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Noij L, Terheggen-Lagro S, Muselaers E, Whittaker E, Gosling J, Brackel C, Oostrom K, Alsem M. A Multidisciplinary Approach: Management and Rehabilitation of Children With Pediatric Post-COVID-19 Condition. Pediatr Infect Dis J 2024; 43:880-884. [PMID: 38808972 PMCID: PMC11319073 DOI: 10.1097/inf.0000000000004408] [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] [Accepted: 04/17/2024] [Indexed: 05/30/2024]
Abstract
Post-COVID-19 condition in children is a still largely unknown syndrome with a diverse pattern of symptoms, which can have a major impact on daily life. Currently, there are no evidence-based proven treatments, and the focus is on symptom management and recovery of daily functioning. A multidisciplinary, tailored approach is recommended, with attention to energy management and activity building, where the main goal should be a return to baseline levels of cognitive, physical and social activity.
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Affiliation(s)
- Lieke Noij
- From the Department of Pediatric Pulmonology and Allergy, Emma Children’s Hospital, Amsterdam University Medical Centers
| | - Suzanne Terheggen-Lagro
- From the Department of Pediatric Pulmonology and Allergy, Emma Children’s Hospital, Amsterdam University Medical Centers
| | - Eefje Muselaers
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Elizabeth Whittaker
- Department of Pediatric Infectious Diseases, Imperial College Healthcare NHS Trust
- Section of Pediatric Infectious Diseases, Imperial College, London, United Kingdom
| | | | - Caroline Brackel
- From the Department of Pediatric Pulmonology and Allergy, Emma Children’s Hospital, Amsterdam University Medical Centers
- Department of Pediatrics, Tergooi MC, Hilversum, The Netherlands
| | - Kim Oostrom
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction & Development, Amsterdam University Medical Centers, Amsterdam
| | - Mattijs Alsem
- Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
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Takken T, Hulzebos EH. Practical Aspects of Cardiopulmonary Exercise Testing in Children. Int J Sports Med 2024; 45:403-410. [PMID: 37827506 PMCID: PMC11150037 DOI: 10.1055/a-2191-0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The use of cardiopulmonary exercise testing (CPET) in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Furthermore, CPET helps evaluate exercise performance in children with chronic (lung/heart) diseases. For instance, it can ascertain any adverse reaction to exercise and estimate the effects of specific treatment measures. It affords a global assessment of the pathophysiological patterns, responses and abnormalities to exercise that is inadequately reflected by resting lung function and/or cardiac function assessment. Clinical interpretation of the results of a CPET in pediatrics requires specific knowledge regarding pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child's medical condition or disability.
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Affiliation(s)
- Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, UMC Utrecht - Locatie WKZ, Utrecht, Netherlands
| | - Erik H Hulzebos
- Child Development & Exercise Center, Wilhelmina Children's Hospital, UMC Utrecht - Locatie WKZ, Utrecht, Netherlands
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3
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Warnink-Kavelaars J, de Koning LE, van der Hulst AE, Buizer AI, Poissonnier N, Wijninga LE, Menke LA, Mosquera LM, Rombaut L, Engelbert RHH. Physical fitness in children with Marfan and Loeys-Dietz syndrome: associations between cardiovascular parameters, systemic manifestations, fatigue, and pain. Eur J Pediatr 2024; 183:2421-2429. [PMID: 38466415 PMCID: PMC11035467 DOI: 10.1007/s00431-024-05456-z] [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: 11/28/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 03/13/2024]
Abstract
Children with Marfan (MFS) and Loeys-Dietz syndrome (LDS) report limitations in physical activities, sports, school, leisure, and work participation in daily life. This observational, cross-sectional, multicenter study explores associations between physical fitness and cardiovascular parameters, systemic manifestations, fatigue, and pain in children with MFS and LDS. Forty-two participants, aged 6-18 years (mean (SD) 11.5(3.7)), diagnosed with MFS (n = 36) or LDS (n = 6), were enrolled. Physical fitness was evaluated using the Fitkids Treadmill Test's time to exhaustion (TTE) outcome measure. Cardiovascular parameters (e.g., echocardiographic parameters, aortic surgery, cardiovascular medication) and systemic manifestations (systemic score of the revised Ghent criteria) were collected. Pain was obtained by visual analog scale. Fatigue was evaluated by PROMIS® Fatigue-10a-Pediatric-v2.0-short-form and PROMIS® Fatigue-10a-Parent-Proxy-v2.0-short-form. Multivariate linear regression analyses explored associations between physical fitness (dependent variable) and independent variables that emerged from the univariate linear regression analyses (criterion p < .05). The total group (MFS and LDS) and the MFS subgroup scored below norms on physical fitness TTE Z-score (mean (SD) -3.1 (2.9); -3.0 (3.0), respectively). Univariate analyses showed associations between TTE Z-score aortic surgery, fatigue, and pain (criterion p < .05). Multivariate analyses showed an association between physical fitness and pediatric self-reported fatigue that explained 48%; 49%, respectively, of TTE Z-score variance (F (1,18) = 18.6, p ≤ .001, r2 = .48; F (1,15) = 16,3, p = .01, r2 = .49, respectively). Conclusions: Physical fitness is low in children with MFS or LDS and associated with self-reported fatigue. Our findings emphasize the potential of standardized and tailored exercise programs to improve physical fitness and reduce fatigue, ultimately enhancing the physical activity and sports, school, leisure, and work participation of children with MFS and LDS. What is Known: • Marfan and Loeys-Dietz syndrome are heritable connective tissue disorders and share cardiovascular and systemic manifestations. • Children with Marfan and Loeys-Dietz syndrome report increased levels of disability, fatigue and pain, as well as reduced levels of physical activity, overall health and health-related quality of life. What is New: • Physical fitness is low in children with Marfan and Loeys-Dietz syndrome and associated with self-reported fatigue. • Our findings emphasize the potential of standardized and tailored exercise programs to improve physical fitness and reduce fatigue, ultimately enhancing the physical activity and sports, school, leisure, and work participation of children with Marfan and Loeys-Dietz syndrome.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
| | - Lisanne E de Koning
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, The Netherlands
| | - Annelies E van der Hulst
- Department of Pediatric Cardiology, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Nicole Poissonnier
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Laura E Wijninga
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Leonie A Menke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Laura Muiño Mosquera
- Department of Pediatrics, Division of Pediatric Cardiology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, Ghent, Belgium
| | - Lies Rombaut
- Center for Medical Genetics, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, Ghent, Belgium
| | - Raoul H H Engelbert
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, PO box 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
- Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Tafelbergweg 51, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Bourchtein E, McLaughlin A, Walainis K, Hughes A, Scott EL, Foxen-Craft E. Psychological predictors of performance-based physical functioning among pediatric pain program participants. J Pediatr Rehabil Med 2024:PRM220132. [PMID: 38427508 DOI: 10.3233/prm-220132] [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] [Indexed: 03/03/2024] Open
Abstract
PURPOSE The purpose of the present study was to evaluate changes in performance-based physical functioning and investigate psychological predictors of physical functioning over time in pediatric patients with chronic pain who completed an interdisciplinary rehabilitation intensive outpatient program (IOP). METHODS Participants (N = 55; mean age = 14.92 years; 12.7% male, 87.3% female; 83.6% White, 5.6% African-American/Black; 9.1% Latinx) completed baseline measures assessing pain intensity and modifiable psychological factors (i.e., pain catastrophizing, kinesiophobia, anxiety and depressive symptoms). Participants were administered performance-based assessments of physical functioning (i.e., physical endurance, high-level motor abilities) before and after IOP completion. RESULTS Pain intensity was not significantly associated with physical functioning at either timepoint. There was significant improvement on measures of physical functioning after completion of the IOP when controlling for the effects of sex, race, and ethnicity. Depressive symptoms were associated with baseline physical endurance, β = - .28, p = .047, while pain catastrophizing was associated with baseline gross motor abilities, β = - .28, p = .032. CONCLUSION Participation in an IOP led to significant improvement in physical endurance and high-level motor ability. Depressive symptoms and pain catastrophizing were associated with physical functioning at baseline but not post-program completion. Integration of pain psychology and physical therapy in an IOP can help address the interrelated psychological and physical factors impacting physical functioning to improve outcomes for children with chronic pain.
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Affiliation(s)
- Elizaveta Bourchtein
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alix McLaughlin
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Kimberly Walainis
- Ambulatory Rehabilitation Therapies Department, Michigan Medicine, Ann Arbor, MI, USA
| | - Amanda Hughes
- Ambulatory Rehabilitation Therapies Department, Michigan Medicine, Ann Arbor, MI, USA
| | - Eric L Scott
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Emily Foxen-Craft
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
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Conroy KE, Islam MF, Jason LA. Pediatric pain rehabilitation during the COVID-19 pandemic: exploring the effectiveness of a hybrid intensive interdisciplinary pain treatment model. Disabil Rehabil 2023; 45:3079-3086. [PMID: 36129253 PMCID: PMC9437146 DOI: 10.1080/09638288.2022.2125083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/29/2022] [Accepted: 09/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aimed to (1) examine improvements in rehabilitation outcomes after participation in a pediatric hybrid intensive interdisciplinary pain treatment model (50% in-person and 50% video-based telehealth) and (2) compare magnitude of hybrid model improvements to patients treated in a traditional, 100% in-person model prior to the pandemic. MATERIALS AND METHODS Rehabilitation outcomes for 33 youth with chronic pain from the model were compared to 33 youth with chronic pain who completed a traditional, in-person model. Improvements between admission and discharge in both models were examined using paired student t-tests. Independent samples t-tests compared change scores for the hybrid and traditional models. RESULTS Participants in both models experienced significant improvements on all rehabilitation outcomes, including cardiovascular endurance, pain interference, functional disability, and occupational performance (p < 0.001), except for pain intensity (p = 0.15). Change scores for rehabilitation outcomes did not significantly differ between models. CONCLUSIONS Quantitatively, hybrid model rehabilitation outcomes appeared clinically equivalent to the traditional, in-person model. Qualitative and psychosocial outcome comparisons of each model are warranted to better understand challenges and barriers associated with hybrid pain treatment models. The feasibility and impact of tools to enhance telehealth, such as actigraphy or virtual reality, should also be explored.IMPLICATIONS FOR REHABILITATIONThis study supports the efficacy of video-based telehealth interventions for children and adolescents with chronic pain syndromes.Disability outcomes for a hybrid (50% in-person, 50% video-based telehealth) intensive interdisciplinary pain treatment program appear to be equivalent to patients treated within a fully in-person program.
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Affiliation(s)
- Karl E. Conroy
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Mohammed F. Islam
- Department of Psychology, Chicago State University, Chicago, IL, USA
| | - Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
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Faigenbaum AD, Kang J, DiFiore M, Finnerty C, Garcia A, Cipriano L, Bush JA, Ratamess NA. A Comparison of Warm-Up Effects on Maximal Aerobic Exercise Performance in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14122. [PMID: 36361000 PMCID: PMC9658710 DOI: 10.3390/ijerph192114122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to compare the warm-up effects of treadmill walking (TW) with a dynamic (DY) bodyweight warm-up on maximal aerobic exercise performance in children. Sixteen children (10.9 ± 1.5 vrs) were tested for peak oxygen uptake (VO2 peak) on 2 nonconsecutive days following different 6 min warm-up protocols. TW consisted of walking on a motor-driven treadmill at 2.2 mph and 0% grade whereas the DY warm-up consisted of 9 body weight movements including dynamic stretches, lunges, and jumps. Maximal heart rate was significantly higher following DY than TW (193.9 ± 6.2 vs. 191.6 ± 6.1 bpm, respectively; p = 0.008). VO2 peak (54.8 ± 9.6 vs. 51.8 ± 8.7 mL/kg/min; p = 0.09), maximal minute ventilation (68.9 ± 14.8 vs. 64.9 ± 9.4 L/min; p = 0.27), maximal respiratory exchange ratio (1.12 ± 0.1 vs. 1.11 ± 0.1; p = 0.85) and total exercise time (614.0 ± 77.1 vs. 605 ± 95.0 s; p = 0.55) did not differ significantly between DY and TM warm-ups, respectively. These findings indicate that the design of the warm-up protocol can influence the heart rate response to maximal aerobic exercise and has a tendency to influence VO2 peak. A DY warm-up could be a viable alternative to a TW warm-up prior to maximal exercise testing in children.
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Ettema S, Oudenhoven LM, Roeleveld K, Buizer AI, van der Krogt MM. The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy. Gait Posture 2022; 93:7-13. [PMID: 35042058 DOI: 10.1016/j.gaitpost.2022.01.004] [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: 06/08/2021] [Revised: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Muscle fatigue of the lower limbs is considered a main contributor to the perceived fatigue in children with cerebral palsy (CP) and is expected to occur during prolonged walking. In adults without disabilities, muscle fatigue has been proposed to be associated with adaptations in complexity of neuromuscular control. RESEARCH QUESTION What are the effects of prolonged walking on signs of muscle fatigue and complexity of neuromuscular control in children with CP? METHODS Ten children with CP and fifteen typically developing (TD) children performed a standardised protocol on an instrumented treadmill consisting of three stages: six-minutes walking at preferred speed (6 MW), moderate-intensity walking (MIW, with two minutes at heart rate > 70% of predicted maximal heart rate) and four-minutes walking at preferred speed (post-MIW). Electromyography (EMG) data were analysed for eight muscles of one leg during three time periods: 6 MW-start, 6 MW-end and post-MIW. Signs of muscle fatigue were quantified as changes in EMG median frequency and EMG root mean square (RMS). Complexity of neuromuscular control was quantified by total variance accounted for by one synergy (tVAF1). Muscle coactivation was assessed for antagonistic muscle pairs. RESULTS EMG median frequency was decreased at 6 MW-end and post-MIW compared to 6 MW-start in children with CP (p < 0.05), but not in TD children. In both groups, EMG-RMS (p < 0.01) and muscle coactivation (p < 0.01) were decreased at 6 MW-end and post-MIW compared to 6 MW-start. tVAF1 decreased slightly at 6 MW-end and post-MIW compared to 6 MW-start in both groups (p < 0.05). Changes were most pronounced from 6 MW-start to 6 MW-end. SIGNIFICANCE Children with CP presented signs of muscle fatigue after prolonged walking, while no effects were found for TD. Both groups showed minimal changes in tVAF1, suggesting signs of muscle fatigue are not associated with changes in complexity of neuromuscular control.
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Affiliation(s)
- Sanne Ettema
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, Netherlands; Department of Research and Development, Wijk aan Zee, Heliomare Netherlands.
| | - Laura M Oudenhoven
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, Netherlands.
| | - Karin Roeleveld
- Department of Neuromedicine and Movement Sciene, NTNU- Norwegian University of Science and Technology, N-7491 Trondheim, Norway.
| | - Annemieke I Buizer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, Netherlands; Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
| | - Marjolein M van der Krogt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, Netherlands.
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Mohammed MHH, Al-Qahtani MHH, Takken T. Effects of 12 weeks of recreational football (soccer) with caloric control on glycemia and cardiovascular health of adolescent boys with type 1 diabetes. Pediatr Diabetes 2021; 22:625-637. [PMID: 33745203 DOI: 10.1111/pedi.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/09/2021] [Accepted: 03/11/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To determine the effects of recreational football combined with caloric control on glycemia and cardiovascular health of adolescent boys with type 1 diabetes. BACKGROUND Though 12 weeks of physical activity alone improves the health of people with type 1 diabetes, there is little evidence that physical activity alone can improve glycemia in 12 weeks. RESEARCH DESIGN AND METHODS The participants were divided into four groups as follows: football with diet, football-only, diet-only, and the control groups. Each group consisted of 10 participants. The football with diet and the football-only groups had 1.5 h of football twice a week for 12 weeks. The following outcomes were measured before and after 12 weeks: Glycated hemoglobin, fasting blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and resting blood pressures. Changes were considered significant when p ≤ 0.050 and common language effect size ≤42% or common language effect size ≥58%. RESULTS Glycated hemoglobin decreased in the football with diet group (mean change (standard deviation) = -0.9 (1.0) %, p = 0.019, and common language effect size = 31.5%) and was different from the control group (p = 2.4 × 10-4 and common language effect size = 95.5%.). However, none of the intervention groups showed a clear change in blood lipids nor blood pressure. CONCLUSIONS 12 weeks of combined football with diet intervention provides the greatest improvement in glycemia in adolescent boys with type 1 diabetes.
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Affiliation(s)
| | | | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Shulman J, Smith A, Keysor J, Kenney A, Damice B, DeFabio R, Jervis K, Zurakowski D, Sethna N. Putting fitness to the test: clinical application of the Fitkids Treadmill Test in youth with chronic pain. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1779343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Julie Shulman
- Department of Physical and Occupational Therapy, Boston Children’s Hospital, Boston, MA, USA
- Interprofessional PhD in Rehabilitation Science Program, MGH Institute of Health Professions, Boston, MA, USA
| | - Allison Smith
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Julie Keysor
- Interprofessional PhD in Rehabilitation Science Program, MGH Institute of Health Professions, Boston, MA, USA
| | - Anne Kenney
- Department of Physical and Occupational Therapy, Boston Children’s Hospital, Boston, MA, USA
| | - Brittany Damice
- Department of Physical and Occupational Therapy, Boston Children’s Hospital, Boston, MA, USA
| | - Roxanne DeFabio
- Department of Physical and Occupational Therapy, Boston Children’s Hospital, Boston, MA, USA
| | - Kelsey Jervis
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Anesthesiology, Harvard Medical School, Boston, MA, USA
| | - Navil Sethna
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Anesthesiology, Harvard Medical School, Boston, MA, USA
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Acute Cardiometabolic Responses to Multi-Modal Integrative Neuromuscular Training in Children. J Funct Morphol Kinesiol 2019; 4:jfmk4020039. [PMID: 33467354 PMCID: PMC7739431 DOI: 10.3390/jfmk4020039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 12/18/2022] Open
Abstract
Integrative neuromuscular training (INT) has emerged as an effective strategy for improving health- and skill-related components of physical fitness, yet few studies have explored the cardiometabolic demands of this type of training in children. The aim of this study was to examine the acute cardiometabolic responses to a multi-modal INT protocol and to compare these responses to a bout of moderate-intensity treadmill (TM) walking in children. Participants (n = 14, age 10.7 ± 1.1 years) were tested for peak oxygen uptake (VO2) and peak heart rate (HR) on a maximal TM test and subsequently participated in two experimental conditions on nonconsecutive days: a 12-min INT protocol of six different exercises performed twice for 30 s with a 30 s rest interval between sets and exercises and a 12-min TM protocol of walking at 50% VO2peak. Throughout the INT protocol mean VO2 and HR increased significantly from 14.9 ± 3.6 mL∙kg-1∙min-1 (28.2% VO2 peak) to 34.0 ± 6.4 mL∙kg-1∙min-1 (64.3% VO2 peak) and from 121.1 ± 9.0 bpm (61.0% HR peak) to 183.5 ± 7.9 bpm (92.4% HR peak), respectively. While mean VO2 for the entire protocol did not differ between INT and TM, mean VO2 and HR during selected INT exercises and mean HR for the entire INT protocol were significantly higher than TM (all Ps ≤ 0.05). These findings suggest that INT can pose a moderate to vigorous cardiometabolic stimulus in children and selected INT exercises can be equal to or more metabolically challenging than TM walking.
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de Lima LRA, Silva DAS, do Nascimento Salvador PC, Alves Junior CAS, Martins PC, de Castro JAC, Guglielmo LGA, Petroski EL. Prediction of peak V˙ O 2 in Children and Adolescents With HIV From an Incremental Cycle Ergometer Test. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2019; 90:163-171. [PMID: 30908124 DOI: 10.1080/02701367.2019.1571676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/09/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE To examine the capacity of physiological variables and performance to predict peak oxygen consumption (peak V˙ O2) in children and adolescents living with HIV. METHOD Sixty-five children and adolescents living with HIV (30 boys) aged 8-15 years, participated in the study. Peak V˙ O2 was measured by breath-by-breath respiratory exchange during an incremental cycle ergometer until volitional exhaustion. Information on the time to exhaustion, maximal power output (Pmax), and peak heart rate (peak HR) were also recorded. RESULTS Predictive models were developed and all equations showed the ability of performance variables to predict peak V˙ O2. However, Model 1 was based only on Pmax by following equation: Y = 338.8302 + (Pmax [W] * 11.16435), R2 = 0.90 and standard error of estimation (SEE) = 180 ml ⋅ min-1. CONCLUSION The V˙ O2 peak can be predicted simply by the Pmax obtained from the incremental cycle ergometer test. This protocol is a valid and useful tool for monitoring the aerobic fitness of children and adolescents living with HIV, especially in resource-limited settings.
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12
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Kotte EMW, de Groot JF, Winkler AMF, Veenhof C, Takken T. Fitkids Treadmill Test: Clinical Utility and Factors Associated With Its Use Among Physical Therapists. Phys Ther 2019; 99:428-439. [PMID: 30690630 DOI: 10.1093/ptj/pzy142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 09/04/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although the Fitkids Treadmill Test (FTT) has been validated and normative values are available for healthy 6- to 18-year-old children and adolescents, these facts do not automatically imply uptake of the test in routine practice of physical therapists. OBJECTIVE The objectives of this study were to evaluate the utility of the FTT in different diagnostic groups and to explore potential factors affecting the use of the FTT in clinical practice. DESIGN Mixed methods with both quantitative and qualitative data were used in this study. METHODS Outcome parameters from the FTT were retrieved from the Fitkids database. For evaluation of the utility of the FTT, 2 indicators, exercise duration and maximal effort, were used. An online survey was sent to physical therapists in Fitkids practices to identify factors affecting the use of the FTT in clinical practice. RESULTS The proportion of children and adolescents in each of the diagnostic groups who reached the minimal duration of a maximal exercise test ranged from 94% to 100%. The proportion of participants who reached a peak heart rate ≥180 beats/min ranged from 46% for participants with cognitive, psychological, or sensory disorders to 92% for participants with metabolic diseases. The most important facilitator for use of the FTT was the fact that most physical therapists were convinced of the additional value of the FTT. The main barriers were therapists' attitudes (resistance to change/lack of experience) and, on the environmental level, the absence of a treadmill ergometer in physical therapist practice. LIMITATIONS Structured interviews would have provided more information on potential factors affecting the use of the FTT in clinical practice. CONCLUSIONS This study has shown the clinical utility of the FTT in different diagnostic groups in pediatric physical therapist practice. Responding to the factors identified in this study should enable improved uptake of the FTT in clinical practice.
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Affiliation(s)
- Elles M W Kotte
- Fitkids Foundation, Box 75751, 1070 AT Amsterdam, the Netherlands
| | - Janke F de Groot
- University of Applied Science, Utrecht, the Netherlands; Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; and Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Cindy Veenhof
- University of Applied Science; and University Medical Center Utrecht
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht
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Faigenbaum AD, Kang J, Ratamess NA, Farrell A, Golda S, Stranieri A, Coe J, Bush JA. Acute Cardiometabolic Responses to a Novel Training Rope Protocol in Children. J Strength Cond Res 2018; 32:1197-1206. [PMID: 29683913 DOI: 10.1519/jsc.0000000000002466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Faigenbaum, AD, Kang, J, Ratamess, NA, Farrell, A, Golda, S, Stranieri, A, Coe, J, and Bush, JA. Acute cardiometabolic responses to a novel training rope protocol in children. J Strength Cond Res 32(5): 1197-1206, 2018-The purpose of this study was to quantify the acute cardiometabolic responses to a novel training rope (TR) protocol in children. Fifteen boys (10.6 ± 1.4 years) were tested for peak oxygen uptake (V[Combining Dot Above]O2) on a treadmill and subsequently (2-7 days later) performed a progressive 10-minute protocol of 5 TR exercises (EX): EX1: standing side-to-side waves, EX2: seated alternating waves, EX3: standing alternating waves, EX4: jumping jacks, and EX5: double-arm slams. Participants performed 2 sets of each TR exercise for 30 seconds per set with a 30-second rest interval between sets and exercises. A 12.8-m TR (4.1 kg) was used for all trials, and a metronome was used to standardize cadence. Peak values for V[Combining Dot Above]O2 and HR during the treadmill test were 47.4 ± 8.8 ml·kg·min and 195.1 ± 6.6 b·min, respectively. During the TR protocol, mean V[Combining Dot Above]O2 and HR significantly increased (p ≤ 0.05) from set 1 of EX1 (10.3 ± 2.6 ml·kg·min and 103.2 ± 11.6 b·min, respectively) to set 2 of EX5 (30.0 ± 3.9 ml·kg·min and 168.6 ± 11.8 b·min, respectively). Percentage of peak V[Combining Dot Above]O2 and peak HR values attained during the TR protocol ranged from 21.5 to 64.8% and from 52.9 to 86.4%, respectively. These descriptive data indicate that TR exercise can pose a moderate to vigorous cardiometabolic stimulus in children and with proper supervision and instruction may serve as a worthwhile complement to youth fitness programs.
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Affiliation(s)
- Avery D Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey
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Fitkids Treadmill Test: Age- and Sex-Related Normative Values in Dutch Children and Adolescents. Phys Ther 2016; 96:1764-1772. [PMID: 27197825 DOI: 10.2522/ptj.20150399] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 05/03/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent research has shown that the Fitkids Treadmill Test (FTT) is a valid and reproducible exercise test for the assessment of aerobic exercise capacity in children and adolescents who are healthy. OBJECTIVE The study objective was to provide sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. DESIGN This was a cross-sectional, observational study. METHODS Three hundred fifty-six children and adolescents who were healthy (174 boys and 182 girls; mean age=12.9 years, SD=3.7) performed the FTT to their maximal effort to assess time to exhaustion (TTE). The least-mean-square method was used to generate sex- and age-related centile charts (P3, P10, P25, P50, P75, P90, and P97) for TTE on the FTT. RESULTS In boys, the reference curve (P50) showed an almost linear increase in TTE with age, from 8.8 minutes at 6 years of age to 16.1 minutes at 18 years of age. In girls, the P50 values for TTE increased from 8.8 minutes at 6 years of age to 12.5 minutes at 18 years of age, with a plateau in TTE starting at approximately 10 years of age. LIMITATIONS Youth who were not white were underrepresented in this study. CONCLUSIONS This study describes sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. These age- and sex-related normative values will increase the usefulness of the FTT in clinical practice.
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