s
Gende , Age, and BMI
Pa en s p o ided hei child en’s gende (op ions: gi l o boy) and bi h da e in he
baseline ques ionnai e. The exac ages o he child en a bo h he baseline and ollow-
up poin s we e calcula ed by compa ing he bi h da e o he da e o he assessmen .
Body mass (seca 877, seca GmbH and Co. KG) and heigh (HM 200P,
Cha de Elec onic Co., L d.) we e measu ed di ec ly o he nea es decimal, wi h
child en ligh ly d essed and ba e oo . BMI SDSs and BMI ca ego ies we e
calcula ed based on Finnish na ional s anda ds (Saa i e al., 2011). The BMI SDS
alues we e subsequen ly con e ed o z-sco es (BMI SDS z-sco es) ha we e
s anda dized sepa a ely o boys and gi ls, eflec ing gende -specific di e ences in
in e p e ing he sco es. Fo compa ison in he desc ip i e s a is ics, In e na ional
Obesi y Task Fo ce BMI ca ego ies (Cole & Lobs ein, 2012) we e assigned using a
classifie (Sanchez-Delgado e al., n.d.).
FMSs and Skill Domains
The FMS sco e (maximum 28 poin s) was de i ed om he sum o he ollowing
ou sub es s om he p ocess-o ien ed TGMD-3: wo LMS sub es s (skip, 0–6
poin s, and one-legged hop, 0–8 poin s; maximum 14 poin s) and wo OCS
sub es s (o e hand h ow, 0–8 poin s, and one-handed s a iona y d ibble, 0–6
poin s; maximum 14 poin s; Ul ich, 2019). These sub es s we e selec ed om hose
ha bes ep esen ed he skill domains (Wagne e al., 2016). Each sub es was
pe o med wice and quali a i ely e alua ed by a ained obse e using specific
pe o mance c i e ia (Ul ich, 2019).
The TGMD-3 is designed o child en aged 3–11 yea s old (Ul ich, 2019).
Bo h he in e - and in a a e eliabili y o he TGMD-3 we e >0.9, and he es –
e es eliabili y exceeded 0.8. Mo eo e , he in e nal consis ency o he TGMD-3
anged om accep able o excellen (C onbach’s alpha .7–.9; Rey e al., 2020). The
in aclass co ela ion coe ficien s (ICCs =.730–.757) o consis ency be ween
di e en esea ch eams we e iewed as ai o he FMS sco es, LMS sco es,
and OCS sco es measu ed using he TGMD-3. Howe e , he ag eemen ICCs
(Ahead o P in )
4KASANEN ET AL.
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(.363–.478) we e iewed as poo . The e o e, his a iabili y sugges s ha compa -
isons be ween s udies o esea ch g oups employing he TGMD-3 may no always
be eliable (Hul een e al., 2023). In his s udy, he same esea ch g oup pe o med
he TGMD-3 measu emen s a baseline and a ollow-up.
As FMSs a e ela ed o age (Ba ne e al., 2016), age-adjus ed FMS, LMS, and
OCS s anda dized esiduals (FMSz e, LMSz e, and OCSz e, espec i ely) we e
employed o add ess he s ong co ela ion be ween he sco es and age (baseline:
.460–.602; ollow-up: .309–.397; Wu m & Fisica o, 2014) and o elimina e he
influence o a ying du a ions be ween measu emen s and di e en ages (Duncan
e al., 2021) a baseline and ollow-up. S anda dized esiduals a baseline we e
used as p edic o s, while esiduals a ollow-up we e used as dependen a iables.
This adjus men allowed o an in e p e a ion o how pa icipan s de ia ed om
a e age FMS, LMS, o OCS sco es o hei age, wi h posi i e esiduals indica ing
pe o mance abo e he age-p edic ed alue and nega i e esiduals indica ing
pe o mance below he expec ed le el.
Da a Analyses
We employed wo-le el, c oss-classified models (Finch & Bolin, 2017) o analyze
he da a due o he clus e ed na u e o he da a, as pa icipan s (Le el 1) we e c oss-
classified (Le el 2) by 36 childca e cen e s (on a e age, 18.1 pa icipan s, ange
5–35) and 97 schools (on a e age, 6.9 pa icipan s, ange 1–31). Only p edic o s a
he indi idual le el (Le el 1) we e measu ed and inco po a ed in o he analyses.
C oss-lagged models (Kea ney, 2017) we e used in he wo-le el, c oss-
classified analysis o in es iga e he bidi ec ional ela ionship be ween BMI SDS
z-sco es and FMSz e. The ollowing models we e implemen ed: (a) an in e cep -
only model o ou comes (FMSz e and BMI SDS z-sco es a ollow-up) wi h no
p edic o s o e i y he app op ia eness o mul ile el analysis; (b) a model ha
included indi idual-le el p edic o s (FMSz e and BMI SDS z-sco es a baseline)
along wi h in e ac ions o FMSz e ×Gende and BMI SDS z-sco es ×Gende a
baseline; and (c) sepa a e models o gi ls and boys wi h indi idual-le el p edic o s
(FMSz e and BMI SDS z-sco es a baseline), execu ed i he in e ac ion be ween
he baseline FMSz e and gende , o be ween baseline BMI SDS z-sco es and
gende was a s a is ically significan p edic o in he p e ious model. To accoun
o he mul ile el s uc u e o he da a, all a iables we e allowed o co ela e a he
be ween le els. The same models we e execu ed wi h wo skill domains, LMSz e
and OCSz e, indi idually se ing as p edic o s and ou come a iables ins ead o
using FMSz e. All p edic o s we e g and mean cen e ed (Finch & Bolin, 2017)in
he analyses.
The models we e implemen ed using a Bayesian analysis wi h algo i hms
o an i e a i e Ma ko chain Mon e Ca lo me hod (using he algo i hm:
GIBBS[PX1], poin es ima e—median, wo pa allel Ma ko chain Mon e Ca lo
chains, maximum 50,000 i e a ions). Bayesian app oaches u ilize a dis ibu ion
o alues. P io dis ibu ions (mean 0, a iance ∞) we e selec ed wi h he aim o
ob aining pa ame e es ima es based on he obse ed da a. Con e gence o he
pos e io dis ibu ion was confi med by po en ial scale educ ion coe ficien s
(below 1.05) and ace plo s. Au oco ela ion plo s we e employed o examine
an accep able le el o au oco ela ion (Finch & Bolin, 2017).
(Ahead o P in )
LONGITUDINAL RELATIONSHIP BETWEEN FMS AND BMI 5
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The s anda diza ion o BMI SDS and he esidualiza ion o FMS, LMS, and
OCS, along wi h he desc ip i e s a is ical analysis, we e pe o med using SPSS
( e sion 28, IBM) so wa e. Two-le el c oss-classified, c oss-lagged models, and
co ela ions be ween a iables wi hin models, we e conduc ed using Mplus
( e sion 8.8, Mu hén & Mu hén). The s a is ical significance le el was se a a
p obabili y o <.05 o all analyses. C edibili y in e als (C.I.) o he Bayesian
c oss-classified models we e in e p e ed simila ly o confidence in e als (CI) in
equen is models (Finch & Bolin, 2017).
The model fi was e alua ed using he pos e io p edic i e p obabili y alue
(PPP) and he 95% CI o he di e ence be ween obse ed and eplica ed chi-
squa e alues. The PPP alues nea .5 sugges ed an op imal model fi , and a 95% CI
ha included ze o indica ed a fi ing model (Finch & Bolin, 2017).
Resul s
Desc ip i e S a is ics
Desc ip i e s a is ics a baseline and ollow-up a e displayed in Table 1. S a is i-
cally significan di e ences be ween gi ls and boys we e obse ed in LMS and
OCS a bo h baseline and ollow-up (p<.001). Gende di e ences in FMS we e
s a is ically significan only a ollow-up (p=.002). The baseline da a included
measu emen s om wo gi ls ages 2.97 yea s. This age is ma ginally below he
alida ed age h eshold o 3 yea s o he TGMD-3.
Fo compa ison, he dis ibu ion o he pa icipan s’weigh s a uses acco ding
o Finnish BMI- o -age e e ences wi h fi e ca ego ies (Saa i e al., 2011) and
In e na ional Obesi y Task Fo ce e e ences wi h eigh ca ego ies (Cole &
Lobs ein, 2012;Sanchez-Delgado e al., n.d.), classified as unde weigh , no mal
weigh , o e weigh , obesi y, and o al o e weigh and obesi y, is p esen ed in he
Supplemen a y Table S1 (a ailable online). The dis ibu ions o he pa icipan s’
weigh s a uses, pa icula ly he p opo ions o gi ls and boys, appea o di e
be ween he Finnish and In e na ional Obesi y Task Fo ce e e ences, as no ed in
p e ious esea ch (Saa i e al., 2011). Howe e , he p opo ion o o e weigh and
obese gi ls (18.0%–18.6%) and boys (27.1%–29.7%) in his s udy aligns closely
wi h he p opo ion o o e weigh and obese Finnish child en o he same age
(gi ls: 16.0%–19.0%, boys: 27.0%–30.0%) ha was epo ed in Finnish e e ences
(Jääskeläinen e al., 2021).
Table 2indica ed o a s ong co ela ion be ween baseline and ollow-up BMI
SDS z-sco es ( =.774–.775, p<.001) bu showed no ela ionship be ween BMI
SDS z-sco es and FMSz e, o be ween BMI SDS z-sco es and age- esidualized
skill domains. Likewise, wi hin- a iable co ela ions be ween baseline and ollow-
up we e s a is ically significan o FMSz e, LMSz e, and OCSz e ( =.281–.390,
p≤.001).
The esul s o he in e cep -only model indica ed ha FMSz e, LMSz e, and
OCSz e and he BMI SDS z-sco es exhibi ed s a is ically significan a ia ions
(Table 3) ac oss childca e cen e s (1.9%–6.0%, p<.001) and schools (1.0%–5.2%,
p<.001). The s a is ical significance o he be ween-le el a iances sugges s ha
mul ile el analy ical echniques we e wa an ed.
(Ahead o P in )
6KASANEN ET AL.
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Table 1 Desc ip i e S a is ics o Age, TGMD-3-Based FMSs
(Maximum: 28 Poin s), LMSs (Maximum: 14 Poin s), OCSs
(Maximum: 14 Poin s), and Finnish Na ional S anda ds-Based BMI
SD Sco es a Baseline and Follow-Up (N=675)
NMSDMinimum Maximum
Gende
di e ences
(p)
Age a baseline 675 5.53 1.09 2.97
a
7.80 .303
Gi ls 341 5.48 1.10 2.97 7.29
Boys 334 5.58 1.08 3.10 7.80
Age a ollow-up 674 8.76 1.08 6.33 11.44 .316
Gi ls 341 8.72 1.08 6.72 11.44
Boys 333 8.80 1.09 6.33 11.28
FMS a baseline 596 12.2 5.4 0 27 .439
Gi ls 299 12.3 4.9 0 24
Boys 297 12.0 5.8 0 27
FMS a ollow-up 643 17.2 5.0 0 28 .002
Gi ls 328 16.7 4.3 5 27
Boys 315 17.8 5.5 0 28
LMS a baseline 602 7.0 3.5 0 14 <.001
Gi ls 304 7.7 3.3 0 14
Boys 298 6.4 3.5 0 14
LMS a ollow-up 645 8.9 2.9 0 14 <.001
Gi ls 330 9.5 2.5 2 14
Boys 315 8.3 3.2 0 14
OCS a baseline 604 5.1 3.1 0 14 <.001
Gi ls 302 4.6 2.6 0 12
Boys 302 5.7 3.3 0 14
OCS a ollow-up 648 8.3 3.3 0 14 <.001
Gi ls 329 7.2 2.8 0 14
Boys 319 9.4 3.3 0 14
BMI SDS a baseline 621 0.18 1.05 −4.55 3.24 .325
Gi ls 311 0.21 1.13 −4.55 3.24
Boys 310 0.14 0.95 −3.37 2.47
BMI SDS a ollow-up 641 0.22 0.99 −3.43 3.22 .580
Gi ls 328 0.25 1.02 −3.01 3.22
Boys 313 0.19 0.96 −3.43 2.51
No e. p alues o gende di e ences unde .05 a e shown in bold. LMS =locomo o skill le el; OCS =
objec con ol skill le el; FMS = undamen al mo emen skill le el; BMI SDS =body mass index SD
sco e; TGMD-3 =Tes o G oss Mo o De elopmen , hi d edi ion.
a
The baseline da a include measu emen s om wo gi ls ages 2.97 yea s.
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Table 2 Co ela ions Wi hin Models: S anda dized BMI SDS Sco es and Age-Residualized FMSs and Skill
Domain Le els a Baseline and Follow-Up
BMI SDS z-sco es FMSz e
Baseline Follow-up Baseline Follow-up
BMI SDS z-sco es a baseline 1
BMI SDS z-sco es a ollow-up 0.774
a
1
FMSz e a baseline −0.032 −0.035 1
FMSz e a ollow-up 0.002 0.002 0.390
a
1
BMI SDS z-sco es LMSz e OCSz e
Baseline Follow-up Baseline Follow-up Baseline Follow-up
BMI SDS z-sco es a baseline 1
BMI SDS z-sco es a ollow-up 0.775
a
1
LMSz e a baseline −0.061 −0.058 1
LMSz e a ollow-up −0.028 −0.036 0.299
a
1
OCSz e a baseline 0.019 0.010 0.113
a
0.219
a
1
OCSz e a ollow-up 0.032 0.035 0.099
a
0.189
a
0.281
a
1
No e. BMI SDS =body mass index SD sco e; FMSz e =age- esidualized undamen al mo emen skill le el; LMSz e =age- esidualized locomo o skill le el; OCSz e =
age- esidualized objec con ol skill le el.
a
Co ela ion is significan a he .05 le el ( wo- ailed).
8(Ahead o P in )
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challenging, and e en using he same es does no always gua an ee eliable
compa isons. Fo example, esul s om he TGMD-3 can a y be ween di e en
esea ch eams (Hul een e al., 2023), and he TGMD-2 and TGMD-3 do no align
comple ely in e ms o sub es s and sco ing, wi h a pa icula ly no able di e ence
obse ed in he OCS be ween he es s (Field e al., 2020). Fu he mo e, when
conside ing cul u al a ia ions and di e en s udy popula ions (e.g., age, sex,
e hnici y, and numbe o o e weigh o obese child en), compa ing esul s
becomes e en mo e complex (Adeyemi-Walke e al., 2018;Jeong e al., 2023).
The s eng h o his esea ch lies in i s analysis o longi udinal da a ga he ed
om child en in hei ea ly childhood o e an a e age 3-yea pe iod and in i s use
o a wo-le el, c oss-classified, c oss-lagged eg ession analysis as a s a is ical
me hod, conside ing he impac s o childca e cen e s and schools. We also adop ed
a p ocess-o ien ed app oach o measu e FMS, and we analyzed skill domains
sepa a ely o explo e mo e p ecisely he bidi ec ional longi udinal ela ionship
be ween BMI and FMS. Fu he mo e, we used BMI- o -age, which conside s age
(Saa i e al., 2011), and age- esidualized FMS, LMS, and OCS, as well as he
in e ac ion be ween FMS, LMS, OCS, and gende , as p edic o a iables o ensu e
a mo e de ailed depic ion.
None heless, his s udy did ha e ce ain limi a ions. The fi s limi a ion is ha
FMS le els we e based only on he esul s o ou sub es s o TGMD-3; hus, LMS
and OCS le els we e each based on wo sub es s. This may gi e a limi ed pic u e o
skill le els, e en hough he sub es s we e selec ed om among hose ound o bes
desc ibe he skill domains (Wagne e al., 2016). Addi ionally, he po en ial ceiling
e ec o TGMD-3 migh ha e influenced he esul s (Ul ich, 2019). The cul u al
cha ac e is ics and homogenei y o he Finnish sample, especially in e ms o BMI,
compa ed wi h o he in e na ional s udies, could also impac he findings.
Mo e s udies a e needed in he u u e ha examine he bidi ec ional longi u-
dinal ela ionship be ween FMS and BMI om ea ly childhood o adolescence and
beyond. I is also c ucial o conside ha his ela ionship may a y be ween
indi iduals o no mal weigh and hose who a e obese (Cheng e al., 2016).
Ga he ing da a om he same s udy popula ion a mul iple ime poin s would make
he g ow h cu e analysis me hod also possible. Fu u e esea ch should also aim o
compa e he bidi ec ional longi udinal ela ionship be ween weigh s a us and
FMS, measu ed using bo h p ocess- and p oduc -o ien ed me hods. This could
enhance ou unde s anding o he ela ionships be ween hese a iables, e en
hough bo h p ocess- and p oduc -o ien ed measu es o FMS a e ecommended
(Williams & Monsma, 2006).
The esul s o his s udy highligh he impo ance o conside ing mul iple le els
o influence when examining he p edic o s o BMI. They also emphasize ha
indi idual di e ences alone may no ully explain he a ia ion, and a iables ela ed
o childca e cen e s and schools should also be conside ed. A mo e holis ic pic u e o
a bidi ec ional ela ionship be ween BMI and FMS may also equi e including he
influence o he amily (Rooney e al., 2011;Sco -Sheldon e al., 2020).
Pe spec i e
The cu en s udy sugges s ha a bidi ec ional longi udinal ela ionship be ween
BMI and FMSs o indi idual skill domains may ela e mo e o he physical
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LONGITUDINAL RELATIONSHIP BETWEEN FMS AND BMI 15
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capaci y componen o FMS han he quali a i e in o ma ion gleaned om he
p ocess-o ien ed way o measu ing FMS. Thus, we ecommend conside ing he
influence o he childca e cen e , school, and amily (Rooney e al., 2011;Sco -
Sheldon e al., 2020) in he p e en ion and ea men o obesi y and being
o e weigh , in addi ion o he indi idual cha ac e is ics o child en. O e all, he
esul s o his and a p e ious s udy (Rooney e al., 2011) highligh he impo ance
o paying a en ion o weigh s a us in ea ly childhood because i has a s ong
associa ion wi h weigh s a us la e in li e.
Acknowledgmen s
Da a collec ion o bo h he Skilled Kids and Ac i e Family s udies was financially
suppo ed by he Finnish Minis y o Educa ion and Cul u e (OKM/48/626/2014 and
OKM/59/626/2017). Fu he mo e, he co esponding au ho is hank ul o he schola ship
ecei ed om he Juho Vainio Founda ion (202300159/2023). The au ho s a fi m ha he e
a e no conflic s o in e es ela ed o his s udy. Ou g a i ude ex ends o all s udy pa icipan s
and hei pa en s o hei ac i e engagemen in he s udy, and o all indi iduals who
acili a ed he da a collec ion p ocess.
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(Ahead o P in )
LONGITUDINAL RELATIONSHIP BETWEEN FMS AND BMI 19
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