Association of Screen Time with Cardiopulmonary Endurance among Adolescents
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Abstract
Background: Excessive screen exposure is increasingly common among adolescents and may contribute to sedentary behavior, reduced physical activity, and poorer health-related fitness. However, the direct association between screen time and functional cardiopulmonary capacity remains unclear, particularly in local school-going adolescent populations. Objective: This study aimed to determine the association between total, work-related, and recreational screen time and Six-Minute Walk Distance among adolescents aged 10–19 years. Methods: A cross-sectional analytical study was conducted among 194 adolescents in Lahore, Pakistan. Screen time was assessed using the Questionnaire for Screen Time of Adolescents, while functional cardiopulmonary capacity was assessed using the Six-Minute Walk Test. Pre-exercise heart rate, post-exercise heart rate, and heart rate recovery were also recorded. Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression, with Six-Minute Walk Distance as the dependent variable. Results: The mean age was 14.54 ± 2.879 years, and male and female participants were equally represented. Mean total screen time was 6.60 ± 2.029 hours/day, while mean Six-Minute Walk Distance was 547.73 ± 80.123 m. Total screen time (r = 0.124, p = 0.085), work-related screen time (r = 0.010, p = 0.885), and recreational screen time (r = 0.133, p = 0.065) were not significantly correlated with Six-Minute Walk Distance. Pre-exercise heart rate (r = −0.975, p < 0.001) and post-exercise heart rate (r = −0.909, p < 0.001) showed strong inverse correlations with walking distance. The regression model including total screen time, age, gender, and BMI was not statistically significant, F(4,189) = 1.620, p = 0.171, and explained 3.3% of variance in Six-Minute Walk Distance. Conclusion: Screen time was not significantly associated with Six-Minute Walk Distance in this adolescent sample, whereas heart rate parameters showed stronger associations with functional walking capacity. Future studies should include objective physical activity monitoring, standardized heart rate assessment, and longitudinal designs
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1. Santos RMS, Mendes CG, Sen Bressani GY, de Alcantara Ventura S, de Almeida Nogueira YJ, de Miranda DM, et al. The associations between screen time and mental health in adolescents: a systematic review. BMC Psychol. 2023;11(1):127.
2. Baird S, Choonara S, Azzopardi PS, Banati P, Bessant J, Biermann O, et al. A call to action: the second Lancet Commission on adolescent health and wellbeing. Lancet. 2025;405(10493):1945-2022.
3. Lehnhard AR, Sehn AP, de Castro Silveira JF, Burns RD, Reuter CP, Franke SIR. Longitudinal relationship between screen time, cardiorespiratory fitness, and waist circumference of children and adolescents: a 3-year cohort study. BMC Pediatr. 2023;23(1):553.
4. Charoensittisup P, Udomittipong K, Mahoran K, Palamit A. Longitudinal effects of obesity on pulmonary function in obese children and adolescents. Pediatr Res. 2025;97(5):1644-9.
5. Vanhelst J, Beghin L, Drumez E, Casajus JA, De Henauw S, Widhalm K, et al. School time is associated with cardiorespiratory fitness in adolescents: The HELENA study. J Sports Sci. 2021;39(18):2068-72.
6. Dong Q, Liu H, Fu Q. Associations between physical fitness and different aspects of screen time in children and adolescents. Sci Rep. 2025;15(1):25607.
7. Kjellenberg K, Ekblom Ö, Stålman C, Helgadóttir B, Nyberg G. Associations between physical activity patterns, screen time and cardiovascular fitness levels in Swedish adolescents. Children (Basel). 2021;8(11):998.
8. Araujo RH, Werneck AO, Martins CL, Barboza LL, Tassitano RM, Aguilar-Farias N, et al. Global prevalence and gender inequalities in at least 60 min of self-reported moderate-to-vigorous physical activity 1 or more days per week: an analysis with 707,616 adolescents. J Sport Health Sci. 2024;13(5):709-16.
9. Aslam S, Bin SY. Active futures: combating youth sedentary lifestyles in Pakistan through smart use of fragmented time. Front Sports Act Living. 2025;7:1518884.
10. Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al. Cardiorespiratory fitness in youth: an important marker of health: a scientific statement from the American Heart Association. Circulation. 2020;142(7):e101-e18.
11. Chen X, Ma J, Dong L, Chen Y, Chen K. The association between physical activity and lung function in adolescents: a cross-sectional NHANES study. Front Med (Lausanne). 2025;12:1538221.
12. Horner D, Jahn M, Bønnelykke K, Chawes B, Flensborg-Madsen T, Schoos AMM, et al. Screen time is associated with cardiometabolic and cardiovascular disease risk in childhood and adolescence. J Am Heart Assoc. 2025;14(16):e041486.
13. Manuja R, Pattankar TP, Yadavannavar MC, Udgiri RS, Yadavannavar M, Udgiri Sr R. Impact of elevated screen time on school-age adolescents during the COVID-19 pandemic: an analytical study. Cureus. 2024;16(7).
14. Yahat H. Optimising adolescent health: a comparative study of high-intensity interval training and moderate-intensity continuous training on body composition and cardiovascular fitness in sedentary male youth. Front Sports Act Living. 2025;7:1655906.
15. Kägi-Braun N, Hedin L, Cassel S, Carlander A, J-Son Höök M, Löf M. Physical activity and screen time trends in Swedish youth: the Generation Pep study 2018-2023. Acta Paediatr. 2025;114(10):2589-602.
16. Nagata JM, Weinstein S, Alsamman S, Lee CM, Dooley EE, Ganson KT, et al. Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study. BMC Public Health. 2024;24(1):1346.