Athletic participation and its impact on self-concept, body image, and physical fitness in Saudi female adolescents: a cross-sectional comparison between athletes and non-athletes

Ethics considerations

Ethical approval was obtained from Majmaah University Institutional Review Board (Reference # MUREC-Mar.3/COM-2024/7-1). Written informed consents were secured from parents, and a signed assent from students. The anonymity and confidentiality of the participants were protected throughout the study.

Study design and participants

A cross-sectional study design was conducted between October 2024 and February 2025 in Al Majma’ah, Riyadh Province. Included 493 female students, divided nearly equally between athletes (n = 252) and non-athletes (n = 241). Although a formal a priori power analysis was not conducted, this sample size is adequate for detecting medium effect sizes with 80% power at a significance level of 0.05, as supported by standard guidelines for t-tests and chi-square analyses in cross-sectional designs.

Female students aged 12–18 was recruited from middle and high schools and categorized as either athletes (participating in school official sports club) or non-athletes. Healthy female students aged 12–18 years were recruited. Schools were randomly selected. Males, individuals with neurological or musculoskeletal conditions, and those unwilling to participate were excluded.

Outcome measures

• Physical Self-Inventory-Short (PSI-S): The PSI-S evaluates multidimensional aspects of physical self-concept, including perceived strength, attractiveness, and overall physical self-worth. It is a validated tool that captures adolescents’ internal evaluations of their physical capabilities and image, directly aligning with the study’s focus on self-perception. It uses a Likert-type scale, ranging from a 6-point Likert scale (1 = Not at all to 6 = Entirely). Overall, scores are categorized into low (18–36), moderate (54–72), and high (90–108). Low scores suggest poor self-perception and possible dissatisfaction, moderate scores suggest neutral perception, neither positive nor negative, and high scores indicate stronger positive perception (Morin et al., 2016).

• Stunkard Scale: This visual scale assesses perceived body image through silhouette selection. It helps quantify body dissatisfaction by comparing a participant’s self-identified body shape with culturally internalized ideals. This tool is particularly useful in adolescent populations where visual body cues heavily influence self-concept. It requires participants to select the figure corresponding with their self-perception of current body type or body type they believe is standard (Stunkard, Sørensen & Schulsinger, 1983).

• Shuttle Run Test: Chosen to assess cardiorespiratory fitness and agility, the shuttle run reflects physical performance, which may impact one’s self-concept and perceived competence. Better performance can be linked to higher self-worth and body satisfaction. It requires participants to run between two cones which are placed 20 m apart (Cadenas-Sánchez et al., 2014).

• V-Sit-and-Reach Test: This test measures flexibility, which is often associated with physical capability in sports. Improvements in flexibility contribute to a sense of physical competence and can influence how adolescents perceive their functional abilities and body (Das et al., 2022). It requires participant to sit on the floor with extended legs and leaning forward with both hands towards the toes.

• Wall Sit Test: The wall sit test evaluates lower limb muscular endurance, a key indicator of athletic fitness. Stronger performance in this test supports a more positive perception of physical strength, contributing to better physical self-concept and body confidence. It requires participant to stay in a sitting posture while leaning back against a wall with bent knee at 90° and time is recorded (Philippe et al., 2022; Tomchuk, 2011).

Study procedure and data collection

The director of each school in Riyadh province was contacted and informed about the objectives of the study. An official written permission letter was submitted to the school administrations to obtain approval for conducting the research. Upon receiving formal written authorization, the research team coordinated with a designated teaching faculty member at each school. Prior to student enrollment, informed consent forms were distributed through the teaching faculty to students and their parents. Ample time was provided for parents to review the forms, ask relevant questions, and make an informed decision before signing.

Following parental consent during the initial visit, the research team identified athletes by directly approaching female students who were actively participating in school sports teams or athletic clubs. The aims and procedures of the study were thoroughly explained, and verbal assent was obtained before beginning any measurements. For the non-athlete group, students were selected based on teacher recommendations confirming that they were not enrolled in any school or extracurricular sports programs and did not engage in regular physical activity in any form.

Subsequently, research team members demonstrated each test and ensured appropriate completion of the Physical Self-Inventory–Short (PSI-S), Stunkard Scale, Shuttle Run Test, V Sit-and-Reach Test, and Wall Sit Test. To minimize fatigue and ensure reliable performance, participants were given a two-minute rest period between each test.

Statistical analyses

Data entry and management were conducted using Office 365’s Microsoft Excel, while the data analysis was performed using the Stata 18 software (StataCorp. 2023. Stata Statistical Software: Release 18. College Station, TX: StataCorp LLC). Quantitative data were presented as means ± standard deviations (SDs) and categorical data were shown as frequencies and percentages. Chi-square (χ²) test was applied to evaluate the difference of PSI-S self-perception categories (low, moderate, and high) between non-athletes and athletes. In addition, stratified analyses were conducted by stratifying participants based on body mass index (BMI) categories (normal, underweight, overweight, and obese) to investigate whether the differences varied across BMI groups. To determine mean differences for Stunkard Scale, Shuttle Run Test, V Sit-and-Reach Test, and Wall Sit Test between non-athletes and athletes, an independent samples t-test was conducted. Adjusted mean values (adjusted for BMI (Kg/m²)) for aforementioned tests along with 95% confidence intervals (CIs) were obtained by applying analysis of covariance (ANCOVA). The p value <0.05 was considered statistically significant.

Demographic characteristics of study participants

In the present research study, a total of 493 female school students consented and participated. The distribution of participants based on their athletic status was almost identical; non-athletes (n = 241, 48.9%) and athletes (n = 252, 51.1%). In anthropometric measurement, mean BMI was 24.66 ± 6.78 kg/m². On PSI-S, 101 (20.5%) participants had low, 168 (34.1%) had moderate, and 224 (45.4%) high self-perception. Mean scores on Stunkard Scale, Shuttle Run Test, V Sit-and-Reach Test, and Wall Sit Test were 5.09 ± 2.29, 9.01 ± 1.55, 13.77 ± 6.59, and 60.79 ± 23.86, respectively. Table 1 demonstrates the demographic characteristics middle and high school female non-athletes and athletes.

Comparison of self-perception (PSI-S) between non-athletes and athletes

Table 2 presents the comparison of self-perception using PSI-S questionnaire between non-athletes and athletes with stratified analysis by BMI categories. Overall, fairly higher proportion of athletes demonstrated high self-perception in contrast to non-athletes (53.17% versus 37.34%). Similarly, compared to non-athletes, low (17.46% versus 23.65%) and moderate (29.37% versus 39.00%) self-perception was noted lesser among athletic female students. The overall findings were statistically significant (p = 0.002). When stratified analysis was performed based on BMI categories, no statistical difference was observed between non-athletes and athletes for self-perception (normal; p = 0.170, underweight; p = 0.326, overweight; p = 0.111, and obese; p = 0.390).

Mean differences for stunkard scale, shuttle run test, V sit-and-reach test, and wall sit test between non-athletes and athletes

Mean values of instruments assessing perceived body figure (Stunkard Scale), cardiorespiratory fitness (Shuttle Run Test), lower back and hamstring muscles flexibility (V Sit-and-Reach Test), and lower body strength and muscular endurance (Wall Sit Test) are presented in Table 3. Mean scores on instruments were significantly higher for athletic female students middle and high schools in comparison to non-athletes; Stunkard Scale (5.81 ± 2.10 versus 4.34 ± 2.24; p < 0.001), Shuttle Run Test (9.96 ± 1.19 versus 8.01 ± 1.22; p < 0.001), V Sit-and-Reach Test (14.53 ± 7.49 versus 12.98 ± 5.41; p = 0.009), and Wall Sit Test (63.20 ± 24.14 versus 58.27 ± 23.36; p = 0.022).

Adjusted mean values of instruments are shown in Table 4. Data were adjusted for a BMI (Kg/m²) covariate. After BMI adjustment, the findings remained statistically significant and revealed that athletes had significantly higher mean scores on Stunkard Scale (5.83 versus 4.31; p < 0.001), Shuttle Run Test (9.96 versus 8.01; p < 0.001), V Sit-and-Reach Test (14.50 versus 113.02; p = 0.012), and Wall Sit Test (63.17 versus 58.30; p = 0.024) compared to non-athletes. Figure 1 displays margins plot for BMI-adjusted mean and 95% CI for Stunkard Scale, Shuttle Run Test, V Sit-and-Reach Test, and Wall Sit Test between non-athletes and athletes.

Strengths and limitations

This study has several limitations that should be acknowledged. First, its cross-sectional design restricts the ability to infer causality between athletic participation and self-perception or body image. Second, data on athletic status and physical self-perception were based on self-report, which may be influenced by social desirability bias, particularly in adolescent girls within conservative settings. Third, the Stunkard Scale silhouettes may not accurately reflect the diverse body types of Saudi adolescents, potentially affecting validity. Fourth, Lack of dietary/nutritional data, which may confound body image perceptions. Furthermore, although the Stunkard scale is a widely used tool for assessing body image perception, it has not been formally validated in the Saudi population. Future studies are encouraged to culturally adapt and validate this instrument to ensure its appropriateness in the local context. Although BMI was included and adjusted for in our analyses, we did not specifically evaluate the concordance between participants’ actual BMI and the figure selected as ‘feel’. Future research should address this gap to better assess the accuracy of body image perception among adolescents. Lastly, the study was geographically limited to Al Majma’ah City, reducing the generalizability of findings to other regions of Saudi Arabia.

Recommendations

We believe that following recommendations could work as a catalyst for future research work in this domain: (1) we encourage that future work should focus on utilizing more objective measures of body size and shape in school-going Saudi female adolescents like that undertaken by Speight (2013), (2) it is equally important for males to be enrolled along with females to understand the gender-based differences of involvement in physical activity, self-concept, and body image, (3) participants from other geographical regions in Saudi Arabia must be included as this would enhance the generalization of the research findings, (4) longitudinal designs to track changes post-sports participation, and (5) a qualitative or mixed method study can be conducted to gain precise understanding of the sociocultural influence and adolescents’ self-perception.