Tanner–Whitehouse Skeletal Ages in Male Youth Soccer Players: TW2 or TW3?

Abstract

Background. The Tanner-Whitehouse radius-ulna-short bone protocol (TW2 RUS SA) is a widely used indicator of maturity status. The scale for converting ratings to an SA has been revised (TW3 RUS SA) which may have implications for studies of youth athletes.Objectives. To compare TW2 and TW3 RUS SAs in an international sample of youth soccer players and to compare distributions of players by maturity status defined by each SA Methods. SA assessments with the TW RUS method were collated for 1831 soccer players 11-17 years from 8 countries. RUS scores were converted to TW2 and TW3 SAs using the appropriate tables. SAs were compared within chronological age (CA) groups. The difference of SA minus CA with each method was used to classify players as late, average or early maturing. Concordance of maturity classifications with TW2 and TW3 SAs was evaluated with Cohen's Kappa coefficients.Results. For the same RUS score, SAs were systematically and substantially reduced with TW3 compared to TW2; mean differences ranged, on average, from -0.97 to -1.16 years. Kappa coefficients indicated fair concordance of maturity classifications based on TW2 and TW3 SAs.Conclusion. TW3 SAs were systematically lower than corresponding TW2 SAs in youth soccer players. The differences between scales have major implications for the classification of players by maturity status, which is central to many talent development programs.

Cross-Sectional Analysis Investigating the Concordance of Maturity Status Classifications in Elite Caucasian Youth Tennis Players

“…The former used the TW2 method, while the latter used the TW3 method of SA assessment. Of relevance, SAs with the TW3 method were consistently less than SAs with the TW2 method by about one year in a large international sample of youth soccer players 11–17 years of age [23]. The systematic difference between TW2 and TW3 SAs has major implications for the classification of players by maturity status.…”

“…Classifying players as early, on time, or late with different methods (years, z -scores, standard deviations) and the broad CA range of the sample (9 to 16 years) may influence the sensitivity of the maturity indicators and in turn affect the number of players assigned to each category. The band of ± one year of SA from CA within single-year CA groups is commonly used, although the range of observed standard deviations in studies of SA varies somewhat with CA and also among samples and with the method of assessment [23]. Nevertheless, maturity status classifications of players within two year competitive age groups (Additional file 1: Table S1, Additional file 2: Table S2, Additional file 3: Table S3, Additional file 4: Table S4) suggested similar trends, but numbers were limited.…”

“…An SA within ± 1.0 year of CA indicated average or on-time maturity status, and a SA less than CA by < 1.0 year defined late status while a SA in advance of CA by > 1.0 year defined early status. The band of ± 1.0 year approximated standard deviations of SA with the Fels and other methods of SA assessment within single-year CA groups [23]. No player was classified as skeletally mature.…”

Defining a Growing and Maturing Skeleton and its Relevance in Diseases that Affect Skeletal Growth, Such as X-Linked Hypophosphataemia (XLH)

“…Techniques used to identify time of epiphyseal fusion include the Tanner-Whitehouse 2nd edition (TW2) radius-ulna-short bone, which uses 20 regions of the bone to assess bone age [105]. Each of these regions is further split into several developmental stages, one of which identifies when epiphyseal fusion is complete [106].…”

Automated ROI Detection in Left Hand X-ray Images using CNN and RNN

“…The TW method [7,10,11] assigns score to relevant bone through a detailed structural analysis and evaluates the bone maturity based on the sum of the scores. Thirteen bone areas are used in this bone maturity determination analysis, including weak bone, small bone (RUS), and male bones.…”