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Martínez-Zamora MD, Martín-Martínez C, Martínez-de-Quel Ó, Valenzuela PL. Influence of Preterm Birth and Low Birthweight on Physical Fitness: A Systematic Review, Meta-Analysis, and Meta-Regression. Sports Med 2024; 54:1907-1919. [PMID: 38709451 PMCID: PMC11258071 DOI: 10.1007/s40279-024-02026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Preterm birth and low birthweight (LBW) might be associated with reduced physical fitness, although evidence remains inconclusive. OBJECTIVE To examine the influence of preterm birth and LBW on physical fitness, as well as to assess whether variables such as gestational age, birthweight, or age at assessment moderate these effects. METHODS PubMed, Scopus, and PsycINFO were systematically searched from inception to 7 December 2023 for case-control and cohort studies analyzing the association between preterm birth or LBW (or gestational age or birthweight as continuous variables) with at least one physical fitness-related outcome (i.e., cardiorespiratory fitness (CRF), muscle strength, flexibility, speed, agility). Random-effects meta-analysis and meta-regression models were used to estimate the pooled effect size, as well as to examine potential associations between the magnitude of the effect and gestational age, birthweight, or age at assessment. RESULTS Fifty-two studies (n = 920,603 participants, average age ranging from 4.7 to 34.4 years) were included. Preterm birth was associated with reduced CRF (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI) = -0.51 to -0.25) and muscle strength (SMD = -0.44, 95% CI = -0.79 to -0.08). LBW was associated with reduced CRF (SMD = -0.40, 95% CI = -0.64 to -0.17), muscle strength (SMD = -0.18, 95% CI = -0.24 to -0.13), flexibility (SMD = -0.11, 95% CI = -0.22 to -0.01), and agility (SMD = -0.99, 95% CI = -1.91 to -0.07). Meta-regression analyses showed that a lower gestational age or birthweight were associated with larger reductions in physical fitness, whereas no consistent association was found for the age at assessment. CONCLUSION Both preterm birth and LBW seem associated with reduced physical fitness regardless of age, with larger reductions overall observed in individuals with lower gestational age or birthweight. These findings might support the implementation of preventive strategies (e.g., fitness monitoring and physical exercise interventions) in these populations through the life course. PROSPERO registration: CRD42021231845.
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Affiliation(s)
| | | | - Óscar Martínez-de-Quel
- Faculty of Education, Complutense University of Madrid, Madrid, Spain.
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, C/Martín Fierro, 7, 28040, Madrid, Spain.
| | - Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid, Spain.
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre ('imas12'), Centro de Actividades Ambulatorias, 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain.
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Deprez A, Poletto Bonetto JH, Ravizzoni Dartora D, Dodin P, Nuyt AM, Luu TM, Dumont NA. Impact of preterm birth on muscle mass and function: a systematic review and meta-analysis. Eur J Pediatr 2024; 183:1989-2002. [PMID: 38416257 DOI: 10.1007/s00431-023-05410-5] [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: 08/10/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 02/29/2024]
Abstract
Individuals born preterm present lower exercise capacity. Along with the cardiopulmonary responses and activity level, muscle strength is a key determinant of exercise capacity. This systematic review aimed to summarize the current knowledge on the impact of preterm birth on skeletal muscle mass and function across the lifespan. The databases PubMed, MEDLINE, EBM, Embase, CINAHL Plus, Global Index Medicus, and Google Scholar were searched using keywords and MeSH terms related to skeletal muscle, preterm birth, and low birth weight. Two independent reviewers undertook study selection, data extraction, and quality appraisal using Covidence review management. Data were pooled to estimate the prematurity effect on muscle mass and function using the R software. From 4378 studies retrieved, 132 were full-text reviewed and 25 met the inclusion/exclusion criteria. Five studies presented a low risk of bias, and 5 had a higher risk of bias due to a lack of adjustment for confounding factors and presenting incomplete outcomes. Meta-analyses of pooled data from homogenous studies indicated a significant reduction in muscle thickness and jump test (muscle power) in individuals born preterm versus full-term with standardized mean difference and confidence interval of - 0.58 (0.27, 0.89) and - 0.45 (0.21, 0.69), respectively. Conclusion: Overall, this systematic review summarizing the existing literature on the impact of preterm birth on skeletal muscle indicates emerging evidence that individuals born preterm, display alteration in the development of their skeletal muscle mass and function. This work also highlights a clear knowledge gap in understanding the effect of preterm birth on skeletal muscle development. What is Known: • Preterm birth, which occurs at a critical time of skeletal muscle development and maturation, impairs the development of different organs and tissues leading to a higher risk of comorbidities such as cardiovascular diseases. • Preterm birth is associated with reduced exercise capacity. What is New: • Individuals born preterm display alterations in muscle mass and function compared to individuals born at term from infancy to adulthood. • There is a need to develop preventive or curative interventions to improve skeletal muscle health in preterm-born individuals.
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Affiliation(s)
- Alyson Deprez
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Jéssica H Poletto Bonetto
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Daniela Ravizzoni Dartora
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Philippe Dodin
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Anne Monique Nuyt
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Thuy Mai Luu
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Nicolas A Dumont
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
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Martinez-Zamora MD, Valenzuela PL, Esteban Díez I, Martínez-de-Quel Ó. Influence of preterm birth on physical fitness in early childhood. Eur J Sport Sci 2023; 23:2129-2138. [PMID: 37093663 DOI: 10.1080/17461391.2023.2207082] [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] [Indexed: 04/25/2023]
Abstract
Evidence suggests that preterm birth is associated with an impaired physical fitness later in life, but whether these effects are already visible since early childhood remains unknown. We aimed to compare the physical fitness of preterm preschoolers with that of children born at term. Children aged three to six years and born preterm (<35 weeks) were recruited from a Neonatal Intensive Care Unit, and children born at term (>37 weeks) were included as controls. A variety of physical fitness indicators (strength, cardiorespiratory fitness, agility, flexibility and balance) were assessed with the PREFIT battery and the adapted sit and reach test. Physical activity levels were measured through the PrePAQ questionnaire. A total of 98 preterm children (gestational age 32.4 ± 2.3 weeks, age 5.1 ± 0.8 years) and 74 controls (gestational age 39.9 ± 1.0 weeks, age 4.8 ± 0.9 years) were analysed. Despite no significant differences in physical activity levels (p > 0.05), preterm children showed an overall poorer physical fitness compared to controls. Specifically, preterm children had an impaired handgrip strength (-13.95%, p < 0.001), lower-limb muscle strength (-12.67%, p = 0.003), agility (-14.9%, p = 0.001), cardiorespiratory fitness (-12.73% p = 0.005) and flexibility (-17.04%, p = 0.001) compared to controls. An inverse dose-response association was observed between the level of prematurity and physical fitness, with very preterm children (gestational age ≤32 weeks) presenting the poorest fitness levels. In summary, prematurity seems to impair physical fitness since early childhood, which might support the need for promoting preventive strategies (e.g. fitness monitoring and applying exercise interventions).Highlights Preterm children present an impaired physical fitness compared with peers born at term since early childhood (3-6 years), as reflected by lower muscle strength, agility, flexibility and cardiorespiratory fitness.A greater impairment of physical fitness in observed in children born very preterm (≤32 weeks of gestation).These findings might support the implementation of preventive strategies (e.g. fitness monitoring and exercise training) in preterm children since early childhood.
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Affiliation(s)
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
| | - Inés Esteban Díez
- Neonatal Intensive Care Unit, San Pedro Hospital Rioja Salud, Logroño, Spain
| | - Óscar Martínez-de-Quel
- Faculty of Education, Complutense University of Madrid, Madrid, Spain
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, 28040 Madrid, Spain
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O'Dea CA, Beaven ML, Wilson AC, Smith EF, Maiorana A, Simpson SJ. Preterm birth and exercise capacity: what do we currently know? Front Pediatr 2023; 11:1222731. [PMID: 37868270 PMCID: PMC10587559 DOI: 10.3389/fped.2023.1222731] [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: 05/15/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Objectives The long-term cardiopulmonary outcomes following preterm birth during the surfactant era remain unclear. Respiratory symptoms, particularly exertional symptoms, are common in preterm children. Therefore, cardiopulmonary exercise testing may provide insights into the pathophysiology driving exertional respiratory symptoms in those born preterm. This review aims to outline the current knowledge of cardiopulmonary exercise testing in the assessment of children born preterm in the surfactant era. Design This study is a narrative literature review. Methods Published manuscripts concerning the assessment of pulmonary outcomes using cardiopulmonary exercise testing in preterm children (aged <18 years) were reviewed. Search terms related to preterm birth, bronchopulmonary dysplasia, and exercise were entered into electronic databases, including Medline, PubMed, and Google Scholar. Reference lists from included studies were scanned for additional manuscripts. Results Preterm children have disrupted lung development with significant structural and functional lung disease and increased respiratory symptoms. The association between these (resting) assessments of respiratory health and exercise capacity is unclear; however, expiratory flow limitation and an altered ventilatory response (rapid, shallow breathing) are seen during exercise. Due to the heterogeneity of participants, treatments, and exercise protocols, the effect of the aforementioned limitations on exercise capacity in children born preterm is conflicting and poorly understood. Conclusion Risk factors for reduced exercise capacity in those born preterm remain poorly understood; however, utilizing cardiopulmonary exercise testing to its full potential, the pathophysiology of exercise limitation in survivors of preterm birth will enhance our understanding of the role exercise may play. The role of exercise interventions in mitigating the risk of chronic disease and premature death following preterm birth has yet to be fully realized and should be a focus of future robust randomized controlled trials.
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Affiliation(s)
- Christopher A O'Dea
- Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Michael L Beaven
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Andrew C Wilson
- Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Elizabeth F Smith
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Andrew Maiorana
- School of Allied Health, Curtin University, Perth, WA, Australia
- Department of Allied Health, Fiona Stanley Hospital, Perth, WA, Australia
| | - Shannon J Simpson
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Allied Health, Curtin University, Perth, WA, Australia
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5
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Weigelt A, Bleck S, Huebner MJ, Rottermann K, Waellisch W, Morhart P, Abu-Tair T, Dittrich S, Schoeffl I. Impact of premature birth on cardiopulmonary function in later life. Eur J Pediatr 2023:10.1007/s00431-023-04952-y. [PMID: 37147470 DOI: 10.1007/s00431-023-04952-y] [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: 01/25/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 05/07/2023]
Abstract
Pulmonary function is reduced in children after preterm birth. The variety of subgroups ranges from early to late preterm births. Limitations in pulmonary function can be observed even after late preterm birth without signs of bronchopulmonary dysplasia and/or history of mechanical ventilation. Whether this reduction in lung function is reflected in the cardiopulmonary capacity of these children is unclear. This study aims to investigate the impact of moderate to late premature birth on cardiopulmonary function. Cardiopulmonary exercise testing on a treadmill was performed by 33 former preterm infants between 8 and 10 years of age who were born between 32 + 0 and 36 + 6 weeks of gestation and compared with a control group of 19 children born in term of comparable age and sex. The former preterm children achieved comparable results to the term-born controls with respect to most of the cardiopulmonary exercise parameters [Formula: see text]. The only differences were in a slightly higher oxygen uptake efficiency slope [Formula: see text] and higher peak minute ventilation [Formula: see text] in the group of children born preterm. With respect to heart rate recovery [Formula: see text] and breathing efficiency [Formula: see text], there were no significant differences. CONCLUSION Children born preterm did not show limitations in cardiopulmonary function in comparison with matched controls. WHAT IS KNOWN • Preterm birth is associated with reduced pulmonary function in later life, this is also true for former late preterms. • As a consequence of being born premature, the lungs have not finished their important embryological development. Cardiopulmonary fitness is an important parameter for overall mortality and morbidity in children and adults and a good pulmonary function is therefore paramount. WHAT IS NEW • Children born prematurely were comparable to an age- and sex-matched control group with regards to almost all cardiopulmonary exercise variables. • A significantly higher OUES, a surrogate parameter for VO2peak was found for the group of former preterm children, most likely reflecting on more physical exercise in this group. Importantly, there were no signs of impaired cardiopulmonary function in the group of former preterm children.
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Affiliation(s)
- Annika Weigelt
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany.
| | - Steffen Bleck
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Matthias Jens Huebner
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Kathrin Rottermann
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Wolfgang Waellisch
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Patrick Morhart
- Department of Neonatology and Intensive Medical Care, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Tariq Abu-Tair
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Sven Dittrich
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
| | - Isabelle Schoeffl
- Department of Pediatric Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Loschgestrasse 15, 91054, Erlangen, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, LS13HE, UK
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Gibbons JT, Course CW, Evans EE, Kotecha S, Kotecha SJ, Simpson SJ. Increasing airway obstruction through life following bronchopulmonary dysplasia: a meta-analysis. ERJ Open Res 2023; 9:00046-2023. [PMID: 37342090 PMCID: PMC10277871 DOI: 10.1183/23120541.00046-2023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
Background Few studies exist investigating lung function trajectories of those born preterm; however growing evidence suggests some individuals experience increasing airway obstruction throughout life. Here we use the studies identified in a recent systematic review to provide the first meta-analysis investigating the impact of preterm birth on airway obstruction measured by the forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio. Methods Cohorts were included for analysis if they reported FEV1/FVC in survivors of preterm birth (<37 weeks' gestation) and control populations born at term. Meta-analysis was performed using a random effect model, expressed as standardised mean difference (SMD). Meta-regression was conducted using age and birth year as moderators. Results 55 cohorts were eligible, 35 of which defined groups with bronchopulmonary dysplasia (BPD). Compared to control populations born at term, lower values of FEV1/FVC were seen in all individuals born preterm (SMD -0.56), with greater differences seen in those with BPD (SMD -0.87) than those without BPD (SMD -0.45). Meta-regression identified age as a significant predictor of FEV1/FVC in those with BPD with the FEV1/FVC ratio moving -0.04 sds away from the term control population for every year of increased age. Conclusions Survivors of preterm birth have significantly increased airway obstruction compared to those born at term with larger differences in those with BPD. Increased age is associated with a decline in FEV1/FVC values suggesting increased airway obstruction over the life course.
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Affiliation(s)
- James T.D. Gibbons
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia
- Department of Respiratory Medicine, Perth Children's Hospital, Perth, Australia
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | | | - Emily E. Evans
- Department of Paediatrics, Cardiff and Vale University Health Board, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, UK
| | - Sarah J. Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, UK
| | - Shannon J. Simpson
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia
- Curtin School of Allied Health, Curtin University, Perth, Australia
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Cardiopulmonary Exercise Testing in Childhood in Late Preterms: Comparison to Early Preterms and Term-Born Controls. J Pers Med 2022; 12:jpm12101547. [PMID: 36294686 PMCID: PMC9605114 DOI: 10.3390/jpm12101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Late preterm (340−366 weeks gestational age [GA]) infants may have abnormal pulmonary development and possible exercise physiology parameters. We aim to assess the effect of late prematurity on exercise capacity in childhood and to compare it to early preterm (EP) (born < 300 GA), and to term healthy control (TC) (>370 week GA). Methods: Late preterm and early preterm (7−10 years) completed a cardiopulmonary exercise test (CPET) and spirometry and were compared to EP and to TC. Results: Eighty-four children (age 9.6 ± 1.0 years, 48% girls) participated. Twenty-one former LP were compared to 38 EP (15 with Bronchopulmonary dysplasia (BPD) [EP+], 23 without BPD [EP−]) and to 25 TC children. Peak oxygen uptake (peakV̇O2) was statistically lower than in the TC, but within the normal range, and without difference from the EP (LP 90.2 ± 15.1%, TC 112.4 ± 16.9%, p < 0.001; EP+ 97.3 ± 25.5%, EP− 85.4 ± 20.8%, p = 0.016 and p < 0.001, respectively, when compared with TC). Lung function (FEV1) was lower than normal only in the EP+ (75.6 ± 14.9% predicted, compared with 12.5 ± 87.8 in EP−, 87.5 ± 16.9 in LP and 91.0 ± 11.7 in TC). Respiratory and cardiac limitations were similar between all four study groups. Conclusions: This study demonstrated lower exercise capacity (peakV̇O2) in former LP children compared with healthy term children. Exercise capacity in LP was comparable to that of EP, with and without BPD. However, the exercise test parameters, specifically peakV̇O2, were within the normal range, and no significant physiological exercise limitations were found.
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Kotecha SJ, Gibbons JTD, Course CW, Evans EE, Simpson SJ, Watkins WJ, Kotecha S. Geographical Differences and Temporal Improvements in Forced Expiratory Volume in 1 Second of Preterm-Born Children: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:867-877. [PMID: 35759258 PMCID: PMC9237805 DOI: 10.1001/jamapediatrics.2022.1990] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Although preterm birth is associated with later deficits in lung function, there is a paucity of information on geographical differences and whether improvements occur over time, especially after surfactant was introduced. Objective To determine deficits in percentage predicted forced expiratory volume in 1 second (%FEV1) in preterm-born study participants, including those with bronchopulmonary dysplasia (BPD) in infancy, when compared with term-born control groups. Data Sources Eight databases searched up to December 2021. Study Selection Studies reporting spirometry for preterm-born participants with or without a term-born control group were identified. Data Extraction and Synthesis Data were extracted and quality assessed by 1 reviewer and checked by another. Data were pooled using random-effects models and analyzed using Review Manager and the R metafor package. Main Outcomes and Measures Deficits in %FEV1 between preterm-born and term groups. Associations between deficits in %FEV1 and year of birth, age, introduction of surfactant therapy, and geographical region of birth and residence were also assessed. Results From 16 856 titles, 685 full articles were screened: 86 with and without term-born control groups were included. Fifty studies with term controls were combined with the 36 studies from our previous systematic review, including 7094 preterm-born and 17 700 term-born participants. Of these studies, 45 included preterm-born children without BPD, 29 reported on BPD28 (supplemental oxygen dependency at 28 days), 26 reported on BPD36 (supplemental oxygen dependency at 36 weeks' postmenstrual age), and 86 included preterm-born participants. Compared with the term-born group, the group of all preterm-born participants (all preterm) had deficits of %FEV1 of -9.2%; those without BPD had deficits of -5.8%, and those with BPD had deficits of approximately -16% regardless of whether they had BPD28 or BPD36. As year of birth increased, there was a statistically significant narrowing of the difference in mean %FEV1 between the preterm- and term-born groups for the all preterm group and the 3 BPD groups but not for the preterm-born group without BPD. For the all BPD group, when compared with Scandinavia, North America and western Europe had deficits of -5.5% (95% CI, -10.7 to -0.3; P = .04) and -4.1% (95% CI, -8.8 to 0.5; P = .08), respectively. Conclusions and Relevance Values for the measure %FEV1 were reduced in preterm-born survivors. There were improvements in %FEV1 over recent years, but geographical region had an association with later %FEV1 for the BPD groups.
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Affiliation(s)
- Sarah J Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - James T D Gibbons
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kid's Institute, Perth, Australia.,Department of Respiratory Medicine, Perth Children's Hospital, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia
| | - Christopher W Course
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Emily E Evans
- Department of Paediatrics, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Shannon J Simpson
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kid's Institute, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia
| | - W John Watkins
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, Cardiff University School of Medicine, Cardiff, United Kingdom
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9
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Qi Y, Lin Z, Lu H, Zhao P, Hou Y, Mao J. The Association Between Pregnancy-Induced Hypertension and Neonatal Cerebral Metabolism, Hemodynamics, and Brain Injury as Determined by Physiological Imaging. Front Physiol 2022; 13:756386. [PMID: 35295587 PMCID: PMC8918661 DOI: 10.3389/fphys.2022.756386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Pregnancy-induced hypertension (PIH) is common and may affect maternal and children’s healthcare. However, the neurobiological status of neonates born from mothers with PIH has yet to be elucidated. The present study employed physiological imaging to investigate the association between maternal PIH and a number of neonatal health parameters, including cerebral metabolism, hemodynamics, and pathophysiological vulnerabilities. Following the acquisition of ethical approval, we recruited 16 neonates with maternal PIH and 22 normal neonates (non-PIH) as controls. All neonates underwent magnetic resonance imaging (MRI) of the brain. Phase-contrast (PC) MRI and T2-relaxation-under-spin-tagging (TRUST) MRI were performed to determine global cerebral blood flow, oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO2). These physiological parameters were then compared between PIH neonates and controls. Linear regression analysis was performed to investigate the associations between maternal PIH and each of the physiological parameters. Receiver operating characteristic curves (ROCs) were used to determine whether maternal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) which could facilitate the diagnosis of neonatal brain injuries. PIH neonates showed significantly lower OEF (25.5 ± 8.8% vs. 32.6 ± 7.3%, P = 0.01) and CMRO2 (29.7 ± 9.4 vs. 40.9 ± 15.0 μmol/100 g/min, P = 0.01) compared to the controls. Maternal blood pressure levels [PIH or non-PIH groups, each one standard deviation (SD) increase in SBP, DBP, and MAP, respectively] were negatively associated with OEF [regression coefficient (β) = −7.9, P = 0.007; β = −4.2, P = 0.004; β = −3.6, P = 0.02; β = −4.0, P = 0.008, respectively). Furthermore, each one SD increase in maternal DBP and MAP was negatively associated with CMRO2 (β = −4.7, P = 0.03; β = −4.4, P = 0.04, respectively). The areas under the curves (AUCs) with 95% confidence intervals (CIs) for maternal SBP, DBP, and MAP were 0.90 (0.80–0.97), 0.85 (0.73–0.97), and 0.89 (0.76–0.99), respectively. The AUC values for maternal SBP, DBP, and MAP indicated good diagnostic ability for identifying neonatal brain injuries. The present study demonstrated that maternal PIH may be associated with a lower oxygen extraction and lower cerebral metabolism in neonates.
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Affiliation(s)
- Ying Qi
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Ying Qi,
| | - Zixuan Lin
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Pengfei Zhao
- Department of Pharmacology, School of Pharmaceutical Sciences, China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jian Mao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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10
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Satrell E, Clemm H, Røksund O, Hufthammer KO, Thorsen E, Halvorsen T, Vollsæter M. Development of lung diffusion to adulthood following extremely preterm birth. Eur Respir J 2021; 59:13993003.04103-2020. [PMID: 34625479 PMCID: PMC9117733 DOI: 10.1183/13993003.04103-2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
Background Gas exchange in extremely preterm (EP) infants must take place in fetal lungs. Childhood lung diffusing capacity of the lung for carbon monoxide (DLCO) is reduced; however, longitudinal development has not been investigated. We describe the growth of DLCO and its subcomponents to adulthood in EP compared with term-born subjects. Methods Two area-based cohorts born at gestational age ≤28 weeks or birthweight ≤1000 g in 1982–1985 (n=48) and 1991–1992 (n=35) were examined twice, at ages 18 and 25 years and 10 and 18 years, respectively, and compared with matched term-born controls. Single-breath DLCO was measured at two oxygen pressures, with subcomponents (membrane diffusion (DM) and pulmonary capillary blood volume (VC)) calculated using the Roughton–Forster equation. Results Age-, sex- and height-standardised transfer coefficients for carbon monoxide (KCO) and DLCO were reduced in EP compared with term-born subjects, and remained so during puberty and early adulthood (p-values for all time-points and both cohorts ≤0.04), whereas alveolar volume (VA) was similar. Development occurred in parallel to term-born controls, with no signs of pubertal catch-up growth nor decline at age 25 years (p-values for lack of parallelism within cohorts 0.99, 0.65, 0.71, 0.94 and 0.44 for z-DLCO, z-VA, z-KCO, DM and VC, respectively). Split by membrane and blood volume components, findings were less clear; however, membrane diffusion seemed most affected. Conclusions Pulmonary diffusing capacity was reduced in EP compared with term-born subjects, and development from childhood to adulthood tracked in parallel to term-born subjects, with no signs of catch-up growth nor decline at age 25 years. Pulmonary diffusing capacity following extremely preterm (EP) birth was reduced compared with term-born subjects. From mid-childhood to adulthood, development tracked in parallel in the EP and term-born groups, with preterms following lower trajectories.https://bit.ly/3ARPD7D
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Affiliation(s)
- Emma Satrell
- Department of Clinical Science, University of Bergen, Bergen, Norway .,Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Clemm
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ola Røksund
- Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,The Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Einar Thorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Maria Vollsæter
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
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11
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Qi Y, He J. Neurophysiologic Profiling of At-Risk Low and Very Low Birth-Weight Infants Using Magnetic Resonance Imaging. Front Physiol 2021; 12:638868. [PMID: 33833688 PMCID: PMC8021729 DOI: 10.3389/fphys.2021.638868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
Low birth-weight (LBW) and very low birth-weight (VLBW) newborns have increased risks of brain injuries, growth failure, motor difficulties, developmental coordination disorders or delay, and adult-onset vascular diseases. However, relatively little is known of the neurobiologic underpinnings. To clarify the pathophysiologic vulnerabilities of such neonates, we applied several advanced techniques for assessing brain physiology, namely T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging (MRI) and phase-contrast (PC) MRI. This enabled quantification of oxygen extraction fraction (OEF), global cerebral blood flow (CBF), and cerebral metabolic rate of oxygen (CMRO2). A total of 50 neonates (LBW-VLBW, 41; term controls, 9) participated in this study. LBW-VLBW neonates were further stratified as those with (LBW-VLBW-a, 24) and without (LBW-VLBW-n, 17) structural MRI (sMRI) abnormalities. TRUST and PC MRI studies were undertaken to determine OEF, CBF, and CMRO2. Ultimately, CMRO2 proved significantly lower (p = 0.01) in LBW-VLBW (vs term) neonates, both LBW-VLBW-a and LBW-VLBW-n subsets showing significantly greater physiologic deficits than term controls (p = 0.03 and p = 0.04, respectively). CMRO2 and CBF in LBW-VLBW-a and LBW-VLBW-n subsets did not differ significantly (p > 0.05), although OEF showed a tendency to diverge (p = 0.15). However, OEF values in the LBW-VLBW-n subset differed significantly from those of term controls (p = 0.02). Compared with brain volume or body weight, these physiologic parameters yield higher area-under-the-curve (AUC) values for distinguishing neonates of the LBW-VLBW-a subset. The latter displayed distinct cerebral metabolic and hemodynamic, whereas changes were marginal in the LBW-VLBW-n subset (i.e., higher OEF and lower CBF and CMRO2) by comparison. Physiologic imaging may therefore be useful in identifying LBW-VLBW newborns at high risk of irreversible brain damage.
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Affiliation(s)
- Ying Qi
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jingni He
- Department of Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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12
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de Souza LV, de Meneck F, Parizotto GP, Franco M. Low birth weight and its relation to physical fitness parameters in children: Its negative effect on muscle strength and cardiorespiratory endurance. Am J Hum Biol 2021; 34:e23595. [PMID: 33709521 DOI: 10.1002/ajhb.23595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/16/2021] [Accepted: 02/26/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is increasing evidence that low birth weight has a negative effect on physical fitness, muscle strength, and cardiorespiratory endurance, although the findings are inconsistent. OBJECTIVES This study aimed to evaluate whether birth weight acts as a prenatal determinant of physical fitness parameters and to determine the role of environmental or biological variables on this effect. METHODS One hundred and sixty-seven children aged 6-14 years were included in this study. The anthropometric data, physical activity index, standing long jump, flexibility, handgrip strength, and cardiorespiratory fitness were evaluated. RESULTS A positive correlation was found between birth weight and cardiorespiratory fitness (r = .349; p < .001), right handgrip strength (r = .337; p < .001), and left handgrip strength (r = .320; p < .001), suggesting that children with low birth weight had the worst performance in both cardiorespiratory endurance and grip strength tests. These findings remained significant after adjustment for prematurity, sex, age, physical activity index, and body mass index (BMI). Stepwise multiple regression analyses revealed a significant interaction of high birth weight, older age, and low BMI in predicting better cardiorespiratory endurance (R2 = .308). When handgrip strength was tested as the dependent variable, we found that high birth weight, male sex, and older age emerged as important determinants for both sides. CONCLUSION Children aged 6-14 years born with a birth weight < 2.5 kg have low handgrip strength and cardiorespiratory fitness, which seems to be mediated partially by influences of both prenatal environment (e.g., birth weight) and biological variables (e.g., age, sex, BMI).
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Affiliation(s)
| | - Franciele de Meneck
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Maria Franco
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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13
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O'Dea CA, Logie K, Wilson AC, Pillow JJ, Murray C, Banton G, Simpson SJ, Hall GL, Maiorana A. Lung abnormalities do not influence aerobic capacity in school children born preterm. Eur J Appl Physiol 2020; 121:489-498. [PMID: 33141263 DOI: 10.1007/s00421-020-04530-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/12/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Children born preterm have impaired lung function and altered lung structure. However, there are conflicting reports on how preterm birth impacts aerobic exercise capacity in childhood. We aimed to investigate how neonatal history and a diagnosis of bronchopulmonary dysplasia (BPD) impact the relationship between function and structure of the lung, and aerobic capacity in school-aged children born very preterm. METHODS Preterm children (≤ 32 w completed gestation) aged 9-12 years with (n = 38) and without (n = 35) BPD, and term-born controls (n = 31), underwent spirometry, lung volume measurements, gas transfer capacity, a high-resolution computer tomography (CT) scan of the chest, and an incremental treadmill exercise test. RESULTS Children born preterm with BPD had an elevated breathing frequency to tidal volume ratio compared to term controls (76% vs 63%, p = 0.002). The majority (88%) of preterm children had structural changes on CT scan. There were no differences in peak V̇O2 (47.1 vs 47.7 mL/kg/min, p = 0.407) or oxygen uptake efficiency slope when corrected for body weight (67.6 vs 67.3, p = 0.5) between preterm children with BPD and term controls. There were no differences in any other exercise outcomes. The severity of structural lung disease was not associated with exercise outcomes in this preterm population. CONCLUSION Children born preterm have impaired lung function, and a high prevalence of structural lung abnormalities. However, abnormal lung function and structure do not appear to impact on the aerobic exercise capacity of preterm children at school age.
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Affiliation(s)
- Christopher A O'Dea
- Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Karla Logie
- Telethon Kids Institute, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.,Division of Paediatrics and Child Health, Medical School, University of Western Australia, Perth, WA, Australia
| | - Andrew C Wilson
- Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - J Jane Pillow
- Division of Paediatrics and Child Health, Medical School, University of Western Australia, Perth, WA, Australia.,School of Human Sciences, University of Western Australia, Perth, WA, Australia
| | - Conor Murray
- Diagnostic Imaging, Perth Children's Hospital, Perth, WA, Australia
| | | | - Shannon J Simpson
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Graham L Hall
- Respiratory Medicine, Perth Children's Hospital, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, WA, Australia.
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14
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Engan M, Engeseth MS, Fevang S, Vollsæter M, Eide GE, Røksund OD, Halvorsen T, Clemm H. Predicting physical activity in a national cohort of children born extremely preterm. Early Hum Dev 2020; 145:105037. [PMID: 32438296 DOI: 10.1016/j.earlhumdev.2020.105037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
UNLABELLED Predicting physical activity in a national cohort of children born extremely preterm. OBJECTIVES To compare physical activity among school-aged children born extremely preterm or with extremely low birthweight (EP/ELBW) to term-born children, and to identify early predictors for physical inactivity in the EP/ELBW-children. METHODS A national cohort born during 1999-2000 at gestational age < 28 weeks or birthweight <1000 g and term-born controls were assessed. EP/ELBW-children without neurodevelopmental disabilities were labeled "healthy". At five years, we examined the EP/ELBW-children's motor, mental and intellectual functioning using the Movement Assessment Battery for Children (MABC), The Strength and Difficulties Questionnaire (SDQ) and The Wechsler Preschool and Primary Scale of Intelligence-revised. At 11 years, the parents reported their children's physical activity (PA) in questionnaires. RESULTS Information was obtained from 231/372 EP/ELBW and 57/61 term-born children. At 11 years, EP/ELBW-children had fewer exercise events per week, were less engaged in team sports, had lower endurance, lower sports proficiency, and were less vigorous during PA than term-born children (p < 0.05). Low sports proficiency in the healthy EP/ELBW-children at 11 years was predicted (odds ratio; 95% confidence interval) by abnormal MABC-score (3.0; 1.0 to 8.7), and abnormal SDQ-score (4.0; 1.6 to 10.0) at 5 years. Lower endurance at PA was predicted by abnormal MABC-score (2.6; 1.0 to 6.6), abnormal SDQ-score (3.0; 1.4 to 6.5), and borderline intellectual functioning (4.2; 1.8 to 10.1). CONCLUSIONS Eleven-year-old EP/ELBW-children were less physically active than term-born. In healthy EP/ELBW-children, impaired motor coordination, borderline intellectual functioning and behavioral problems at 5 years of age predicted unfavorable PA habits at 11 years.
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Affiliation(s)
- Mette Engan
- Department of Clinical Science, University of Bergen, Norway; Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Merete Salveson Engeseth
- Department of Clinical Science, University of Bergen, Norway; Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Silje Fevang
- Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Maria Vollsæter
- Department of Clinical Science, University of Bergen, Norway; Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Ola Drange Røksund
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hege Clemm
- Department of Clinical Science, University of Bergen, Norway; Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
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15
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Brown L, Burns YR, Watter P, Gibbons KS, Gray PH. Randomised clinical trial of group-based physiotherapy in extremely low birthweight children with minimal/mild motor impairment: A preliminary study. J Paediatr Child Health 2020; 56:727-734. [PMID: 31821654 DOI: 10.1111/jpc.14712] [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: 06/12/2019] [Revised: 10/11/2019] [Accepted: 11/03/2019] [Indexed: 11/27/2022]
Abstract
AIM Extremely low birthweight infants often present with mild neurodevelopmental impairments in gross motor function and postural stability in early childhood. The aim of the study was to undertake a randomised controlled trial to determine the short- and longer-term effects of group-based physiotherapy compared to standard care on performance in extremely low birthweight children with minimal/mild impairment. METHODS Fifty children aged 4 years, born <28 weeks gestation and/or birthweight <1000 g with minimal/mild motor impairment were enrolled in a randomised controlled trial and randomly allocated to 6 weeks of group-based intervention (n = 24) or standard care (n = 26). The intervention consisted of a combination of traditional physiotherapy and task-oriented approaches of approximately 1 h in duration and varied according to each child's strengths and weaknesses. Baseline, post intervention and 1 year post baseline assessments included Movement Assessment Battery for Children-2 (MABC-2), single leg stance, lateral reach and long jump. RESULTS Forty-eight (96%) children completed the study, which demonstrated no significant differences between the intervention and standard care groups on any of the assessments. Both groups improved initially from baseline to initial reassessment on the MABC-2 (P < 0.001). For both groups, however, MABC-2 manual dexterity, aiming/catching and total score declined from baseline to 1 year follow-up. However, for both groups, single leg stance and limb strength were significantly improved from baseline to 1 year follow-up. CONCLUSIONS There were no differences in outcomes between groups. Both approaches may contribute to improved short-term performance and longer-term improvements on functional skills in extremely preterm children.
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Affiliation(s)
- Laura Brown
- Growth and Development Unit, Mater Health Services, Brisbane, Queensland, Australia.,School of Health and Rehabilitation, University of Queensland, Brisbane, Queensland, Australia
| | - Yvonne R Burns
- Growth and Development Unit, Mater Health Services, Brisbane, Queensland, Australia.,School of Health and Rehabilitation, University of Queensland, Brisbane, Queensland, Australia
| | - Pauline Watter
- School of Health and Rehabilitation, University of Queensland, Brisbane, Queensland, Australia
| | - Kristen S Gibbons
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Peter H Gray
- Growth and Development Unit, Mater Health Services, Brisbane, Queensland, Australia.,Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
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16
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Ruf K, Thomas W, Brunner M, Speer CP, Hebestreit H. Diverging effects of premature birth and bronchopulmonary dysplasia on exercise capacity and physical activity - a case control study. Respir Res 2019; 20:260. [PMID: 31752871 PMCID: PMC6873747 DOI: 10.1186/s12931-019-1238-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/11/2019] [Indexed: 01/24/2023] Open
Abstract
Background Extreme prematurity has been associated with exercise intolerance and reduced physical activity. We hypothesized that children with bronchopulmonary dysplasia (BPD) would be especially affected based on long-term lung function impairments. Therefore, the objective of this study was to compare exercise capacity and habitual physical activity between children born very and extremely preterm with and without BPD and term-born children. Methods Twenty-two school-aged children (aged 8 to 12 years) born with a gestational age < 32 weeks and a birthweight < 1500 g (9 with moderate or severe BPD (=BPD), 13 without BPD (=No-BPD)) and 15 healthy term-born children (=CONTROL) were included in the study. Physical activity was measured by accelerometry, lung function by spirometry and exercise capacity by an incremental cardiopulmonary exercise test. Results Peak oxygen uptake was reduced in the BPD-group (83 ± 11%predicted) compared to the No-BPD group (91 ± 8%predicted) and the CONTROL group (94 ± 9%predicted). In a general linear model, variance of peak oxygen uptake was significantly explained by BPD status and height but not by prematurity (p < 0.001). Compared to CONTROL, all children born preterm spent significantly more time in sedentary behaviour (BPD 478 ± 50 min, No-BPD 450 ± 52 min, CONTROL 398 ± 56 min, p < 0.05) and less time in moderate-to-vigorous-physical activity (BPD 13 ± 8 min, No-BPD 16 ± 8 min, CONTROL 33 ± 16 min, p < 0.001). Prematurity but not BPD contributed significantly to explained variance in a general linear model of sedentary behaviour and likewise moderate-to-vigorous-physical activity (p < 0.05 and p < 0.001 respectively). Conclusion In our cohort, BPD but not prematurity was associated with a reduced exercise capacity at school-age. However, prematurity regardless of BPD was related to less engagement in physical activity and more time spent in sedentary behaviour. Thus, our findings suggest diverging effects of prematurity and BPD on exercise capacity and physical activity.
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Affiliation(s)
- Katharina Ruf
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
| | - Wolfgang Thomas
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Abteilung für Kinder- und Jugendmedizin, Klinikum Mutterhaus der Borromäerinnen, Feldstr. 16, 54290, Trier, Germany
| | - Maximilian Brunner
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Christian P Speer
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| | - Helge Hebestreit
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
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17
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Belanger R, Leroux D, Lefebvre P. Supporting caregivers of children born prematurely in the development of language: A scoping review. Paediatr Child Health 2019; 26:e17-e24. [PMID: 33542775 DOI: 10.1093/pch/pxz124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Infants born prematurely can display impairments that negatively impact the early years of their development. Compared to their peers born at term, preterm children have higher risks of cerebral palsy, sensory deficits, learning disabilities, cognitive and language deficits, as well as difficulties related to attention and behaviour. Following discharge, parents of preterm children are often supported through neonatal follow-up programs or by community health care practitioners. Through assessment and consultation, professionals foster parental resilience by teaching them about their child's development. Research shows a large volume of literature on improving outcomes for preterm infants, but less attention has been given to the impact and potential importance of education of parents regarding the care they provide from the home. Objective A scoping review was completed to determine the best practices for early intervention in premature children regarding the development of language skills during the preschool years. Methods The review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Results Four general themes emerged from the review and included the importance of providing (1) parental training in the care of an infant born prematurely during neonatal intensive care unit stay; (2) education on the development of language and the importance of parental responsiveness; (3) provision of activities to support child language learning; and (4) overall and ongoing monitoring and support by qualified health professionals. Conclusions The conclusions drawn will provide guidance to health care professionals regarding the education of parents on best practices for stimulating language development in their child.
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Affiliation(s)
- Roxanne Belanger
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Dominique Leroux
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Pascal Lefebvre
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
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18
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Tamai K, Nishihara M, Hirata K, Shiraishi J, Hirano S, Fujimura M, Yano S, Kanazawa T, Kitajima H. Physical fitness of non-disabled school-aged children born with extremely low birth weights. Early Hum Dev 2019; 128:6-11. [PMID: 30392918 DOI: 10.1016/j.earlhumdev.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/06/2018] [Accepted: 10/20/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The assessment of long-term outcomes in survivors born with extremely low birth weights (ELBWs) has become increasingly important. However, little has been reported on the physical fitness of non-disabled school-aged children born with ELBWs. AIMS To assess the physical fitness of non-disabled school-aged children born with ELBWs. STUDY DESIGN Retrospective cohort study. SUBJECTS We analyzed 169 ELBW infants without cerebral palsy or intellectual disability (based on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) Full Scale intelligence quotient (IQ) test < 70). OUTCOME MEASURES Physical fitness was assessed using the grip strength, sit-up repetitions, sit & reach, side steps, standing long jump, and softball throw tests. T-scores were calculated using national survey data. RESULTS The T-scores for the grip strength, sit-up repetitions, sit & reach, side steps, standing long jump, softball throw tests, and the overall T-score were 43.7 ± 7.5, 44.2 ± 10.5, 46.0 ± 9.7, 40.9 ± 8.0, 40.0 ± 9.8, 42.4 ± 8.1, and 42.9 ± 5.5, respectively. After adjusting for other age-related factors, the height (SD score), WISC-III Performance IQ score, and percent predicted forced vital capacity (FVC) independently predicted the overall T-scores. Their standardized partial regression coefficients (β) were 0.334 (p = 0.009), 0.190 (p = 0.022), and 0.187 (p = 0.032), respectively. CONCLUSIONS Our cohort's physical fitness at approximately 8 years of age was significantly impaired compared to average Japanese children of the same age. Height, FVC, and Performance IQ independently predicted physical fitness, with height being the strongest predictor.
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Affiliation(s)
- Kei Tamai
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan; Department of Neonatology, Okayama Medical Center, National Hospital Organization, 1711-1 Tamasu, Kita-ku, Okayama, Okayama 701-1192, Japan.
| | - Masahiro Nishihara
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Katsuya Hirata
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Jun Shiraishi
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Shinya Hirano
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Masanori Fujimura
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Suguru Yano
- Department of Education, Faculty of Health and Physical Education, Wakayama University, 930 Sakaedani, Wakayama, Wakayama 640-8510, Japan.
| | - Tadahiro Kanazawa
- Department of Comparative and Developmental Psychology, Faculty of Human Sciences, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Hiroyuki Kitajima
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
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19
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Risk Factors Associated with Poor Physical Fitness in Three- to Six-Year-Old Children in Tujia-Nationality Settlement of China. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5702190. [PMID: 30532796 PMCID: PMC6250012 DOI: 10.1155/2018/5702190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/11/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
Background Physical fitness has been recognized not only as an integrated predictor of the body's functional status, but also as an important marker of health outcomes. The aim of this study was to examine the factors associated with physical fitness among 3-6-year-old children within the Tujia-Nationality settlement in the years 2005, 2010, and 2014. Methods Demographics questionnaires and fitness assessment were performed to identify the risk factors for poor physical fitness (PPF) among 3- to 6-year-old children in the years 2005, 2010, and 2014 in the area of southwest Hubei of China. Results Of the 2128 children, 495 were classified as PPF (23.3%). In 2005, the percentage of PPF children was 21.7%, and the percentage of PPF children decreased from 29.1% in 2010 to 18.8% in 2014. Furthermore, Urban area children had a significant risk of PPF than rural area children (OR=1.299, P=0.031). Three-year-old children had 2.150-fold risk of PPF as compared to 6-year-old children. The children with less than 0.5 hours of activity time per day had 1.95-fold risk of PPF as compared to those with 1-2-hour activity time per day, respectively. Underweight and overweight/obese children had 2.74-fold and 1.67-fold risk of PPF as compared to normal weight children. Children had 1.97-fold risk of PPF when their father's schooling ceased after middle school and 1.51-fold risk of PPF when their father's schooling ceased after high school, respectively. Conclusions These results demonstrated that the incidence of PPF children went up from 2005 to 2010 and then down from 2010 to 2014 within the Tujia settlement. For the children in this area, the risk factors associated with PPF included urban location, younger age, less than 1-hour activity time per day in kindergarten, underweight/overweight, low father's education level, and mother's childbearing age being less than 20 years.
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O'Dea CA, Logie K, Maiorana A, Wilson AC, Pillow JJ, Banton GL, Simpson SJ, Hall GL. Increased prevalence of expiratory flow limitation during exercise in children with bronchopulmonary dysplasia. ERJ Open Res 2018; 4:00048-2018. [PMID: 30320130 PMCID: PMC6174284 DOI: 10.1183/23120541.00048-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 07/29/2018] [Indexed: 11/15/2022] Open
Abstract
Evidence regarding the prevalence of expiratory flow limitation (EFL) during exercise and the ventilatory response to exercise in children born preterm is limited. This study aimed to determine the prevalence of EFL as well as contributing factors to EFL and the ventilatory response to exercise in preterm children with and without bronchopulmonary dysplasia (BPD). Preterm children (≤32 weeks gestational age) aged 9–12 years with (n=64) and without (n=42) BPD and term controls (n=43), performed an incremental treadmill exercise test with exercise tidal flow–volume loops. More preterm children with BPD (53%) had EFL compared with preterm children without BPD (26%) or term controls (28%) (p<0.05). The presence of EFL was independently associated with decreased forced expiratory volume in 1 s/forced vital capacity z-score and lower gestational age (p<0.05). There was no difference in peak oxygen uptake between preterm children with BPD and term controls (48.0 versus 48.4 mL·kg−1·min−1; p=0.063); however, children with BPD had a lower tidal volume at peak exercise (mean difference −27 mL·kg−1, 95% CI −49– −5; p<0.05). Children born preterm without BPD had ventilatory responses to exercise similar to term controls. Expiratory flow limitation is more prevalent in children born preterm with BPD and is associated with airway obstruction and a lower gestational age. Children born preterm have an increased prevalence of expiratory limitation during exercise associated with reduced lung function and lower gestational agehttp://ow.ly/jLsk30leOVI
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Affiliation(s)
- Christopher A O'Dea
- Respiratory Medicine, Princess Margaret Hospital, Perth, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - Karla Logie
- Telethon Kids Institute, Perth, Australia.,Centre for Child Health Research, University of Western Australia, Perth, Australia.,Division of Paediatrics and Child Health, Medical School, University of Western Australia, Perth, Australia
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Allied Health Dept and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia
| | - Andrew C Wilson
- Respiratory Medicine, Princess Margaret Hospital, Perth, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia.,Centre for Child Health Research, University of Western Australia, Perth, Australia
| | - J Jane Pillow
- Centre for Neonatal Research and Education, Division of Paediatrics and Child Health, Medical School, University of Western Australia, Perth, Australia.,School of Human Sciences, University of Western Australia, Perth, Australia
| | | | - Shannon J Simpson
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia.,Centre for Child Health Research, University of Western Australia, Perth, Australia.,Both authors contributed equally
| | - Graham L Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia.,Centre for Child Health Research, University of Western Australia, Perth, Australia.,Both authors contributed equally
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21
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Feng EC, Jiang L. Effects of leptin on neurocognitive and motor functions in juvenile rats in a preterm brain damage model. Mol Med Rep 2018; 18:4095-4102. [PMID: 30106108 DOI: 10.3892/mmr.2018.9389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 06/12/2018] [Indexed: 11/05/2022] Open
Abstract
Preterm infants face lifelong disabilities, including learning disorders, as well as visual, auditory and behavioral problems. Recent studies have demonstrated that leptin, an adipocytokine encoded by a gene associated with obesity and expressed in adipose tissue, affects neurocognitive and motor function; however, the mechanisms of brain damage in preterm infants are unclear. In the present study, the neuroprotective effects of leptin in a rat model of preterm hypoxic‑ischemic brain damage were investigated. Rats (2‑days‑old) were subjected to brain damage (ligation of the common carotid artery followed by exposure to 6% oxygen for 2 h) and treated with vehicle (control) or leptin. Spatial memory was analyzed in the present study using the Morris water maze test 19 days following ligation. Over the 24‑day post‑surgical observation period, capture‑resistance test, forelimb suspension and open field tests were conducted to evaluate motor function and anxiety‑associated behavior. Treatment with leptin did not affect survival rate or body weight. Treatment with leptin increased the number of platform crossings in rats with premature brain damage in the Morris water maze test, which was used to assess spatial memory. Multivariate analysis revealed that leptin reduced the latency to finding the platform location, independent of gender and weight. In the capture‑resistance, forelimb suspension and open field tests, there were no differences between animals administered leptin and the sham group. Collectively, the results of the present study suggested that leptin may alleviate spatial memory impairment resulting from premature brain damage, independent of gender or weight. These results may improve understanding of the neuroprotective effects exhibited by leptin in infants with preterm brain damage.
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Affiliation(s)
- Er-Cui Feng
- School of Biological Science & Medical Engineering, Southeast University, Nanjing, Jiangsu 210096, P.R. China
| | - Li Jiang
- Department of Pediatrics, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, P.R. China
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Clutterbuck GL, Auld ML, Johnston LM. SPORTS STARS study protocol: a randomised, controlled trial of the effectiveness of a physiotherapist-led modified sport intervention for ambulant school-aged children with cerebral palsy. BMC Pediatr 2018; 18:258. [PMID: 30071830 PMCID: PMC6090768 DOI: 10.1186/s12887-018-1190-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/24/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Modified sport interventions run by physiotherapists have shown potential as cost-effective, engaging, and effective interventions to improve gross motor skills and support transition to real-world sports participation for children with cerebral palsy. At present, this population demonstrates decreased participation in physical activities and sport compared to peers due to barriers ranging from body function to accessibility challenges. Sport provides culturally relevant opportunities for social integration, community participation and physical activity and has been shown to improve the fitness, self-esteem, confidence and quality of life of children with disabilities. The Sports Stars physiotherapy group has been designed to support the development of a range of fundamental movement and sports skills through activity skill practice and participation in modified popular Australian sports. METHODS This randomised, waitlist controlled, assessor blinded, superiority trial with two parallel groups will aim to compare the effectiveness of Sports Stars to standard care across all ICF domains. Children in the Sports Stars group are expected to demonstrate greater improvement in their individually-selected, sports related goals measured by the Canadian Occupational Performance Measure. This study will aim to assess sixty ambulant children aged six to 12 years with a diagnosis of cerebral palsy. Children will be excluded if they have had recent Botox or neurological/orthopaedic surgery. The Sports Stars intervention includes eight, one-hour, weekly physiotherapy group sessions with four to six participants and one lead physiotherapist. Outcome measures will be collected pre, post and 12 weeks post the immediate Sports Stars group to assess change immediately after, and at follow up time points. DISCUSSION This will be the first study of its kind to investigate a culturally relevant sports-focussed fundamental movement skills physiotherapy group for ambulant children with cerebral palsy. The findings will add to a growing pool of evidence supporting group physiotherapy for children with cerebral palsy and the Sports Stars group will provide an avenue for children to transition from individual physiotherapy to mainstream and modified recreational and competitive sports. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12617000313336 Registered 28, February 2017. WHO Universal Trial Number: U1111-1189-3355 Registered 1, November 2016.
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Affiliation(s)
- Georgina L. Clutterbuck
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, Australia
- The Cerebral Palsy League, Brisbane, Australia
| | - Megan L. Auld
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, Australia
- The Cerebral Palsy League, Brisbane, Australia
| | - Leanne M. Johnston
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, Australia
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Tikanmäki M, Kaseva N, Tammelin T, Sipola-Leppänen M, Matinolli HM, Eriksson JG, Järvelin MR, Vääräsmäki M, Kajantie E. Leisure Time Physical Activity in Young Adults Born Preterm. J Pediatr 2017; 189:135-142.e2. [PMID: 28751124 DOI: 10.1016/j.jpeds.2017.06.068] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/14/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the amount of self-reported physical activity in young adults born prematurely compared with those born at term. STUDY DESIGN Unimpaired participants of the Preterm Birth Study (Preterm Birth and Early Life Programming of Adult Health and Disease) birth cohort study were studied at age 23.3 ± 1.2 (SD) years: 118 born early preterm (<34 weeks), 210 late preterm (34-36 weeks), and 311 born at term (≥37 weeks, controls). The participants completed a validated 30-item, 12-month physical activity questionnaire. The annual frequency and total volume of conditioning and nonconditioning leisure time physical activity and commuting physical activity were calculated and the data analyzed by means of linear regression. RESULTS Adults born early preterm reported a 31.5% (95% CI, 17.4-43.2) lower volume of leisure time physical activity (in metabolic equivalents [MET] h/year) and had a 2.0-fold increased OR (1.2-3.3) of being in the least active quintile than controls. Lower amounts of conditioning, nonconditioning, and commuting physical activity all contributed to the difference. In addition, early preterm participants undertook less vigorous physical activity (≥6 MET). No differences in physical activity were found between the late preterm and control groups. Adjustments for potential early life confounders and current mediating health characteristics did not change the results. CONCLUSIONS Young adults born early preterm engage less in leisure time physical activities than peers born at term. This finding may in part underlie the increased risk factors of cardiometabolic and other noncommunicable diseases in adults born preterm. Low physical activity is a risk factor for several noncommunicable diseases and amenable to prevention.
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Affiliation(s)
- Marjaana Tikanmäki
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland.
| | - Nina Kaseva
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Marika Sipola-Leppänen
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hanna-Maria Matinolli
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Health Research Center, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Center for Environment & Health, School of Public Health, Imperial College London, United Kingdom; Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland; Biocenter Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Marja Vääräsmäki
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland; Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu, Helsinki, Finland; PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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24
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Ferreira I, Gbatu PT, Boreham CA. Gestational Age and Cardiorespiratory Fitness in Individuals Born At Term: A Life Course Study. J Am Heart Assoc 2017; 6:e006467. [PMID: 28954725 PMCID: PMC5721855 DOI: 10.1161/jaha.117.006467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 08/04/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND In contrast to the effects of preterm birth, the extent to which shorter gestational age affects the cardiorespiratory fitness (CRF) levels of individuals who were born at term (ie, between 37 and 42 weeks) is largely unknown. The aim of this study was to examine whether life-course CRF levels varied across different gestational ages within the at-term range. METHODS AND RESULTS The association between gestational age (in weeks) obtained from Child Health Services records and CRF, estimated from field and laboratory tests and expressed by maximal oxygen uptake level through adolescence to young adulthood, was examined in 791 participants in the Northern Ireland Young Hearts Study, all singletons born at term. Longitudinal data were analyzed with generalized estimating equations, accounting for important potential confounders. Mean levels of CRF were 45.6, 43.7, and 33.0 mL/kg per minute when participants were aged 12, 15, and 22 years, respectively. After adjustment for confounders, each week increase in gestational age was associated with 0.46 mL/kg per minute (95% confidence interval, 0.14-0.79) in CRF. Compared with individuals born full term (39-40 weeks, n=533) or late term (41-42 weeks, n=148), those who were born early term (37-38 weeks, n=110) had a higher incidence of poor CRF (risk ratio, 1.57; 95% confidence interval, 1.14-2.16). The changes in CRF through adolescence to young adulthood were similar across groups, with those born early term consistently displaying the lowest CRF. CONCLUSIONS These findings suggest that early-term births within the at-term range are linked to poorer CRF through adolescence to young adulthood, and may have important clinical and public health implications for policies about (avoidable) early-term deliveries given their recent increasing trends.
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Affiliation(s)
- Isabel Ferreira
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Pei T Gbatu
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Colin A Boreham
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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Hestnes J, Hoel H, Risa OJ, Romstøl HO, Røksund O, Frisk B, Thorsen E, Halvorsen T, Clemm HH. Ventilatory Efficiency in Children and Adolescents Born Extremely Preterm. Front Physiol 2017; 8:499. [PMID: 28751866 PMCID: PMC5508024 DOI: 10.3389/fphys.2017.00499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/29/2017] [Indexed: 11/14/2022] Open
Abstract
Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP−born compared to term−born individuals. Methods: Two area−based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982−85 (n = 46) and 1991–92 (n = 35) were compared with individually matched controls born at term. Mean ages were 18 and 10 years, respectively. The participants performed an incremental treadmill exercise test to peak oxygen uptake with data averaged over 20 s intervals. For each participant, the relationship between exhaled minute ventilation (V˙E) and carbon dioxide output (V˙CO2) was described by a linear model, and the relationship between tidal volume (VT) and V˙E by a quadratic model. Multivariate regression analyses were done with curve parameters as dependent variables, and the categories EP vs. term−born, sex, age, height, weight and forced expiratory volume in 1 s (FEV1) as independent variables. Results: In adjusted analyses, the slope of the V˙E−V˙CO2 relationship was significantly steeper in the EP than the term-born group, whereas no group difference was observed for the breathing pattern, which was related to FEV1 only. Conclusion: EP-born participants breathed with higher V˙E for any given CO2 output, indicating lower ventilatory efficiency, possibly contributing to lower aerobic capacity. The breathing patterns did not differ between the EP and term−born groups when adjusted for FEV1.
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Affiliation(s)
- Julie Hestnes
- Department of Clinical Science, University of BergenBergen, Norway
| | - Hedda Hoel
- Department of Clinical Science, University of BergenBergen, Norway
| | - Ole J Risa
- Department of Clinical Science, University of BergenBergen, Norway
| | - Hanna O Romstøl
- Department of Clinical Science, University of BergenBergen, Norway
| | - Ola Røksund
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied ScienceBergen, Norway
| | - Bente Frisk
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied ScienceBergen, Norway.,Department of Physiotherapy, Haukeland University HospitalBergen, Norway
| | - Einar Thorsen
- Department of Clinical Science, University of BergenBergen, Norway
| | - Thomas Halvorsen
- Department of Clinical Science, University of BergenBergen, Norway.,Department of Paediatrics, Haukeland University HospitalBergen, Norway
| | - Hege H Clemm
- Department of Clinical Science, University of BergenBergen, Norway.,Department of Paediatrics, Haukeland University HospitalBergen, Norway
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Goal Attainment Scaling to Evaluate Intervention on Individual Gains for Children Born Extremely Preterm. Pediatr Phys Ther 2017; 29:215-221. [PMID: 28654488 DOI: 10.1097/pep.0000000000000388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the effect of group-based physical therapy on individual gains among preterm and/or extremely low-birth-weight children with minimal or mild impairment at 4 years using Goal Attainment Scaling (GAS). To explore the relationship between GAS with motor and postural outcomes and effect of gender on GAS scores. METHODS Twenty-four 4-year-old children (born <28 weeks' gestation and/or birth weight <1000 g) with minimal or mild motor impairment completed 6 group-based weekly intervention sessions and a goal-based home program. Assessments included GAS, Movement Assessment Battery for Children-Second Edition (MABC-2), postural stability, and limb strength after intervention. RESULTS GAS group T score improved, exceeding expected goal of "0" score after intervention (mean = 58.2, standard deviation = 0.82). GAS mean T-score and MABC-2 percentile were moderately correlated (r = 0.42, P = .04). Females improved more than males (P = .05). CONCLUSIONS Goals were achieved above expected level after intervention and were related to motor coordination. Male gender is a risk factor for less favorable outcomes.
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Tikanmäki M, Tammelin T, Vääräsmäki M, Sipola-Leppänen M, Miettola S, Pouta A, Järvelin MR, Kajantie E. Prenatal determinants of physical activity and cardiorespiratory fitness in adolescence - Northern Finland Birth Cohort 1986 study. BMC Public Health 2017; 17:346. [PMID: 28427374 PMCID: PMC5399469 DOI: 10.1186/s12889-017-4237-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 04/06/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Lower levels of physical activity and cardiorespiratory fitness are key risk factors of chronic adult diseases. Physical activity and cardiorespiratory fitness are predicted by birth weight, but the underlying parental and pregnancy-related factors remain largely unknown. We examined how prenatal determinants are associated with physical activity and cardiorespiratory fitness in adolescence. METHODS Of the 16-year-old members of the population-based Northern Finland Birth Cohort 1986 (NFBC 1986), 6682 singletons with no major physical disability reported their amount of physical activity outside school hours, and 4706 completed a submaximal cycle ergometer test assessing cardiorespiratory fitness. Physical activity was expressed as metabolic equivalent hours per week (METh/week) and cardiorespiratory fitness as peak oxygen uptake (ml·kg-1·min-1). Prenatal determinants included birth weight, length of gestation, mother's and father's body mass index (BMI), maternal gestational diabetes mellitus (GDM), and maternal hypertension and smoking during pregnancy. Data were analyzed by multiple linear regression. RESULTS A higher birth weight and longer length of gestation predicted lower levels of physical activity and cardiorespiratory fitness at 16 years, although the association between length of gestation and physical activity was inverse U-shaped. Mother's or father's overweight or obesity before pregnancy were associated with lower levels of their offspring's physical activity and fitness in adolescence. Adjusting for maternal pregnancy disorders and the adolescent's own BMI attenuated the associations with the mother's but not the father's overweight/obesity. Furthermore, maternal GDM predicted lower cardiorespiratory fitness. CONCLUSIONS A high birth weight and parental overweight/obesity are associated with lower levels of both physical activity and cardiorespiratory fitness in adolescence, while maternal GDM and longer length of gestation are associated with lower cardiorespiratory fitness. Both long and short lengths of gestation predict low physical activity.
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Affiliation(s)
- Marjaana Tikanmäki
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Marja Vääräsmäki
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Marika Sipola-Leppänen
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Satu Miettola
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anneli Pouta
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Government Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, UK
- Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland
- Pediatrics and Adolescence and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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28
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Tikanmäki M, Tammelin T, Kaseva N, Sipola-Leppänen M, Matinolli HM, Hakonen H, Ekelund U, Eriksson JG, Järvelin MR, Vääräsmäki M, Kajantie E. Objectively measured physical activity and sedentary time in young adults born preterm-The ESTER study. Pediatr Res 2017; 81:550-555. [PMID: 27935902 DOI: 10.1038/pr.2016.262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/13/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Young adults born preterm have higher levels of cardio metabolic risk factors and they report less physical activity than their peers born at term. Physical activity provides important cardio metabolic health benefits. We hypothesized that objectively measured physical activity levels are lower and time spent sedentary is higher among preterm-born individuals compared with controls. METHODS We studied unimpaired participants of the ESTER birth cohort study at age 23.3 y (SD: 1.2): 60 born early preterm (<34 wk), 108 late preterm (34-36 wk), and 178 at term (controls). Physical activity and sedentary time were measured by hip-worn accelerometer (ActiGraph). RESULTS As compared with controls' (mean physical activity, 303 counts per minute (cpm; SD 129)), physical activity was similar among adults born early preterm (mean difference = 21 cpm, 95% CI -61, 19) or late preterm (5 cpm, -27, 38). Time spent sedentary was also similar. Adjustments for early life confounders or current mediating characteristics did not change the results. CONCLUSION In contrast to our hypothesis, we found no difference in objectively measured physical activity or time spent sedentary between adults born preterm and at term. The previously reported differences may be limited to physical activity captured by self-report.
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Affiliation(s)
- Marjaana Tikanmäki
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Nina Kaseva
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland
| | - Marika Sipola-Leppänen
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hanna-Maria Matinolli
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Harto Hakonen
- LIKES Research Center for Physical Activity and Health, Jyväskylä, Finland
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Johan G Eriksson
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom.,Faculty of Medicine, Center for Life Course Epidemiology, University of Oulu, Oulu, Finland.,Biocenter Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Marja Vääräsmäki
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Welfare, Children, Adolescents and Families Unit, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Oulu and Helsinki, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.,Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Lowe J, Watkins WJ, Kotecha SJ, Kotecha S. Physical Activity and Sedentary Behavior in Preterm-Born 7-Year Old Children. PLoS One 2016; 11:e0155229. [PMID: 27168339 PMCID: PMC4864195 DOI: 10.1371/journal.pone.0155229] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 04/26/2016] [Indexed: 11/19/2022] Open
Abstract
Background Previous studies of preterm-born children (<37 weeks’ gestation) have demonstrated decrements in lung function, exercise capacity, and increased respiratory symptoms compared to their term-born peers. However, it is unclear if these children have decreased levels of physical activity (PA) and increased sedentary behavior as a consequence of this increased respiratory morbidity. We therefore compared objectively measured PA in 7-year old preterm-born children with those born at term. Methods Children in the Millennium Cohort Study underwent assessment of PA at 7 years of age using accelerometry. 6422/12781 (50%) provided valid accelerometry and had gestational age data. A series of general linear models adjusted for confounders investigated the association between gestational age and levels of Total PA (average accelerometer counts per minute over the period of the recording), Moderate-to-Vigorous PA (MVPA) and sedentary behavior. Mediation analysis was performed to specifically investigate whether the observed association of gestational age on PA was mediated by respiratory symptoms. Results PA data were available for 79, 119, 275 and 5949 children born at 25–32, 33–34, 35–36 and 37–43 weeks’ gestation respectively. Boys born at ≤32 weeks’ gestation had modest but statistically significant reductions in MVPA when compared to term controls. This equated to a reduction of 9 minutes per day. No differences were found for Total PA or sedentary behavior. The association between gestational age and MVPA was not mediated by respiratory symptoms. In females, there was no association between gestational age and any measure of PA or sedentary behavior. Conclusions Boys born at ≤32 weeks’ gestation took part in less MVPA than their term-born peers at 7 years of age. The differences were modest, but equated to a reduction of over 1 hour per week. Since PA levels have been shown to decline during childhood and adolescence, this vulnerable group deserves further surveillance.
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Affiliation(s)
- John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - W. John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sarah J. Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
- * E-mail:
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Luz LGO, Cumming SP, Duarte JP, Valente-dos-Santos J, Almeida MJ, Machado-Rodrigues A, Padez C, Carmo BCM, Santos R, Seabra A, Coelho-E-Silva MJ. Independent and Combined Effects of Sex and Biological Maturation on Motor Coordination and Performance in Prepubertal Children. Percept Mot Skills 2016; 122:610-35. [DOI: 10.1177/0031512516637733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sex differences and maturation-associated variation in fitness and motor coordination were examined in children aged 8–9 years ( n = 128, 67 girls). Assessments included stature and body mass, two-component body composition, percentage of predicted adult stature (as an index of biological maturation), and motor performance and coordination (Körperkoordinationstest für Kinder). Compared to girls, boys were less advanced in maturation status, possessed larger fat mass, demonstrated superior performances in six tests of fitness, and obtained one superior score on the Körperkoordinationstest für Kinder. After controlling for somatic maturation, sex differences persisted in the two multivariate domains: motor performance and motor coordination.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Australia; CIAFEL, University of Porto, Portugal
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Tikanmäki M, Tammelin T, Sipola-Leppänen M, Kaseva N, Matinolli HM, Miettola S, Eriksson JG, Järvelin MR, Vääräsmäki M, Kajantie E. Physical Fitness in Young Adults Born Preterm. Pediatrics 2016; 137:peds.2015-1289. [PMID: 26715606 DOI: 10.1542/peds.2015-1289] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Young adults born preterm have higher levels of cardiometabolic risk factors than their term-born peers. Muscular and cardiorespiratory fitness have important cardiometabolic and other health benefits. We assessed muscular, cardiorespiratory, and self-rated fitness in preterm-born young adults. METHODS We studied unimpaired participants of the ESTER (Ennenaikainen syntymä ja aikuisiän terveys [Preterm Birth and Early-Life Programming of Adult Health and Disease]) birth cohort study at age 23.3 (SD: 1.2) years: 139 born early preterm (EPT; <34 weeks), 247 late preterm (LPT; 34-36 weeks), and 352 at term (control group). We measured muscular fitness with the number of modified push-ups performed in 40 seconds and maximal handgrip strength of the dominant hand, cardiovascular fitness with heart rate at the end of a 4-minute step test, and self-rated fitness. Data were analyzed with linear regression. RESULTS Young adults born EPT (-0.8; 95% confidence interval: -1.5 to -0.1; adjusted for gender, age, and source cohort) and LPT (-0.8; -1.4 to -0.3) performed fewer modified push-ups than controls. Handgrip strength was 23.8 (0.9-46.8) N lower in EPT participants. Cardiorespiratory fitness, measured by submaximal step test, was similar. On a self-rated fitness scale (1-5), the EPT adults reported 0.2 (0.0-0.4) lower scores than controls. After adjustment for early-life confounders, the results remained. They attenuated after further adjustment for mediating factors. CONCLUSIONS Young adults born EPT and LPT had lower muscular fitness than controls, which may predispose them to cardiometabolic and other chronic diseases. Adults born EPT also perceived themselves as less fit than controls.
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Affiliation(s)
- Marjaana Tikanmäki
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences and
| | - Tuija Tammelin
- LIKES-Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - Marika Sipola-Leppänen
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences and Departments of Pediatrics and Adolescence and
| | - Nina Kaseva
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Children's Hospital and
| | - Hanna-Maria Matinolli
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences and
| | - Satu Miettola
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Institute of Health Sciences and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Epidemiology and Biostatistics, Medical Research Council Health Protection Agency Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Biocenter Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland; and
| | - Marja Vääräsmäki
- Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Children's Hospital and Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Clemm HH, Vollsaeter M, Røksund OD, Markestad T, Halvorsen T. Adolescents who were born extremely preterm demonstrate modest decreases in exercise capacity. Acta Paediatr 2015; 104:1174-81. [PMID: 26096772 DOI: 10.1111/apa.13080] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 04/14/2015] [Accepted: 06/09/2015] [Indexed: 11/28/2022]
Abstract
AIM We aimed to investigate exercise capacity in adolescents who were born extremely preterm and to study changes through puberty and associations with neonatal data, exercise habits and lung function. METHODS This Norwegian population-based controlled cohort study focused on all infants (n = 35) born at a gestational age of ≤ 28 weeks or with a birthweight of ≤ 1000 grams in 1991-1992, together with matched term-born controls. Participants underwent spirometry and a maximal cardiopulmonary treadmill exercise test at 10 and 18 years. RESULTS At 18 years of age, mean (95% confidence interval) peak oxygen consumption (peak VO2 ) was 42.3 (39.2-45.4) vs 45.3 (41.3-49.3) mL/kg/min in the preterm- and term-born groups, while the completed treadmill distance was 915 (837-992) vs 1017 (912-1122) metres. Peak VO2 was unrelated to neonatal factors and current lung function. Changes between 10 and 18 were similar in the two groups, and positive associations between exercise habits and peak VO2 developed during the period. CONCLUSION Exercise capacity was modestly reduced in adolescents born extremely preterm, but the values were considered normal in most participants. Changes during puberty were similar to those observed for term controls, and the findings suggest similar trainability.
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Affiliation(s)
- Hege H. Clemm
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Maria Vollsaeter
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Ola D. Røksund
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Occupational Therapy, Physiotherapy and Radiography; Bergen University College; Bergen Norway
| | - Trond Markestad
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
| | - Thomas Halvorsen
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; University of Bergen; Bergen Norway
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Luz LGDO, Teixeira e Seabra AF, Santos R, Padez C, Ferreira JP, Coelho-e-Silva MJ. Associação entre IMC e teste de coordenação corporal para crianças (KTK). Uma meta-análise. REV BRAS MED ESPORTE 2015. [DOI: 10.1590/1517-869220152103144469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O Teste de Coordenação Corporal para Crianças (Körperkoordinationstest für Kinder, KTK) tem sido utilizado na avaliação da coordenação motora de crianças e adolescentes. O objetivo desta revisão sistemática com meta-análise foi analisar a relação entre o índice de massa corporal (IMC) e o desempenho motor no KTK em crianças e jovens escolares saudáveis. O estudo baseou-se em pesquisas indexadas nas bases eletrônicas PubMed e SciELO. Os descritores foram: "Körperkoordinationstest für Kinder" e "KTK". Foram considerados artigos em inglês e português publicados até Outubro de 2014. A qualidade dos estudos foi determinada pelas Escalas PEDro e STROBE. Foi realizada meta-análise utilizando o software Comprehensive Meta-Analysis V2. Foram incluídos 10 estudos. O resultado global com base no modelo de efeitos fixos mostrou que valores maiores de IMC estão diretamente associados ao baixo desempenho no KTK. Apesar da pequena diferença entre ambos, a magnitude do efeito da associação foi classificada como pequena, porém, significativa para o sexo masculino (r=0,29; IC95% 0,27 a 0,32; Z=22,47; p=0,000) e moderada para o sexo feminino (r=0,32; IC95% 0,30 a 0,34; Z=24,76; p=0,000). Os estudos apresentaram características amostrais bastante divergentes quanto ao tamanho da amostra e a faixa etária dos sujeitos, além de nenhum deles ter analisado o estado maturacional dos participantes. Conclui-se que há uma tendência de relação positiva entre valores elevados de IMC e o baixo desempenho no KTK. Para confirmação desta tendência, recomenda-se que os próximos trabalhos considerem o estado maturacional dos participantes, além de possibilitarem uma análise por sexo e idade.
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Brown L, Burns YR, Watter P, Gibbons KS, Gray PH. Motor performance, postural stability and behaviour of non-disabled extremely preterm or extremely low birth weight children at four to five years of age. Early Hum Dev 2015; 91:309-15. [PMID: 25841102 DOI: 10.1016/j.earlhumdev.2015.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/13/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Extremely preterm or extremely low birth weight (ELBW) children who are non-disabled and otherwise healthy are at risk of neurodevelopmental impairments. Further understanding of these impairments is needed before commencement of formal education to optimise participation levels at a critical time point for these children. AIMS To explore motor co-ordination, postural stability, limb strength and behaviour of non-disabled four to five year old children with a history of extreme prematurity or ELBW. STUDY DESIGN Prospective-descriptive-cohort-study. SUBJECTS 50 children born at less than 28 weeks gestation or who had a birth weight less than 1000g with minimal/mild motor impairments and no significant neurological/cognitive impairments. OUTCOME MEASURES Movement Assessment Battery for Children second-edition (MABC-2), single leg stance test (SLS), lateral reach test, standing long jump test and Child Behaviour Checklist for preschool children (CBCL). RESULTS The mean percentile rank of the extremely preterm or ELBW sample on MABC-2 was 31% (SD 23%). SLS right (mean ± SD; 4.6 ± 2.5s) and lateral reach to the right (10.0 ± 3.9 cm) were slightly stronger than SLS left (4.4 ± 3.3s) and lateral reach left (9.9 ± 3.5 cm). The average for standing long jump was 71.6 cm (SD 21.0 cm). All participants were classified as 'normal' on CBCL syndrome scale scores, internalizing and externalizing syndrome T scores and total problem T score. CONCLUSIONS This sample of non-disabled extremely preterm or ELBW children performed in the lower range of normal. These children continue to be at risk of impairments, therefore, ongoing monitoring and tailored intervention may optimise development.
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Affiliation(s)
- Laura Brown
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; The University of Queensland, St Lucia, Queensland 4072, Australia.
| | - Yvonne R Burns
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Pauline Watter
- The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Kristen S Gibbons
- Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Peter H Gray
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, Queensland 4101, Australia
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Lowe J, Watkins WJ, Kotecha SJ, Edwards MO, Henderson AJ, Kotecha S. Physical activity in school-age children born preterm. J Pediatr 2015; 166:877-83. [PMID: 25601656 DOI: 10.1016/j.jpeds.2014.12.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/29/2014] [Accepted: 12/04/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare objectively measured physical activity in 11- and 15-year-old children who were born preterm with term-born controls and related physical activity measures to lung function measures. STUDY DESIGN We used data from the Avon Longitudinal Study of Parents and Children. We compared total physical activity, moderate-to-vigorous physical activity, and sedentary behavior between children born at 25-32, 33-34, 35-36, and 37-43 weeks' gestation at ages 11 and 15 years. At age 11 years, physical activity measures were correlated with lung spirometry recorded at age 7-9 years. RESULTS Valid physical activity data at age 11 years were available for 5025, 197, 57, and 48 children born at 37-43, 35-36, 33-34, and 25-32 weeks' gestation, respectively. At age 15 years, valid physical activity data were available for 1829, 62, 32, and 24 children born at 37-43, 35-36, 33-34, and 25-32 weeks' gestation. Boys were more physically active than girls at both ages. There were no differences in total physical activity, moderate-to-vigorous physical activity, or sedentary behavior in children between the different gestation groups. Physical activity at age 11 years did not correlate with spirometry measures at age 7-9 years. CONCLUSIONS Physical activity was similar for the different gestational groups and did not correlate with lung spirometry. Physical activity does not appear to be limited in preterm-born children despite lung function deficits noted in childhood.
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Affiliation(s)
- John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - W John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Martin O Edwards
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom.
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Edwards MO, Kotecha SJ, Lowe J, Watkins WJ, Henderson AJ, Kotecha S. Effect of preterm birth on exercise capacity: A systematic review and meta-analysis. Pediatr Pulmonol 2015; 50:293-301. [PMID: 29889363 DOI: 10.1002/ppul.23117] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 09/10/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Survivors of preterm-birth have increased prevalence of respiratory, cardiovascular, and neurological diseases in later life however, the overall impact of prematurity on cardiorespiratory exercise capacity is unclear. OBJECTIVE We, therefore, systematically reviewed the literature on cardiorespiratory exercise capacity in survivors of preterm birth. METHODOLOGY Relevant studies up to March 2013 were searched using eight electronic health databases. Studies reporting exercise capacity in participants born preterm (<37 weeks) were included. The main outcome of interest was oxygen uptake (V˙O2max) at maximal exercise. Data were categorized into four groups: (i) preterm-born subjects including those with or without bronchopulmonary dysplasia (BPD) but excluding study groups biased towards BPD; (ii) preterm-born subjects (BPD excluded); (iii) preterm-born subjects who had BPD28 (defined as oxygen dependency at 28 days of life) in infancy; (iv) preterm born subjects with BPD36 (oxygen dependency at 36 weeks post menstrual age) in infancy. RESULTS From 9,341 abstracts, 22 included publications reported V˙O2max in ml/kg/min from 685 preterm and 680 term-born subjects. Overall 20 studies reported results for preterm-born subjects including BPD; 14 studies for the preterm group excluding BPD; 10 studies for the BPD28 group; and 8 studies for BPD36 group. The mean differences (95% CI) for the four groups were -2.20 (-3.70, -0.70) ml/kg/min; -2.26 (-4.44, -0.07 ml/kg/min; -3.04 (-5.48, -0.61) ml/kg/min, and -3.05 (-5.93, -0.18) ml/kg/min, respectively. CONCLUSION Despite marked deficits in spirometry, preterm-born children have a marginally decreased V˙O2max, which is unlikely to be of great clinical significance. Pediatr Pulmonol. 2015; 50:293-301. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Martin O Edwards
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - W John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Watkins S, Jonsson-Funk M, Brookhart MA, Rosenberg SA, O'Shea TM, Daniels J. Preschool motor skills following physical and occupational therapy services among non-disabled very low birth weight children. Matern Child Health J 2014; 18:821-8. [PMID: 23820671 DOI: 10.1007/s10995-013-1306-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Children born very low birth weight (VLBW) are at an increased risk of delayed development of motor skills. Physical and occupational therapy services may reduce this risk. Among VLBW children, we evaluated whether receipt of physical or occupational therapy services between 9 months and 2 years of age is associated with improved preschool age motor ability. Using data from the Early Childhood Longitudinal Study Birth Cohort we estimated the association between receipt of therapy and the following preschool motor milestones: skipping eight consecutive steps, hopping five times, standing on one leg for 10 seconds, walking backwards six steps on a line, and jumping distance. We used propensity score methods to adjust for differences in baseline characteristics between children who did and did not receive physical or occupational therapy, since children receiving therapy may be at higher risk of impairment. We applied propensity score weights and modeled the estimated effect of therapy on the distance that the child jumped using linear regression. We modeled all other end points using logistic regression. Treated VLBW children were 1.70 times as likely to skip eight steps (RR 1.70, 95 % CI 0.84, 3.44) compared to the untreated group and 30 % more likely to walk six steps backwards (RR 1.30, 95 % CI 0.63, 2.71), although these differences were not statistically significant. We found little effect of therapy on other endpoints. Providing therapy to VLBW children during early childhood may improve select preschool motor skills involving complex motor planning.
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Affiliation(s)
- Stephanie Watkins
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Blvd CB#7426, Chapel Hill, NC, 27599-7426, USA,
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Farhat F, Masmoudi K, Cairney J, Hsairi I, Triki C, Moalla W. Assessment of cardiorespiratory and neuromotor fitness in children with developmental coordination disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3554-3561. [PMID: 25241114 DOI: 10.1016/j.ridd.2014.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/14/2014] [Accepted: 08/20/2014] [Indexed: 06/03/2023]
Abstract
The decreased participation in physical activity by children with probable developmental coordination disorder (pDCD) has raised concerns about their aerobic fitness and lung function levels. The purpose of the present study was to examine assessment of cardiorespiratory and neuromotor fitness, using laboratory-based tests during an incremental treadmill protocol in healthy children with and without pDCD. Twenty sex children ages 6-9 years took part in this study. Motor coordination was assessed using the Movement Assessment Battery for Children (MABC). All participants performed a cardiopulmonary exercise test (CPET) on a cycle ergometer. Pulmonary function was assessed by spirometric measurements (forced vital capacity: FVC, forced expiratory volume in 1s: FEV1) and walking distance (6MWD) was assessed using the 6-min walking test. The children with pDCD had lower VO2max than children without pDCD (p < 0.01). Moreover, FVC and FEV1 were significantly higher in children without pDCD than in children with the disorder (p < 0.05, p < 0.01 respectively). Likewise, children with pDCD had poorer performance on the 6MWD than children without pDCD (p < 0.01). A significant correlation between the absolute value for FEV1 and 6MWD (r = 0.637, p < 0.05) in pDCD group was observed. We found a significant correlation between VO2max and MABC score (r = -0.612, p < .001) and between VO2max and 6MWD (r = 0.502, p < .001) for all children. Moreover, a significant correlation between VO2max and FEV1 (r = 0.668, p < .05) was found in children with pDCD. Overall, the reduced aerobic capacity of DCD was associated with decreased of lung function, as well as an alteration of peripheral muscle responses.
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Affiliation(s)
- Faiçal Farhat
- Research Unit EM2S: Education, Motricité, Sport et Santé" ISSEP, Sfax, Tunisia.
| | - Kaouthar Masmoudi
- Service d'Explorations Fonctionnelles, Unité d'Effort Cardio-pulmonaire, Hôpital Habib Bourguiba, Sfax, Tunisia
| | - John Cairney
- Departments of Family Medicine and Kinesiology, The Infant Child Health (INCH) Research Lab, and The CanChild Centre for Studies in Childhood Disability, McMaster University, Hamilton, Ontario, Canada
| | - Ines Hsairi
- Research Unit Neuropediatry UR.0805, Hedi Chaker Hosîtal Faculty of Medicine, Sfax, Tunisia
| | - Chahinez Triki
- Research Unit Neuropediatry UR.0805, Hedi Chaker Hosîtal Faculty of Medicine, Sfax, Tunisia
| | - Wassim Moalla
- Research Unit EM2S: Education, Motricité, Sport et Santé" ISSEP, Sfax, Tunisia
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Lifshitz N, Raz-Silbiger S, Weintraub N, Steinhart S, Cermak SA, Katz N. Physical fitness and overweight in Israeli children with and without developmental coordination disorder: gender differences. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2773-2780. [PMID: 25086737 DOI: 10.1016/j.ridd.2014.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 07/07/2014] [Indexed: 06/03/2023]
Abstract
Physical fitness and overweight among children has become paramount in the general population and more so in children with developmental coordination disorder (DCD). The purpose of the current study was to examine the association between physical fitness and overweight in a sample of Israeli children in comparison to typical children, and to examine gender differences. DCD was identified through total scores on the movement assessment battery for children 2 (MABC-2) equal to or less than the 16th percentile as well as parents' report that the child's deficits in motor skills interfered with at least two daily life activities. The sample included a group of children with DCD (n=22, M age=8.70 [SD=1.36], 16 boys [73%]) and a control group of typical children (n=47, M age=8.90 [SD=1.52], 34 boys [72%]). Measures included the strength subtest of the Bruininks-Oseretsky test of motor proficiency (BOT-2), the six minutes' walk test (6MWT) with heart rate measure, BMI and the percentage of body fat. Significant differences between DCD and typical children were found on all variables of physical fitness and weight. A two-way analysis of variance (ANOVA) analysis (group/gender) also revealed significant interactions for the percentage of body fat (F=8.51, p<.005) and BMI (F=4.50, p<.038) meaning that less fit children are more obese. The current study supports previous findings that children with DCD are less physically fit and more overweight compared to typically developing children. Moreover, in comparing between the genders, the girls in the study sample weighed more and had a significantly higher percentage of body fat than boys, it is essential to further our understanding of the relationships between obesity, physical fitness and gender among children with and without DCD.
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Affiliation(s)
- N Lifshitz
- Department of Occupational Therapy, Faculty of Health Professions, Ono Academic College, Israel.
| | - S Raz-Silbiger
- School of Occupational Therapy, Hebrew University Jerusalem, Israel; Alyn Hospital, Pediatric & Adolescent Rehabilitation Center, Jerusalem, Israel
| | - N Weintraub
- School of Occupational Therapy, Hebrew University Jerusalem, Israel
| | - S Steinhart
- Alyn Hospital, Pediatric & Adolescent Rehabilitation Center, Jerusalem, Israel
| | - S A Cermak
- Division of Occupational Science and Occupational Therapy, College of Health Professions, University of Southern California, LA, USA
| | - N Katz
- Research Institute for Health and Medical Professions, Ono Academic College, Israel
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Spittle AJ, Orton J. Cerebral palsy and developmental coordination disorder in children born preterm. Semin Fetal Neonatal Med 2014; 19:84-9. [PMID: 24290908 DOI: 10.1016/j.siny.2013.11.005] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Children born early (<37 weeks of gestation) are at high risk of a range of motor impairments due to a variety of biological and environmental risk factors. Cerebral palsy occurs more frequently in those children born preterm, with the risk increasing with decreasing gestational age. Mild and moderate motor impairments, consistent with developmental coordination disorder, occur in almost half of those children born preterm and include difficulties with balance, manual dexterity and ball skills. All forms of motor impairment are associated with comorbidities, which may have a greater effect on quality of life, academic achievement and participation in extracurricular activities than the motor impairment itself. Infants at risk of motor impairment can be identified in early infancy with a combination of clinical assessment tools and perinatal risk factors. However, the reliable diagnosis of motor impairment requires follow-up into early childhood and it is important to ensure that the appropriate intervention is implemented.
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Affiliation(s)
- Alicia Jane Spittle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Australia; Department of Physiotherapy, School of Health Sciences, University of Melbourne, Carlton, Australia; Neonatal Services, Royal Women's Hospital, Parkville, Australia.
| | - Jane Orton
- Neonatal Services, Royal Women's Hospital, Parkville, Australia
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Abstract
Survival of extremely preterm infants has improved since 2000. Neurodevelopmental impairment rates remain high at the limits of viability. Although improved survival and neurodevelopmental impairment rates are associated with higher gestational age and more recent year of birth, significant variability in findings among geographic areas and networks is evident, and seems related to differences in population, management style, regional protocols, definitions, and outcome assessments. Outcome studies during adolescence and young adult age are needed to determine the long-term impact of extremely preterm birth.
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Affiliation(s)
- Betty R Vohr
- Neonatal Follow-up Program, Women and Infants Hospital, Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905, USA.
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42
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Auld ML, Johnston LM. “Strong and steady”: a community-based strength and balance exercise group for children with cerebral palsy. Disabil Rehabil 2014; 36:2065-71. [DOI: 10.3109/09638288.2014.891054] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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An official American Thoracic Society workshop report: optimal lung function tests for monitoring cystic fibrosis, bronchopulmonary dysplasia, and recurrent wheezing in children less than 6 years of age. Ann Am Thorac Soc 2013; 10:S1-S11. [PMID: 23607855 DOI: 10.1513/annalsats.201301-017st] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Although pulmonary function testing plays a key role in the diagnosis and management of chronic pulmonary conditions in children under 6 years of age, objective physiologic assessment is limited in the clinical care of infants and children less than 6 years old, due to the challenges of measuring lung function in this age range. Ongoing research in lung function testing in infants, toddlers, and preschoolers has resulted in techniques that show promise as safe, feasible, and potentially clinically useful tests. Official American Thoracic Society workshops were convened in 2009 and 2010 to review six lung function tests based on a comprehensive review of the literature (infant raised-volume rapid thoracic compression and plethysmography, preschool spirometry, specific airway resistance, forced oscillation, the interrupter technique, and multiple-breath washout). In these proceedings, the current state of the art for each of these tests is reviewed as it applies to the clinical management of infants and children under 6 years of age with cystic fibrosis, bronchopulmonary dysplasia, and recurrent wheeze, using a standardized format that allows easy comparison between the measures. Although insufficient evidence exists to recommend incorporation of these tests into the routine diagnostic evaluation and clinical monitoring of infants and young children with cystic fibrosis, bronchopulmonary dysplasia, or recurrent wheeze, they may be valuable tools with which to address specific concerns, such as ongoing symptoms or monitoring response to treatment, and as outcome measures in clinical research studies.
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Nascimento RO, Ferreira LF, Goulardins JB, Freudenheim AM, Marques JCB, Casella EB, Oliveira JA. Health-related physical fitness children with severe and moderate developmental coordination disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4222-4231. [PMID: 24077071 DOI: 10.1016/j.ridd.2013.08.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/18/2013] [Accepted: 08/14/2013] [Indexed: 06/02/2023]
Abstract
The present study aims to examine physical fitness among children with developmental coordination disorder (DCD) with varying degrees of severity (moderate and severe - mDCD, sDCD), and a group of children without DCD (wDCD), in the city of Manaus, Brazil. Initially, 180 children aged 6-10 years old participated in this study. After being diagnosed according to the DSM-IV-TR, 63 children were then divided into three groups (21 in each group). Health-related physical fitness was measured by means of the Fitnessgram, which included several core components, namely, body composition, muscle strength and endurance, flexibility, and cardiorespiratory resistance. The results showed no statistically significant differences between both groups in any of the assessed components. However, when analyzing the results of each component according to the criteria of the Fitnessgram, we observed that, regardless of the classification group, less than half of the children achieved scores that, according to the motor tests, would classify them as having a healthy fitness. Children with sDCD, mDCD and wDCD presented similar levels of health-related physical fitness, with an unsatisfactory performance for the component strength and muscular endurance. We therefore emphasize the importance of further research in this area, more particularly when it comes to following the development of motor skills and physical fitness in children with DCD, as well as the observation of the interactions between these variables over time.
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Affiliation(s)
- Roseane O Nascimento
- University Nilton Lins, Manaus, AM, Brazil; Laboratory Motor of Behavior, Physical Education and Sport School of University of São Paulo, Brazil.
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van Deutekom AW, Chinapaw MJM, Vrijkotte TGM, Gemke RJBJ. Study protocol: the relation of birth weight and infant growth trajectories with physical fitness, physical activity and sedentary behavior at 8-9 years of age - the ABCD study. BMC Pediatr 2013; 13:102. [PMID: 23835159 PMCID: PMC3710272 DOI: 10.1186/1471-2431-13-102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/01/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low birth weight and accelerated infant growth have been identified as independent risk factors for childhood and adult obesity and cardiovascular disease. This led to the 'Developmental Origins of Health and Disease' (DOHaD) hypothesis, stating that environmental factors during pregnancy and early postnatal life affect disease risk in later life. There is growing evidence that perinatal factors may influence adult health through the programming of energy balance regulation, including sedentary behavior and physical activity. The present study focuses on the influence of birth weight and infant growth on physical fitness, physical activity and sedentary behavior in 8-9 year old children, as this might partly explain the higher obesity and cardiovascular risk associated with low birth weight and accelerated infant growth. In addition, this study provides the opportunity for a validation study of a linguistic and cross-cultural translated physical activity questionnaire compared to accelerometer data. This article describes the study protocol for this study. METHODS/DESIGN This is a study embedded in the Amsterdam Born Children and their Development (ABCD) birth cohort. In 200 children of Dutch ethnicity, physical fitness, physical activity and sedentary behavior were assessed at age 8-9. We measured aerobic fitness using the 20 meter multistage shuttle run test, and neuromuscular fitness using the standing broad jump and handgrip strength test. Sedentary behavior and physical activity levels were measured using accelerometry. All children also completed a translated physical activity questionnaire, the scores of which will be compared to accelerometry data to assess the construct validity of the questionnaire in Dutch school-aged children. DISCUSSION This study will be the first population-based prospective cohort study to address the association of both prenatal and postnatal growth with physical fitness and objectively-assessed physical activity and sedentary behavior. This will contribute to a better understanding of the way perinatal growth relate to lifestyle and obesity in later life. The results may guide both future studies in the field of DOHaD, and public health strategies in the prevention of childhood obesity.
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Affiliation(s)
- Arend W van Deutekom
- Department of Pediatrics, EMGO Institute for Health & Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, the Netherlands
| | - Mai JM Chinapaw
- Department of Public and Occupational Health, EMGO institute for Health & Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Tanja GM Vrijkotte
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinoud JBJ Gemke
- Department of Pediatrics, EMGO Institute for Health & Care Research, VU University Medical Center, Amsterdam, the Netherlands
- Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, the Netherlands
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Danks M, Burns YR, Gibbons K, Gray PH, O'Callaghan MJ, Poulsen L, Watter P. Fitness limitations in non-disabled extremely low birthweight adolescents. J Paediatr Child Health 2013; 49:548-53. [PMID: 23751052 DOI: 10.1111/jpc.12281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2013] [Indexed: 11/28/2022]
Abstract
AIM This study aims to compare non-disabled otherwise healthy extremely low birthweight (ELBW) (<1000 g) children and term-born peers in an investigation of relationship between cardiorespiratory endurance and parent report of competence. METHODS Forty-eight of 105 eligible ELBW 11- to 13-year-old children (27 male) and 55 term-born school peers (28 male) completed a 20-m shuttle run, anthropometric measures, respiratory function tests and the Motor Assessment Battery for Children. Parents completed the Child Behavior Checklist (CBCL). RESULTS The ELBW group had poorer cardiorespiratory endurance (P = 0.002), growth (P = 0.002), respiratory function (P = 0.003) and motor ability (P < 0.001) than term-born peers. Parents reported the ELBW children to be less competent than term-born peers: CBCL total T score mean difference -9, 95% confidence interval -14, -5 (P < 0.001). Cardiorespiratory endurance predicted competence (regression coefficient 0.865; 95% confidence interval 0.352, 1.378; P = 0.001) independent of prematurity, growth, respiratory function, motor score, gender and socio-economic status. Cardiorespiratory endurance had association with social competence for all participating children, but was related to CBCL Activities Competence only for the ELBW children who were the significantly less fit group. CONCLUSIONS The poor cardiorespiratory endurance prevalent in non-disabled otherwise healthy ELBW children is associated with general competence independent of prematurity and of the impact of other mild physical deficits, gender or socio-economic status. The relationship demonstrated between cardiorespiratory endurance and competence to engage in general activities of daily living, seen only in the less fit ELBW children, identifies the fitness levels in non-disabled ELBW children as a barrier to participation.
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Affiliation(s)
- Marcella Danks
- School of Health and Rehabilitation, The University of Queensland, Brisbane, QLD 4101, Australia.
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47
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Abstract
Outcome measures may be used for a variety of reasons by clinicians and researchers. This paper provides an overview on motor measures that can be used in research or practice and are classified within the International Classification of Functioning, Disability and Health or ICF. Specifically, body function measures of neuromusculoskeletal and movement-related functions are presented, as are mobility measures within the activity and participation domain of the ICF. Descriptions of measures within these categories and their psychometric properties are provided. Current challenges and future directions for motor measurement are delineated.
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Zanudin A, Gray PH, Burns Y, Danks M, Watter P, Poulsen L. Perinatal factors in non-disabled ELBW school children and later performance. J Paediatr Child Health 2013. [PMID: 23198852 DOI: 10.1111/jpc.12022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To determine the association between perinatal events and subsequent motor performance, cardiorespiratory endurance and respiratory function in non-disabled extremely low birthweight (ELBW) school children at 12 years of age. METHODS Forty-eight ELBW infants were included in this study. The Movement Assessment Battery for Children (MABC), VO(2) max score as a measure of cardiorespiratory endurance and respiratory function testing were performed and perinatal variables were extracted from the children's hospital files. Children with MABC score ≤ 15th centile were described as having suspect motor performance. Children were classified as being unfit with a VO(2) max > 1 standard deviation below the mean according to gender and age. Perinatal risk factors were explored as risk factors for motor outcome, cardiorespiratory endurance and respiratory function. RESULTS MABC category was significantly related with gender (P = 0.005) and chronic neonatal lung disease (P = 0.013). Multiple regression analysis showed motor outcome at 12 years to be independently related to male gender (P = 0.03) and chronic neonatal lung disease (P = 0.045). Sixty-five percent of all the children were identified as unfit. Chronic neonatal lung disease was significantly related to cardiorespiratory endurance (P = 0.03) and predicted VO(2) max at 12 years (P = 0.05). No perinatal factors were significantly related to respiratory function variables. CONCLUSION Male gender and chronic neonatal lung disease were associated with later motor outcome of ELBW school children. It is suggested that objective and consistent follow-up from childhood through preadolescence are important to address motor and fitness issues especially for male children born with ELBW.
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Affiliation(s)
- Asfarina Zanudin
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
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49
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Abstract
PURPOSE To explore the relationship between perinatal variables and motor performance in children who were born with extremely low birth weight (ELBW) and were nondisabled at 1 and 4 years. METHODS Children without neurological or cognitive impairment (n = 48) born weighing less than 1000 g between 1992 and 1994 were assessed at 1 and 4 years corrected age using the Neurosensory Motor Developmental Assessment (NSMDA). Scores were used to categorize motor performance as normal or abnormal. RESULTS Chronic lung disease (CLD) of prematurity, necrotizing enterocolitis (NEC), and patent ductus arteriosus were associated with NSMDA category at 1 year. Chronic lung disease, male gender, and NEC were associated with NSMDA category at 4 years. Multiple regression analyses revealed that CLD and NEC were independently associated with abnormal motor outcomes at 1 year. CONCLUSIONS Early assessment and motor therapy is recommended for infants with CLD, because of its effect on motor performance in this otherwise healthy group of children born with ELBW.
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Sustersic B, Sustar K, Paro-Panjan D. General movements of preterm infants in relation to their motor competence between 5 and 6 years. Eur J Paediatr Neurol 2012; 16:724-9. [PMID: 22727514 DOI: 10.1016/j.ejpn.2012.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 05/21/2012] [Accepted: 05/24/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The criteria for identification of children with high risk of cerebral palsy are well documented, but the early identification of children at highest risk of minor motor deficits remains less clear. AIM To analyze the correlation between the quality of general movements (GMs) from term to twenty weeks postterm age and the motor competence between 5 and 6 years of age. METHODS In the group of 45 preterm infants, the quality of GMs was assessed using Prechtl's method. The Movement Assessment Battery for Children (M-ABC) was used to test motor competence between 5 and 6 years of age. The correlations between GMs and M-ABC results were analyzed. RESULTS During writhing period, the sensitivity of GMs to identify children with definite motor problem was 0.86 for total impairment, 0.67 for manual dexterity, 0.89 for ball skills and 0.92 for balance. During fidgety period, the sensitivity was higher than during the writhing period: 1.00 for total impairment, 1.00 for manual dexterity, 1.00 for ball skills and 0.83 for balance, respectively. The specificity was low at both ages (total scoring 0.24 at term and 0.21 at 3 months corrected age). CONCLUSION The sensitivity of GMs to identify children with definite motor problems is higher at the fidgety than at the writhing period. The specificity of GMs at the term and fidgety age to predict later motor abilities is low.
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