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Physical Literacy, Physical Activity and Health: Toward an Evidence-Informed Conceptual Model

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Abstract

Physical literacy (PL) provides a powerful lens for examining movement in relation to physical activity (PA) and motor skill outcomes, environmental context, and broader social and affective learning processes. To date, limited consideration has been given to the role PL plays in promoting positive health behaviours. There is no clear conceptual framework based on existing empirical evidence that links PL to health, nor has an evidence-informed case been made for such a position. The purpose of this paper is to (1) present a conceptual model positioning PL as a health determinant, and (2) present evidence in support of PL as a health determinant, drawing on research largely from outside physical education. Viewing PL from the perspective of a multidimensional, experiential convergence process enables it to be differentiated from other models. However, parallels between our model and existing models that focus on movement competence are also drawn. Arguing from a pragmatic perspective on PL, we present evidence for positioning PL as a determinant of health from two literature sources: research on motor coordination disorders in children, and associations between motor competence, PA and health in typically developing children. Statistical modelling approaches consistent with the concept of PL are discussed. Results from these approaches—confirmatory factor analysis and cluster analysis—support the idea that measures related to motor competence, motivation and positive affect work in an integrative manner to produce differences in PA and subsequent health outcomes in children. There is increasing interest in PL, particularly in the field of public health. Presenting a model that explicitly links PL to health can lead to the generation of new research questions and the possibility of broadening impact beyond the context of physical education alone. To date, there has been little conceptual attention to what positioning PL as a determinant of health means. By providing an evidence-based model of PL as a determinant of health, we hope to further the discussion and stimulate increased empirical research in the field.

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References

  1. Whitehead M. Definition of physical literacy and clarification of related issues. J Int Counc Sport Sci Phys Educ. 2013; Bulletin 65. http://www.icsspe.org/sites/default/files/bulletin65_0.pdf#page=29. Accessed 15 Aug 2018.

  2. Dudley D, Cairney J, Wainwright N, Kriellaars D, Mitchell D. Critical considerations for physical literacy policy in public health, recreation, sport, and education agencies. Quest. 2017;69(4):436–52. https://doi.org/10.1080/00336297.2016.1268967.

    Article  Google Scholar 

  3. Edwards LC, Bryant AS, Keegan RJ, Morgan K, Cooper S-M, Jones AM. ‘Measuring’ physical literacy and related constructs: a systematic review of empirical findings. Sports Med. 2018;48(3):659–82. https://doi.org/10.1007/s40279-017-0817-9.

    Article  PubMed  Google Scholar 

  4. Whitehead M. The concept of physical literacy. Eur J Phys Educ. 2001;6(2):127–38. https://doi.org/10.1080/1740898010060205.

    Article  Google Scholar 

  5. Hastie PA, Wallhead TL. Operationalizing physical literacy through sport education. J Sport Health Sci. 2015;4(2):132–8. https://doi.org/10.1016/j.jshs.2015.04.001.

    Article  Google Scholar 

  6. Cairney J, Health C, Bedard C, Dudley D, Kriellaars D. Towards a physical literacy framework to guide the design, implementation and evaluation of early childhood movement- based interventions targeting cognitive development. Ann Sport Med Res. 2016;3(4):1073.

    Google Scholar 

  7. Australian Sports Commission. Physical literacy definition. 2017. https://www.ausport.gov.au/__data/assets/pdf_file/0008/658079/ASC_34651_Physical_Literacy_Consensus_Statement_FA2.pdf. Accessed 15 Aug 2018.

  8. International Physical Literacy Association. Canada's Physical Literacy Consensus Statement. 2015. http://physicalliteracy.ca/physical-literacy/consensus-statement/. Accessed 30 Jan 2019.

  9. Dudley DA. A conceptual model of observed physical literacy. Phys Educ. 2015;72(5):236–60. https://doi.org/10.18666/TPE-2015-V72-I5-6020.

    Article  Google Scholar 

  10. Lounsbery MAF, McKenzie TL. Physically literate and physically educated: a rose by any other name? J Sport Health Sci. 2015;4(2):139–44. https://doi.org/10.1016/j.jshs.2015.02.002.

    Article  Google Scholar 

  11. Whitehead M. Physical literacy: philosophical considerations in relation to developing a sense of self, universality and propositional knowledge. Sport Ethics Philos. 2007;1(3):281–98. https://doi.org/10.1080/17511320701676916.

    Article  Google Scholar 

  12. Tremblay M, Lloyd M. Physical literacy measurement-the missing piece. Phys Health Educ J. https://static1.squarespace.com/static/54a621cae4b02cb3ce0a4071/t/57017b7c40261d88349d939f/1459714941516/Physical%2BLiteracy%2BArticle%2BPHE%2BJournal%2B2010.pdf. Accessed 15 Aug 2018.

  13. Higgs C. Physical literacy—two approaches, one concept. Phys Health Educ J. 2010;76(1):6–10. https://search.proquest.com/openview/f7faef2c15ec6497c69070dd9c45c9a7/1?pq-origsite=gscholar&cbl=42913. Accessed 15 Aug 2018.

  14. Jurbala P. What is physical literacy, really? Quest. 2015;67(4):367–83. https://doi.org/10.1080/00336297.2015.1084341.

    Article  Google Scholar 

  15. Mandigo J, Francis N, Ken Lodewyk E, Lopez R. Position paper physical literacy for educators. 2009. https://phecanada.ca/sites/default/files/content/docs/resources/pl_position_paper.pdf. Accessed 15 Aug 2018.

  16. Stodden DF, Goodway JD, Langendorfer SJ, Roberton MA, Rudisill ME, Garcia C, et al. A developmental perspective on the role of motor skill competence in physical activity: an emergent relationship. Quest. 2008;60(2):290–306. https://doi.org/10.1080/00336297.2008.10483582.

    Article  Google Scholar 

  17. Hulteen R, Morgan P, Barnett L, Stodden D, Lubans D. The role of movement skill competency in the pursuit of physical literacy: are fundamental movement skills the only pathway? J Sci Med Sport. 2017;1(20):e77. https://doi.org/10.1016/j.jsams.2017.01.028.

    Article  Google Scholar 

  18. Cairney J, Bulten R, King-Dowling S, Arbour-Nicitopoulos K. A longitudinal study of the effect of organized physical activity on free active play. Med Sci Sport Exerc. 2018;50(9):1772–9. https://doi.org/10.1249/MSS.0000000000001633.

    Article  Google Scholar 

  19. Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801–9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Melancon MO, Lorrain D, Dionne IJ. Changes in markers of brain serotonin activity in response to chronic exercise in senior men. Appl Physiol Nutr Metab. 2014;39(11):1250–6.

    Article  PubMed  CAS  Google Scholar 

  21. Rhodes RE, Janssen I, Bredin SSD, Warburton DER, Bauman A. Physical activity: health impact, prevalence, correlates and interventions. Psychol Health. 2017;32(8):942–75. https://doi.org/10.1080/08870446.2017.1325486.

    Article  PubMed  Google Scholar 

  22. Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541–56.

    Article  PubMed  Google Scholar 

  23. Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills in children and adolescents. Sports Med. 2010;40(12):1019–35. https://doi.org/10.2165/11536850-000000000-00000.

    Article  PubMed  Google Scholar 

  24. Cliff DP, Okely AD, Smith LM, Mckeen K. Relationships between fundamental movement skills and objectively measured physical activity in pre-school children. Pediatr Exerc Sci. 2009; 21(4):436–49. https://pdfs.semanticscholar.org/9a33/52d31a7f93d4685727c68cb1fd640c212100.pdf. Accessed 20 Aug 2018.

  25. Sallis JF, Floyd MF, Rodríguez DA, Saelens BE. Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation. 2012;125(5):729–37. https://doi.org/10.1161/CIRCULATIONAHA.110.969022.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sugden D, Wade MG, Hart H. Typical and atypical motor development [ebook]. In: An introduction to motor development. London: Mac Keith Press; 2013. p. 1–14. https://www.wiley.com/en-us/Typical+and+Atypical+Motor+Development-p-9781908316554. Accessed 15 Aug 2018.

  27. Janke K, Propper C, Shields MA. Assaults, murders and walkers: the impact of violent crime on physical activity. J Health Econ. 2016;47:34–49.

    Article  PubMed  Google Scholar 

  28. Blair SN, LaMonte MJ, Nichaman MZ. The evolution of physical activity recommendations: how much is enough? Am J Clin Nutr. 2004;79(5):913S–20S.

    Article  PubMed  CAS  Google Scholar 

  29. Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA. 1989;262(17):2395–401.

    Article  PubMed  CAS  Google Scholar 

  30. Hands B, Parker H, Larkin D. What do we really know about the constraints and enablers of physical activity levels in young children? Health Science Conference Papers. 2002. https://researchonline.nd.edu.au/health_conference/4. Accessed 15 Aug 2018.

  31. Cairney J, editor. Developmental coordination disorder and its consequences. Toronto: University of Toronto Press; 2015. p. 62–107. https://books.google.ca/books?id=ncO5BgAAQBAJ&pg=PA66&lpg=PA66&dq=cairney+hypoactivity&source=bl&ots=MdxhbNMuPJ&sig=Q2e9MYuxVCmQ6QBnMZL-T7HIPoI&hl=en&sa=X&ved=2ahUKEwi8ltDhwfDcAhVQL6wKHeb3B8EQ6AEwBHoECAYQAQ#v=onepage&q=cairneyhypoactivity&f=false. Accessed 15 Aug 2018.

  32. Hulteen RM, Barnett LM, Morgan PJ, Robinson LE, Barton CJ, Wrotniak BH, et al. Development, content validity and test-retest reliability of the Lifelong Physical Activity Skills Battery in adolescents. J Sports Sci. 2018;36(20):2358–67. https://doi.org/10.1080/02640414.2018.1458392.

    Article  PubMed  Google Scholar 

  33. Standage M, Duda JL, Ntoumanis N. A model of contextual motivation in physical education: using constructs from self-determination and achievement goal theories to predict physical activity intentions. J Educ Psychol. 2003;95(1):97–110. https://doi.org/10.1037/0022-0663.95.1.97.

    Article  Google Scholar 

  34. Ryan RM, Deci EL. Self-determination theory: basic psychological needs in motivation, development, and wellness. New York: Guildford Press; 2017. p. 756.

    Google Scholar 

  35. Cairney J, Kwan MY, Velduizen S, Hay J, Bray SR, Faught BE. Gender, perceived competence and the enjoyment of physical education in children: a longitudinal examination. Int J Behav Nutr Phys Act. 2012;9(1):26. https://doi.org/10.1186/1479-5868-9-26.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Conner M, McEachan R, Taylor N, O’Hara J, Lawton R. Role of affective attitudes and anticipated affective reactions in predicting health behaviors. Health Psychol. 2015;34(6):642–52. https://doi.org/10.1037/hea0000143.

    Article  Google Scholar 

  37. Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015;49(5):715–31. https://doi.org/10.1007/s12160-015-9704-5.

    Article  PubMed  Google Scholar 

  38. Teixeira PJ, Carraça EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act. 2012;9(1):78. https://doi.org/10.1186/1479-5868-9-78.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Rochat P. Five levels of self-awareness as they unfold early in life. Conscious Cogn. 2003;12(4):717–31.

    Article  PubMed  Google Scholar 

  40. Roetert EP, Kriellaars D, Ellenbecker TS, Richardson C. Preparing students for a physically literate life. J Phys Educ Recreat Danc. 2017;88(1):57–62.

    Article  Google Scholar 

  41. Longmuir PE, Boyer C, Lloyd M, Yang Y, Boiarskaia E, Zhu W, et al. The Canadian Assessment of Physical Literacy: methods for children in grades 4 to 6 (8 to 12 years). BMC Public Health. 2015;15:767.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gibbs J, Appleton J, Appleton R. Dyspraxia or developmental coordination disorder? Unravelling the enigma. Arch Dis Child. 2007;92(6):534–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Sugden D, Chambers M, Utley A. Development coordination disorder as a specific learning difficulty. Leeds Consensus Statement (2006). https://www.pearsonclinical.co.uk/Psychology/ChildCognitionNeuropsychologyandLanguage/ChildPerceptionandVisuomotorAbilities/MABC-2/Resources/LeedsConsensus06.pdf. Accessed 26 Jan 2019.

  44. Zwicker JG, Missiuna C, Harris SR, Boyd LA. Developmental coordination disorder: a review and update. Eur J Paediatr Neurol. 2012;16(6):573–81.

    Article  PubMed  Google Scholar 

  45. Lingam R, Hunt L, Golding J, Jongmans M, Emond A. Prevalence of developmental coordination disorder using the DSM-IV at 7 years of age: a UK population-based study. Pediatrics. 2009;123(4):e693–700. https://doi.org/10.1542/peds.2008-1770.

    Article  PubMed  Google Scholar 

  46. Cairney J, Hay J, Mandigo J, Wade T, Faught BE, Flouris A. Developmental coordination disorder and reported enjoyment of physical education in children. Eur Phys Educ Rev. 2007;13(1):81–98.

    Article  Google Scholar 

  47. Wright HC, Sugden DA. The nature of developmental coordination disorder: inter- and intragroup differences. Adapt Phys Act Q. 1996;13(4):357–71.

    Google Scholar 

  48. Yu J, Sit CHP, Capio CM, Burnett A, Ha ASC, Huang WYJ. Fundamental movement skills proficiency in children with developmental coordination disorder: does physical self-concept matter? Disabil Rehabil. 2016;38(1):45–51.

    Article  PubMed  Google Scholar 

  49. Missiuna C, Rivard L, Pollock N. Children with developmental coordination disorder (DCD): at home, at school, and in the community [booklet]. https://www.canchild.ca/system/tenon/assets/attachments/000/000/195/original/developmental_coordination_disorder_home_school_community_booklet.pdf. Accessed 20 Aug 2018.

  50. Poulsen AA, Ziviani JM, Cuskelly M, Smith R. Boys with developmental coordination disorder: loneliness and team sports participation. Am J Occup Ther. 2007;61(4):451–62.

    Article  PubMed  Google Scholar 

  51. Poulsen AA, Ziviani JM. Can I play too? Physical activity engagement of children with developmental coordination disorders. Can J Occup Ther. 2004;71(2):100–7.

    Article  PubMed  Google Scholar 

  52. Cairney J, Hay J, Faught B, Mandigo J, Flouris A. Developmental coordination disorder, self-efficacy toward physical activity, and play: does gender matter? Adapt Phys Act Q. 2005;22(1):67–82.

    Google Scholar 

  53. Campbell WN, Missiuna C, Vaillancourt T. Peer victimization and depression in children with and without motor coordination difficulties. Psychol Sch. 2012;49(4):328–41.

    Article  Google Scholar 

  54. Cairney J, Hay JA, Veldhuizen S, Missiuna C, Faught BE. Developmental coordination disorder, sex, and activity deficit over time: a longitudinal analysis of participation trajectories in children with and without coordination difficulties. Dev Med Child Neurol. 2010;52(3):e67–72.

    Article  PubMed  Google Scholar 

  55. Schott N, Alof V, Hultsch D, Meermann D. Physical fitness in children with developmental coordination disorder. Res Q Exerc Sport. 2007;78(5):438–50.

    Article  PubMed  Google Scholar 

  56. Cairney J, Hay J, Veldhuizen S, Missiuna C, Mahlberg N, Faught BE. Trajectories of relative weight and waist circumference among children with and without developmental coordination disorder. CMAJ. 2010;182(11):1167–72. https://doi.org/10.1503/cmaj.091454.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Wahi G, LeBlanc PJ, Hay JA, Faught BE, O’Leary D, Cairney J. Metabolic syndrome in children with and without developmental coordination disorder. Res Dev Disabil. 2011;32(6):2785–9.

    Article  PubMed  Google Scholar 

  58. Cairney J, Hay J, Veldhuizen S, Faught BE. Trajectories of cardiorespiratory fitness in children with and without developmental coordination disorder: a longitudinal analysis. Br J Sports Med. 2011;45(15):1196–201.

    Article  PubMed  Google Scholar 

  59. Missiuna C, Cairney J, Pollock N, Campbell W, Russell DJ, Macdonald K, et al. Psychological distress in children with developmental coordination disorder and attention-deficit hyperactivity disorder. Res Dev Disabil. 2014;35(5):1198–207.

    Article  PubMed  Google Scholar 

  60. Bart O, Hajami D, Bar-Haim Y. Predicting school adjustment from motor abilities in kindergarten. Infant Child Dev. 2007;16(6):597–615.

    Article  Google Scholar 

  61. Robinson LE, Stodden DF, Barnett LM, Lopes VP, Logan SW, Rodrigues LP, et al. Motor competence and its effect on positive developmental trajectories of health. Sports Med. 2015;45(9):1273–84. https://doi.org/10.1007/s40279-015-0351-6.

    Article  PubMed  Google Scholar 

  62. Holfelder B, Schott N. Relationship of fundamental movement skills and physical activity in children and adolescents: a systematic review. Psychol Sport Exerc. 2014;15(4):382–91. https://doi.org/10.1016/j.psychsport.2014.03.005.

    Article  Google Scholar 

  63. Logan SW, Kipling Webster E, Getchell N, Pfeiffer KA, Robinson LE. Relationship between fundamental motor skill competence and physical activity during childhood and adolescence: a systematic review. Kinesiol Rev. 2015;4(4):416–26. https://doi.org/10.1123/kr.2013-0012.

    Article  Google Scholar 

  64. Barnett LM, van Beurden E, Morgan PJ, Brooks LO, Beard JR. Childhood motor skill proficiency as a predictor of adolescent physical activity. J Adolesc Health. 2009;44(3):252–9. https://doi.org/10.1016/j.jadohealth.2008.07.004.

    Article  PubMed  Google Scholar 

  65. Lopes VP, Rodrigues LP, Maia JAR, Malina RM. Motor coordination as predictor of physical activity in childhood. Scand J Med Sci Sports. 2011;21(5):663–9. https://doi.org/10.1111/j.1600-0838.2009.01027.x.

    Article  PubMed  CAS  Google Scholar 

  66. Cattuzzo MT, dos Santos Henrique R, Ré AHN, de Oliveira IS, Melo BM, de Sousa Moura M, et al. Motor competence and health related physical fitness in youth: a systematic review. J Sci Med Sport. 2016;19(2):123–9. https://doi.org/10.1016/j.jsams.2014.12.004.

    Article  PubMed  Google Scholar 

  67. King-Dowling S, Rodriguez C, Missiuna C, Timmons BW, Cairney J. Health-related fitness in preschool children with and without motor delays. Med Sci Sport Exerc. 2018;50(7):1442–8. https://doi.org/10.1249/MSS.0000000000001590.

    Article  Google Scholar 

  68. Wall AET. The developmental skill-learning gap hypothesis: implications for children with movement difficulties. Adapt Phys Act Q. 2004;21(3):197–218. https://doi.org/10.1123/apaq.21.3.197.

    Article  Google Scholar 

  69. De Meester A, Stodden D, Brian A, True L, Cardon G, Tallir I, et al. Associations among elementary school children’s actual motor competence, perceived motor competence, physical activity and BMI: a cross-sectional study. PLoS One. 2016;11(10):e0164600. https://doi.org/10.1371/journal.pone.0164600.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  70. Cairney J, Clark H. Physical literacy in children and youth: a construct validation study. Pediatr Exerc Sci. 2016;28:17.

    Google Scholar 

  71. Hay JA. Adequacy in and predilection for physical activity in children. Clin J Sport Med. 1992;2(3):192–201.

    Article  Google Scholar 

  72. Léger LA, Mercier D, Gadoury C, Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6(2):93–101. https://doi.org/10.1080/02640418808729800.

    Article  PubMed  Google Scholar 

  73. Biddle SJH, Atkin AJ, Cavill N, Foster C. Correlates of physical activity in youth: a review of quantitative systematic reviews. Int Rev Sport Exerc Psychol. 2011;4(1):25–49. https://doi.org/10.1080/1750984X.2010.548528.

    Article  Google Scholar 

  74. Cameron DS, Bertenshaw EJ, Sheeran P. Positive affect and physical activity: Testing effects on goal setting, activation, prioritisation, and attainment. Psychol Health. 2018;33(2):258–74. https://doi.org/10.1080/08870446.2017.1314477.

    Article  PubMed  Google Scholar 

  75. Balyi I, Way R, Higgs C. Long-term athlete development. Champaign: Human Kinetics; 2013. p. 5–46.

    Google Scholar 

  76. Stevens-Smith D. Physical literacy: getting kids active for life. Strategies. 2016;29(5):3–9.

    Article  Google Scholar 

  77. Vandorpe B, Vandendriessche J, Vaeyens R, Pion J, Matthys S, Lefevre J, et al. Relationship between sports participation and the level of motor coordination in childhood: a longitudinal approach. J Sci Med Sport. 2012;15(3):220–5.

    Article  PubMed  Google Scholar 

  78. Robinson DB, Randall L. Marking physical literacy or missing the mark on physical literacy? A conceptual critique of Canada’s physical literacy assessment instruments. Meas Phys Educ Exerc Sci. 2017;21(1):40–55.

    Article  Google Scholar 

  79. Krueger H, Turner D, Krueger J, Ready AE. The economic benefits of risk factor reduction in Canada: tobacco smoking, excess weight and physical inactivity. Can J Public Health. 2014;105(1):e69.

    Article  PubMed  Google Scholar 

  80. Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy for the Lancet Physical Activity Series Working Group. Lancet. 2012;380(380):219–29.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Mavrovouniotis F. Inactivity in childhood and adolescence: a modern lifestyle associated with adverse health consequences. Sport Sci Rev. 2012;21(3–4):75–99.

    Article  Google Scholar 

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JC conceived the review, wrote and edited significant sections of the manuscript, and assisted with the literature review. DD wrote and edited sections of the manuscript, contributed expertise to the written material and assisted with the literature review. MK wrote and edited sections of the manuscript and contributed expertise to the written material. RB wrote and edited sections of the manuscript, assisted with the literature review and formatted the manuscript. DK edited significant sections of the manuscript and contributed expertise to the written material. All authors reviewed and approved the final manuscript.

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Correspondence to John Cairney.

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John Cairney, Dean Dudley, Matthew Kwan, Rheanna Bulten and Dean Kriellaars declare that they have no conflicts of interest relevant to the content of this review.

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Cairney, J., Dudley, D., Kwan, M. et al. Physical Literacy, Physical Activity and Health: Toward an Evidence-Informed Conceptual Model. Sports Med 49, 371–383 (2019). https://doi.org/10.1007/s40279-019-01063-3

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