Abstracts - Pediatria

Nº de abstracts = 76

Modificado em 23 Fevereiro 2012

Randomized, controlled trial promotes physical activity and reduces consumption of sweets and sodium among overweight and obese adults.

Assunção, MC, Gigante DP, Cardoso MA, Sartorelli DS, Santos IS.: Nutrition research (New York, N.Y.)

201008 30(8):541-9. Department of Nutrition, School of Nutrition, Federal University of Pelotas. Rua Marechal Deodoro 1160. Pelotas, RS 96020220, Brazil.

The present study sought to assess the impact of an intervention to reduce weight and control risk factors of noncommunicable chronic diseases in overweight or obese adults who are users of primary and secondary healthcare units of the public health system of Pelotas, Brazil. We hypothesized that individuals who received an educational intervention regarding how to lose weight and prevent other noncommunicable chronic disease risk factors through nutrition would lose weight and acquire active habits during leisure time more frequently than individuals under regular care. Two hundred forty-one participants from the Nutrition Outpatient Clinic of the Medical Teaching Hospital of the Federal University of Pelotas, Brazil, aged 20 years or older and classified as overweight or obese were randomly allocated to either the intervention group (IG; n = 120) or control group (CG; n = 121). The IG received individualized nutritional care for 6 months, and the CG received individualized usual care of the health services. Intention-to-treat analyses showed that at 6 months, mean fasting glycemia and daily consumption of sweet foods and sodium were reduced, and the time spent on physical leisure activity was increased in IG. Analysis of adherence to the protocol of the study revealed that individuals from IG had lost more in body weight, waist circumference, and fasting glucose compared to the CG. Leisure time physical activity increased in IG. Individuals adhered equally to the dietetic recommendations, irrespective of the nutrition approach that was used.

Risks associated with exercise testing and sports participation in cystic fibrosis.

Ruf K, Winkler B, Hebestreit A, Gruber W, Hebestreit .: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society 2010 9(5):339-45. Children's Hospital of the University, University of Würzburg, Germany.

BACKGROUND: Severe adverse reactions (SARs) associated with physical exercise have not been systematically studied in cystic fibrosis (CF). METHODS: Two surveys were conducted to assess the incidence of exercise-related SARs: a caregiver survey asking for complications associated with exercise testing and in-hospital training therapy and a web-based patient survey asking for problems with exercise. RESULTS: 78 of 107 CF facilities caring for 4208 patients responded to the caregiver survey, 256 patients answered the web-based survey. No SARs were reported for 713 exercise tests. With in-hospital training, the yearly incidence of exercise-related SARs such as pneumothorax, cardiac arrhythmia, injury or hypoglycaemia was <1% each, the respective lifetime incidences reported by the patients were 0.8-6.3%. 67% of the patients reported no SARs with exercise. CONCLUSIONS: Exercise testing is safe in patients with CF. Despite the limitations in quality of data, the incidence of exercise-related SARs appears low in this population.

Physical fitness levels among European adolescents: the HELENA study. Br J Sports Med, 2011; 45:20-29.

F B Ortega, E G Artero, J R Ruiz, V España-Romero, D Jiménez-Pavón, G Vicente-Rodriguez, L A Moreno, Y Manios, L Béghin, C Ottevaere, D Ciarapica, K Sarri, S Dietrich, S N Blair, M Kersting,

D Molnar, M González-Gross, Á Gutiérrez, M Sjöström, M J Castillo, on behalf of the HELENA studyϕ

Objective To report sex- and age-specific physical fitness levels in European adolescents. Methods A sample of 3428 adolescents (1845 girls) aged 12.5–17.49 years from 10 European cities in Austria, Belgium, France, Germany, Greece (an inland city and an island city), Hungary, Italy, Spain and Sweden was assessed in the Healthy Lifestyle in Europe by Nutrition in Adolescence study between 2006 and 2008. The authors assessed muscular fitness, speed/agility, flexibility and cardiorespiratory fitness using nine different fitness tests: handgrip, bent arm hang, standing long jump, Bosco jumps (squat jump, counter movement jump and Abalakov jump), 4×10-m shuttle run, back-saver sit and reach and 20-m shuttle run tests. Results The authors derived sex- and age-specific normative values for physical fitness in the European adolescents using the LMS statistical method and expressed as tabulated percentiles from 10 to 100 and as smoothed centile curves (P₅, P₂₅, P₅₀, P₇₅ and P₉₅). The figures showed greater physical fitness in the boys, except for the flexibility test, and a trend towards increased physical fitness in the boys as their age increased, whereas the fitness levels in the girls were more stable across ages. Conclusions The normative values hereby provided will enable evaluation and correct interpretation of European adolescents' fitness status.

Sports concussion in the child and adolescent athlete.

Nesmith JD.: The Journal of the Arkansas Medical Society, 201011 107(6):111-4.

Sports concussions are common among children and adolescents, and recent evidence suggests that concussions are more serious injuries than previously thought. Young athletes appear to recover from concussion more slowly than older athletes. Recovery is prolonged if these athletes return to play or school prematurely, and reinjury increases their risk of more serious sequelae. These newer data on concussions have raised our appreciation of this injury and have informed the development of more conservative treatment guidelines for the child and adolescent athlete. The purpose of this JAMS article is to review the new evidence and the most recent management guidelines regarding sports concussion in the young athlete.

Effects of aerobic exercise on overweight children's cognitive functioning: a randomized controlled trial.

Davis CL, Tomporowski PD, Boyle CA, Waller JL, Miller PH, Naglieri JA, Gregoski M.: Research quarterly for exercise and sport, 200712 78(5):510-9. Department of Pediatrics, Medical College of Georgia, USA.

The study tested the effect of aerobic exercise training on executive function in overweight children. Ninety-four sedentary, overweight but otherwise healthy children (mean age = 9.2 years, body mass index 85th percentile) were randomized to a low-dose (20 min/day exercise), high-dose (40 min/day exercise), or control condition. Exercise sessions met 5 days/week for 15 weeks. The Cognitive Assessment System (CAS), a standardized test of cognitive processes, was administered individually before and following intervention. Analysis of covariance on posttest scores revealed effects on executive function. Group differences emerged for the CAS Planning scale (p = .03). Planning scores for the high-dose group were significantly greater than those of the control group. Exercise may prove to be a simple, yet important, method of enhancing aspects of children's mental functioning that are central to cognitive and social development.

Secular trends in muscular fitness among Finnish adolescents.

Huotari PR, Nupponen H, Laakso L, Kujala UM.: Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland.

AIM: To investigate secular change over time in health-related muscular fitness and how leisure time physical activity (LTPA), sport club participation, and body mass index are associated with muscular fitness in adolescents. METHODS: Two cross-sectional samples of Finnish 13-16-year-old adolescents were studied in 1976 (n = 643; 312 boys and 331 girls) and in 2001 (n = 579; 308 boys and 271 girls). Muscular fitness index was calculated as the sum of age- and sex-specific z-scores of four tests measuring muscular fitness and agility. Height and weight were also measured. Self-reported weekly frequency of LTPA of at least 30-min duration and regularity of participation in organised sport were obtained by questionnaire. Identical methods were used in 1976 and 2001. RESULTS: Muscular fitness index was higher in 2001 than in 1976 in both boys (by 0.77 points, p = 0.008, effect size d = 0.17, small difference) and girls (1.01 points, p = 0.004, d = 0.20, small difference). Sport club participation, body mass index, and participation in LTPA together explained more of the muscular fitness index variance in 2001 than in 1976 in both boys (coefficient of determination from 0.10 to 0.24) and girls (from 0.25 to 0.40). CONCLUSIONS: The muscular fitness of 13-16-year old adolescents slightly improved over time. Organised LTPA showed a stronger association with muscular fitness in 2001 than in 1976. Due to increased polarisation in fitness, in health promotion more attention should be paid on adolescents' health-related fitness and its association to LTPA.

An activity-based intervention for obese and physically inactive children organized in primary care: feasibility and impact on fitness and BMI A one-year follow-up study.

Sola K, Brekke N, Brekke M.: Scandinavian journal of primary health care, 201012 28(4):199-204. Trekanten legesenter, Kristiansand, Norway.

OBJECTIVE: To investigate the feasibility and impact on BMI and physical fitness of an intervention for obese and inactive children, based on physical activity and carried out in primary health care. DESIGN: A prospective, longitudinal one-year follow-up study. SETTING: The community of Kristiansand, Norway (80 000 inhabitants). INTERVENTION: A 40-week structured intervention based on physical training with some lifestyle advice for the obese child and one parent. Subjects. A total of 62 physically inactive children aged 6-14 years with iso-BMI = 30 kg/m². MAIN OUTCOME MEASURES: Body mass index (BMI), maximum oxygen uptake, and physical fitness in tests of running, jumping, throwing, and climbing assessed at baseline and after six and 12 months as well as number of dropouts and predicting factors. RESULTS: A total of 49 out of 62 children completed the first six months and 37 children completed 12 months. Dropout rate was higher when parents reported being physically inactive at baseline or avoided physical participation in the intervention. The children's maximum oxygen uptake increased significantly after 12 months from 27.0 to 32.0 ml/kg/min (means), as did physical fitness (endurance, speed, agility, coordination, balance, strength) and BMI was significantly reduced. CONCLUSION IMPLICATIONS: This one-year activity-based intervention for obese and inactive children performed in primary health care succeeded by increasing cardiovascular capacity and physical fitness combined with reduced BMI in those who completed. Dropout was substantial and depended on the attendance and compliance with physical activity by the parents.

Longer breastfeeding is associated with increased lower body explosive strength during adolescence.

Artero EG, Ortega FB, EspaÃ±a-Romero V, Labayen I, Huybrechts I, Papadaki A, Rodriguez G, Mauro B, Widhalm K, Kersting M, Manios Y, Molnar D, Moreno LA, SjÃ¶strÃ¶m M, Gottrand F, Castillo MJ, De Henauw S.: The Journal of nutrition, 201011 140(11):1989-95. EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada SP-18012, Spain.

Our aim in this study was to examine the association between breastfeeding duration and cardiorespiratory fitness, isometric strength, and explosive strength during adolescence. A total of 2567 adolescents (1426 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study aged 12.5-17.5 y were included. Information about duration of any and exclusive breastfeeding was obtained retrospectively by means of a parental questionnaire. The 20-m shuttle run, handgrip strength, and standing long jump tests were used to assess physical fitness. Significant differences among the categories of breastfeeding duration were tested using ANCOVA after adjusting for a set of potential confounders: gestational and current age, birth weight, sexual maturation, fat mass, fat-free mass, maternal education, parental weight status, country, smoking behavior, and days of vigorous physical activity. Longer breastfeeding (either any or exclusive) was associated with a higher performance in the standing long jump test in both boys and girls (P < 0.001), regardless of fat mass, fat-free mass, and the rest of potential confounders. In adolescents who were breastfed for 3-5 mo or =6 mo, the risk of having a standing long jump performance below the 5th percentile was reduced by half compared with those who were never breastfed [odds ratio (OR) = 0.54, 95% CI = 0.30-0.96, P < 0.05; and OR = 0.40, 95% CI = 0.22-0.74, P < 0.01, respectively). These findings suggest a role of breastfeeding in determining lower body explosive strength during

Exercise for children with chronic kidney disease and end-stage renal disease. Clapp EL, Bevington A, Smith AC

Pediatric nephrology (Berlin, Germany)

27(2):165-72, 2012 It is well known that adults suffering from chronic kidney disease (CKD) experience muscle wasting and excessive fatigue, which results in a reduced exercise capacity and muscle weakness compared to their healthy counterparts, but research suggests that this can be improved through exercise. There is very limited data available regarding exercise tolerance in children with CKD and even less on the effects of exercise training programs. However, the available evidence does suggest that like adults, children also suffer from poor exercise capacity and reduced muscle strength, although the reasons for these limitations remain unclear. Studies that have attempted to implement exercise training programs in pediatric CKD populations have experienced high dropout rates, suggesting that the approach used to implement such programs in children needs to be different from the approach used for adults. This review summarizes the current knowledge regarding exercise capacity and muscle strength in children with CKD, the methods used to perform these assessments, and the possible causes of physical limitations. The results of exercise training studies, and the potential reasons as to why training programs have proved relatively unsuccessful are also discussed.

Associations between the school environment and adolescent girls' physical activity. Kirby J, Levin KA, Inchley J

Health education research

27(1):101-14, 2012This paper explores school sports facility provision, physical education allocation and opportunities for physical activity and their association with the number of days adolescent girls participate in at least 60 min of moderate-vigorous physical activity per week (MVPAdays). Data were collected through self-administered questionnaires from Scottish secondary school girls (n = 1978) and head teachers (n = 123) participating in the Health Behaviour in School-aged Children 2005/06 study. The best predictor of adolescent girls' MVPAdays was hours allocated to PE in fourth year of secondary school (ß = 0.27, 95% CI 0.06-0.48). Having shower facilities resulted in decreased MVPA (ß = -0.51, CI -0.90 to -0.12), as did providing less than two team sports clubs (ß = -0.69, CI -1.28 to -0.10), compared with schools who provided four or more. Compared with schools with no after school clubs, girls who attended schools with activities at least 1 day per week were likely to have increased MVPAdays. PE allocation and extra-curricular clubs are likely to be of greater importance to girls' participation than school facilities per se. This study demonstrates how schools can maximize their environment to increase girls' PA and offers encouraging findings for those with limited sports facilities.

Prenatal and childhood growth and leisure time physical activity in adult life. Salonen MK, Kajantie E, Osmond C, ForsÃ©n T, YlihÃ¤rsilÃ¤ H, Paile-HyvÃ¤rinen M, Barker DJ, Eriksson JG

European journal of public health 21(6):719-24, 2011 Dez BACKGROUND: Physical activity plays an important role in prevention of chronic diseases. Animal studies have suggested that lifestyle and exercise habits may have a prenatal origin. Our aim was to assess the role of early growth on leisure time physical activity (LTPA) in later life among 57-70-years-old men and women.

METHODS: We examined 2003 individuals born in Helsinki, Finland between 1934 and 1944. Of them, 1967 individuals with adequate information on their LTPA in adult life were included in this study. LTPA was assessed by a validated exercise questionnaire (KIHD Study 12 month physical activity history). Subjects' birth and serial growth measurements were obtained from birth, child welfare and school health records.

RESULTS: Participants with higher engagement in LTPA showed a more favourable adult anthropometric and body composition profile than those who were less active. LTPA was positively associated with adult social class. Higher weight and length at birth, and weight at 2 years after adult BMI adjustment, predicted higher intensity of total LTPA (P?=?0.04, P?=?0.01 and P?=?0.03), respectively. Higher height at 2, 7 and 11 years predicted higher intensity of conditioning LTPA (P?=?0.01, P?=?0.04 and P?=?0.004). Higher weight and height at 2, 7 and 11 years predicted higher energy expenditure (EE) of total LTPA (P-values being from 0.01 to 0.03). Furthermore, higher height at 2 and 11 years predicted higher EE of conditioning LTPA (P?=?0.02 and P?=?0.03).

CONCLUSION: People who as children were taller and weighed more engage more in leisure time physical activity in late adulthood.

Exercise in a child with systemic lupus erythematosus and antiphospholipid syndrome. Prado DM, Gualano B, Pinto AL, Sallum AM, Perondi MB, Roschel H, Silva CA

Medicine and science in sports and exercise 43(12):2221-3, 2011 Dez 1Pediatric Rheumatology Unit, School of Medicine, University of São Paulo, São Paulo, BRAZIL; 2School of Physical Education and Sport, University of São Paulo, São Paulo, BRAZIL; and 3Rheumatology Division, School of Medicine, University of São Paulo, São Paulo, BRAZIL.

UNLABELLED: Exercise training has emerged as a potential therapeutic strategy to counteract the decline in physical function and aerobic capacity in pediatric rheumatic disease.

PURPOSE: We report for the first time on the effects of exercise training in juvenile systemic lupus erythematosus (JSLE) and antiphospholipid syndrome (APS).

METHODS: A 15-yr-old boy with JSLE and APS treated with warfarin, azathioprine, and prednisone underwent a 12-wk aerobic exercise training program to improve his physical capacity and functioning. Before and after the 12-wk exercise program, the patient was submitted to incremental cardiopulmonary tests to determine V?O2peak, peak and submaximal exercise intensity, and time to exhaustion. In addition, a 6-min square-wave test was performed for assessing metabolic parameters. Functioning was assessed by using the visual analog scale. Laboratory parameters of inflammation were also assessed at baseline and 48 h after the last training session.

RESULTS: All the cardiopulmonary parameters (e.g., V?O2max = +36.0%, time to exhaustion = +67.8%, peak exercise intensity = +16.7%) and the metabolic cost of movement (e.g., energy expenditure = -28.3% to -33.3%, V?O2 = -29.3% to -33.4%) were improved. Both disease activity and cumulative damage scores did not change after the intervention, and no evidence of exercise-induced exacerbation of inflammation was observed. Visual analog scale scores were also improved according to the patients' evaluation (before intervention = 8 vs after intervention = 10), parents' evaluation (before intervention = 8 vs after intervention = 10), and physicians' evaluation (before intervention = 6 vs after intervention = 9).

CONCLUSIONS: This is the first evidence that a 12-wk supervised aerobic training program can be safe and effective in improving aerobic conditioning and physical function in a patient with JSLE and APS. In light of these findings, the therapeutic effects of exercise training in pediatric rheumatic diseases merit further investigations.

Exercise intervention for management of obesity. Deusinger SS

Pediatric blood & cancer 58(1):135-9, 2012 JanWashington University School of Medicine, St. Louis, Missouri. Este endereço de e-mail está protegido de spam bots, pelo que necessita do Javascript activado para o visualizar .

Obesity touches the lives of most Americans regardless of age. In adults, accrual of co-morbidities, including frank disability, impacts health in ways that mandate aggressive public health action. In children, the rising prevalence of overweight and obesity raises serious prospective concerns for life as these children enter adulthood. Action is imperative to provide medical interventions and preventive strategies to reduce the threat this condition poses to future generations. Obesity primarily results from an energy regulation imbalance within the body; understanding its origin and effects requires considering both the intake (via eating) and output (via moving) of energy. This article focuses on how exercise and physical activity (i.e., energy output) can influence the primary condition of obesity and its health sequelae. Components, strategies, and expected outcomes of exercise and lifestyle activity are addressed. Successful long-term participation in daily movement requires matching exercise regimens and physical activity outlets to individual preferences and environmental conditions. Activity habits of Americans must change at home and in the workplace, schools and the community to positively influence health. Although the goals of Healthy People 2010 to reduce sedentary behavior have not been met, success of other public health interventions (e.g., immunizations, use of bicycle helmets) suggests that social change to alter activity habits can be achieved. Failure to reach our public health goals should serve as a catalyst for broad-based action to help children, adolescents, and adults attain and maintain behaviors that reduce the risk of obesity and its health insults. Pediatr Blood Cancer 2012; 58: 135-139. © 2011 Wiley Periodicals, Inc.

Economic burden of physical activity-related injuries in Dutch children aged 10-12. Collard DC, Verhagen EA, van Mechelen W, Heymans MW, Chinapaw MJ

.: Bristish Journal Sports Medicine, 2011,10 - 45(13):1058-63.Background Injuries in children occur most often in physical activity-related activities. A lot of these injuries result in direct and indirect costs. A detailed overview of the economic burden of those injuries in children is lacking. Method A prospective study was conducted with 996 children in Dutch primary schools to describe the economic burden of injuries that occur during organised sports, leisure time and physical education (PE) class activities. Injuries were continuously monitored by PE teachers during the school year 2006-2007. An injury was recorded if it occurred during PE class, leisure time or organised sports activity and caused the child to at least stop the current activity. If an injury was recorded, parents received a cost diary to report the direct and indirect costs of the child's injury. Costs were collected from a societal perspective. Results During one school year, a total of 119 injuries were reported by 104 children. The mean total costs as a result of an injury were €188±317. The mean direct costs as a result of an injury were much higher than the mean indirect costs (€131±213 and €57±159, respectively). The highest costs were found for upper extremity and leisure time injuries. Conclusion Physical activity-related injuries are common in children and result in medical costs. Injuries that lead to the highest costs are those that occur during leisure time activities and upper extremity injuries. Intervention programmes for children to prevent upper extremity injuries and leisure time activity injuries may reduce direct (ie, healthcare) and indirect costs. Trial registration: ISRCTN78846684.

Exercise Training Associated with Diet Improves Heart Rate Recovery and Cardiac Autonomic Nervous System Activity in Obese Children - Int J Sports Med 2010; 31(12): 860-865

Physical fitness levels among European adolescents: the HELENA study.

Br J Sports Med, 2011; 45:20-29. F B Ortega, E G Artero, J R Ruiz, V España-Romero, D Jiménez-Pavón, G Vicente-Rodriguez, L A Moreno, Y Manios, L Béghin, C Ottevaere, D Ciarapica, K Sarri, S Dietrich, S N Blair, M Kersting, D Molnar, M González-Gross, Á Gutiérrez, M Sjöström, M J Castillo, on behalf of the HELENA studyϕ

Sports concussion in the child and adolescent athlete.

Nesmith JD.: The Journal of the Arkansas Medical Society, 201011 107(6):111-4.

Effects of aerobic exercise on overweight children's cognitive functioning: a randomized controlled trial.

Secular trends in muscular fitness among Finnish adolescents.

Huotari PR, Nupponen H, Laakso L, Kujala UM.: Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland.

An activity-based intervention for obese and physically inactive children organized in primary care: feasibility and impact on fitness and BMI A one-year follow-up study.

Sola K, Brekke N, Brekke M.: Scandinavian journal of primary health care, 201012 28(4):199-204. Trekanten legesenter, Kristiansand, Norway.

Longer breastfeeding is associated with increased lower body explosive strength during adolescence.

Accelerometer-Determined Steps per Day in US Children and Youth

TUDOR-LOCKE, CATRINE; JOHNSON, WILLIAM D.; KATZMARZYK, PETER T.: Medicine & Science in Sports & Exercise: Dec 2010 - Volume 42 - Issue 12 - pp 2244-2250

Purpose: The 2005-2006 National Health and Nutrition Examination Survey collected accelerometer-defined step data in addition to activity counts. The accelerometer used (ActiGraph AM-7164) is known to detect more low-force steps than research-quality pedometers. This study extends similar research focused on adults in National Health and Nutrition Examination Survey. Its purpose is to provide the descriptive epidemiology of accelerometer-determined steps per day in US children (6-11 yr) and youth (12-19 yr), with and without censoring steps detected at <500 activity counts per minute, in an attempt to interpret these data against existing pedometer-based scales.

Methods: The analysis sample represents 2610 children and youth who had at least one valid day (i.e., at least 10 h) of monitoring. Means (SE) for steps per day were computed using all detected steps (i.e., uncensored) and again after disregarding those steps below 500 activity counts per minute (i.e., censored).

Results: US children average approximately 13,000 (boys) and 12,000 (girls) uncensored accelerometer-determined steps per day. Comparable values for male and female youth are 11,000 and 9000 uncensored accelerometer-determined steps per day, respectively. Censoring low-force steps reduces uncensored values by approximately 2600 steps per day overall, shifts distributions to the left, and shows that almost 42% of US male children and almost 21% of female children are sedentary as interpreted against expected values for steps per day in childhood using a pedometer-based scale.

Conclusions: Regardless of censoring or not, across age, the US data show a peak value at 6 yr followed by generally consistent declines in steps per day values throughout childhood and into youth.

Injuries to primary school pupils and secondary school students during physical education classes and in their leisure time

Videmsek M, Karpljuk D, Mlinar S, Mesko M, Stihec J.: Collegium Antropologicum, 2010, 34(3):973-80, Faculty of Sport, Ljubljana, Slovenia.

The study aimed to establish the frequency of injuries in primary and secondary schools during leisure time and physical education classes in school as well as in group and individual sports. The sample included 2842 pupils from nine primary schools and 1235 students from five secondary schools in Slovenia. The data were processed with the SPSS statistical software package and the frequencies and Crosstabs were calculated. The results showed that substantially more pupils and students were injured in their leisure time than during physical education classes. Girls were more frequently injured in group and individual sports practiced during physical education classes and in individual sports practiced in their leisure time, whereas boys suffered more injuries in group sports practiced in their leisure time. As regards group sports, pupils and students were most frequently injured while playing football in their leisure time whereas, during physical education classes, they suffered most injuries in volleyball, followed closely by basketball and football; as regards individual sports, pupils and students were most frequently injured while cycling and rollerblading in their leisure time, whereas during physical education classes they suffered most injuries in athletics.

Bone properties in child and adolescent male hockey and soccer players

Falk B, Braid S, Moore M, Yao M, Sullivan P, Klentrou N.: Journal of Science and Medicine in Sport / Sports Medicine Australia, 2010, 13(4):387-91. Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.

Children and adolescents who train extensively in high-impact, weight-bearing activities have enhanced bone mineral density. The purpose of this study was to evaluate bone strength, as reflected by quantitative ultrasound (QUS, Sunlight Omniscence), of child (10-12 yrs old) and adolescent (14-16 yrs old) male soccer and hockey players in comparison with age-matched controls. The groups included 30 child (CH) and 31 adolescent (AH) hockey players, 26 child (CS) and 30 adolescent (AS) soccer players, as well as 34 child (CC) and 31 adolescent (AC) healthy, non-athletic, age-matched controls. All athletes trained at an elite level year-round, with no difference in training volume between groups. Ultrasound speed of sound (SOS) was measured at the distal-radius and mid-tibia. In both age groups, hockey players were the heaviest and had the highest fat-free mass. No differences were found among groups in total energy intake, calcium or vitamin D intake. Radial and tibial SOS increased with age. Hockey players had higher radial SOS in both age groups (children: CH:3763+/-74, CS:3736+/-77, CC:3721+/-88 m/s; adolescents: AH:3809+/-105, AS:3767+/-85, AC:3760+/-94 m/s). Tibial SOS was higher in soccer players compared with controls. In spite of the higher body mass and fat-free mass in hockey players, their tibial SOS was similar to the non-athletes in both age groups. These findings support previous suggestions of sport-specific effects on bone strength. However, they need to be corroborated with longitudinal or prospective intervention studies.

A growth curve to model changes in sport participation in adolescent boys.

Maia JA, Lefevre J, Claessens AL, Thomis MA, Peeters MW, Beunen GP.: Scandinavian journal of medicine & science in sports, 2010, 20(4):679-85. CIFID and Faculty of Sport, University of Porto, Porto, Portugal.

The aims of this study are twofold: (1) to present the latent growth model, its strategy and usefulness in modelling sport participation over a 6-year period in youngsters (2) and to study the impact of biological maturation in sport participation changes. A standardized sport participation questionnaire using h/week/year as the unit of analysis was applied to 588 Belgium boys 13-18 years of age followed longitudinally for 6 years. Skeletal age was used to estimate biological maturation. Growth curve modelling with robust estimation was used. Sport participation changes showed a curvilinear trend: baseline values (3.18+/-0.13 h/week/year), a linear trend that indicates the rate of change (0.70+/-0.11) and a quadratic trend indicating deceleration, i.e. a change in the rate of change (-0.07+/-0.02) were all statistically significant (P<0.05), as well as inter-individual differences in these three parameters. Up to 16.8 years, the rate of sports participation increased 0.70 h/week/year and then declined. Biological maturation did not show any association with adolescent changes in sport participation.

Clinical management of musculoskeletal injuries in active children and youth.

Mazer, Barbara, Shrier, Ian, Feldman, Debbie Ehrmann: Clinical Journal of Sport Medicine : official journal of the Canadian Academy of Sport Medicine, 2010, 20(4):249-55. McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada.

OBJECTIVE: To describe how different health care specialists manage musculoskeletal injury in children and examine factors influencing return to play decisions. DESIGN: National survey. SETTING: Secure Web site hosting online questionnaire. PARTICIPANTS: Medical doctors, physical therapists, and athletic therapists who were members of their respective sport medicine specialty organizations. INDEPENDENT VARIABLES: Professional affiliation and the effect of the following factors were examined: pushy parent, cautious parent, protective equipment, previous injury, musculoskeletal maturity, game importance, position played, team versus individual sport, and time since injury. MAIN OUTCOME MEASURES: Recommendation of return to activity after common injuries seen in children and adolescents as described in 5 vignettes; consistency of responses across vignettes. RESULTS: The survey was completed by 464 respondents (34%). There were several differences between the professional groups in their recommendations to return to activity. Most factors studied did not tend to influence the decision to return to activity, although protective equipment often increased the response to return sooner. The number of participants who would return a child to activity sooner or later for each factor varied greatly across the 5 vignettes, except for pushy parent or cautious parent. CONCLUSIONS: Management practices of sport medicine clinicians vary according to profession, child, clinical factors, and sport-related factors. Decisions regarding return to play vary according to 5 specific characteristics of each clinical case. These findings help establish areas of consensus and disagreement in the management of children with injuries and safe return to physical activity.

Six-minute walk test in children with chronic conditions.

J Hassan, J van der Net, P J M Helders, B J Prakken, T Takken, British Journal of Sports Medicine, 2010, 44(4):270-4. Child Development & Exercise Centre, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Room KB 02.056.0, PO Box 85090, 3508 AB Utrecht, The Netherlands.

OBJECTIVES: The 6-minute walk test (6MWT) is a frequently used indicator of functional exercise capacity. The goals of this study were to compare the 6-minute walk performance of three paediatric patient groups with that of healthy peers, to assess differences between published reference values and to investigate which anthropometric characteristics best predict 6-minute walk performance. METHODS: 47 children with haemophilia (mean (SD) age 12.5 (2.9) years), 44 with juvenile idiopathic arthritis (JIA) (mean age 9.3 (2.2) years) and 22 with spina bifida (SB) (mean age 10.3 (3.1) years) were included. Subjects performed a 6MWT, and the distance walked (6MWD) was compared with published reference values. RESULTS: The haemophilia, JIA and SB patients achieved 90%-92%, 72%-75% and 60%-62% of predicted walking distances, respectively. There were significant associations between 6MWD and age, height and weight in the haemophilia group and 6MWD and height in the JIA group. None of the anthropometric variables was significantly related to 6MWD in the SB group. All anthropometric variables were strongly correlated with walking distance-body weight product (6Mwork) in all groups. Height explained 24% (haemophilia) and 11% (JIA) of the variance in 6MWD and 84% (haemophilia), 78% (JIA) and 73% (SB) of the variance in 6Mwork. CONCLUSIONS: Walking distances of children with haemophilia, JIA and SB are significantly reduced compared with healthy references. Walking distance-body weight product seems to be a better outcome measure of the 6MWT compared with distance walked alone. Height is the best predictor of 6MWD and 6Mwork.

Management of blunt duodenal and pancreatic injuries in children (about a series of 8 cases)

Ben Hassine L, Boughanmi N, Douira W, Mormeche J, Louati H, Hamzaoui M, Chaouachi B, Bellagha I.: La Tunisie médicale, 2010, 88(8):586-92. Service de Tadiologie Pédiatrique, Hôpital d'Efants de Tunis.

AIM: The aim of this retrospective study is to report eight cases of blunt duodeno-pancreatic trauma in infants, emphasizing on the role of imaging in acute assessment of the lesions and in further management. METHODS: We reported eight cases of duodeno-pancreatic injuries between 2006 and 2008, 5 boys and 3 girls with an age ranging from 3 to 12 years (median age: 7 years). Trauma circumstances were: car accident (n=2), domestic injury (n=5) and bicycle's fall injury (n=1). All patients underwent abdominal ultrasonography and CT scan in the initial evaluation and during the follow-up. RESULTS: Imaging showed the following pancreatic lesions: 3 corporeal fractures, 2 caudal fractures and one between the corporeal and the caudal portions. Four pancreatic haematomas were found. The associated lesions were duodenal, splenic, hepatic and renal. Two isolated duodenal haematomas were found. Two patients improved spontaneously, the six others developed complications: 4 acute pancreatitis, two infections, 3 pseudocysts and one retroperitoneal collection. Management was chirurgical in one case, medical in two cases, endoscopic in 2 cases and three percutaneaous drainages were performed. CONCLUSION: Blunt duodeno-pancreatic injuries in children have to be evaluated by an early imaging modality, in order to perform acute assessment of the lesions. Primary conservative treatment is advocated while clinic, biologic and imaging follow-up is required to detect complications, which management can be endoscopic, percutaneous or surgical.

Sustained participation in youth sport decreases metabolic syndrome in adulthood

Yang X, Telama R, Hirvensalo M, Viikari JS, Raitakari OT.: International journal of obesity (2005), 2009, 33(11):1219-26. LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland.

OBJECTIVE: to explore the effect of organized youth sport on metabolic syndrome (MetS) in adulthood. DESIGN: Longitudinal study data from the cardiovascular risk in young Finns study. SUBJECTS: A total of 1493 males (n=704) and females (n=789) aged 3, 6, 9, 12, 15 and 18 years were randomly selected from five university towns and their rural surroundings in 1980. They were followed up for 21 years. In 2001 they were 24, 27, 30, 33, 36 and 39 years old. MEASUREMENTS: Youth sports participation data (participation in sport-club training and competitions) were assessed in 1980 and 1983 using a self-report questionnaire completed in connection with a medical examination. Participants were divided into athletes and non-athletes at each measurement point, and then classified into four groups: Persistent athlete, Starter, Leaver and Non-athlete. A mean score of youth sport was assessed by calculating the average of four consecutive measurements (1980-1989). MetS risk in 2001 was defined as a categorical variable based on the guidelines of the European Group for the Study of Insulin Resistance (EGIR) and as a continuous MetS-score variable by summing the z-scores of individual metabolic variables. RESULTS: In males and females, intense participation in youth sports over 3 years was inversely and significantly associated with clustered MetS score and prevalence of MetS defined by EGIR in adulthood (P<0.05). The association remained significant after adjustment for age, baseline clustered MetS score, smoking and total caloric intake and after additional adjustments for adult leisure-time physical activity. Starters during 3 years were less likely to have MetS than non-athletes. Leavers were at a higher risk for MetS than persistent athletes. These associations were attenuated in males by adjustment for all potential confounders. Similar associations were found using EGIR MetS as an outcome. CONCLUSIONS: Sustained participation in organized sport lasting at least 3 years in youth is associated with reduced risk for developing MetS in adulthood.

Infant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy.

Voisin C, Sardella A, Marcucci F, Bernard A

.: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology, 2010, 36(1):41-.7 Dept of Public Health, Catholic University of Louvain, Louvain, Belgium.

Recent studies suggest that swimming in chlorinated pools during infancy may increase the risks of lower respiratory tract infection. The aim of the present study was to assess the influence of swimming in chlorinated pools on the risks of bronchiolitis and its late consequences. A total of 430 children (47% female; mean age 5.7 yrs) in 30 kindergartens were examined. Parents completed a questionnaire regarding the child's health history, swimming practice and potential confounders. Attendance at indoor or outdoor chlorinated pools ever before the age of 2 yrs was associated with an increased risk of bronchiolitis (OR 1.68; 95% CI 1.08-2.68; p = 0.03), which was exposure-dependent for both types of pool (p-value for trend 20 h spent in chlorinated pools during infancy. Infant swimmers who developed bronchiolitis also showed higher risks of asthma and respiratory allergies later in childhood. Swimming pool attendance during infancy is associated with a higher risk of bronchiolitis, with ensuing increased risks of asthma and allergic sensitization.

Comparison of technical and physiological characteristics of prepubescent soccer players of different ages.

Fernandez-Gonzalo R, De Souza-Teixeira F, Bresciani G, García-López D, Hernández-Murúa JA, Jiménez-Jiménez R, De Paz JÁ.: Journal of strength and conditioning research / National Strength & Conditioning Association, 2010, 24(7):1790-8. Department of Biomedical Sciences, University of León, León, Spain.

Although soccer is one of the most widely played sports around the world, studies about young players and the success factors in soccer are still scarce. Therefore, the purpose of this study was to offer some insight into the factors contributing to success in this sport and to describe how physiological and technical performance evolves in young soccer players. Soccer technical skills during match play, maximum voluntary isometric contraction and power of lower limbs, jumping ability and endurance parameters were assessed in 30 prepubescent male soccer players with the same experience in soccer training. Subjects were divided into 2 groups of 15 children, a younger group (YG), aged 9.4 +/- 0.3 years, and an older group (OG), aged 11.8 +/- 0.2 years. Correlations between technical and physiological parameters were also described. Significant difference was set at p < 0.05. Differences between YG and OG appeared in physiological performance, mainly in VO(2)peak expressed in absolute values, VO(2) at different speeds, perceived exertion in treadmill test, jump performance, strength, and peak power of lower limbs. Among the technical skills measured, significant differences were found only in heading. The differences found between groups showed that most physical capacities that were measured here have an important increase during the first stages of puberty, pointing out that a specific training at these ages is necessary to get an appropriate basis for future performance. Besides, over 30% of the technical performance measured in this study can be explained with the physiological parameters. The data shown in this paper help to determine the most important capacities in youth soccer, which can facilitate the development of more appropriate selection models and trainings.

Are overweight and obese youth at increased risk for physical activity injuries?

Warsh J, Pickett W, Janssen I.:

Obesity facts, 2010, 3(4):225-30. Department of Community Health and Epidemiology, Queen's University, Kingston, ON, Canada.

OBJECTIVE: To determine whether relationships between physical activity and physical activity injuries are modified by BMI status in youth. METHOD: Data were obtained from the 2006 Canadian Health Behaviour in School-Aged Children survey; a representative study of 7,714 grade 6-10 youth. A sub-sample of 1,814 were re-administered the survey in 2007. Analyses considered relationships among the major variables in theory-driven cross-sectional and longitudinal analyses. RESULT: Among normal weight youth, cross-sectional analyses indicated that those who reported high levels of physical activity outside of school experienced 2.28 (95% confidence interval 1.95-2.68) the relative odds for physical activity injury in comparison to those with low levels of physical activity outside of school. Analogous odds ratios for overweight and obese youth were 1.89 (1.31-2.72) and 3.72 (1.89-7.33), respectively. BMI status was not an effect modifier of the relationship between physical activity and physical activity injury. Similar observations were made in the confirmatory longitudinal analyses. CONCLUSION: Concerns surrounding the design of physical activity programmes include side-effects such as injury risk. This study provides some re-assurance that physical activity participation relates to injury in a consistent manner across BMI groups.

Are standard behavioral weight loss programs effective for young adults?

Gokee-LaRose J, Gorin AA, Raynor HA, Laska MN, Jeffery RW, Levy RL, Wing RR.:

International journal of obesity (2005), 2009, 33(12):1374-80. Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, Brown Medical School and The Miriam Hospital, Providence, RI, USA.

OBJECTIVE: To compare the enrollment, attendance, retention and weight losses of young adults in behavioral weight loss (BWL) programs with older participants in the same trials. METHODS: Data were pooled from three NIH-funded adult BWL trials from two clinical centers in different regions of the country (total N=298); young adults were defined as those aged 18-35 years. Both young adults and adults were compared on session attendance, retention at the 6-month assessment, weight loss and physical activity at 6 months. RESULTS: Young adults represented 7% of the sample, attended significantly fewer sessions than did adults (52 vs 74%, respectively; P<0.001) and were less likely to be retained for the 6-month assessment (67 vs 95%, respectively; P<0.05). Controlling for demographic variables, study and baseline weight, the mean weight losses achieved were significantly less for young adults compared with adults (-4.3 kg (6.3) vs -7.7 kg (7.0), respectively; P or =5% weight loss at 6 months compared with older participants (8/21 (38%) vs 171/277 (62%); P<0.05). After controlling for session attendance, differences in the mean weight loss were not significant (P=0.81). Controlling for baseline values, study and demographics, changes in total physical activity over the initial 6 months of treatment were less for young adults compared with adults, but these differences only approached statistical significance (P=0.07). CONCLUSION: These data indicate that standard programs do not meet the weight control needs of young adults. Research is urgently required to improve recruitment and retention efforts with this high-risk group.

Does childhood and adolescence fracture influence bone mineral content in young adulthood?

Chantal E. Kawalilak, Adam D.G. Baxter-Jones, Robert A. Faulkner, Donald A. Bailey, and Saija A. Kontulainen: Appl. Physiol. Nutr. Metab. 35(3): 235–243 (2010) .
Abstract: Previous fracture may predispose an individual to bone fragility because of impaired bone mineral accrual. The primary objective of the study was to investigate the influence of fractures sustained during childhood and (or) adolescence on total body (TB), lumbar spine (LS), femoral neck (FN), and total hip (TH) bone mineral content (BMC) in young adulthood. It was hypothesized that there would be lower TB, LS, FN, and TH BMC in participants who had sustained a pediatric fracture. Participant anthropometrics, physical activity, and BMC (measured with dual energy X-ray absorptiometry) were assessed longitudinally during childhood and adolescence (from 1991 to 1997), and again in young adulthood (2002 to 2006). Sex, adult height, adult lean mass, adult physical activity, and adolescent BMC adjusted TB, LS, FN, and TH BMC in young adulthood, for those who reported 1 or more fractures (n = 42), were compared with those who reported no fractures (n = 101). There were no significant differences (p > 0.05) in adjusted BMC between fracture and nonfracture groups at the TB, LS, FN, and TH sites in young adulthood. These results suggest that fractures sustained during childhood and adolescence may not interfere with bone mass in young adulthood at clinically relevant bone sites.

Exploring the mechanisms of physical activity and dietary behavior change in the program x intervention for adolescents.

Lubans DR, Morgan PJ, Callister R, Collins CE, Plotnikoff RC.: The Journal of Adolescent Health : official publication of the Society for Adolescent Medicine, 2010, 47(1):83-91. School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan Campus, Callaghan, Newcastle, NSW 2308, Australia.

PURPOSE: The objective of this investigation was to examine the mechanisms of physical activity and dietary behavior change in the Program X intervention. METHODS: Program X involved a clustered randomized controlled design with six schools (N=124 participants, mean age=14.1+/-0.8 years) randomized to intervention or control conditions for the 6-month study period. Physical activity and fruit and vegetable consumption were assessed using pedometers and questionnaires, respectively. The theoretical framework of the intervention was assessed using structural equation modeling, mediation, and moderation analyses. RESULTS: The model explained 56% of the variance in physical activity at 6-months, but did not represent a good fit to the data, chi(2)=87.43, df=19, p < .001. The model explaining fruit and vegetable consumption explained 31% of the variance and provided a good fit to the data, chi(2)=12.40, df=10, p=.259. None of the variables satisfied the criteria for mediation or moderation in the physical activity model, but gender moderated the effects of intervention on fruit and vegetable consumption. CONCLUSIONS: None of the hypothesized mediators were responsible for behavior change in the Program X intervention. Future studies should address the limitations of existing psychosocial scales and continue to explore the mechanisms of behavior change using model testing, mediation, and moderation analyses.

Adolescents' physical activity: competition between perceived neighborhood sport facilities and home media resources.

Wong BY, Cerin E, Ho SY, Mak KK, Lo WS, Lam TH.: International Journal of Pediatric Obesity : IJPO : an official journal of the International Association for the Study of Obesity, 2010, 5(2):169-76. Department of Community Medicine and School of Public Health, University of Hong Kong, Pokfulam, Hong Kong SAR.

OBJECTIVE: To examine the independent, competing, and interactive effects of perceived availability of specific types of media in the home and neighborhood sport facilities on adolescents' leisure-time physical activity (PA). METHODS: Survey data from 34 369 students in 42 Hong Kong secondary schools were collected (2006-07). Respondents reported moderate-to-vigorous leisure-time PA, presence of sport facilities in the neighborhood and of media equipment in the home. Being sufficiently physically active was defined as engaging in at least 30 minutes of non-school leisure-time PA on a daily basis. Logistic regression and post-estimation linear combinations of regression coefficients were used to examine the independent and competing effects of sport facilities and media equipment on leisure-time PA. RESULTS: Perceived availability of sport facilities was positively (OR(boys) = 1.17; OR(girls) = 1.26), and that of computer/Internet negatively (OR(boys) = 0.48; OR(girls) = 0.41), associated with being sufficiently active. A significant positive association between video game console and being sufficiently active was found in girls (OR(girls) = 1.19) but not in boys. Compared with adolescents without sport facilities and media equipment, those who reported sport facilities only were more likely to be physically active (OR(boys) = 1.26; OR(girls) = 1.34), while those who additionally reported computer/Internet were less likely to be physically active (OR(boys) = 0.60; OR(girls) = 0.54). CONCLUSIONS: Perceived availability of sport facilities in the neighborhood may positively impact on adolescents' level of physical activity. However, having computer/Internet may cancel out the effects of active opportunities in the neighborhood. This suggests that physical activity programs for adolescents need to consider limiting the access to computer-mediated communication as an important intervention component.

Availability of sports facilities as moderator of the intention-sports participation relationship among adolescents.

Prins RG, van Empelen P, Te Velde SJ, Timperio A, van Lenthe FJ, Tak NI, Crawford D, Brug J, Oenema A.: Health education research, 2010 , 25(3):489-97. Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.

This longitudinal study aimed to identify individual and environmental predictors of adolescents' sports participation and to examine whether availability of sports facilities moderated the intention-behaviour relation. Data were obtained from the Environmental Determinants of Obesity in Rotterdam SchoolchildrEn study (2005/2006 to 2007/2008). A total of 247 adolescents (48% boys, mean age at follow-up 15 years) completed the surveys at baseline and follow-up. At baseline, adolescents completed a survey that assessed engagement in sports participation, attitude, subjective norm, perceived behavioral control and intention towards sports participation. Availability of sports facilities (availability) was assessed using a geographic information system. At follow-up, sports participation was again examined. Multiple logistic regression analyses were conducted to test associations between availability of sports facilities, theory of planned behavior variables and the interaction of intention by availability of sports facilities, with sports participation at follow-up. Simple slopes analysis was conducted to decompose the interaction effect. A significant availability x intention interaction effect [odds ratio: 1.10; 95% confidence interval: 1.00-1.20] was found. Simple slopes analysis showed that intention was more strongly associated with sports participation when sports facilities were more readily available. The results of this study indicate that the intention-sports participation association appears to be stronger when more facilities are available.

Tobacco advertising through French TV in 2005: frequent illicit broadcasting; its impact on teenagers and young adults.

Béguinot E, Gallopel-Morvan K, Wirth N, Spinosa A, Martinet Y.: Journal of Public Health (Oxford, England), 2010, 32(2):184-90. Comité National Contre le Tabagisme, Paris, France.

BACKGROUND: Sports sponsorship is one of the tobacco industry's main strategies to recruit new smokers among teenagers and young adults. METHODS: Monitoring Motor sports illicit broadcasting based on six channels in 2005; Dakar Rally (DR) and China Grand Prix impact evaluated with a one on one questionnaire administered on 12-24-year-old males and females (n = 805). RESULTS: 75,000 TV tobacco sponsoring appearances (90 h) were observed, total value: euro200.10(6); Mild Seven, Marlboro, West, Lucky Strike, Gauloises Blondes accounted for 92% appearances and 95% of euro values, with illegal broadcasting value worth euro19.10(6). A high interest in DR (71%) and Formula One (F1) (66%) was observed among males (versus females; P < 0.001), increasing with age (P < 0.05). Levels of spontaneous and assisted recall of cigarette brands were high among individuals interested in DR and F1, with better recall of brand names (versus non interested; P < 0.01); all individuals made correct associations between tobacco brands and car colors (P < 0.01). A non-significant higher percentage of daily smokers was observed among respondents interested in DR (34 versus 21%; P < 0.01) and F1 (30 versus 24%; P = 0.10). CONCLUSION: This high level of indirect advertising for tobacco through motor sport sponsoring confirms the urgent need for a worldwide absolute ban on tobacco advertising in motor sports.

Comparative analysis of the six-minute walk test in healthy children and adolescents

Aquino ES, Mourão FA, Souza RK, Glicério BM, Coelho CC.: Revista Brasileira de Fisioterapia, 2010, 14(1):75-80. Departamento de Ciências Biológicas, Ambientais e da Saúde, Centro Universitário de Belo Horizonte, Belo Horizonte, MG, Brasil. evanirso-

Objective: To perform a comparative analysis of the six-minute walk test in healthy children and adolescents in corridors of 30.5m (100 feet) 20m (65.6 feet) in length. Methods: We evaluated 67 participants (36 boys and 31 girls), aged 7 to 14 years old, from public schools of a city in a metropolitan area. All were submitted to four walking tests, two in each of the corridors. The variables analyzed were: walked distance, work rate, mean blood pressure, heart rate and oxygen saturation. Statistical analysis was performed using one-way ANOVA for repeated measures and significance level at p<0.05. Results: The comparison between the tests in each corridor and between the best tests in the different corridors did not show significant differences in the blood pressure, heart rate and oxygen saturation. The walked distance was not statistically different in the two tests on each corridor. However, the participants covered greater distances on the 30.5m corridor (p<0.05) compared to the best test between corridors. However, this increase was less than 10%. Regarding the cardiac overload and the work rate, there were no significant differences between the corridors. Conclusions: There were differences in walked distance between the corridors, however they were less than 10% with no significant changes in the other measured parameters. Therefore, the 20m corridor had a good reproducibility for the population of this study.

Physical activity and sedentary behavior among schoolchildren: a 34-country comparison.

Guthold R, Cowan MJ, Autenrieth CS, Kann L, Riley LM.: The Journal of Pediatrics, 2010, 157(1):43-49.e1. Department of Chronic Diseases and Health Promotion, WHO, Geneva, Switzerland.

Objective: To describe and compare levels of physical activity and sedentary behavior in schoolchildren from 34 countries across 5 WHO Regions. Study Design: The analysis included 72,845 schoolchildren from 34 countries that participated in the Global School-based Student Health Survey (GSHS) and conducted data collection between 2003 and 2007. The questionnaire included questions on overall physical activity, walking, or biking to school, and on time spent sitting. Results: Very few students engaged in sufficient physical activity. Across all countries, 23.8% of boys and 15.4% of girls met recommendations, with the lowest prevalence in Philippines and Zambia (both 8.8%) and the highest in India (37.5%). The prevalence of walking or riding a bicycle to school ranged from 18.6% in United Arab Emirates to 84.8% in China. In more than half of the countries, more than one third of the students spent 3 or more hours per day on sedentary activities, excluding the hours spent sitting at school and doing homework. Conclusions: The great majority of students did not meet physical activity recommendations. Additionally, levels of sedentariness were high. These findings require immediate action, and efforts should be made worldwide to increase levels of physical activity among schoolchildren.

Locomotor treadmill training for children with cerebral palsy.

Mattern-Baxter K.: Orthopaedic nursing / National Association of Orthopaedic Nurses, 2010, 29(3):169-73; quiz 174-5. Department of Physical Therapy, University of the Pacific, Stockton, CA, USA. Due to a rise in the incidence of cerebral palsy, this diagnosis is increasingly encountered by orthopaedic nurses. The majority of children with cerebral palsy have difficulty with ambulation. Because ambulation is important for orthopaedic and cardiopulmonary development, as well as independence with activities of daily living, the achievement of ambulation is an important therapeutic goal for these children. Locomotor treadmill training is a relatively new method that is used to teach children how to walk and make their ambulation more efficient. This article reviews the underlying principles of locomotor treadmill training and examines related literature for children with cerebral palsy.

Pediatric resistance training: benefits, concerns, and program design considerations.

Faigenbaum AD, Myer GD.: Current Sports Medicine Reports, 2010, 9(3):161-8. Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ 08628, USA.

A growing number of children and adolescents are involved in resistance training in schools, fitness centers, and Sports training facilities. In addition to increasing muscular strength and power, regular participation in a pediatric resistance training program may have a favorable influence on body composition, bone health, and reduction of Sports-related injuries. Resistance training targeted to improve low fitness levels, poor trunk strength, and deficits in movement mechanics can offer observable health and fitness benefits to young athletes. However, pediatric resistance training programs need to be well- ed and supervised by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents. The sensible integration of different training methods along with the periodic manipulation of programs design variables over time will keep the training stimulus effective, challenging, and enjoyable for the participants.

Sleep and effort in adolescent athletes.

Engle-Friedman M, Palencar V, Riela S.: Journal of Child Health Care : for professionals working with children in the hospital and community, 2010-06 14(2):131-41. Baruch College of the City University of New York, USA.

Adolescents' sleep and next day effort was studied in 18 female competitive adolescent athletes. A subjective assessment of the previous night's sleep, their perception of the difficulty of the choices offered and the difficulty of tasks selected was completed before routine lessons. Sleep amount was related to the perception of the difficulty of the task, while awakenings were related to an avoidance of the least preferred maneuvers. Individuals who experienced the greatest number of awakenings and most time awake at night were more likely to select the least difficult of these tasks. Sleep disturbance in adolescence may magnify the challenges they experience and cause them to underestimate their ability to meet those challenges.

Status of bone mineral content and body composition in boys engaged in intensive physical activity.

Madic D, Obradovic B, Smajic M, Obradovic J, Maric D, Boskovic K.: Vojnosanitetski pregled. Military-medical and pharmaceutical review, 2010-05 67(5):386-90. School of Sport and Physical Education, Novi Sad, Serbia.

BACKGROUND/AIM: It is well known that physical activity has an anabolic effect on bone tissue. But there is a lack of information about the effect of intensive physical activity in childhood, particularly at the prepubertal stage. To examine the influence of training on body composition and bone mineral density we have studied a group of prepubertal soccer players as well as a group of inactive prepubertal boys at the starting phase of their peak bone mass acquisition. METHODS: A total of 62 healthy prepubertal boys took part in this study. They were divided into two groups. The first one consisted of 32 soccer players (aged 10.7 +/- 0.5 years), who had been playing football for at least 1 year (10-15 h per week). The second group a control group 30 boys (aged 11.2 +/- 0.7 years) doing 1.5 h per week physical activity at school. Body composition was assessed by a Body Fat Analyzer "BES 200 Z". Bone mineral density measurements of the left and the right calcaneus were done by using ultrasound densitometer "Sahara" (Hologic, Inc., MA, USA). RESULTS: There were significant differences between soccer players and the control group in fat mass (p = 0.01). Besides, a significant difference was determined between the group of athletes and the control group in bone mineral density of both calcaneal bones (p = 0.01). CONCLUSION: The results of this study confirm the significant effects of physical activity on reducing body mass and increasing bone density. Considering that football training can be very easily implemented in the broader population of children and young people, which does not apply to many other sports, it should be used more in the prevention of obesity and osteoporosis.

Are children and adolescents less active if parents restrict their physical activity and active transport due to perceived risk?

Carver A, Timperio A, Hesketh K, Crawford D.: Social Science & Medicine (1982), 2010-06 70(11):1799-805. Deakin University, Burwood, VIC 3125, Australia.

The study examined parental restriction of children's active transport and physical activity outside school hours due to safety concerns, and how this restriction was associated with perceived risk and with youth physical activity levels. We used a cross-sectional design with data from children aged 10-11 years (n=170) and adolescents aged 15-17 years (n=270) who participated in the five-year follow-up of the Children Living in Active Neighbourhoods longitudinal study in Melbourne, Australia. Walking/cycling to local destinations was survey-reported. Moderate-to-vigorous physical activity (MVPA) was recorded during non-school hours using accelerometers. Using surveys, parents reported perceived risk of their children being harmed in their neighbourhood, and restrictions they placed on their children's physical activity. Linear regression analyses examined how perceived risk, constrained behaviour, and physical activity were related. We found that perceived risk did not vary by age-group and was positively associated with constrained behaviour among adolescents but not children. Children were subject to higher levels of constrained behaviour than adolescents. Constrained behaviour was negatively associated with active transport among younger boys and among girls in both age-groups. Furthermore, it was negatively associated with younger boys' MVPA on weekends and with adolescent girls' MVPA during evenings. There were no associations between constrained behaviour and active transport or MVPA among adolescent boys. The findings demonstrate that constrained behaviour exhibited by parents may result in lower levels of active transport and of MVPA outside school hours. In particular, this was true for children and adolescent girls. Social interventions to improve perceived safety and physical interventions involving redesign of the built environment to improve actual safety may help to ease parental restriction of their children's active transport and physical activity in their neighbourhood.

Correlation between 6-min walk test and exercise stress test in healthy children.

Limsuwan A, Wongwandee R, Khowsathit P.: Acta Paediatrica (Oslo, Norway : 1992), 2010-03 99(3):438-41. Division of Pediatric Cardiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

AIM: To investigate the correlation between 6-min walk test (SMWT) and incremental treadmill exercise stress test (EST) as indicators for the functional capacity in children. METHODS: Healthy children aged 9-12 years were included. The anthropometric data, SMWT and EST were prospectively measured using the standard protocols. Various parameters were analysed to define the correlation between SMWT and EST. RESULTS: A total of 100 subjects (53 boys) aged 10.3 +/- 1.0 years participated in the study. The SMWT distance was 586.1 +/- 44.0 m. Height (r = 0.59, R(2) = 35%), length of the leg (r = 0.64, R(2) = 41%), heart rate at the end of SMWT (r = 0.59, R(2) = 35%) and heart rate difference at the end of SMWT (r = 0.71, R(2) = 50%) were found to have significant correlation with SMWT distance. The estimated maximal oxygen consumption (eVO2) obtained during the EST tended to be greater in boys than in girls. Among the parameters obtained during EST, maximal heart rate (r = 0.33, R(2) = 11%) and the eVO2 (r = 0.54, R(2) = 53%) were found to have significant correlation with SMWT. CONCLUSIONS: SMWT distance is significantly correlated with the eVO2 obtained during the EST. This indicates that SMWT is also one of the predictive markers for EST performance.

Probability of walking, wheeled mobility, and assisted mobility in children and adolescents with cerebral palsy.

Palisano RJ, Hanna SE, Rosenbaum PL, Tieman B.: Developmental Medicine and Child Neurology,

2010, 52(1):66-71. Department of Physical Therapy, Rehabilitation Sciences, Drexel University, Philadelphia, PA 19102-1192, USA.

AIM: Our aim was to describe how the probability of walking, wheeled mobility, and assisted mobility changes with environmental setting and age in children and adolescents with cerebral palsy (CP). METHOD: The parents of a population-based sample of 642 children and adolescents (360 males, 282 females; age range 16mo-21y) reported their children's mobility at home, school, and outdoors at 6- or 12-month intervals a mean of 5.2 times. Generalized mixed-effects analyses were used to model the probabilities. RESULTS: By age 3 years, children with motor function classified as level I according to the Gross Motor Function Classification System (GMFCS) walked in all three settings. Children/adolescents classified as level V used assisted mobility, with a small number using wheeled mobility. In the case of children classified as GMFCS level II, the probability of walking varied with the environmental setting, which, at age 18, is outdoors 90% of the time. Among children classified as GMFCS level III, the probability of walking was highest at age 9 at school (68%), and at age 18 was approximately 50% in all three settings. Among children/adolescents rated as GMFCS level IV, the probability of wheeled mobility increased with age and, at age 18, 57% of mobility took place outdoors. INTERPRETATION: The results provide evidence that age and environmental setting influence method of mobility of children/adolescents with CP. The method that is preferred in one setting may not be preferred in another setting or at another age.

Cardiopulmonary fitness and endurance in children with developmental coordination disorder.

Wu SK, Lin HH, Li YC, Tsai CL, Cairney J.: Research in Developmental Disabilities, 2010 Mar-Apr 31(2):345-9 L. Institute of Sport Performance, National Taiwan College of Physical Education, Taiwan.

The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this study. The cardiopulmonary tests included the 800-m run test and the peak oxygen consumption (peak VO(2)) test using the Bruce treadmill protocol. No significant differences in age, body height, body weight, body mass index, and percentage of body fat between children with DCD and without DCD were found. However, there were significant differences in the cardiopulmonary endurance tests between children with DCD and without DCD. Children with DCD had significantly lower peak VO(2) results than children without DCD. In addition, children with DCD ran 800 m in a slower time than children without DCD. A significant negative correlation (r=-0.437) was found between the peak VO(2) results and time to completion for the 800-m run test. Based on the results, cardiopulmonary endurance in children with DCD was worse than that of children without DCD. Due to the small sample size in this study, the results may not be a direct reflection of the entire population.

Ñeurologia

Chronic traumatic encephalopathy (CTE) in a National Football League Player: Case report and emerging medicolegal practice questions.

Omalu BI, Chief Medical Examiner, San Joaquin County, California, USA.

We present a case of chronic traumatic encephalopathy (CTE) in a retired National Football League (NFL) Player with autopsy findings, apolipoprotein E genotype, and brain tissue evidence of chronic brain damage. This 44-year-old retired NFL player manifested a premortem history of cognitive and neuropsychiatric impairment, which included in part, chronic depression, suicide attempts, insomnia, paranoia, and impaired memory before he finally committed suicide. A full autopsy was performed with Polymerase Chain Reaction-based analyses of his blood to determine the apolipoprotein genotype. Histochemical and immunohistochemical analyses were performed on topographical gross sections of the brain. Autopsy confirmed a fatal gunshot wound of the head. The apolipoprotein E genotype was E3/E3 and the brain tissue revealed diffuse cerebral taupathy (Neurofibrillary Tangles and Neuritic Threads). This will be the third case of CTE in a national football player, which has been reported in the medical literature. Omalu et al., reported the first two cases in 2005 and 2006. This case series manifested similar premortem history of neuropsychiatric impairment with autopsy evidence of cerebral taupathy without any neuritic amyloidopathy. For a definitive diagnosis of CTE to be made, and for medicolegal purposes, a full autopsy must be performed with histochemical and immunohistochemical analyses of the brain to identify the presence of Neurofibrillary Tangles (NFTs) and Neuritic Threads (NTs). IMPLICATIONS: Further longitudinal prospective studies are required to confirm the common denominators and epidemiology of CTE in professional American football players, which have been identified by this case series.

Ongoing walking recovery 2 years after locomotor training in a child with severe incomplete spinal cord injury.

Fox EJ, Tester NJ, Phadke CP, Nair PM, Senesac CR, Howland DR, Behrman AL.: Physical Therapy,

201005 90(5):793-802. Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610-0154, USA.

Background and Purpose: The authors previously reported on walking recovery in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury (SCI) after 76 sessions of locomotor training (LT). Although clinical measures did not predict his recovery, reciprocal patterned leg movements developed, affording recovery of independent walking with a reverse rolling walker. The long-term functional limitations and secondary complications often associated with pediatric-onset SCI necessitate continued follow-up of children with SCI. Therefore, the Purpose of this case report is to describe this child's walking function and musculoskeletal growth and development during the 2 years since his participation in an LT program and subsequent walking recovery. Case description: Following LT, the child attended elementary school as a full-time ambulator. He was evaluated 1 month (baseline), 1 year, and 2 years after LT. Examination of walking function included measures of walking independence, gait speed and spatiotemporal parameters, gait kinematics, and daily step activity. Growth and development were assessed by tracking his height, weight, incidence of musculoskeletal complications, and gross motor task performance. Outcomes : Over the 2 years, the child continued to ambulate independently with a reverse rolling walker, increasing his fastest gait speed. Spatiotemporal and kinematic features of his walking improved, and daily step activity increased. Height and weight remained on their preinjury trajectory and within age-appropriate norms. The child experienced only minor musculoskeletal complications. Additionally, he gained the ability to use reciprocal patterned leg movements during locomotor tasks such as assisted stair climbing and independent tricycle pedaling. Conclusions : Two years after recovery of walking, this child with incomplete SCI had maintained and improved his walking function and experienced age-appropriate growth and development.

Talent development in adolescent team sports: a review.

Burgess DJ, Naughton GA.: International Journal of Sports Physiology and Performance, 201003 5(1):103-16. Australian Catholic University, Faculty of the Health Sciences, North Sydney, Australia.

Traditional talent development pathways for adolescents in team sports follow talent identification procedures based on subjective games ratings and isolated athletic assessment. Most talent development models are exclusive rather than inclusive in nature. Subsequently, talent identification may result in discontentment, premature stratification, or dropout from team sports. Understanding the multidimensional differences among the requirements of adolescent and elite adult athletes could provide more realistic goals for potential talented players. Coach education should include adolescent development, and rewards for team success at the adolescent level should reflect the needs of long-term player development. Effective talent development needs to incorporate physical and psychological maturity, the relative age effect, Objective measures of game sense, and athletic prowess. The influences of media and culture on the individual, and the competing time demands between various competitions for player training time should be monitored and mediated where appropriate. Despite the complexity, talent development is a worthy investment in professional team sport.

Judo injuries in children

Salanne S, Zelmat B, Rekhroukh H, Claudet I.: Archives de Pédiatrie : organe officiel de la Sociéte française de pédiatrie, 201003 17(3):211-8 . TSA 70034, urgences pédiatriques, hôpital des Enfants, 31059 Toulouse cedex 9, France.

Aims: Analyze the epidemiology and the distribution of judo injuries in a pediatric population. Patients and Methods: A retrospective study was conducted from May 2006 to May 2008, including all patients aged less than 15 years admitted to a tertiary-level pediatric emergency unit. The data collected were age, sex, geographic origin, time and day of admission, duration in the pediatric emergency department, body weight, type and location of injuries, and progression. For statistical analysis, data were entered in Microsoft Excel tables. In the descriptive analysis, data are presented as mean values with SD. To compare qualitative variables, a chi(2) test was used and the two-tailed Fisher exact test if the expected value was lesser or equal to 5. Statistical significance was considered at P<0.05. Results: During the study period, 173 patients were included, with a male:female ratio of 2.46. The mean age was 10.6+/-2.4 years. Most children were admitted during the weekend (59 %). The distribution of lesions was contusions (44 %), fractures (31 %), sprains (19 %), dislocations (3 %), and wounds (3 %). The upper extremities were more frequently affected than the lower extremities (46 % vs. 25 %), with a significant male prevalence (78 %) (P<0.0001), dominated by fractures (54 %), especially clavicle fractures (72 %). Compared to the other injuries, the male population had a significantly higher risk of fractures (P=0.04). Thirteen children required hospitalization for surgical repair of fractures. Conclusion: Frequent and often benign, judo accidents in children are different from adult injuries in their mechanisms and injury distribution. There is also an additional risk of growth plate damage. Risk factors have been attributed to an increased injury incidence: body weight loss over 5 % or overweight, age and judo experience, and male gender. During competition and training sessions, the evaluation and prevention of these factors could decrease the occurrence of such injuries.

Physical activity and walking onset in infants with Down syndrome.

Lloyd M, Burghardt A, Ulrich DA, Angulo-Barroso R.: Adapted Physical Activity Quarterly : APAQ

201001 27(1):1-16. The Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario Canada.

Infants with Down syndrome (DS) are described as being less active and they also experience significant delays in motor development. It is hypothesized that early infant physical activity may be influential for the acquisition of independent walking. Physical activity was monitored longitudinally in 30 infants with DS starting at an average age of 10 months participating in a treadmill training intervention. Actiwatches were placed on infants' trunk and right ankle for a 24-hr period, every other month until walking onset. Data were analyzed to separate sedentary-to-light activity (low-act) and moderate-to-vigorous activity (high-act). Results showed that more leg high-act at an average age of 12 and 14 months is related to earlier onset of walking. It is recommended that early leg activity should be promoted in infants with DS.

Athletics, minor trauma, and pediatric arterial ischemic stroke.

Sepelyak K, Gailloud P, Jordan LC.: European Journal of Pediatrics , 201005 169(5):557-62.Department of Neurology, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Baltimore, MD 21287, USA.

Pediatric arterial ischemic stroke may occur as the result of trivial head or neck trauma sustained during a sports activity. We describe three cases of sports-related stroke in previously healthy school-age children and discuss acute and long-term stroke care. Possible mechanisms of sports-related stroke are addressed, as is evaluation for cause of stroke in children. In one of the reported cases, the child was found to have a vertebral artery dissection as the cause of his stroke, but no definitive cause of stroke was identified in the other two cases despite extensive evaluation. The advisability and timing of returning to athletic activities after stroke is also discussed. Many children with sports-related stroke are initially seen by a sports trainer, a pediatrician, or an ER physician. Thus, it is particularly important that these professionals are aware of the possibility of ischemic stroke occurring after even mild athletic injury. Childhood stroke may result from injuries sustained during athletic activities and should be considered when a child has acute focal neurologic signs.

Fitness of Canadian children and youth: results from the 2007-2009 Canadian Health Measures Survey.

Tremblay MS, Shields M, Laviolette M, Craig CL, Janssen I, Gorber SC.: Health Reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information , 201003 21(1):7-20. Children's Hospital of Eastern Ontario Research Institute.

Background: The fitness of Canadian children and youth has not been measured in more than two decades, a period during which childhood obesity and sedentary behaviours have increased. This paper provides up-to-date estimates of the fitness of Canadians aged 6 to 19 years. DATA AND Methods: Data are from the 2007-2009 Canadian Health Measures Survey (CHMS), the most comprehensive direct health measures survey ever conducted on a nationally representative sample of Canadians. Descriptive statistics for indicators of body composition, aerobic fitness and musculoskeletal fitness are provided by sex and age group, and comparisons are made with the 1981 Canada Fitness Survey (CFS). Results: Fitness levels of children and youth have declined significantly and meaningfully since 1981, regardless of age or sex. Significant sex differences exist for most fitness measures. Fitness levels change substantially between ages 6 and 19 years. Youth aged 15 to 19 years generally have better aerobic fitness and body composition indicators than 20- to 39-year-olds. INTERPRETATION: This decline in fitness may result in accelerated chronic disease development, higher health care costs, and loss of future productivity.

Mechanical work performed by the legs of children with spastic diplegic cerebral palsy.

Kurz MJ, Stuberg WA, DeJong SL.: Gait & Posture, 201003 31(3):347-50. Munroe-Meyer Institute for Genetics and Rehabilitation, Physical Therapy Department, University of Nebraska Medical Center, Omaha, Nebraska, USA.

The Purpose of this investigation was to evaluate the work performed on the center of mass by the legs of children with cerebral palsy. 10 children that were diagnosed as having cerebral palsy with spastic diplegia (Age=9.1+/-2 years), and 10 healthy children with no walking disabilities participated (Age=9.4+/-2 years). We collected individual leg ground reaction forces from four force platforms, and calculated the mechanical work performed on the center of mass by the lead and trail legs. The normalized walking speeds were not significantly (p=0.33) different between the children with cerebral palsy (0.26+/-0.07) and the controls (0.28+/-0.06). The children with cerebral palsy performed significantly more negative work by the lead leg during double support (p=0.0004), and significantly less positive work by the trail leg (p<0.00001). During single support, the children with cerebral palsy performed significantly more positive work on the center of mass (p<0.00001). No significant differences were found for the amount of negative work performed by the leg in single support (p=0.84). Children with spastic diplegic cerebral palsy show a diminished ability to appropriately perform mechanical work by the legs to lift and redirect the center of mass. The altered mechanical work performed by the legs on the center of mass may play a role in the higher metabolic cost for walking noted in children with cerebral palsy.

Probability of walking, wheeled mobility, and assisted mobility in children and adolescents with cerebral palsy.

Palisano RJ, Hanna SE, Rosenbaum PL, Tieman B.: Developmental Medicine and Child Neurology , 201001 52(1):66-71. Department of Physical Therapy, Rehabilitation Sciences, Drexel University, Philadelphia, PA 19102-1192, USA. r

AIM: Our aim was to describe how the probability of walking, wheeled mobility, and assisted mobility changes with environmental setting and age in children and adolescents with cerebral palsy (CP). Method: The parents of a population-based sample of 642 children and adolescents (360 males, 282 females; age range 16mo-21y) reported their children's mobility at home, school, and outdoors at 6- or 12-month intervals a mean of 5.2 times. Generalized mixed-effects analyses were used to model the probabilities. Results: By age 3 years, children with motor function classified as level I according to the Gross Motor Function Classification System (GMFCS) walked in all three settings. Children/adolescents classified as level V used assisted mobility, with a small number using wheeled mobility. In the case of children classified as GMFCS level II, the probability of walking varied with the environmental setting, which, at age 18, is outdoors 90% of the time. Among children classified as GMFCS level III, the probability of walking was highest at age 9 at school (68%), and at age 18 was approximately 50% in all three settings. Among children/adolescents rated as GMFCS level IV, the probability of wheeled mobility increased with age and, at age 18, 57% of mobility took place outdoors. Interpretation: The results provide evidence that age and environmental setting influence method of mobility of children/adolescents with CP. The method that is preferred in one setting may not be preferred in another setting or at another age.

Cardiopulmonary fitness and endurance in children with developmental coordination disorder.

Wu SK, Lin HH, Li YC, Tsai CL, Cairney J.: Research in Developmental Disabilities , 2010 Mar-Apr 31(2):345-9 . Institute of Sport Performance, National Taiwan College of Physical Education, Taiwan.

The Purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this study. The cardiopulmonary tests included the 800-m run test and the peak oxygen consumption (peak VO(2)) test using the Bruce treadmill protocol. No significant differences in age, body height, body weight, body mass index, and percentage of body fat between children with DCD and without DCD were found. However, there were significant differences in the cardiopulmonary endurance tests between children with DCD and without DCD. Children with DCD had significantly lower peak VO(2) results than children without DCD. In addition, children with DCD ran 800 m in a slower time than children without DCD. A significant negative correlation (r=-0.437) was found between the peak VO(2) results and time to completion for the 800-m run test. Based on the results, cardiopulmonary endurance in children with DCD was worse than that of children without DCD. Due to the small sample size in this study, the results may not be a direct reflection of the entire population.

Modificado em 17 de Junho de 2010

Effects of water exercise swimming program on aquatic skills and social behaviors in children with autism spectrum disorders.

Pan CY.: Autism : The International Journal of Research and Practice, 2010, 14(1):9-28. Department of Physical Education, National Kaohsiung Normal University, Kaohsiung, Taiwan.

The Purpose of this study was to determine the effectiveness of a 10 week water exercise swimming program (WESP) on the aquatic skills and social behaviors of 16 boys with autism spectrum disorders (ASDs). In the first 10 week phase (phase I), eight children (group A) received the WESP while eight children (group B) did not. A second 10 week phase (phase II) immediately followed, with the treatments reversed. Both groups continued their regular treatment/ activity throughout the study. Improvements were seen in aquatic skills for both groups subsequent to the WESP. Following phase I, significant social improvements were seen in group A. Following phase II, social improvements were seen for group B, whereas group A merely maintained the improvements they attained through the implementation of the WESP during phase I. Results indicate that the WESP improved aquatic skills in the participants, and holds potential for social improvements.

Modificado em 03 de Junho de 2010

Soccer injuries in children.

Paterson A.: Pediatric Radiology, 2009, 39(12):1286-98. Radiology Department, Royal Belfast Hospital for Sick Children, Belfast, UK.

Soccer is the most popular sport in the world, with FIFA recognizing more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics.

Basketball injuries in children.

Gaca AM.: Pediatric Radiology, 2009, 39(12):1275-85. Division of Pediatric Radiology, Department of Radiology, Duke University Health Systems, Durham, NC 27710, USA.

Basketball is a popular, worldwide sport played outdoors and indoors year-round. Patterns of injury are related to abrupt changes in the athlete's direction, jumping, contact between athletes, the hard playing surface and paucity of protective equipment. Intensity of play and training in the quest of scholarships and professional careers is believed to contribute to an increasing occurrence of injury. Radiologists' appreciation of the breadth of injury and its relation to imaging and clinical findings should enhance the care of these children. Some of the patterns of injury are well known to radiologists but vary due to age- and size-related changes; the growing skeleton is affected by differing susceptibilities from biomechanical stresses at different sizes. Beyond screening radiographs, the accuracy of MRI and CT has improved diagnosis and treatment plans in this realm. Investigations to detect symptoms and signs in an attempt to prevent the tragedy of sudden cardiac death in basketball players may lead to MRI and CTA studies that compel radiologists to evaluate cardiac function along with myocardial and coronary artery anatomy. Worthy of mention also is the female athlete triad of disordered eating, amenorrhea, and osteoporosis that is observed in some young women participating in this and other sports.

Modificado em 31 de Maio de 2010

The nature and characteristics of abdominal injuries sustained during children's sports.

Noaman F, Lam LT, Soundappan SV, Browne GJ.: Pediatric Emergency Care, 2010, 26(1):30-5. Discipline of Emergency Medicine, Faculty of Medicine, The University of Sydney, Sydney, Australia.

Objective: To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries. DESIGN: A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006. Setting: The Children's Hospital at Westmead is a tertiary-level pediatric trauma center servicing Sydney's west. It sees approximately 50,000 patients a year. Participants: Only those injuries occurring during an organized sport were included for analysis. Thirty-three of the original 513 patients were eligible for inclusion. Main outcomes: The data collected included basic demographics, mechanism of injury, sport injury, time to presentation, length of stay, diagnoses, treatment, and complications. Injury severity scores were assigned retrospectively. Results: Males sustained more injuries than females. Collisions and falls were the most common modes of injury. Rugby was the most common sport for injury. Most patients presented within 12 hours, and most presented with musculoskeletal injuries. Injury severity was usually mild; treatment, conservative; length of stay, short; and complications, uncommon. When characteristics were compared by sex, males had mostly collision injuries in high-impact/contact sports, with females having more falls in other sports. When characteristics were compared by age, the only statistically significant difference was in the organ injured: older children had more single solid organ injuries, and younger children had more multiple and hollow viscus injuries. Conclusions: Sports-related abdominal injuries in children are mostly minor and not as common as other injury mechanisms. Despite this, they can be serious, with early diagnosis often delayed because of their subtle nature. Sports-related abdominal injuries in children require a high index of suspicion in the part of the clinician if they are to be recognized early and managed effectively.

Mountain biking injuries in children and adolescents.

Aleman KB, Meyers MC.: Sports Medicine (Auckland, N.Z.), 2010, 40(1):77-90. Human Performance Research Laboratory, Department of Sports and Exercise Sciences, West Texas A&M University, Canyon, Texas, USA.

Over the last decade, the sport of mountain biking has experienced extensive growth in youth participation. Due to the unpredictable nature of outdoor sport, a lack of rider awareness and increased participation, the number of injuries has unnecessarily increased. Many believe that the actual incidence of trauma in this sport is underestimated and is just the 'tip of the iceberg'. The most common mechanism of injury is usually attributed to downhill riding and forward falling. Although rare, this type of fall can result in serious cranial and thoraco-abdominal trauma. Head and neck trauma continue to be documented, often resulting in concussions and the possibility of permanent neurological sequelae. Upper limb injuries range from minor dermal abrasions, contusions and muscular strains to complex particular fracture dislocations. These are caused by attempting to arrest the face with an outstretched hand, leading to additional direct injury. Common overuse injuries include repeated compression from the handlebars and vibration leading to neurovascular complications in the hands. Along with reports of blunt abdominal trauma and lumbar muscle strains, lower extremity injuries may include various hip/pelvic/groin contusions, patellofemoral inflammation, and various muscle strains. The primary causes of mountain biking injuries in children and adolescents include overuse, excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Additional factors contributing to trauma among this age group involve musculoskeletal immaturity, collisions and falls, excessive speed, environmental conditions, conditioning and fitness status of the rider, nonconservative behavioural patterns, and inadequate medical care. The limited available data restrict the identification and understanding of specific paediatric mountain biking injuries and injury mechanisms. Education about unnecessary risk of injury, use of protective equipment, suitable bikes and proper riding technique, coupled with attentive and proper behaviour, are encouraged to reduce unnecessary injury. This article provides information on the causation and risk factors associated with injury among young mountain bikers, and recommendations to minimize trauma and enhance optimal performance and long-term enjoyment in this outdoor sport.

Does the 6-min walk test correlate with the exercise stress test in children?

Lesser DJ, Fleming MM, Maher CA, Kim SB, Woo MS, Keens TG.: Pediatric Pulmonology, 2010, 45(2):135-40. Division of Pediatric Pulmonology, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027-6062, USA.

Is there a correlation between the 6-min walk and aerobic fitness in children? We studied healthy and cystic fibrosis (CF) subjects age 8-20 years using the 6-min walk test, treadmill graded exercise stress test, and spirometry. Six-minute walk distance (6MWD) and the product of 6MWD and body weight (6MWORK) were related to aerobic capacity. Data were analyzed using Student's t-test and Pearson correlation. 13 healthy subjects [9 females, mean age 15.8 +/- 3.6 years, % predicted forced expiratory volume in one second (FEV(1)) 105 +/- 12%, 6MWD 557 +/- 73 m, peak oxygen uptake (V' O2 max) 41.4 +/- 7.2 ml/kg/min, and heart rate (HR) at V' O2 max 180 +/- 10] and 11 CF subjects (3 females, mean age 14.3 +/- 3.8 years, FEV(1) 67 +/- 25.9%, 6MWD 468 +/- 68 m, V' O2 max 27.0 +/- 8.1 ml/kg, and HR at V' O2 max 163 +/- 22] were studied. 6MWD correlates with V' O2 max in normal subjects (r = 0.59, P < 0.05) but not in CF subjects (r = 0.09, NS). 6MWORK correlates with V' O2 max in CF subjects (r = 0.65, P < 0.05) but not in normal subjects (r = 0.278, NS). We conclude that the 6MWD corresponds with aerobic fitness in normal pediatric subjects and 6MWORK corresponds with aerobic fitness in CF subjects. We speculate that 6MWORK is superior to 6MWD for assessment of aerobic fitness in children with CF.

Modificado em 26 de Maio 2010

Interventions to prevent obesity in 0-5 year olds: an updated systematic review of the literature.

Hesketh KD, Campbell KJ.: Obesity (Silver Spring, Md.), 2010, 18 Suppl 1:S27-35.

Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia.

The small number and recency of the early childhood obesity-prevention literature identified in a previous review of interventions to prevent obesity, promote healthy eating, physical activity, and/or reduce sedentary behaviors in 0-5 year olds suggests this is a new and developing research area. The current review was conducted to provide an update of the rapidly emerging evidence in this area and to assess the quality of studies reported. Ten electronic databases were searched to identify literature published from January 1995 to August 2008. Inclusion criteria: interventions reporting child anthropometric, diet, physical activity, or sedentary behavior outcomes and focusing on children aged 0-5 years of age. Exclusion criteria: focusing on breastfeeding, eating disorders, obesity treatment, malnutrition, or school-based interventions. Two reviewers independently extracted data and assessed study quality. Twenty-three studies met all criteria. Most were conducted in preschool/childcare (n = 9) or home settings (n = 8). Approximately half targeted socioeconomically disadvantaged children (n = 12) and three quarters were published from 2003 onward (n = 17). The interventions varied widely although most were multifaceted in their approach. While study design and quality varied most studies reported their interventions were feasible and acceptable, although impact on behaviors that contribute to obesity were not achieved by all. Early childhood obesity-prevention interventions represent a rapidly growing research area. Current evidence suggests that behaviors that contribute to obesity can be positively impacted in a range of settings and provides important insights into the most effective strategies for promoting healthy weight from early childhood.

The role of physical activity and fitness on the metabolic syndrome in adolescents: effect of different scores. The AFINOS Study.

Martínez-Gómez D, Eisenmann JC, Moya JM, Gómez-Martínez S, Marcos A, Veiga OL.: Journal of Physiology and Biochemistry, 2009, 65(3):277-89. Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition, Spanish National Research Council (CSIC), Madrid, Spain.

The aim of this study was to examine the associations of objectively measured physical activity (PA) and cardiorespiratory fitness (CRF) with different continuous metabolic syndrome (MetS) scores in adolescents. A cross-sectional sub-sample of 202 adolescents (99 girls), aged 13-17 years, were selected from the AFINOS Study. Body mass index, sum of 6 skindfold, waist circumference, systolic and diastolic blood pressure, insulin, glucose, triacylglycerol, and HDL-cholesterol levels were determined. Moderate PA (MPA), vigorous PA (VPA) and moderate to vigorous PA (MVPA) were assessed by the ActiGraph accelerometer for 7 consecutive days and CRF was estimated by the 20-m shuttle run test. Three continuous MetS scores were calculated according to the methodology of the Corpus Christi Child Heart Study (CCCHS), the Aerobic Center Longitudinal Study (ACLS), and the European Youth Heart Study (EYHS). VPA and MVPA were significantly related with CRF. Only CRF, and not patterns of PA, was inversely and independently associated with the three MetS scores although with different magnitudes (ranged: beta = 0.22 to 0.36, p < 0.05). A significant VPA x CRF interaction (p = 0.011) was found using the ACLS MetS score. Trends across VPA-CRF groups were significantly different with ACLS and EYHS (p = 0.002 and p = 0.006, respectively), but not with CCCHS (p = 0.313) continuous MetS scores. These findings support the key role of CRF on the MetS and the relevance of PA, especially VPA, to provide CRF in adolescents. A unified pediatric definition of MetS might minimize the discrepancies among studies.

Reductions in child obesity among disadvantaged school children with community involvement: the Travis County CATCH Trial.

Hoelscher DM, Springer AE, Ranjit N, Perry CL, Evans AE, Stigler M, Kelder SH.: Obesity (Silver Spring, Md.), 2010, 18 Suppl 1:S36-44. Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health, Austin Regional Campus, Austin, Texas, USA.

The objective of this study was to compare the impact of two intervention approaches on the prevalence of child overweight and obesity: (i) Coordinated Approach To Child Health BasicPlus (CATCH BP), in which schools were provided evidence-based coordinated school health program training, materials, and facilitator support visits, and (ii) CATCH BP and Community (BPC), in which BP schools received additional promotion of community partnerships with the aim of integrating community members and organizations into schools, local decision making and action, and best practices workshops. Schools (n = 97) in four central Texas districts were recruited to participate in the 4-year project. Of the low-income schools (n = 58), 15 schools were selected to receive the BPC intervention and matched with 15 schools in the BP condition. A serial cross-sectional design was used, in which 4th grade student BMI, physical activity, and diet were assessed in the 30 schools in spring 2007 and 2008. Measurements in spring 2007 included 1,107 students, with 53% female; 61% Hispanic, and 14% African American; and mean age of 9.9 years. Adjusted prevalence of overweight/obesity (>or=85th percentile) was 42.0 and 47.4% in spring 2007 for the BP and BPC students, respectively. From spring 2007 to spring 2008, the percent of students classified as overweight/obese decreased by 1.3 percentage points (P = 0.33) in BP schools, compared to a decrease of 8.3 percentage points (P < 0.005) in students from BPC schools; the difference between conditions was significant (P = 0.05). CATCH BPC students also reported more positive trends in related behaviors. Implementation of a community-enhanced school program can be effective in reducing the prevalence of child overweight in low-income student populations.

Reference values for the 6-min walk test in healthy children aged 6-12 years.

Priesnitz CV, Rodrigues GH, Stumpf Cda S, Viapiana G, Cabral CP, Stein RT, Marostica PJ, Donadio MV.: Pediatric Pulmonology, 2009, 44(12):1174-9. Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.

Objective: To establish reference values for the 6-min walk test in healthy children and adolescents aged 6-12 years. Methods: This cross-sectional, prospective study selected healthy children and adolescents aged 6-12 years, at three elementary schools in Porto Alegre. The anthropometric data of all the individuals were evaluated and two 6-min walk tests were performed. Based on this, a reference equation was generated, and the test reproducibility was evaluated. Results: One hundred eighty-eight children (92 boys) performed the test. Pearson correlation showed that age (r = 0.51), height (r = 0.49), difference in heart rate before and after the test (dif. HR) (r = 0.30), and weight (r = 0.29) were significantly correlated with the distance covered in 6 min. The best multiple regression model included these four variables resulting in the following equation: 145.343 + [11.78 x age (years)] + [292.22 x height (m)] + [0.611 x dif. HR (bpm)] - [2.684 x body weight (kg)]. The intraclass correlation coefficient confirmed the reproducibility among tests. Conclusion: The reference equation for the 6-min walk test was generated and the distance covered is influenced by age, height, difference in heart rate before and after the test, and body weight.

Modificado Sábado, 27 de Fevereiro 2010 17:10

Physical fitness in relation to transport to school in adolescents: the Danish youth and sports study.

Andersen LB, Lawlor DA, Cooper AR, Froberg K, Anderssen SA. Scandinavian Journal of Medicine & Science in Sports, 19(3):406-11, 2009.

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.

In many Western countries, there are concerns about declining levels of physical activity in school-aged children. Active transport is one way to increase physical activity in children, but few studies have evaluated whether active transport in school-aged children and adolescents has beneficial effects on fitness and, if so, whether different modes of transport affect different aspects of fitness. In this study, we examined the association of active transport with different aspects of fitness in a representative Danish sample of 545 boys and 704 girls, 15-19 years of age. Physical fitness was assessed through a number of field tests, including a maximal cycle test, dynamic and static strength in different muscle groups, muscle endurance, flexibility and agility. Transport to school was reported as the mode of transport. Almost two-thirds of the population cycled to school. Cyclists had higher aerobic power than both walkers and passive travelers (4.6-5.9%). Isometric muscle endurance (10-16%), dynamic muscle endurance in the abdominal muscles (10%) and flexibility (6%) were also higher in cyclists compared with walkers and passive travelers. Mode of travel was not related to leisure-time sports participation. Our findings suggest that commuter bicycling may be a way to improve health in adolescents.

Maternal insulin sensitivity during pregnancy predicts infant weight gain and adiposity at 1 year of age.

Hamilton JK, Odrobina E, Yin J, Hanley AJ, Zinman B, Retnakaran R. Obesity (Silver Spring, Md.), 18(2):340-6 , 2009.

Hospital for Sick Children, Department of Pediatrics, Toronto, Ontario, Canada.

Emerging evidence suggests that fetal environmental exposures impact on future development of obesity. The objectives of this study were to assess the relationships between (i) maternal insulin sensitivity and glucose tolerance status in pregnancy and (ii) early infant weight gain and adiposity in the first year of life. In this prospective cohort study, 301 women underwent oral glucose tolerance testing for assessment of glucose tolerance status and insulin sensitivity (IS(OGTT)) in pregnancy. Their infants underwent anthropometric assessment at 12 months of age, including determination of weight gain in the first year of life and sum of skinfold thickness (SFT), a measure of infant adiposity. Infant weight gain and sum of SFT at 12 months did not differ according to maternal glucose tolerance status. On univariate analyses, weight gain from 0 to 12 months and sum of SFT were negatively associated with maternal IS(OGTT) during pregnancy. On multiple linear regression analysis, negative independent predictors of weight gain from 0 to 12 months were maternal IS(OGTT) during pregnancy (t = -2.73; P = 0.007), infant female gender (t = -3.16; P = 0.002), and parental education (t = -1.98; P = 0.05), whereas white ethnicity was a positive independent predictor (t = 2.68; P = 0.008). Maternal IS(OGTT) (t = -2.7; P = 0.008) and parental education (t = -2.58; P = 0.01) were independent negative predictors of sum of SFT at 12 months. Independent of maternal glucose tolerance status, maternal insulin resistance during pregnancy is associated with increased infant weight gain and adiposity over the first year of life. Further longitudinal study to evaluate obesity in this group of children will increase our understanding of the contribution of the intrauterine environment to their long-term health.

Intraperitoneal fat and insulin resistance in obese adolescents.

Obesity (Silver Spring, Md.), 18(2):402-9, 2009.

Obesity is epidemic among adolescents in the United States. We sought to analyze the anthropometric measures of adiposity and fasting indices of insulin resistance, including insulin-like growth factor-binding protein-1 (IGFBP-1), and to provide a clinical estimate of intraperitoneal (IP) fat in obese adolescents (BMI > or =95th percentile), between ages 13 and 17 years. Subjects had baseline testing to determine eligibility for a subsequent randomized, placebo-controlled trial of metformin XR therapy. Anthropometry and dual-energy X-ray absorptiometry (DXA) were used to quantify total body fat while abdominal computed tomography (CT) was used to measure IP (CT-IP) and subcutaneous (CT-SQ) fat. Using anthropometry and fasting laboratory data, we constructed regression models for both CT-IP and CT-SQ. A total of 92 subjects, 33 males, were evaluated. Of the 92 subjects, 19 were black. Fasting insulin concentrations were highly associated with other measures of insulin resistance. Median percent body fat across all subjects, as measured by DXA, was 41%. Using CT measures, 67% of abdominal cross-sectional area was fat, 14% of which was IP fat. In multiple regression analysis, waist circumference (WC) and BMI, jointly and independently, were strongly associated with both CT-IP and CT-SQ fat. BMI and WC explained 62% of variance of CT-SQ fat, but only 26% of variance of CT-IP fat. Adding triglyceride:high-density lipoprotein (TG:HDL) ratio and IGFBP-1 (among nonblacks) to the regression model increased the explained variance for estimating CT-IP fat to 45%. When evaluating the metabolic morbidity of an obese adolescent, a model using fasting IGFBP-1, TG:HDL, BMI, and WC may be worthwhile as an estimate of IP fat.

Motocross morbidity: economic cost and injury distribution in children.

Larson AN, Stans AA, Shaughnessy WJ, Dekutoski MB, Quinn MJ, McIntosh AL. Journal of pediatric orthopedics, 29(8):847-50, 2009.

Mayo Clinic, Rochester, MN 55905, USA.

Background: Motocross is a nationally organized sport that is growing in popularity. The distribution and severity of motocross injuries in the pediatric population is not known. We hypothesize a high rate of musculoskeletal injuries requiring hospitalization and/or surgical intervention. Methods: All patients 17 years of age or younger with injuries sustained while using off-road 2-wheeled motorcycles were identified through surgical, diagnostic, and trauma registries at a level 1 regional trauma center. Type, severity, and mechanism of injury were assessed, as well as charges billed for medical care. Both recreational and competitive motocross activities were included. Results: From 2000 to 2007, 299 cases were noted in 249 unique patients. In 141 instances, hospital admission was required, for a total of 412 inpatient days. Twenty patients required ICU admission. Surgery was performed in 91 cases (81 orthopaedic, 6 general, 1 urology, and 4 facial reconstructions). Orthopaedic surgical procedures included treatment of 29 femur fractures, 8 forearm, 6 ankle, 5 tibial shaft, 6 proximal tibia, 5 spine, 6 proximal humerus, 4 hand, 4 foot, 3 elbow fractures, and 5 other. Orthopaedic interventions also included 8 reductions under general anesthesia and 31 conscious sedations. Mean age at injury was 14.1 years (range: 5.4 to 17.9). Ninety-four percent of patients were male and 85% were White. The majority of patients were wearing helmets/safety equipment. One hundred and eighty-four injuries occurred on a track, with 150 during competition. The mean charge billed per injury was $14,947 (range: $105 to $217,780), with a total cost of $4.5 million. Conclusions: Nearly half of motocross patients treated at a regional level 1 trauma center required hospitalization, and nearly one-third required surgery. The vast majority of surgical procedures (89%) were orthopaedic. Despite a high usage rate of helmets and protective gear, severe injuries were still sustained, including femur fracture (29), hemiparesis/spinal cord injury (2), and head injury (43). The majority of injuries occurred during organized race or practice. Families should be counseled with regard to the use of safety equipment and the severity of injuries sustained during competitive motocross activity. LEVEL OF EVIDENCE: Level IV, case series.

Skeletal geometry and indices of bone strength in artistic gymnasts.

Dowthwaite JN, Scerpella TA. Journal of Musculoskeletal & Neuronal Interactions , 9(4):198-214, 2009. Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA.

This review addresses bone geometry and indices of skeletal strength associated with exposure to gymnastic loading during growth. A brief background characterizes artistic gymnastics as a mechanical loading model and outlines densitometric techniques, skeletal outcomes and challenges in assessment of skeletal adaptation. The literature on bone geometric adaptation to gymnastic loading is sparse and consists of results for disparate skeletal sites, maturity phases, gender compositions and assessment methods, complicating synthesis of an overriding view. Furthermore, most studies assess only females, with little information on males and adults. Nonetheless, gymnastic loading during growth appears to yield significant enlargement of total and cortical bone geometry (+10 to 30%) and elevation of trabecular density (+20%) in the forearm, yielding elevated indices of skeletal strength (+20 to +50%). Other sites exhibit more moderate geometric and densitometric adaptations (5 to 15%). Mode of adaptation appears to be site-specific; some sites demonstrate marked periosteal and endosteal expansion, whereas other sites exhibit negligible or moderate periosteal expansion coupled with endocortical contraction. Further research is necessary to address sex-, maturity- and bone tissue-specific adaptation, as well as maintenance of benefits beyond loading cessation.

Redox, iron, and nutritional status of children during swimming training.

Kabasakalis A, Kalitsis K, Nikolaidis MG, Tsalis G, Kouretas D, Loupos D, Mougios V. Journal of Science and Medicine in Sport / Sports Medicine Australia12(6):691-6, 2009.

Department of Physical Education and Sport Science, University of Thessaloniki, Greece.

Effects of exercise training on important determinants of children's long-term health, such as redox and iron status, have not been adequately investigated. The aim of the present study was to examine changes in markers of the redox, iron and nutritional status of boy and girl swimmers during a prolonged period of training. 11 boys and 13 girls, aged 10-11 years, were members of a swimming club. They were assessed at the beginning of the training season, at 13 weeks and at 23 weeks through blood sampling and recording of the diet. Reduced glutathione increased at 13 and 23 weeks, whereas oxidised glutathione decreased at 13 weeks, resulting in an increase of the reduced/oxidised glutathione ratio at 13 and 23 weeks. Total antioxidant capacity, catalase, thiobarbituric acid-reactive substances, hemoglobin, transferrin saturation and ferritin did not change significantly. Carbohydrate intake was below 50% of energy and fat intake was above 40% of energy. Intakes of saturated fatty acids and cholesterol were excessive. Iron intake was adequate but intakes of folate, vitamin E, calcium and magnesium did not meet the recommended daily allowances. No significant differences were found between sexes in any of the parameters measured. In conclusion, child swimmers improved the redox status of glutathione during training, although the intake of antioxidant nutrients did not change. The iron status was not impaired by training. Suboptimal intake of several nutrients suggests the need for nutritional monitoring and education of children athletes.

The energy cost of cycling and aerobic performance of obese adolescent girls.

Lafortuna CL, Agosti F, Busti C, Galli R, Sartorio A.: Journal of Endocrinological Investigation, 32(8):647-52, 2009.

Istituto di Bioimmagini e Fisiologia Molecolare del Consiglio Nazionale delle Ricerche, I-20090 Segrate, Milan, Italy.

In order to assess the energy cost of cycling and aerobic capacity in juvenile obesity, responses to cycle ergometer exercise were studied in 10 pubertal obese (OB) [body mass index (BMI) SD score (SDS): 3.40+/-0.58 SD] adolescent girls (age: 16.0+/-1.2 yr) and in 10 normal-weight (NW, BMI SDS: -0.30+/-0.54) girls of the same age (15.1+/-1.9). To this aim, gas exchange, heart rate (HR), and energy expenditure (EE) were studied during graded cycle ergometer test at 40, 60, 80, 100, and 120 W. The energy cost of cycling was higher in OB, being oxygen uptake (VO2) higher (about 20%) in OB than in NW girls at all workloads (p<0.01-0.001). Estimated maximal VO2 and VO2 at anaerobic threshold were significantly (p<0.05) higher in OB girls [although lower per unit body mass (p<0.01) and similar for unit fat-free mass], and explained the higher oxygen pulse and lower HR for any EE observed during submaximal exercise in OB. While net mechanical efficiency (ME) was significantly lower in OB (p<0.01), delta ME was similar in both groups, indicating no substantial derangement of muscle intrinsic efficiency. It is concluded that, despite a higher cost of cycling, OB girls can rely on a larger aerobic capacity which makes them able to sustain this kind of exercise within a wide range of work loads, with relevant implications when planning protocols of physical activity in the context of interventions for the reduction of juvenile obesity.

Organized youth sport as a predictor of physical activity in adulthood.

Kjønniksen L, Anderssen N, Wold B

. Scandinavian journal of medicine & science in sports, 19(5):646-54, 2009.

Faculty of Arts, Folk Culture and Teacher Education, Telemark University College, Porsgrunn, Norway.

The aim of this study was to examine whether early and sustained organized youth sport during childhood and adolescence predicts the frequency of leisure-time physical activity (PA) at age 23 years. A 10-year longitudinal study of 630 adolescents was conducted. Data were collected from these participants eight times from the ages of 13 to 23 years and were analyzed by analysis of variance and regression. There was a high degree of consistency in participation in organized youth sport in terms of reporting to be a member of a sports club, especially from age 13 to 16 years. The correlation coefficients tended to be higher among males and decreased over time both in females and males. The age at becoming a member in organized sport and duration of participation in organized youth sports during adolescence predicted 9% of the variance of young adult PA. The correlations were higher in males than in females, but these differences were not significant. Organized youth sports during childhood and adolescence was positively related to frequency of leisure-time PA in young adulthood. Joining organized youth sports at an early age and continuing through adolescence appear to increase the likelihood for a physically active lifestyle in young adulthood.

Actualizado em Quinta, 23 Fevereiro 2012 17:01