Controlling for maturation in pediatric exercise science

The process of maturation is continuous throughout childhood and adolescence. In a biological context, the effects of a child's maturation might mask or be greater than the effects associated with exposure to exercise. Pediatric exercise scientists must therefore include an assessment of biological age in study designs so that the confounding effects of maturation can be controlled for. In order to understand how maturation can be assessed, it is important to appreciate that one year of chronological time is not equivalent to one year of biological time. Sex- and age-associated variations in the timing and tempo of biological maturation have long been recognized. This paper reviews some of the possible biological maturity indicators that the pediatric exercise scientist can use. As a result, we recommend that any of the methods discussed could be used for gender-specific comparisons. Gender-comparison studies should either use skeletal age or some form of somatic index.