Reliability and validity of the Timed Floor To Stand Test-Natural in school-aged children

The relative contributions of adiposity and activity levels to physical performance in children with excess weight

OBJECTIVE

This study examined predictors of physical performance, a key aspect of quality of life, in children with excess weight.

METHODS

Participants were 269 children aged 6-12 years with a body mass index above the 85th percentile. Children completed a standardized physical performance task capturing lower extremity strength, balance, and gait speed. Height, weight, and waist circumference were objectively measured, and daily moderate-vigorous physical activity (min/day) and sedentary time (% of day) were assessed with a 7-day accelerometer protocol.

RESULTS

Physical performance task completion averaged 15.0 (SD = 2.5) seconds. Children with higher body mass index z-scores and waist circumferences had significantly longer task completion times. The task took 1.8 additional seconds per 1.0 body mass index z-score (p < .001), and 1.2 additional seconds for every 20 cm higher waist circumference (p < .001). Daily moderate-vigorous physical activity and sedentary time were unrelated to physical performance, and did not moderate its associations with the adiposity measures.

CONCLUSION

Among children with excess weight, physical performance declines with increasing levels of total and central adiposity. Daily activity levels do not moderate this association. Interventions that directly target weight reduction would likely yield the greatest improvement in physical performance in children with overweight or obesity.

Feasibility and Reliability of Functional Mobility Measures in Children With Cri du Chat (5P-) Syndrome

PURPOSE

To investigate feasibility and reliability of functional mobility measures in children with Cri du Chat syndrome (CdCS).

METHODS

Nine children with CdCS and 9 children with typical development (TD) completed the Timed Up and Go, 5 times sit-to-stand test, Timed Floor to Stand, and 4 Square Step Test. Feasibility was determined using testing time and need for modifications. Intraclass correlation coefficients were calculated for intrarater and interrater reliability.

RESULTS

Children with CdCS required modifications to complete all tests. One child with CdCS completed the 4 Square Step Test. Good reliability was found for both groups.

CONCLUSIONS

The Timed Up and Go, 5 times sit-to-stand test, and Timed Floor to Stand are feasible and reliable tools for children with TD between ages of 5 and 15 years; however, may require modifications to the protocols to be feasible in children with CdCS. The 4 Square Step Test is not a feasible tool for children with CdCS.

CHECK: A randomized trial evaluating the efficacy and cost-effectiveness of home visitation in pediatric weight loss treatment

BACKGROUND

Socioeconomically-disadvantaged households have a high prevalence of pediatric overweight/obesity, and also face barriers to accessing weight loss treatment in healthcare settings. Delivering family-based pediatric weight loss treatment in the home setting may enhance its efficacy by facilitating treatment attendance, enabling more tailored treatment recommendations informed by observations of the home environment, and increasing accountability. This paper describes the design of the Creating Health Environments for Chicago Kids (CHECK) Trial, which evaluates the efficacy, cost-effectiveness, and mechanisms of home visitation in family-based pediatric weight loss treatment for children in low-income households.

DESIGN

CHECK is a two-arm, parallel group, randomized controlled trial that is enrolling N = 266 children, ages 6-12 y, who have overweight/obesity (BMI percentile ≥85) and live in a low-income household. Participants are randomized in a 1:1 ratio to either standard of care family-based weight loss treatment delivered in the home, or the identical intervention delivered in an academic medical center. The primary outcome is change in child BMI z-score from baseline to 12 months. Program delivery costs are rigorously documented to enable cost-effectiveness analyses from the societal and payer perspectives. Objectively-documented changes to the home environment and aspects of intervention delivery (e.g., hours of in-person contact received, quantity of behavioral goals set per session) will be tested as hypothesized treatment mechanisms.

IMPLICATIONS

Findings will inform the design of future interventions, and treatment dissemination decisions by public health agencies and third-party payers.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03195790.

Timed Floor to Stand-Natural: Reference Data for School Age Children

PURPOSE

To collect reference data for the Timed Floor to Stand-Natural (TFTS-N) on a large, diverse sample of school children who are typically developing, taking into account age, sex, and body mass index (BMI).

METHODS

Five physical therapists administered the TFTS-N on a sample of convenience of 1476 school children who were typically developing, aged 5 to 14 years (male = 637, female = 839), using previously tested, standardized reliable procedures.

RESULTS

The average time ranged from 7.91 ± 1.65 seconds to 8.98 ± 1.62 seconds; 8 year-old students were the quickest and the 13-year-old students were the slowest. The mean difference between males and females was clinically negligible at 0.38 seconds. Post hoc analyses revealed no significant differences among BMI categories.

CONCLUSIONS

Reference data for the TFTS-N test are now available. Neither sex nor BMI affects the timing of the task in this age range.