Pediatric Exercise Science最新文献

Purpose: With a rising incidence of childhood-onset Crohn's disease (CD), linked to genetics, environmental, and lifestyle factors, there is a need to further understand the physical (in)activity behaviors of young people with the condition. We explored the barriers and facilitators to physical activity and exercise in children and young people with CD from the perspectives of patients, caregivers, and specialist clinicians.

Methods: Five children, 7 caregivers, and 6 specialist clinicians completed semistructured interviews in this UK-based qualitative study. Recordings were transcribed verbatim, and emergent themes were inductively derived.

Results: Three overarching themes were constructed: (1) navigating barriers to a physically active lifestyle with CD, (2) building knowledge and support for a physically active lifestyle with CD, and (3) creating an enabling environment for a physically active lifestyle through family and social support networks.

Conclusion: Young people living with CD, their caregivers, and clinicians clearly value the importance of physical activity and exercise but face several disease-specific barriers that can hinder long-term participation. Targeted educational and practical support is needed to address these challenges. Involving those with lived experience is essential in designing effective resources and home-based support programs that meet their needs.

Purpose: To assess biases in physical activity beliefs/behaviors between research volunteers and those assessed through clinical care.

Method: Physical activity behavior (pedometer steps) and adequacy/predilection (Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity scale) were compared among 198 pediatric cardiology patients (5-17 y) with moderate/severe congenital heart disease. Volunteers (n = 142, 59% male, 11.0 (3.4) y) participated in a multicenter activity trial. The clinical subgroup (n = 56, 58% male, 11.1 (4.0) y) completed assessments during a routine clinical encounter. Independent t tests compared outcomes within child/adolescent age groups.

Results: Child volunteers tended to report higher activity adequacy (mean difference = 1.9 (1.0), P = .06) than clinic patients, suggesting increased confidence for activity participation. Daily steps did not differ between groups (P > .10). The extra 1600 steps per day among volunteers enabled child volunteers to achieve the recommended 12,000 steps per day. Cardiologist reported activity restrictions were associated with more steps per day (P < .01).

Conclusion: Research volunteers may be more likely to achieve daily physical activity recommendations. Child volunteers tend to be more confident in their ability to participate successfully. Cardiologist reported activity restrictions may provide confidence regarding appropriate types of activity, leading children and adolescents to take more steps each day. Physical activity research participants and those with cardiologist reported activity restrictions may not reflect those most in need of additional support.

Purpose: Given the growing interest in Bio-Banding (BB) game formats, this review aimed to investigate its effects on physiological, physical, technical, and tactical parameters in youth soccer players.

Methods: A systematic search was conducted across 5 databases: Google Scholar, PubMed, ScienceDirect, SPORTDiscus, and Web of Science. Studies with experimental or observational designs assessing the effects of BB formats on these parameters were included. The quality of the studies was evaluated using the version 2 of the Cochrane Risk of Bias Tool and Cochrane Risk of Bias Tool for Non-Randomized Studies of Interventions tools for quantitative studies and the Critical Appraisal Tool by the Johanna Briggs Institute for qualitative studies.

Results: Ten studies (n = 591 players) were included, with 8 employing quantitative methods and 2 utilizing qualitative approaches. The results revealed variability in study designs, limiting cross-study comparability. Physical demands and physiological responses differed across maturational groups and game formats, while technical and tactical behaviors adapted to BB formats particularly for early and late-maturing players. Despite observed differences between BB and comparator games, conclusive evidence on BB's effectiveness is lacking due to methodological limitations and bias risk.

Conclusion: BB presents a promising approach to support player development and mitigate maturity-related selection bias. Further research is needed to deepen our understanding of BB-implementations in youth soccer.

Purpose: Research on menstrual health in adolescent athletes particularly for specific sports is limited. This study aimed to identify menstrual characteristics and symptoms in adolescent volleyball athletes compared with nonathletes.

Methods: The study included 154 adolescents (aged 10-19 y) who had experienced menarche for at least 1 year. Participants were split into 2 groups: 77 volleyball athletes (average age: 15.09 [1.33] y) and 77 nonathletes (average age: 14.79 [1.27] y). Data were collected using an online survey. Age at menarche, regularity, use of menstruation delay pills, cycle characteristics (length and duration), and characteristics of dysmenorrhea (onset, frequency, medication use, and school/training absenteeism) were assessed. The menstrual symptoms were evaluated using the Menstrual Symptom Questionnaire, which includes 3 subscales: menstrual pain, coping methods, and somatic complaints.

Results: Volleyball athletes demonstrated significantly higher use of medication for dysmenorrhea (P = .006) but lower Menstrual Symptom Questionnaire menstrual pain score (P = .029) compared with nonathletes. No differences were found in age at menarche (P = .878), cycle length (P = .149), use of menstruation delay pill (P = .221), amount of bleeding (P = .869), or absenteeism rates due to dysmenorrhea (P = .210).

Conclusion: Adolescent volleyball players reported lower menstrual pain compared with nonathletes in this study. Discussing menstruation-related pain with adolescents is important to support better symptom management.

Purpose: To investigate the effects of a gait training program on functional mobility and balance in children with cerebral palsy.

Methods: Twenty-two children 6-12 years old with spastic cerebral palsy (Gross Motor Function Classification System levels I-III) participated. They were randomly assigned to a gait training program or a control group. Both groups received neurodevelopmental treatment over a 12-week period. In addition, the intervention group received treadmill training combined with balance exercises. Walking speed, Gross Motor Function Measure dimension D and E, Pediatric Balance Scale, 1-minute walk test, and ankle range of motion were measured at baseline and at 12 weeks by a blind assessor. Data were analyzed with 2-way analysis of variance with 1 repeated factor (time) and 1 independent factor (group).

Results: The intervention group improved walking speed (10-m walk) by a mean of 7.4 units (95% CI, 1.6-16.4) and the Gross Motor Function Measure-E score by a mean of 16.8 units (95% CI, 3.9-29.7) compared with the control group. No other significant between-group differences were observed. Within-group statistically significant differences were observed primarily for the gait training group. No serious adverse events were reported.

Conclusion: A gait training program appeared to be beneficial for mobility-related outcomes in young children with cerebral palsy. Training focused on gait, and this was increased with less, if any, change in other outcomes, such as balance or range of motion.

Purpose: The aim of the present study is to analyze the impact of rule modifications in competition on heart rate and heart rate variability in U-13 basketball players, considering maturity stage as a moderating variable.

Method: Forty basketball players with an average age of 12.91 (0.57) years participated in the study. The study was approved by the ethics committee of the University of Murcia (2828/2020). A quasi-experimental A-B study was designed, where A was a tournament with the FEB regulation and B a tournament with the modified regulation. The dependent variables analyzed were the time players spent in different heart rate zones and heart rate variability. Maturity stage was considered a moderating factor in the intervention effect.

Results: The results show significant differences in time in zone 4, reduced time in zone 5, maximum heart rate, and square root of the mean value of the sum of the squared differences. Maturity stage conditioned the intervention effect for square root of the mean value of the sum of the squared differences when players had a percentage of predicted adult height higher than 89.92%.

Conclusion: From a cardio protective perspective, it has been found that U-13 players spend more time in zones considered cardio protective during the modified tournament. In addition, the modification reduces the differences in terms of fatigue between early and late developing players.

Background: Juvenile idiopathic arthritis is an autoimmune condition of multifactorial etiology resulting in chronic inflammatory joint disease, which may be associated with systemic manifestations. Therapeutic exercise is essential to counteract physical impairments, which requires the implementation of outcome measures (OMs) in research and practice as they provide meaningful results for research efficacy, exercise program evaluation and quality, medication tolerance, and patient improvement.

Purpose: To assess the types of OMs implemented in exercise randomized controlled trials related to the juvenile idiopathic arthritis cohort and the psychometric properties and age appropriateness of the implemented OMs.

Methods: The review was registered with PROSPERO (CRD42022336345) on May 30, 2022, followed by a systematic search across PubMed, EBSCOhost, Web of Science, and Ovid. Studies included were appraised using the Joanna Briggs Critical Appraisal Tool for randomized controlled trials. All data collection occurred according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis.

Results: A total of 51 outcome measures were implemented across the 20 randomized controlled trials: 2 clinician-reported OMs (4%), 19 patient or parent-reported OMs (37%), and 30 physical performance OMs (59%). The vast majority of included OMs increase the difficulty of comparison across studies and indicate a lack of consideration for validity, reliability, and age appropriateness.

Purpose: The aim of this study was to investigate the extent to which relative age effect (RAE) impacts the development of perceptual-cognitive skills and how training background may potentially offset RAE from childhood into adolescence.

Method: One hundred sixty-five 10- to 16-year-old male participants were divided into 8 groups based on their birth quartiles (BQ1 [January-March], BQ2 [April-June], BQ3 [July-September], and BQ4 [October-December]) and training background (moderately trained: 1-2 sessions/wk and well-trained: 4-5 sessions/wk). Their perceptual-cognitive skills were evaluated using a 3D multiple-object tracking task (ie, the NeuroTracker [NT]) with (3D) and without (2D) stereopsis.

Results: In moderately trained children, NT scores progressively decreased from BQ1 to BQ4, with a significant difference between the first 3 birth quartiles and BQ4 (P < .01), independent of stereopsis. In well-trained children, however, no significant differences were detected in NT scores between quartiles, and well-trained children in BQ4 exhibited NT scores comparable to moderately trained children in the first 3 quartiles.

Conclusion: RAE showed a significant disadvantage on the perceptual-cognitive scores in moderately trained children born in BQ4. However, well-trained children born in BQ4 performed similarly to other well-trained children and to moderately trained children born in the first 3 birth quartiles, meaning that training background may offset the disadvantage associated with RAE from childhood into adolescence.

Purpose: We investigated the prevalence of documented physical activity (PA) participation and recommendations among pediatric nephrologists and identified disease-related variables that predicted which patients received PA recommendations.

Method: Patient charts were reviewed for children 3-18 years old, and data were extracted for those with international classification of disease 10 codes N18 (chronic kidney disease) or Z94.0 (kidney transplant). Demographic data, documented PA participation and recommendations, and disease variables were abstracted.

Results: Of 404 patients (64% male; 12.4 [4.0]) with estimated glomerular filtration rate of 67.8 (30.9) mL/min/1.73 m2; 239 (59.2%) had documented PA participation, and 119 (29.6%) had a documented PA recommendation in their chart. PA recommendations were more likely in older patients (odds ratio [OR]: 1.08; 95% CI, 1.03-1.13), those with higher body mass index z score (OR: 1.45; 95% CI, 0.96-1.51), higher height z score (OR: 1.55; 95% CI, 1.31-1.82), higher estimated glomerular filtration rate (OR: 1.01; 95% CI, 1.01-1.02), sport participation (OR: 2.47; 95% CI, 1.46-4.19), and less likely for patients with higher motor score (OR: 0.6; 95% CI, 0.41-0.87; all P < .01). Adjusted analysis maintained significant associations except sports participation and motor score.

Conclusion: A low proportion of children with chronic kidney disease, who are at risk of physical inactivity, received PA recommendations to increase PA. Recommendations were more likely in older, overweight, taller, better kidney function, and sport participants. Effect sizes were small or moderate; further study is needed.