Jarek Mäestu

Background/Objectives: Evidence-based practice (EBP) is a core competence in physiotherapy, yet its implementation in routine clinical practice remains inconsistent. This study aimed to describe self-reported EBP competencies among physiotherapists and to examine factors associated with daily EBP and readiness to implement EBP. Methods: A cross-sectional analytic survey was conducted among 337 practicing Estonian physiotherapists (75% female) between 2022 and 2024. EBP competencies were assessed using the Estonian version of the Evidence-Based Practice Questionnaire (EBPQ-E). Two multiple linear regression models examined associations of demographic and professional characteristics and EBP competencies with (1) daily EBP and (2) readiness to implement EBP. Results: The mean total EBPQ-E score was 4.72 (SD = 0.89), with the highest scores in Attitude, followed by Knowledge/Skills, Practice, and Sharing. While physiotherapists strongly endorsed the value of EBP, critical appraisal and knowledge sharing were less frequent. Readiness to implement EBP was associated with supervisory experience, dual employment, and working with colleagues (p < 0.05), explaining 7.5% of the variance. Daily EBP was primarily explained by EBP competencies (40.8% variance), whereas 5–10 years of qualification showed a negative association. Conclusions: While professional and contextual factors support readiness for EBP, sustained implementation relies on continuous competency development and career-long support for practicing physiotherapists, shifting focus away from static background characteristics, workload, and time constraints.

Introduction: Physical fitness is an important indicator of health in children. Accurately monitoring child and adolescent physical fitness is critical when designing effective public health interventions and strategies. This article aims to provide an overview of the FitBack platform and the health-related criteria that support the reporting system. Methods: Four methodological phases were used to create the FitBack platform. First, a review of existing European fitness databases was conducted to identify common fitness tests and methodologies within a European framework. Second, investigators collated data to create European-level fitness norms, health-related criteria, and health-oriented educational resources dedicated to improving child fitness levels. Third, guidance on how to create one’s own fitness monitoring and surveillance system was created based on good practice examples. The FitBack platform was then piloted and launched based on data received from stakeholders who responded to ≥2 rounds of consultation dialogues. Results: The final version of online platform, with special focus on newly developed Fitback health-related fitness criteria, are communicated herein. Discussion: The FitBack web platform is a first-step towards creating a standardised, person-centred, multi-national fitness surveillance system for children, bridging existing gaps between European political recommendations, individual member states, and harmonious cooperation between sectors. This article also provided the detailed age- and sex-specific health-related fitness cut-points that are used by the FitBack platform, and that could be useful for researchers, practitioners as well as fitness monitoring systems.

Background: FitBack is an international network established to support the creation of physical fitness monitoring and surveillance systems for children and adolescents across Europe.Aims: As a part of the greater scope of the FitBack European project, the FitBack web portal was designed and tailored for various target groups, such as teachers, health professionals, policy makers, parents, and youths, with the aim to promote their physical and health literacy.Methods: The FitBack web portal is a free and multilingual online resource, and two of its webpages were evaluated: “Make interactive report” was evaluated by 78 secondary school students and 27 physical education teachers, and “10 steps to design a physical fitness monitoring system” by 14 physical activity promotion policy makers. Validated scales and open-ended questions were used to collect both quantitative and qualitative responses.Results: ‘Good’-to-‘excellent’ scores emerged for user experience (5.43–6.36 out of 7) and webpage usability (3.70–4.27 out of 5). Qualitative feedback highlighted positive comments and cues on how to improve website features.Conclusions: Results indicate that the current FitBack web portal is a clear and user-friendly mobile health tool, which includes relevant information on how to use and implement youth physical fitness monitoring and surveillance systems.

The aim of this article is to summarize the results of the 2022 Estonian Physical Activity Report Card across 10 indicators based on available scientific data and national databases, and, additionally, to compare the current results with previous Report Card results. A national expert panel, consisting of research and policy experts, identified the available sources and synthesized as well as graded relevant data related to the physical activity (PA) of Estonian children and youth. Grade B was assigned to Organized Sports and Physical Activity (B−), Community and Environment (B+), and Government (B). Grade C was assigned to Overall Physical Activity (C+), Physical Fitness (C+), Family and Peers (C−), and School (C+). The lowest grade, D, was assigned to Active Play (D), Active Transportation (D+), and Sedentary Behaviors (D−). In Estonia, the participation rate in organized sport is relatively high, and government in addition to community support seem to be at a relatively good level. However, a relatively high number of children and youth did not meet the current PA guidelines, and the levels of sedentary behavior and screen time were very high. The PA of children and youth should be a cross-disciplinary priority, and focus should be put on developing schoolyards and outdoor breaks, varied and easily accessible organized sport, the use of active transportation, and the implementation of physical education that supports leisure time activities.

Mäestu, J, Lelle, R, Mäestu, E, Pind, R, Vahtra, E, Purge, P, and Mikulic, P. Long-term rowing performance development in male Olympic and World Championship medal winners compared with nonmedalists. J Strength Cond Res 37(9): e521–e526, 2023—The purpose of this study was, first, to investigate individual longitudinal 2,000 m rowing ergometer performance (2,000 erg) development of world class male rowers from the beginning of their career until reaching the elite level and to compare ELITE performance development with those who did not reach podium places and, second, to provide 2,000 erg milestones for talent prediction in rowing. Individual annual 2,000 erg performances of 54 male rowers were analyzed from age 15 and throughout their career. Olympic or World Championships medal winners (ELITE; n = 11) were compared with those who did not reach international podium places. Two thousand erg increased (p ≤ 0.05) until the age of 24 in ELITE, while plateaued earlier for less successful rowers. No differences in the rate of performance improvement were found between ELITE and lower performers (p > 0.05). At the age of 20, performance between ELITE and international level nonmedal winners reached significant difference (480.7 ± 20.9 W vs. 435.3 ± 33.9 W, respectively) and remained different onwards (p ≤ 0.05). However, the average of the 10 best seasons cross-sectional performances of less successful rowers were significantly higher until age 18, compared with ELITE. ELITE rowers were able to improve their 2,000 erg performance to higher age; therefore, it is difficult to predict elite performers in junior rowers. Cross-sectional performances of less successful rowers may indicate temporary high-level performers, who might not be able to advance the elite level.

Objectives (1) To develop reference values for health-related fitness in European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. Methods This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test–retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. Results A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). Conclusion This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Objectives: (1) To develop reference values for health-related fitness European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multi-language fitness platform (FitBack); (2) To provide comparisons across European countries. Methods: This study builds on a previous large fitness reference study in European youth by: (1) widening the age demographic, (2) identifying the most recent and representative country-level data, and (3) including national data from existing fitness surveillance and monitoring systems. We used the ALPHA test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity, and health-related predictive validity: the 20-m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index, and waist circumference (anthropometry). Percentile values were obtained using the GAMLSS method. Results: A total of 7,966,693 data points from 34 countries (106 datasets) were used to develop sex- and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting, and European fitness maps, is provided and freely available at www.fitbackeurope.eu . Conclusions: This study discusses the major implications of fitness assessment in youth from a health, educational and sport perspective, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe. What is already known on this topic: - Fitness testing in youth is important from a health, educational and sport point of view. - The EU-funded ALPHA project reviewed the existing evidence and proposed a selection of field-based fitness tests that showed the highest test-retest reliability, criterion/construct validity, and health-related predictive validity among available tests. What this study adds: - The FitBack project provides the most up-to-date and geographically diverse reference fitness values for 6-to 18-year-old Europeans. - This study introduces the first web-based, open-access, and multi-lingual fitness reporting platform (FitBack) providing interactive information and visual mapping of the European fitness landscape. How this study might affect research, practice, or policy: - From a health perspective, very low fitness levels are a non-invasive indicator of poor health at both the individual and group level (e.g., school, region), which have utility for health screening and may guide public health policy. There are already examples of regional and national fitness testing systems that are integrated into the healthcare systems. - From an educational perspective, fitness testing is part of the school curriculum in many countries, and the FitBack platform offers physical education teachers an easy-to-use tool for interpreting fitness test results by sex and age. - From a sport perspective, these reference values can help identify young individuals who are talented in specific fitness components.

The aim of the present study was to evaluate the effects of upper-body high-intensity exercise priming on subsequent leg exercise performance. Specifically, to compare maximal 4000 m cycling performance with upper-body pre-load (MPT_high) and common warm-up (MPT_low). In this case, 15 high-level cyclists (23.3 ± 3.6 years; 181 ± 7 cm; 76.2 ± 10.0 kg; V˙O_2max: 65.4 ± 6.7 mL·kg⁻¹·min⁻¹) participated in the study attending three laboratory sessions, completing an incremental test and both experimental protocols. In MPT_high, warm-up was added by a 25 s high-intensity all-out arm crank effort to the traditional 20-min aerobic warm-up. Both 4000 m maximal bouts started with a 12 s all-out start. Heart rate, blood lactate concentration [La) and spirometric data were measured and analyzed. Overall MPT_high time was slower by 5.3 ± 1.2 s (p < 0.05). [La] at the start was 5.5 ± 1.5 mmol·L⁻¹ higher for MPT_high (p < 0.001) reducing anaerobic energy contribution which was higher in MPT_low during the first and third 1000 m split (p < 0.05). Similarly, MPT_low maintained higher total average power during the entire performance (p < 0.05, d = 0.7). Although the MPT_high condition performed less effectively due to decreased anaerobic capacity, pre-load effect may have the potential to enhance performance at longer distances.

Corrigendum: Increases in RPE Rating Predict Fatigue Accumulation Without Changes in Heart Rate Zone Distribution After 4-Week Low-Intensity High-Volume Training Period in High-Level Rowers

The aim of the study was to compare the effects of different types and periodization of strength training on body composition and maximal aerobic performance in 10-week training period in adolescent XC skiers. Twenty-eight adolescent competitive cross-country skiers, including 10 females (age 17.9 ± 1.8 years; body mass 69.6 ± 9.7 kg; height 1.77 ± 0.1 m; training experience 8.6 ± 3.2 years) took part in this study. Pre-and post-intervention performance was measured with the incremental exercise test (Pmax) on a double poling ski ergometer. Changes in body composition were measured with DXA. In addition to regular endurance training, experimental group one (EXP1) performed maximal and explosive strength training two times per week, experimental group two (EXP2) performed maximal and explosive strength training 1–3 times per week, and the traditional (TRAD) group performed low intensity–high volume strength training 2 times per week. Increases in arm, trunk, and overall lean mass were found in TRAD (p < 0.05). Increases in arm lean-mass was found in EXP1 (p < 0.05), while no changes in body composition occurred in EXP2 (p ≥ 0.05). Pmax improved significantly in all groups (p < 0.05). Changes in body mass, overall and arm lean mass was related to changes in absolute performance (W; p < 0.05), while no relationships were found between changes in body composition parameters and relative performance (W/kg; p ≥ 0.05). In conclusion, different periodization of strength training led to similar improvements in double poling ergometer performance, but resulted in different changes in body composition (lean mass) in adolescent cross-country skiers.