Jumping into a Healthier Future: Trampolining for Increasing Physical Activity in Children

COPHYD (Corona Owed Physical Deficiency): The Impact of Lockdown on Cardiopulmonary Function in Paediatric Cardiology Patients

INTRODUCTION

Due to the Corona-lockdowns the closure of sports facilities and schools has led to a decline in physical activity (PA) for months. PA is essential for maintaining cardiopulmonary function assessed by peak oxygen uptake. Since peak oxygen uptake represents the best predictor for mortality and morbidity in children with congenital heart disease the impact of lockdowns on this parameter is vital.

METHODS

We evaluated retrospectively cardiopulmonary exercise data from our patient collective from before lockdown with twin-paired data from during lockdown. The twin-pairing was achieved by matching patients with similar heart disease, age, sex, and test method. Cardiopulmonary exercise testing was achieved on either the treadmill or the bicycle.

RESULTS

We were able to twin-pair 90 cases (26 twins with heart disease and 19 healthy twins). There was a significant decrease of cardiopulmonary function (V̇O2peak: 35.7±9.8 vs.30.4±10.6) in the heart disease cohort along with a significant decrease in peak oxygen pulse (13.3±4.1 vs. 11.4±4.5), and peak minute ventilation (V ̇E: 83.05±29.08 vs.71,49±24.96). The healthy children improved over the timeframe, but this only reached significance for peak minute ventilation (81.72±25.79 vs.97.94±31.4).

CONCLUSION

We observed a significant decline of peak oxygen uptake during lockdown in the group of congenital heart disease (CHD) patients. This involved a loss of cardiac function as well as pulmonary function. This could be explained by limited access to sports facilities and restriction of regular daily movement due to school closure and overprotection. Healthy children improved their pulmonary function. This might be an indication of an improvement of exercise during confinement.Aufgrund des Corona-Lockdowns hat die Schließung von Sportanlagen und Schulen über Monate zu einem Rückgang der körperlichen Aktivität geführt. Körperliche Aktivität ist für die Aufrechterhaltung der kardiopulmonalen Funktion, bewertet durch die maximale Sauerstoffaufnahme, unerlässlich. Da die maximale Sauerstoffaufnahme der beste Prädiktor für Mortalität und Morbidität bei Kindern mit angeborenen Herzerkrankungen ist, sind die Auswirkungen des Lockdowns auf diesen Parameter von entscheidender Bedeutung. Spiroergometriedaten unseres Patientenkollektivs aus der Zeit vor dem Lockdown wurde mit Daten von statistischen Zwillingen aus dem gleichen Kollektiv während des Lockdowns verglichen. Die Zwillingspaarung wurde erreicht, indem Patienten mit ähnlichen Herzerkrankungen, Alter, Geschlecht und Testmodalitäten verglichen wurden. Die Spiroergometrie wurde entweder auf dem Laufband oder auf dem Fahrrad durchgeführt. Insgesamt wurden 90 Datensätze verbunden (26 Zwillinge mit Herzkrankheit und 19 gesunde Zwillinge). In der Kohorte der Herzerkrankten konnte eine signifikante Verschlechterung der kardiopulmonalen Funktion (V̇O2peak: 35,7±9,8 vs. 30,4±10,6), des Spitzensauerstoffpulses (O2puls: 13,3±4,1 vs. 11,4±4,5) und der Spitzenminutenventilation (VE: 83,05 ± 29,08 vs. 71,49 ± 24,96) beobachtet werden. Die gesunden Kinder verbesserten sich im Laufe der Zeit, wobei der Anstieg nur bei der Spitzenminutenventilation (81,72±25,79 vs. 97,94 ± 31,4) signifikant war. in der Kohorte der Patienten mit angeborenen Herzerkrankungen (CHD) beobachteten wir einen deutlichen Rückgang der maximalen Sauerstoffaufnahme während des Lockdowns. Dies liegt begründet in einer Verschlechterung der Herz-, sowie der Lungenfunktion. Erklärung dafür könnte der begrenzte Zugang zu Sporteinrichtungen, sowie Einschränkungen der täglichen Bewegungsfreiheit durch Schulschließungen und Überbehütung sein. Gesunde Kinder konnten ihr Atemminutenvolumen während dem Lockdown steigern und zeigten einen Trend zu besserer Belastbarkeit. Dies könnte auf eine Zunahme der körperlichen Bewegung während des Lockdowns hindeuten.

Effects of Sports, Exercise Training, and Physical Activity in Children with Congenital Heart Disease-A Review of the Published Evidence

Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, need specific individualized training programs. This review article summarizes the current knowledge regarding the clinical effects of sports and exercise training on CHD and its pathophysiologic mechanisms. An evidence-based approach based on a literature search, using PubMed, Medline, CINHAL, Embase, and the Cochrane Library was conducted, last completed on 30 December 2021. In studies with 3256 CHD patients in total, including 10 randomized controlled trials, 14 prospective interventional trials, 9 observational trials, and 2 surveys, exercise training has been shown to improve exercise capacity and physical activity, motoric skills, muscular function, and quality of life. Sports and exercise training appears to be effective and safe in CHD patients. Despite being cost-efficient, training programs are currently scarcely reimbursed; therefore, support from healthcare institutions, commissioners of healthcare, and research-funding institutions is desirable. There is a strong need to establish specialized rehabilitation programs for complex CHD patients to enhance these patients' access to this treatment intervention. Further studies may be desirable to confirm these data to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms.

Three-Dimensional Foot Position Estimation Based on Footprint Shadow Image Processing and Deep Learning for Smart Trampoline Fitness System

In the wake of COVID-19, the digital fitness market combining health equipment and ICT technologies is experiencing unexpected high growth. A smart trampoline fitness system is a new representative home exercise equipment for muscle strengthening and rehabilitation exercises. Recognizing the motions of the user and evaluating user activity is critical for implementing its self-guided exercising system. This study aimed to estimate the three-dimensional positions of the user's foot using deep learning-based image processing algorithms for footprint shadow images acquired from the system. The proposed system comprises a jumping fitness trampoline; an upward-looking camera with a wide-angle and fish-eye lens; and an embedded board to process deep learning algorithms. Compared with our previous approach, which suffered from a geometric calibration process, a camera calibration method for highly distorted images, and algorithmic sensitivity to environmental changes such as illumination conditions, the proposed deep learning algorithm utilizes end-to-end learning without calibration. The network is configured with a modified Fast-RCNN based on ResNet-50, where the region proposal network is modified to process location regression different from box regression. To verify the effectiveness and accuracy of the proposed algorithm, a series of experiments are performed using a prototype system with a robotic manipulator to handle a foot mockup. The three root mean square errors corresponding to X, Y, and Z directions were revealed to be 8.32, 15.14, and 4.05 mm, respectively. Thus, the system can be utilized for motion recognition and performance evaluation of jumping exercises.

The Comparison of Anaerobic Power using Two Tests in Patients with Cystic Fibrosis and Healthy Children

ABSTRACT Purpose: Cystic fibrosis (CF), a progressive and multi-systemic disease, causes reduced anaerobic performance. This study aimed to compare anaerobic power using two tests (Counter-movement Vertical Jump and Wingate Anaerobic Test) in CF patients and healthy children. Material and Methods: Eighteen CF and 18 healthy children were included in this prospective study. Knee extensor muscle strength and body composition were assessed with a digital handheld dynamometer and Tanita-BC 418, respectively. Anaerobic power was evaluated with Wingate Anaerobic Test (WAnT) and Counter-movement Vertical Jump (CMJ) using a triaxial accelerometer (G-Walk). Results: Maximum concentric power, peak speed, impact force, take-off force, and jump height were significantly worse in the CF group than in their healthy peers (p