Syed Muhammad Zeeshan Haider Hamdani

Objective: This study aimed to develop age- and sex-specific normative percentile curves and percentile-based performance zones for core muscular endurance using the plank exercise test among adolescents aged 12–16 years in South Punjab, Pakistan, employing the LMS method and a back substitution procedure to assess internal consistency. Method: This cross-sectional study included 2, 970 adolescents (49.73% boys, 50.27% girls; mean age 14.00 ± 1.41 years) recruited from 60 higher secondary schools across South Punjab, Pakistan, using stratified random sampling in 2020, representing a pre-pandemic baseline. Height, weight, and BMI were recorded, and core muscular endurance was assessed using the isometric plank test. Age- and sex-specific normative references and smoothed percentile curves were established using the LMS (Lambda, Mu, Sigma) method. Internal consistency of the derived reference values was assessed using a back substitution procedure, in which the LMS model’s P50 (50th percentile) estimate for the full sample was compared against its P50 estimate for a randomly drawn 20% subsample of the same cohort, with the Mean Absolute Percentage Error (MAPE) used to quantify agreement. Sex differences were examined using the Mann-Whitney U test, with statistical significance set at p < 0.05. Results: Using the LMS method, the study established age- and sex-specific normative references and smoothed percentile curves for the plank test. Boys were significantly taller, heavier, and had higher BMI than girls (p < 0.001). Boys showed higher mean plank times (80.72 ± 73.48 s vs. 69.07 ± 58.16 s; p < 0.01), effect sizes ranged from negligible to small across all variables (rank-biserial r = 0.00–0.26), with r = 0.06 for plank performance. Median plank performance increased with age in both sexes, from 50 to 61 seconds in boys and from 44 to 66 seconds in girls between ages 12 and 16, with a steeper rise in the upper percentiles among boys. Age- and sex-specific percentile curves and performance cut-points across five zones; Very Poor, Poor, Medium, Good, and Excellent were derived. The majority of participants were classified as “Medium” (32.7%) or “Good” (24.4%), with 9.9% reaching “Excellent”. Boys’ “Excellent” threshold ranged from ≥133 seconds at age 12 to ≥227 seconds at age 16, while in girls it ranged from ≥127 to ≥126 seconds, peaking at ≥146 seconds at age 14. The back substitution procedure produced an average MAPE of 6.69% for boys and 6.04% for girls, supporting the internal consistency of the derived references within this population. Conclusion: This study provides the first age- and sex-specific normative references and percentile-based performance zones for the plank exercise test in Pakistani adolescents, with internal consistency supported by a back substitution procedure. These references offer simple, low-resource, population-based benchmarks for monitoring core muscular endurance, with practical value for physical education teachers, coaches, and health professionals working in school-based health initiatives. However, external validation using an independent sample, and replication in other regions of Pakistan, are needed before these references are applied beyond South Punjab.

Background: Childhood obesity and physical inactivity are growing global public health concerns. Once predominantly observed in wealthier nations, these issues are now increasingly prevalent in low- and middle-income countries. We aimed to examine the relationship between moderate-to-vigorous physical activity (MVPA) and physical literacy (PL) among children aged 8–12 years, and to determine whether body mass index (BMI) mediates this association. Methods: We conducted a cross-sectional study of 1,360 children (8–12 years old, mean age 10.0 ± 1.4 years) from 85 higher secondary schools in South Punjab, Pakistan. Physical activity and PL were assessed using the Canadian Assessment of Physical Literacy (CAPL-2) protocol. Data analyses included descriptive statistics, independent t -tests, chi-square tests, Pearson correlations, and multivariate logistic regression. A regression-based mediation analysis was conducted to examine the mediating role of BMI in the MVPA–PL relationship. Age and sex were included as covariates. Statistical significance was set at p < 0.05 (two-tailed). Results: Overall, 79.9% of participants were of normal weight, 9.7% were overweight, and 5.3% were obese. Normal-weight children demonstrated significantly higher average weekly step counts, more MVPA days per week (5.04 ± 1.09 vs. 4.65 ± 1.17), and higher PL scores (53.76 ± 11.72 vs. 45.86 ± 9.87) than overweight or obese children ( p < 0.001 for all comparisons). BMI was negatively associated with PA and PL measures ( r = −0.136 to −0.300, p < 0.01), while MVPA and step count were positively associated with PL ( r = 0.237 to 0.609, p < 0.01). In the mediation analysis, higher MVPA was associated with lower BMI (Path a: β = −0.377, SE = 0.078, p < 0.001), and lower BMI was associated with higher PL (Path b: β = −0.514, SE = 0.065, p < 0.001). MVPA also showed a strong direct association with PL ( c' = 2.091, SE = 0.189, p < 0.001). The indirect effect of MVPA on PL through BMI was statistically significant [β = 0.194, 95% CI (0.107, 0.291)], accounting for approximately 8.5% of the total effect. Sex-stratified analyses indicated that the proportion of the MVPA–PL association mediated through BMI was slightly higher in girls (10.2%) than in boys (7.1%). Conclusion: This study provides the first evidence from a Pakistani pediatric population that BMI partially mediates the association between MVPA and physical literacy, though the majority of this relationship remained direct. Children with overweight and obesity demonstrated lower PA participation and reduced PL scores than normal-weight peers, while girls consistently underperformed boys despite comparable BMI and knowledge levels. These findings support the need for culturally relevant, gender-responsive, school-based programmes that promote physical activity while addressing weight-related barriers in under-resourced settings.

Objective: This study examined whether psychological resilience mediates the association between anxiety and PA among Pakistani university students and, as a secondary aim, explored heterogeneity in these relationships using person-centred approach. Methods: A cross-sectional survey was conducted among 770 university students (aged 18–26 years) from six cities in Punjab, Pakistan, between May and December 2025. Participants completed validated measures of anxiety (GAD-7), psychological resilience (CD-RISC-10), and self-reported PA. Correlation, regression, mediation, and latent profile analyses were performed, controlling for gender and academic year. Results: Anxiety was significantly and negatively correlated with both resilience (r = −0.475, p < 0.001) and PA (r = −0.378, p < 0.001), while resilience was positively associated with PA (r = 0.419, p < 0.001). Physical activity was significantly predicted by anxiety (B = −0.383, p < 0.001) and resilience (B = 0.174, p < 0.001) in regression models, explaining 21.7% of the variance in PA. The mediation analysis revealed that resilience explained 39% of the total effect of anxiety on PA, indicating partial mediation. LPA revealed three distinct profiles: an Anxious–Inactive group (27.1%) characterised by high anxiety and low resilience; a Moderately Distressed–Moderately Active group (47.0%) with intermediate levels; and a Resilient–Active group (25.8%) with low anxiety and high resilience. Conclusions: Lower physical activity among Pakistani university students is partly explained by reduced psychological resilience in the context of anxiety. These findings highlight the importance of resilience as a protective resource and support integrated mental health and physical activity interventions in resource-limited university settings.

Objective: This study aims to develop and validate age- and sex-specific normative reference standards for muscular strength (MS) using the LMS (Lambda–Mu–Sigma) method and to establish Health Benefit Zones (HBZs) for Pakistani adolescents aged 12–16 years.Methods: A cross-sectional study was conducted with 2,970 adolescents (49.7% boys, 50.3% girls) selected through stratified random sampling from 60 public high schools across three divisions of South Punjab. Anthropometric indicators and muscular strength were measured following standardized protocols. Using the LMS, age- and sex-specific normative reference values and smoothed percentile curves (3rd, 10th, 35th, 50th, 65th, and 90th) were developed. Five Health Benefit Zones (Very Poor, Poor, Medium, Good, and Excellent) were derived from these percentile ranges to classify strength levels. The robustness of the generated standards was examined through internal cross-validation using a back-generation procedure to confirm high predictive accuracy.Results: Boys demonstrated significantly higher muscular strength than girls across all ages (p < 0.001), with strength increasing progressively with age in both sexes. At age 16, median MS reached 35.47 kg for boys and 20.18 kg for girls. LMS-derived percentile reference values and percentile curves illustrated consistent age- and sex-related growth trends. Approximately 40% of participants fell within the “poor” or “very poor” HBZs. MAPE values remained below ±0.05, indicating excellent model fit. Compared to international benchmarks, adolescents from South Punjab exhibited lower MS values across corresponding age groups.Conclusion: This study provides the first LMS-based, age- and sex-specific normative reference standards and HBZs for muscular strength among Pakistani adolescents. These standards offer a population-relevant tool for fitness assessment, enable early identification of youth at risk of low muscular strength, and support targeted interventions to enhance strength development and overall physical health in school-aged populations.

The framework for the Pakistan Touch Ball Federation’s (PTBF) management and governance is set out in their constitution. By looking at four critical dimensions— transparency, accountability, decision-making and solidarity. This research investigates how well a PTBF follows the ideals of good governance. This study sought to investigates the efficiency of the Constitution, highlight flaws and strengths, and give suggestions on how to enhance governance quality. Using a qualitative text analysis approach focusing on the core ideas, semiotic features, and structural elements of the Constitution, Thematic analysis was applied to find dimensions of governance, and the paper was examined for clarity, coherence, and methods supporting stakeholder involvement. Research also looks at the symbols' performance and schedule of the reflection of an administrative identity. Further analysis of the Constitution involves financial provisions, federation architectures, and its dedication to solidarity. Several risk elements in the PTBF legal process include financial oversight systems suggesting federation support and a dedication to financial transparency. Constitutional democracy is including participation in decisions as well as transparency and voting constraints. That said, good governance is mostly about transparency and decision-making. PTBF is urged to include regulations inside the constitution that strengthen transparency and accountability. Furthermore, errors, inconsistencies, and the lack of a qualified author damage its credibility. Finally, this study offers insights on how well the PTBF constitution lines with good governance ideals in sports. According to the research, the PTBF constitution highlights the need for developments in transparency and solidarity even as it shows strengths in democratic processes and financial accountability. Maintaining public trust and raising the PTBF's efficiency depend on developments in these fields. These results seek to direct the federation toward better governance practices and a more efficient constitution.

Background: The increasing prevalence of physical inactivity, declining fitness, and rising childhood obesity highlight the importance of physical literacy (PL), as a foundational component for fostering lifelong health and active lifestyle. This recognition necessitates the development of effective tools for PL assessment that are applicable across diverse cultural landscapes. Aim: This study aimed to translate the Canadian Assessment of Physical Literacy-2 (CAPL-2) into Urdu and adapt it for the Pakistani cultural context, to assess PL among children aged 8–12 years in Pakistan. Method: The Urdu version of CAPL-2 was administered among 1,360 children aged 8–12 from 87 higher secondary schools across three divisions in South Punjab province, Pakistan. Statistical analysis includes test-retest reliability and construct validity, employing confirmatory factor analysis to evaluate the tool’s performance both overall and within specific subdomains. Results: The Urdu version of CAPL-2 demonstrated strong content validity, with a Content Validity Ratio of 0.89. Confirmatory factor analysis supported the four-factor structure proposed by the original developers, evidenced by excellent model fit indices (GFI = 0.984, CFI = 0.979, TLI = 0.969, RMSEA = 0.041). High internal consistency was observed across all domains (α = 0.988 to 0.995), with significant correlations among most, excluding the Knowledge and Understanding domains. Notably, gender and age significantly influenced performance, with boys generally scoring higher than girls, with few exceptions. Conclusion: This study marks a significant step in the cross-cultural adaptation of PL assessment tools, successfully validating the CAPL-2 Urdu version for the Pakistani context for the first time. The findings affirm the tool’s suitability for assessing PL among Pakistani children, evidencing its validity and reliability across the Pakistani population.

Background. Physical literacy is vital for addressing children’s health issues such as childhood obesity, physical inactivity, and sedentary behavior. However, there is a lack of research on PL assessment in Pakistan. This study is aimed at translating and cross-culturally adapting the Canadian Assessment of Physical Literacy-2 (CAPL-2) tool and establishing its validity and reliability in the Pakistani population. Methods. The CAPL-2 was translated to Urdu employing the translation and back translation method. A cross-sectional study involving 350 school children (8-12 years) from Multan, South Punjab, evaluated the CAPL-2U version’s reliability. Results. Expert consensus and pilot testing successfully achieved translation, cross-cultural adaptation, face and content validity. The CAPL-2U demonstrated excellent reliability and internal consistency across the domains. Specifically, daily behavior domain had an internal consistency of and test-retest reliability of . Knowledge and understanding domain showed internal consistency ranging from to 0.986 and test-retest reliability of to 0.986. The motivation and confidence domain had an internal consistency of to 0.997 and test-retest reliability of to 0.993. The correlation between test-retest results for knowledge and understanding and motivation and confidence domains was to 0.973. However, two items in the motivation and confidence domain showed discrepancies in test-retest outcomes. Conclusion. The study confirms the successful translation and adaptation of the CAPL-2 questionnaire for use in Urdu and Pakistani contexts. The findings endorse the tool’s reliability and suitability for assessing physical literacy in Pakistan’s children aged 8-12.

Background: The decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country’s absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12–16 in Pakistan.Methods: A cross-sectional study was conducted among 2,970 school adolescents aged 12–16 years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements.Results: The study’s results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%).Conclusion: The study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population.

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and children with overweight and obesity. Furthermore, this study determined a correlation between PL domains and BMI by weight status among South Punjab school children. (2) Methods: This cross-sectional study involved 1360 (Boys: 675 and Girls: 685) children aged 8 to 12, and was conducted using CAPL-2. T-tests and chi-square were used to determine the difference between categorical variables, with MANOVA used to compare weight statuses. Spearman correlation was employed to determine the correlation between variables; p < 0.05 was considered significant. (3) Results: Normal weight children had significantly higher PL and domain scores, except for the knowledge domain. Most children with normal weights were at the achieving and excelling levels, while children with overweight and obesity were at the beginning and progressing levels. The correlation among PL domains in normal and overweight and obese children ranged from weak to strong (r = 0.001 to 0.737), and the knowledge domain was inversely correlated with the motivation domain (r = −0.023). PL and domain scores were inversely correlated to BMI, except for the knowledge domain. (4) Conclusions: Children with normal weight tend to have higher PL and domain scores, while those with overweight or obesity tend to have lower scores. There was a positive relationship between normal weight and higher PL and domain scores, and an inverse relationship was observed between BMI and higher PL scores.

Relationship between Moderate-to-Vigorous Physical Activity with Health-Related Physical Fitness Indicators among Pakistani School Adolescents: Yaali-Pak Study: Background. The current study is the foremost study exploring the relationships between moderate-to-vigorous physical activity and health-related physical fitness indicators among 12–16-year-old adolescents of the South Punjab region of Pakistan. Methods. The researcher adopted the cross-sectional research design for the study. A total of 2970 participants (1477 boys and 1493 girls) aged adolescents from South Punjab, Pakistan, completed health-related physical fitness indicators measuring strength, endurance, and aerobic capacity through a hand-grip strength test, modified pull-up test, plank test, and 20-m shuttle run test, and physical activity were subjectively assessed by International Physical Activity Questionnaire Short Form (IPAQ-SF). Linear regression models were used to explore the between moderate-to-vigorous physical activity (MVPA) with health-related physical fitness indicators. Results. Positive associations were observed between hand-grip strength ( ), modified pull-up ( ), plank exercise ( ), and 20-m shuttle run test ( ), with MVPA. The gender-specific comparison also indicated a significant ( ) and positive relationship. The results revealed that as MVPA increases, body composition, muscular strength, core muscular endurance, and aerobic capacity could improve in both genders. Conclusions. MVPA appears to be an effective and reliable predictor of health-related physical fitness among school adolescents.