Physical fitness is an important component in the development and health of children and adolescents. Given the equivocal results of previous research regarding the influence of the living environment on physical fitness, this study examined differences in physical fitness in urban and rural elementary school children in Upper Austria. A total of 18,168 (51% male) children between 6 and 11 years of age participated in anthropometric assessments and completed eight fitness tests that assessed cardiorespiratory endurance, muscular power, speed, agility, flexibility, and ball handling skills during a single test session in the school’s gymnasium. Urban living environment was associated with higher body weight (p = 0.01) and lower physical fitness (p < 0.01), except for flexibility, which was better in urban children (p < 0.01) and upper body strength (no difference), even after accounting for differences in body weight. Furthermore, it was shown that urban–rural differences in physical fitness are more pronounced in normal weight children and that these differences increase with age. These results highlight the potential of the living environment for the promotion of an active lifestyle that enhances physical fitness. The availability of safe spaces that facilitate unstructured and structured physical activity, as well as active transportation provide viable options for the promotion of physical fitness in children.

<abstract><sec> <title>Background</title> <p>With the emergence of the COVID-19 pandemic, many countries implemented policies that included movement restrictions, social distancing and school closures in order to control the spread of the virus. Even though these actions may have been necessary to save lives, there have been some unintended consequences that could affect future public health.</p> </sec><sec> <title>Methods</title> <p>The present study uses data from more than 24,500 Austrian elementary school children (51.2% male) that participated in a state-wide fitness evaluation program, which was initiated in the 2016/17 school year. In addition to body weight and height, data on cardiorespiratory endurance, muscular power, speed, agility, flexibility and object control were collected from three cohorts prior to the implementation of movement restrictions (school years: 2016/17, 2017/18, 2018/19) and one cohort in 2022, after the majority of COVID-19 policies had been lifted.</p> </sec><sec> <title>Results</title> <p>Body mass index percentiles were significantly higher in children post-COVID-19 (p &lt; 0.01). Further, cardiorespiratory endurance, agility and flexibility were significantly lower post-COVID-19 compared to the years preceding movement restrictions (p ≤ 0.01), while absolute muscular strength was higher in the year 2022 (p &lt; 0.01).</p> </sec><sec> <title>Conclusion</title> <p>Given the detrimental effects of COVID-19 policies on physical fitness in children, additional efforts are necessary that include versatile opportunities for physical activity and the promotion of physical fitness in order to modify the observed negative health trajectories and ensure future public health.</p> </sec></abstract>