Pediatric Exercise Science最新文献

Despite the well-documented role of swimming competence in preventing childhood drowning, little is known about how preschoolers' swimming competence differs across cultural contexts. This study aimed to examine cross-regional variations in swimming competence and related behavioral and environmental factors among preschoolers. Parent-child dyads (N = 2059) from the United States (n = 500), Australia (n = 500), Singapore (n = 507), and Hong Kong (n = 552), with children aged 2-6 years (Mage = 4.23 [1.10] y), completed the Swimming Competence Questionnaire. Preschoolers had an average maximum swimming distance (max-dis) of 17.80 (61.12) m, and a swimming competence index (SCI) of 15.50 (19.56) out of 100. Preschoolers from Australia (Mmax-dis = 13.46 [12.24] m; MSCI = 19.59 [20.46]) and the United States (Mmax-dis = 13.91 [11.98] m; MSCI = 16.35 [18.77]) had significantly better swimming competence than those from Singapore (Mmax-dis = 26.46 [50.19] m; MSCI = 14.77 [18.44]) and Hong Kong (Mmax-dis = 18.96 [21.05] m; MSCI = 12.80 [20.35]). Compared with those from other regions, preschoolers from Australia had the highest swimming frequency and greatest accessibility to swimming facilities, and they were more likely to receive professional swimming instruction. Findings underscore the importance of providing children with opportunities to engage in swimming to improve swimming competence.

Background: Fundamental motor skills (FMS) support children's participation in health-enhancing physical activity (PA), yet it remains unclear whether postintervention motor skill gains translate into increased PA.

Purpose: This study used cross-sectional and prospective analyses to examine associations between changes in preschoolers' FMS and PA immediately following the Children's Health Activity Motor Program and again 6 months later.

Methods: Preschoolers (N = 153; 86 girls, mean age = 53.14 mo [4.43 y]) from 3 preschool centers participated. Process-oriented FMS were assessed using the Test of Gross Motor Development-Third Edition, and product measures were collected for running, jumping, hopping, kicking, and throwing. Moderate to vigorous PA was measured using wrist-worn ActiGraph accelerometers. Linear mixed models tested associations between FMS and PA changes, controlling for age, sex, and body mass index and accounting for preschool center differences.

Results: Improvements in locomotor skills were positively associated with increased moderate to vigorous PA postintervention, whereas improvements in object control skills were negatively associated with moderate to vigorous PA at the same time point. No significant prospective associations were observed.

Conclusion: These findings suggest that locomotor skill gains may support short-term PA among preschoolers, but further research is needed to clarify additional aspects of the FMS-PA relationship after motor skill interventions.

Purpose: To compare exercise testing results of pediatric patients with postural orthostatic tachycardia syndrome (POTS) and orthostatic intolerance (OI) with those of healthy peers and investigate differences in heart rate (HR) kinetics during and after exercise testing.

Methods: Analysis of maximal exercise data using the Bruce protocol. HR kinetics were analyzed during exercise by comparing the percentage of test completion with percentage of maximal HR and in recovery by calculating HR recovery postcardiopulmonary exercise testing.

Results:  A total of 222 patients aged 15.9 (1.7) years participated in this study. POTS and OI patients had worse HR metrics, exercise duration, peak aerobic capacity, and percentage predicted peak aerobic capacity compared with peers. POTS and OI patients had elevated HR responses at 10%, 25%, and 50% of cardiopulmonary exercise testing duration compared with healthy peers. Furthermore, POTS and OI patients had reduced HR recovery at 3, 4, 5, 9, and 10 minutes postcardiopulmonary exercise testing compared with peers.

Conclusions: Pediatric POTS and OI patients have decreased exercise capacity, exaggerated submaximal HR responses, and blunted HR recovery compared with healthy peers. Exercise capacity and HR kinetics did not differ between POTS and OI patients. Decreased time to peak HR may explain some of the exercise intolerance observed in pediatric patients with POTS and OI and may be a helpful metric for exercise prescription and outcome tracking.

Purpose: The purpose of this study was to explore whether incorporating gyroscopic and accelerometer data will improve the prediction of energy expenditure (EE) of preschool children. Three model configurations were developed and compared using (1) accelerometer, (2) gyroscope, and (3) accelerometer + gyroscope data (dual sensor).

Method: Participants (n = 39; aged 3 to <6 years) were equipped with OPAL, GT9X, and GENEActiv devices, worn on the right hip, right wrist, and left wrist, while EE was simultaneously measured using a portable metabolic unit. The protocol consisted of semistructured activities spanning a range of intensities from low to high. A total of 54 machine learning models were developed to predict EE (2 EE measures [metabolic equivalents, kilojoules per minute] × 3 wear locations × 3 model types [random forest, linear regression, and fully connected neural network] × 3 sensor configurations). Model performance was evaluated using root mean squared error.

Results: Our findings reveal that, across the various configurations, the random forest model utilizing dual-sensor data achieved marginally lower mean root mean squared error in the majority of cases.

Conclusion: Given the minimal improvements observed and the challenges associated with data acquisition, we recommend that researchers utilize accelerometer-based models moving forward.

Purpose: This study aimed to identify the injury profiles of Korean youth soccer players over a 1-year period.

Method: One hundred Korean male soccer players aged 12-15 years were recruited for this prospective epidemiological study. Data on injury characteristics, including the type of field, severity of injuries, time to return to full soccer activities, re-injury rate, and surgery rate were collected by the medical staff. The incidence rate of injuries including body locations, types, and causes was calculated as the number of injuries per 1000 hours.

Results: In total, 140 injuries were reported during the 1-year follow-up. The overall incidence rate was 5.76 per 1000 hours. The incidence rate was higher during matches than during training (14.76 per 1000 h vs 3.88 per 1000 h). The most common body location, type of injury, and cause of injuries were the ankle (n = 46, 32.9%), ligament sprain (n = 54, 37.1%), and noncontact injury (n = 63, 45.0%), respectively.

Conclusions: Prevention strategies should focus on noncontact ankle sprains in Korean youth soccer players. Given the growth spurts experienced by U-15 soccer players, emphasis should be placed on muscle conditioning and balance training to control movement and prevent soccer injuries.

Monitoring weekly training load (WTL) is essential in youth soccer; however, the influence of contextual factors on WTL during the microcycle remains unclear.

Objective: The aim of this study was to (1) analyze the effect of match-related contextual factors, such as match location, and opponent standard on WTL in elite youth soccer players across a competitive season, and (2) compare session and WTLs according to the number of training sessions per microcycle.

Methods: Training and match data were collected from 46 male soccer players of a Spanish First Division academy. External load variables were obtained using Global Positioning System, including total distance covered, high-speed distance (>18 km·h-1), sprint distance (>21 km·h-1), the number of high metabolic load efforts (>20 W·Kg-1), and player load. Training weeks were categorized based on contextual factors, such as match location, opponent level, and the number of training sessions in the microcycle (3, 4, or 5 sessions per week, W3s, W4s, W5s, respectively).

Results: WTL significantly increased (P < .05) in sprint distance weeks before playing away compared with playing at home. In reference to the length of the microcycle, W3s showed a significant decrease (P < .01) in WTL than W4s and W5s in all metrics. Additionally, W5s had significantly greater WTL for total distance covered, player load, and power score than W4s (P < .01).

Conclusions: Match location was the only contextual factor affecting WTL, highlighting the importance of considering its impact when planning training load, as it may influence recovery, fatigue, and overall training strategies.

This study evaluated the effects of a 12-week home-based physical activity program on functional mobility, cancer-related fatigue, and muscle strength in children and adolescents with cancer undergoing active treatment. The uncontrolled clinical trial included 25 participants (14 boys), aged 4-14 years, who utilized physical activity notebooks (Physical Activity Journals 1 for ages 4-11/Physical Activity Journal 2 for ages 12-14). Functional mobility, assessed using the Timed Up and Go test, demonstrated a significant reduction in time (P < .001) in the per-protocol analysis, whereas the intention-to-treat analysis showed no significant differences (P > .1). Cancer-related fatigue, measured by the Pediatric Quality of Life Inventory, revealed significant reductions in total fatigue scores for both per-protocol (P = .038) and intention-to-treat (P = .039) analyses. Although no statistical differences were observed in the sleep, mental, or general fatigue domains, a clinically meaningful reduction in fatigue symptoms was identified. Muscle strength, evaluated with a portable dynamometer, displayed statistically significant improvements in specific muscle groups in both per-protocol and intention-to-treat analyses. In conclusion, the home-based intervention using activity notebooks effectively improved functional mobility, reduced fatigue in certain domains, and enhanced muscle strength, yielding important clinical benefits for this population.

Musculoskeletal fitness (MSF) predicts youth health, but prior research has focused on separate MSF domains, limiting understanding of whole-body MSF.

Purpose: To use latent profile analysis to identify MSF profiles and evaluate whether weight status and moderate to vigorous physical activity predict profile.

Methods: Data came from the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey for participants ages 12-15 years (N = 442). Latent MSF profiles were generated using modified pull-up, leg extension, grip strength, and plank assessments. Multinomial logistic regression models controlled for age and sex.

Results: Fit statistics were optimal for a 3-profile model: Profile 1: high leg extension and grip strength, Profile 2: high pull up and plank, and Profile 3: low overall MSF. Participants in Profile 1 were 6.25 (95% CI, 1.82-21.52) times as likely to be overweight than Profile 2, and 6.21 (95% CI, 1.61-23.94) times as likely to have obesity than Profile 3. Participants in Profile 2 were 5.85 (95% CI, 1.99-17.18) and 5.34 (95% CI, 2.14-13.36) times as likely to be active than Profile 1 and Profile 3, respectively.

Conclusions: Profile 1 shows higher levels of overweight/obesity in children than Profile 3, suggesting that a healthy body mass index does not necessarily equate to greater MSF. Findings suggest MSF assessments are not consistently linked to weight status or moderate to vigorous physical activity, and future research should use multiple assessments to account for fitness differences.

Youth with heart disease experience comorbidities that impact physical activity (PA), mental health (MH), and quality of life (QoL).

Purpose: To explore the relationship between PA and MH and QoL in adolescents with cardiac arrhythmia disorders, cardiomyopathies, or single ventricle heart disease.

Methods: Participants completed surveys/questionnaires regarding PA (Physical Activity Questionnaire for Adolescents), anxiety (Patient-Reported Outcomes Measurement Information System [PROMIS]-Anxiety), depressive symptoms (PROMIS-Depressive Symptoms), global QoL (Pediatric Quality of Life Inventory [PedsQL]-generic), and cardiac disease-specific QoL (PedsQL-cardiac). Pearson correlations and regression analysis examined relationships between PA and MH/QoL.

Results: The study included 63 participants (males = 32, 50.7%), with an age of 15.46 (1.82) years. The sample was mostly inactive (Physical Activity Questionnaire for Adolescents score: 1.95 [0.65]). Outcomes used T-scores for PROMIS-Anxiety (49.7 [12.2]) and PROMIS-Depressive Symptoms (46.9 [12.7]), and summary scores for PedsQL-generic (75.2 [18.9]) and PedsQL-cardiac (74.7 [17.5]). There was a negative correlation between PA and MH (PROMIS-Anxiety: r = -.338, PROMIS-Depressive Symptoms: r = -.337; P < .05) and positive correlation between PA and QoL (PedsQL-generic: r = .37, PedsQL-cardiac: r = .39; P < .001). Adjusting for key variables using regression analysis, greater participation in PA was independently related to decreased anxiety and depression and greater QoL.

Conclusions: Greater PA engagement was associated with more favorable MH and QoL in adolescents with cardiac arrhythmia disorders, cardiomyopathy, or single ventricle heart disease.

Purpose: To explore the multivariate pattern associations between physical fitness and adiposity with cardiometabolic risk among children and adolescents.

Method: Cross-sectional study including 6405 participants (6-18 y; 3567 females). Waist circumference, sum of 3 skinfolds, and physical fitness measures (abdominal endurance, agility, cardiorespiratory fitness, flexibility, speed, and lower/upper limb power) were assessed. A continuous risk score (cMetS) was calculated as the mean of the z-scores for glucose, systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol ratio, and triglycerides. Three models were tested using multivariate patterns analysis, of which the following explanatory variables were included: (1) both physical fitness and adiposity measures, (2) only physical fitness, and (3) physical fitness adjusted for adiposity measures. In the latter model, cMetS was also adjusted for adiposity.

Results: Inverse associations with cMetS were found for abdominal endurance, agility, cardiorespiratory fitness, lower limb power, and speed among males; and agility and cardiorespiratory fitness among females; without adjustment for adiposity. When cMetS and physical fitness were adjusted for adiposity, agility (only among males) and cardiorespiratory fitness remained associated with cMetS.

Conclusion: The findings highlight the consistent adiposity-independent role of cardiorespiratory fitness as the primary fitness marker associated with cardiometabolic health during childhood and adolescence, alongside evidence linking agility to risk.