A multilevel analysis of gross motor coordination of children and adolescents living at different altitudes: the Peruvian Health and Optimist Growth Study

Background Gross motor coordination (GMC) is a potential correlate of lifestyle behaviours and health outcomes in childhood and adolescence. Aims The aim of this study was to examine how sex, age, biological maturation, overweight, stunting, and physical fitness are associated with GMC in children and adolescents from Peru, and to examine associations between geographical area of residence, school-level characteristics, and GMC. Subjects and methods The sample included 7408 subjects, aged 6-14 years, from sea level, Amazon and high-altitude regions of Peru. A composite marker of total coordination was derived by the sum of scores from each test (GMC(T)). Overweight was identified using BMI, and biological maturation, physical fitness, and stunting were assessed. School characteristics were obtained via an objective audit. Results Boys (beta =12.23 +/- 0.90) and older children (beta =13.37 +/- 0.64) had higher GMC(T)than girls and younger children, respectively. Overweight was associated with lower GMC(T)(beta= -5.23 +/- 0.80), whereas fitness was positively associated with GMC(T)(beta = 6.30 +/- 0.25). Biological maturation was not a predictor; however, stunting was negatively associated with GMC(T)(beta= -3.71 +/- 1.56). Subjects living in the Amazon had higher GMC(T)than those at sea level (beta = 16.57 +/- 4.73). Five of nine school-level predictors (number of students, playground area with obstacles, multi-sports roofed, frequency and duration of Physical Education classes) were significant predictors of GMC(T). Conclusions Child- and school-level variables were significantly associated with GMC(T)in this sample. These findings are important for the Peruvian community, especially school principals, councils and physical education teachers, helping them to define more efficient strategies and action plans to increase motor coordination in children.