Pediatric Powerpenia: Conceptual Framework, Clinical Relevance, and Future Directions

Background: Pediatric powerpenia has recently been proposed as an emerging life-course concept describing inadequate development or expression of muscle power during childhood and adolescence. Unlike adult powerpenia, it may reflect insufficient acquisition of power, failure to follow expected developmental trajectories, or power that is inadequate for body size and functional demands. Methods: This narrative review searched PubMed/MEDLINE, Scopus and Web of Science from inception to 31 August 2026. Original studies, reviews, consensus papers, methodological studies and relevant editorials addressing muscle power development, determinants, assessment, clinical correlates and interventions in pediatric populations were considered. Evidence was synthesised qualitatively because of substantial heterogeneity in populations, testing protocols, scaling methods and outcome definitions. Results: Muscle power increases markedly across growth and is influenced by age, sex, maturation, lean mass, adiposity, physical activity and neuromuscular development. Reduced power or power-related performance has been reported in obesity, prolonged deconditioning, chronic systemic diseases, type 1 diabetes, Prader–Willi syndrome, cerebral palsy and Duchenne muscular dystrophy. Interpretation depends strongly on whether power is expressed in absolute terms or normalised to body mass, lean mass or allometric measures. Jump tests, mechanography, force platforms, cycle ergometry and dynamometry are available, but protocol heterogeneity and the absence of validated pediatric diagnostic thresholds limit clinical translation. Exercise, particularly high-velocity resistance and plyometric training, can improve muscle power and power-related performance during childhood and adolescence, although evidence that these interventions specifically prevent or treat pediatric powerpenia is currently lacking. Evidence for nutritional interventions remains indirect and insufficient to establish specific effects on muscle power. Conclusions: Pediatric powerpenia is a promising developmental research framework that may inform future investigations of muscle function and functional phenotyping, although its incremental clinical utility remains unestablished. It is not currently a formal clinical diagnosis. Although muscle power is trainable, effective strategies specifically targeting pediatric powerpenia have not yet been established. Consensus definitions, harmonised assessment, developmental reference standards and longitudinal outcome-based validation demonstrating additional clinical utility beyond established functional measures are required before routine clinical implementation.