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Martins EJ, Serrão P, Leonardi-Figueiredo MM, Ravanelli LS, Serenza FS, Mattiello S, Aagaard P, Mattiello-Sverzut A. Isokinetic arm and shoulder muscle torque-velocity characteristics in mobility limited children and adolescents with spina bifida. Physiother Theory Pract 2024; 40:962-972. [PMID: 36482746 DOI: 10.1080/09593985.2022.2150529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 10/28/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Propulsive wheelchair capacity may be influenced by arm muscle performance.Objectives: To determine whether children and adolescent wheelchair-users with spina bifida show reduced arm muscle strength compared to their typically developing peers and to compare muscle strength data obtained by isokinetic and handheld dynamometry (HHD). METHODS Participants (mean age 12.5 ± 2.5 years) were assigned to spina bifida (SB; n = 11) or control (n = 22) groups. Isokinetic dynamometry was used to measure peak torque (PT) during dynamic (60°s-1 and 120°s-1) and isometric strength testing (MVIC) for shoulder and elbow flexors and extensors. HHD was used to measure MVIC of the same muscle groups. RESULTS SB showed reduced isokinetic PT for shoulder extensors at 60°s-1 and 120°s-1, shoulder flexor MVIC, and elbow flexors at 60°s-1 and MVIC; higher PT for shoulder flexors and elbow flexors at 120°s-1; and decreased MVIC for elbow flexors but not extensors compared to controls when assessed by HHD. The SB and control groups showed strong positive correlations between MVIC data obtained by the two devices for all muscle groups (r ≥ 0.81; p < .01), except for shoulder flexor MVIC in controls (r = 0.68; p < .01). CONCLUSION SB presented reduced levels of dynamic slow-speed and isometric shoulder and elbow muscle strength and greater dynamic high-speed shoulder and elbow flexor strength than controls possibly due to the exposure to self-sustained wheelchair ambulation. Exercise-based intervention protocols to increase slow-speed arm muscle strength should be considered in youth with SB. Strong positive correlations observed between muscle strength assessed by isokinetic dynamometry and HHD support the use of HHD in this clinical population.
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Affiliation(s)
- Emanuela J Martins
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Paula Serrão
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Letícia S Ravanelli
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Felipe S Serenza
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Stela Mattiello
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Per Aagaard
- Institute of Sports Science and Clinical Biomechanics, Muscle Physiology and Biomechanics Research Unit, University of Southern Denmark, Odense, Denmark
| | - Ana Mattiello-Sverzut
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Petersen BA, Erickson KI, Kurowski BG, Boninger ML, Treble-Barna A. Emerging methods for measuring physical activity using accelerometry in children and adolescents with neuromotor disorders: a narrative review. J Neuroeng Rehabil 2024; 21:31. [PMID: 38419099 PMCID: PMC10903036 DOI: 10.1186/s12984-024-01327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Children and adolescents with neuromotor disorders need regular physical activity to maintain optimal health and functional independence throughout their development. To this end, reliable measures of physical activity are integral to both assessing habitual physical activity and testing the efficacy of the many interventions designed to increase physical activity in these children. Wearable accelerometers have been used for children with neuromotor disorders for decades; however, studies most often use disorder-specific cut points to categorize physical activity intensity, which lack generalizability to a free-living environment. No reviews of accelerometer data processing methods have discussed the novel use of machine learning techniques for monitoring physical activity in children with neuromotor disorders. METHODS In this narrative review, we discuss traditional measures of physical activity (including questionnaires and objective accelerometry measures), the limitations of standard analysis for accelerometry in this unique population, and the potential benefits of applying machine learning approaches. We also provide recommendations for using machine learning approaches to monitor physical activity. CONCLUSIONS While wearable accelerometers provided a much-needed method to quantify physical activity, standard cut point analyses have limitations in children with neuromotor disorders. Machine learning models are a more robust method of analyzing accelerometer data in pediatric neuromotor disorders and using these methods over disorder-specific cut points is likely to improve accuracy of classifying both type and intensity of physical activity. Notably, there remains a critical need for further development of classifiers for children with more severe motor impairments, preschool aged children, and children in hospital settings.
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Affiliation(s)
- Bailey A Petersen
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kirk I Erickson
- AdventHealth Research Institute Department of Neuroscience, AdventHealth, Orlando, FL, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brad G Kurowski
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - M L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Treble-Barna
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
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Bertapelli F, Baptista CRDJAD, Mattiello-Sverzut AC. Height and body mass index distribution in children and adolescents with and without spina bifida. J Pediatr (Rio J) 2024; 100:46-52. [PMID: 37524313 PMCID: PMC10751691 DOI: 10.1016/j.jped.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE Children with spina bifida (SB) are at risk for stunting and overweight. However, height and Body Mass Index (BMI) z-score distribution in children and adolescents with SB are unclear. The aim of this study was to examine height and BMI z-score distribution in Brazilian children and adolescents with and without SB. This study further aimed to examine whether height and BMI z-scores differ between individuals with and without SB. METHOD This study included 101 participants (SB: n = 18; non-SB: n = 83, aged 7-16 years). The World Health Organization (WHO) AnthroPlus software was used to calculate height and BMI z-scores. AnthroPlus z-score distribution graphs were used to examine individual z-scores based on the 2007 WHO normal distribution curve. Effects of the group (SB vs non-SB) on height and BMI z-scores were examined with sequential regression. RESULTS In the WHO distribution graph analysis, height z-scores of participants with SB were slightly left-shifted compared to the WHO normal distribution curve. In the regression analysis, group (SB vs non-SB) was a significant predictor of height z-scores after controlling for sex and age (ΔR2 = 0.064, p = 0.010). BMI z-scores of participants with SB were right-shifted compared to the WHO normal curve. However, there was no contribution of the group to BMI z-scores (ΔR2 = 0.011, p = 0.301). CONCLUSIONS These findings suggest that Brazilian children and adolescents with SB may be at risk for reduced height and increased BMI.
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Affiliation(s)
- Fabio Bertapelli
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
| | | | - Ana Claudia Mattiello-Sverzut
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil.
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Yang L, Corpeleijn E, Hartman E. A prospective analysis of physical activity and mental health in children: the GECKO Drenthe cohort. Int J Behav Nutr Phys Act 2023; 20:114. [PMID: 37749578 PMCID: PMC10521540 DOI: 10.1186/s12966-023-01506-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/26/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Mental health problems in young people have become a global health burden. The positive effects of physical activity on mental health in adults are well known but still not clear in children. The aim of this study was to investigate to what extent physical activity in early childhood would affect mental health in middle childhood. METHODS From the Dutch GECKO Drenthe birth cohort, 850 children (51.5% boys) were enrolled in this analysis. Physical activity and sedentary time were measured at age 5-6 using ActiGraph GT3X. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) at age 5-6 and age 10-11. Multiple linear regression models were used to estimate the associations between physical activity, sedentary time and SDQ subscales, stratified by gender, adjusting for age, BMI, maternal education level, family size, accelerometer wear time and season, and additionally adjusting for SDQ scores at age 5-6 to take tracking of mental health over time into account. RESULTS Greater physical activity volume at age 5-6 was associated with lower peer problems scores at age 10-11 in boys and girls. An increase in MVPA was associated with lower peer problems scores in boys (b = -0.445, -0.713 to -0.176) and girls (b = -0.354, -0.601 to -0.107), however, increased sedentary time was linked to higher peer problems scores in boys (b = 1.18, 0.455 to 1.906) and girls (b = 0.870, 0.191 to 1.550). For hyperactivity, higher levels of physical activity volume and MVPA were associated with higher hyperactivity scores in boys. Increased sedentary time was related to lower hyperactivity scores in boys. Further adjustment for SDQ scores at age 5-6 attenuated associations between physical activity and hyperactivity in boys but hardly changed the relationships with peer problems. No significant associations between physical activity and other SDQ subscales or total difficulties scores were observed, neither in boys nor in girls. CONCLUSIONS Children who are more physically active at age 5-6 have fewer peer problems at age 10-11, and for boys, greater activity levels at age 5-6 could be an indicator of hyperactivity at age 10-11.
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Affiliation(s)
- Lu Yang
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Esther Hartman
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Kiselev N, Frey T, Naesbom A, Planzer R, Meyer-Heim A. Perspectives of Swiss Paediatric Health Care Professionals on Factors Influencing Physical Activity Participation in Children with Disabilities. Dev Neurorehabil 2023; 26:328-337. [PMID: 37573511 DOI: 10.1080/17518423.2023.2242483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
AIM Investigation of the perspectives of paediatric health care professionals (PHCPs) in Switzerland regarding factors that influence participation in physical activity programs for children and adolescents with disabilities or chronic conditions (CADCCs). Evaluation of self-reported exercise counselling behavior of those professionals. METHOD A cross-sectional survey was used to collect the opinions of 171 PHCPs working with CADCCs using a structured questionnaire. The information obtained was evaluated by performing a combined quantitative and qualitative statistical analysis. RESULTS PHCPs in Switzerland think that CADCC do not get enough physical activity and see the underlying reasons in lacking information/knowledge and organizational factors. We found that the level of knowledge about disability sports opportunities among PHCPs has a positive influence on their exercise counselling behaviour. CONCLUSIONS We propose three approaches to increase the level of physical activity in CADCC: Establishing personalized exercise counseling, intensifying information about disability sports programmes towards PHCPs, and improving inclusion and integration in PE lessons or regular sports clubs.
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Affiliation(s)
- Nikolai Kiselev
- PluSport, Umbrella Organization of Swiss Disabled Sports, Volketswil, Switzerland
- Swiss Research Institute of Public Health and Addiction (ISGF), University of Zürich, Zurich, Switzerland
| | - Tanja Frey
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern, Switzerland
- Institute of Medical Genetics, University of Zurich, Schlieren, Switzerland
| | - Annika Naesbom
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Reto Planzer
- PluSport, Umbrella Organization of Swiss Disabled Sports, Volketswil, Switzerland
| | - Andreas Meyer-Heim
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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Martins EJ, Mattiello-Sverzut AC, Franco CSB, de Lemos TW, Aagaard P. Muscle strength, rate of torque development and neuromuscular activation of the upper arm muscles in children and adolescents with spina bifida. Clin Biomech (Bristol, Avon) 2023; 102:105861. [PMID: 36623326 DOI: 10.1016/j.clinbiomech.2022.105861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The use of locomotive devices requires sufficient levels of upper limb strength. Therefore, it is important to evaluate the maximal isometric torque, rate of torque development and neuromuscular activation in youth with spina bifida. The objective was to investigate these parameters in the elbow muscles of youth with spina bifida versus healthy age-matched peers. METHODS Forty-eight participants (8-17 years) were recruited: Spina Bifida (n = 23) and non-affected Controls (n = 25). Maximal isometric elbow flexor/extensor contractions were performed to assess maximal muscle strength (peak torque) and rate of torque development, along with synchronized electromyography recording in the biceps and triceps brachii muscles. FINDINGS During elbow flexor contractions, Spina Bifida showed reduced rate of torque development in the early contraction phase (0-50 ms) along with lowered relative rate of torque development in the later rate of torque development phase (0-100/200/300 ms) compared to controls. Spina Bifida showed reduced rate of torque development for the elbow extensors in the later phase of rising muscle force (0-200/300 ms) compared to controls. Lower isometric peak torque and smaller triceps brachii electromyography amplitudes (0-200/300 ms) were observed during elbow extensor contractions in Ambulatory spina bifida participants vs. controls. INTERPRETATION Although a majority of peak torque and rate of torque development parameters did not differ, significant impairments in maximal and rapid elbow muscle force characteristics were noted in Spina Bifida compared to non-affected Controls. Ambulatory and Non-ambulatory spina bifida participants demonstrated similar rate of torque development in their upper arm muscles.
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Affiliation(s)
- Emanuela Juvenal Martins
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | | | | | | | - Per Aagaard
- Institute of Sports Science and Clinical Biomechanics, Muscle Physiology and Biomechanics Research Unit, University of Southern Denmark, Odense, Denmark.
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Ascondo J, Martín-López A, Iturricastillo A, Granados C, Garate I, Romaratezabala E, Martínez-Aldama I, Romero S, Yanci J. Analysis of the Barriers and Motives for Practicing Physical Activity and Sport for People with a Disability: Differences According to Gender and Type of Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1320. [PMID: 36674077 PMCID: PMC9858731 DOI: 10.3390/ijerph20021320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The aim of the study was to analyse the perception of the barriers and motives for the practice of physical activity (PA) in people with a disability, according to gender and type of disability. The participants in this investigation were 103 people with a disability (33.25 ± 11.86 years) who were habitual users of PA or sports programmes. They completed the questionnaire Motives and Barriers for Physical Activity and Sport (MBAFD). The results showed that personal barriers were more important than environmental ones and that the most outstanding motives were those related to leisure, enjoyment or social aspects. Regarding gender, women perceived more barriers than men. For the people with physical (PD) and intellectual (ID) disabilities, the most common barriers were of an intrinsic nature, and for those with a visual disability (VD), barriers of an environmental nature. With respect to the motives, people with PD gave higher scores to the items related to aspects of physical improvement and rehabilitation. In contrast, people with ID and VD placed more importance on reasons of leisure, enjoyment and social relations. Knowledge of these findings can be a tool to help increase the provision of PA for people with a disability.
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Affiliation(s)
- Josu Ascondo
- Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Andrea Martín-López
- Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Aitor Iturricastillo
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Cristina Granados
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Iker Garate
- Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Estibaliz Romaratezabala
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Inmaculada Martínez-Aldama
- Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
| | - Sheila Romero
- Disability Research Department, Fundación GaituzSport Fundazioa, 48003 Bilbao, Spain
| | - Javier Yanci
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Physical Education and Sport Department, Faculty of Education and Sport, University of the Basque Country, UPV/EHU, 01007 Vitoria-Gasteiz, Spain
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Lee MR, Hicks JL, Wren TAL, Delp SL. Independently ambulatory children with spina bifida experience near-typical knee and ankle joint moments and forces during walking. Gait Posture 2023; 99:1-8. [PMID: 36283301 PMCID: PMC9772073 DOI: 10.1016/j.gaitpost.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/12/2022] [Accepted: 10/16/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Spina bifida, a neurological defect, can result in lower-limb muscle weakness. Altered ambulation and reduced musculoskeletal loading can yield decreased bone strength in individuals with spina bifida, yet individuals who remain ambulatory can exhibit normal bone outcomes. RESEARCH QUESTION During walking, how do lower-limb joint kinematics and moments and tibial forces in independently ambulatory children with spina bifida differ from those of children with typical development? METHODS We retrospectively analyzed data from 16 independently ambulatory children with spina bifida and 16 children with typical development and confirmed that tibial bone strength was similar between the two groups. Plantar flexor muscle strength was measured by manual muscle testing, and 14 of the children with spina bifida wore activity monitors for an average of 5 days. We estimated tibial forces at the knee and ankle using motion capture data and musculoskeletal simulations. We used Statistical Parametric Mapping t-tests to compare lower-limb joint kinematic and kinetic waveforms between the groups with spina bifida and typical development. Within the group with spina bifida, we examined relationships between plantar flexor muscle strength and peak tibial forces by calculating Spearman correlations. RESULTS Activity monitors from the children with spina bifida reported typical daily steps (9656 [SD 3095]). Despite slower walking speeds (p = 0.004) and altered lower-body kinematics (p < 0.001), children with spina bifida had knee and ankle joint moments and forces similar to those of children with typical development, with no detectable differences during stance. Plantar flexor muscle weakness was associated with increased compressive knee force (p = 0.002) and shear ankle force (p = 0.009). SIGNIFICANCE High-functioning, independently ambulatory children with spina bifida exhibited near-typical tibial bone strength and near-typical step counts and tibial load magnitudes. Our results suggest that the tibial forces in this group are of sufficient magnitudes to support the development of normal tibial bone strength.
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Affiliation(s)
- Marissa R Lee
- Department of Mechanical Engineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
| | - Jennifer L Hicks
- Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
| | - Tishya A L Wren
- Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.
| | - Scott L Delp
- Department of Mechanical Engineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA; Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
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Gour-Provençal G, Costa C. Metabolic Syndrome in Children With Myelomeningocele and the Role of Physical Activity: A Narrative Review of the Literature. Top Spinal Cord Inj Rehabil 2022; 28:15-40. [PMID: 36017122 DOI: 10.46292/sci21-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. Methods A literature review of articles published in English and French between 1990 and April 2020 was conducted. Results Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Conclusion Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.
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Affiliation(s)
| | - Camille Costa
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
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Physical Activity and Exercise Participation among Malaysian Children (Able-Bodied vs. Physical Disability): A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050704. [PMID: 35626881 PMCID: PMC9139938 DOI: 10.3390/children9050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 11/17/2022]
Abstract
Globally, physical activity levels (PAL) among able-bodied and children with a form of disability remain low. This study aims to characterize PAL and identify the demographic variables affecting children from partaking exercises to promote active lifestyles. Methods: The Physical Activity Scale for Individuals with Physical Disabilities questionnaire was used for the study. A total of 140 data responses were collected online or physically via passive snowball recruitment and quantitatively analyzed. Results: Five factors were extracted from the dimensions, consisting of household chores, household maintenance, high intensity exercise training, miscellaneous activities and school-related activities. Able-bodied children were significantly (p = 0.000) more active (median = 15.05, IQR = 13.06) than children with physical disabilities (median = 3.09, IQR = 2.58). The B40 household group reported significantly (p < 0.05, MET < 5.16/week) lower participation in health-beneficial (moderate-vigorous intensity) exercises as recommended by international guidelines. Conclusion: Children with physical disabilities reported significantly lower education achievements and PAL compared to their able-bodied counterpart. The majority of Malaysian children (69.3%) surveyed did not achieve the recommended aerobic exercise prescription.
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Lee SH, Shin HI, Nam TK, Park YS, Kim DK, Kwon JT. Growth profile assessment of young adults with tethered cord syndrome: a retrospective cohort analysis of Korean conscription data. Childs Nerv Syst 2021; 37:1973-1981. [PMID: 33392650 DOI: 10.1007/s00381-020-05026-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/20/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Tethered cord syndrome (TCS) is characterized by progressive spinal cord degeneration secondary to congenital spinal dysraphism. The associated accompanying physical inactivity and musculoskeletal deformities have raised interest in the growth profile of adult TCS patients. However, few previous studies have investigated the growth profile of adult TCS patients. METHODS We retrospectively reviewed the demographic data and medical records of 20-year-old Korean conscription examinees who were registered between April 2004 and September 2019. In total, 151 examinees with a diagnosis of TCS were enrolled. The height, weight, and body mass index (BMI) of 300 randomly selected examinees were compared to the TCS group. Obesity was defined by the World Health Organization and Asian-Pacific criteria for BMI and compared between the groups. Growth profile differences according to tethering location and musculoskeletal deformities were analyzed in both groups. RESULTS The mean height, weight, and BMI values of the TCS group were lower than those of the control group. The TCS group had a lower proportion of obese and overweight individuals, and a higher proportion of underweight individuals, according to both BMI criteria. The tethering level was not associated with the degree of obesity in the tethered group. The mean height, weight, and BMI were lower in the tethered group regardless of the existence of musculoskeletal deformity. CONCLUSION Enrollees with a history of TCS were smaller than controls of the same age. Monitoring of health behaviors, including nutrition, diet, and exercise, is warranted for TCS patients.
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Affiliation(s)
- Shin Heon Lee
- Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea
| | - Hyun Iee Shin
- Department of Rehabilitation Medicine, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea.
| | - Taek-Kyun Nam
- Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea
| | - Yong-Sook Park
- Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea
| | - Don-Kyu Kim
- Department of Rehabilitation Medicine, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea
| | - Jeong-Taik Kwon
- Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, 06973, South Korea
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Sol ME, Verschuren O, Horemans H, Westers P, Visser-Meily JMA, De Groot JF. The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair. Disabil Rehabil 2021; 44:4398-4407. [PMID: 33874820 DOI: 10.1080/09638288.2021.1907456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. METHODS Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. RESULTS Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. CONCLUSIONS A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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Affiliation(s)
- Marleen E Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Henricus Horemans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Paul Westers
- Department of Biostatistics and Research Support, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janke F De Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
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