The influence of body mass index on long-term fitness from physical education in adolescent girls

Physiotherapy and related management for childhood obesity: A systematic scoping review

INTRODUCTION

Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity.

METHOD

A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy.

RESULTS

From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively.

CONCLUSION

When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.

Promoting Health-Related Cardiorespiratory Fitness in Physical Education: The Role of Class Intensity and Habitual Physical Activity

Physical education (PE) has the potential to promote health-related fitness, however, its contribution is still not clear. The aim of this study was to assess whether students’ health-related cardiorespiratory fitness (CRF) improved from the beginning to the end of the school year, and to examine the role of PE class intensity and habitual physical activity (PA) in promoting students’ CRF. This observational study employed a longitudinal design. Participants were 212 7th and 8th grade students (105 boys), mean age 12.9 years old, followed during one school year, from September 2017 to June 2018. The Progressive Aerobic Cardiovascular Endurance Run (PACER) was used to assess CRF at baseline and follow-up. PA was measured using accelerometers. PE class intensity was assessed using the System for Observing Fitness Instruction Time. Findings indicated that from the beginning to the end of the school year, a greater percentage of participants were in the CRF healthy fitness zone (73.1% to 79.7%, p = 0.022). Among boys, participating in organized sports (B = 4.61, 95% confidence interval [CI]: 0.33, 8.88) and the percentage of PE time being very active (B = 0.90, 95% CI: 0.44, 1.35) were positively associated with the change in PACER laps. Among girls, daily vigorous PA (B = 0.38, 95% CI: 0.15, 0.60) and participating in organized sports (B = 4.10, 95% CI: 0.93, 7.27) were also positively associated with PACER change, while being overweight or obese (B = −5.11, 95% CI: −8.28, −1.93) was negatively associated. In conclusion, PE was demonstrated to have a positive role in the promotion of CRF, especially among boys, while for girls, habitual PA seems to have a greater contribution. Nevertheless, results and conclusions should be considered carefully, taking into account study limitations, such as the non-direct measures of PE class intensity, CRF, and school setting.

Promoting health-related cardiorespiratory fitness in physical education: A systematic review

Background

This article aimed to systematically review the contribution of physical education (PE) classes to improve cardiorespiratory fitness (CRF) in children and adolescents; and to define potentially relevant factors for promoting CRF in PE classes.

Methods

Studies were identified from searches in ERIC, PubMed, SPORTDiscus, and Web of Science databases. Primary source articles, relating PE classes and CRF, published up to July 2019 in peer-reviewed journals were eligible for inclusion. Specific inclusion criteria were: (a) having cross-sectional or longitudinal and observational or interventional study designs; (b) targeting school-aged children or adolescents; (c) measuring CRF, heart rate or CRF test results as an outcome; (d) having statistical analyses of the CRF, heart rate or CRF test results outcomes reported; (e) focusing on PE classes or PE interventions that did not extended time or frequency of the classes; and (f) published in English, French, Portuguese, or Spanish.

Results

A total of 24 studies met the inclusion criteria. Overall, 10 studies have found a neutral effect of PE classes in students’ CRF, eight studies found that PE indeed contributed to the improvement of CRF and six studies revealed mixed findings, when PE classes where controlled for others variables (e.g. body mass index, intensity). Higher intensity PE classes consistently demonstrated contributions to improving students’ CRF.

Conclusion

Review findings suggest that PE classes can contribute to the improvement of students’ CRF. Intensity, age and weight status were identified as potentially relevant factors for promoting CRF in PE classes. To improve CRF, higher intensity classes should be provided.

Longitudinal changes in physical activity, sedentary behavior and body mass index in adolescence: Migrations towards different weight cluster

This study examined longitudinal changes in physical activity, sedentary behavior and body mass index in adolescents, specifically their migrations towards a different weight cluster. A cohort of 755 adolescents participated in a three-year study. A clustering Self-Organized Maps Analysis was performed to visualize changes in subjects' characteristics between the first and second assessment, and how adolescents were grouped. Also a classification tree was used to identify the behavioral characteristics of the groups that changed their weight cluster. Results indicated that boys were more active and less sedentary than girls. Boys were especially keen to technological-based activities while girls preferred social-based activities. A moderate competing effect between sedentary behaviors and physical activities was observed, especially in girls. Overweight and obesity were negatively associated with physical activity, although a small group of overweight/obese adolescents showed a positive relationship with vigorous physical activity. Cluster migrations indicated that 22.66% of adolescents changed their weight cluster to a lower category and none of them moved in the opposite direction. The behavioral characteristics of these adolescents did not support the hypothesis that the change to a lower weight cluster was a consequence of an increase in time devoted to physical activity or a decrease in time spent on sedentary behavior. Physical activity and sedentary behavior does not exert a substantial effect on overweight and obesity. Therefore, there are other ways of changing to a lower-weight status in adolescents apart from those in which physical activity and sedentary behavior are involved.

Association between the summer season and body fatness and aerobic fitness among Hispanic children

BACKGROUND

Few studies have investigated changes in adiposity and fitness during the academic year (AY) and summer season (SS) in minority children. This study aimed to assess if adiposity indicators and fitness change during the school AY and SS in Hispanic children.

METHODS

One hundred nineteen low-income Hispanic children (9.2 ± 0.8) participated in the study. Demographic, body weight and height, percent body fat (% BF), and aerobic endurance were assessed at 3 time points: measurement 1 (M1), beginning of AY; M2, end of AY; and M3, end of SS. Using weight and height, body mass index (BMI) was calculated and normalized (BMI z-scores). Mixed effects between-within-subjects analysis of variance (ANOVA) design was used to examine changes in selected variables.

RESULTS

A significant decrease of BMI z-scores in overweight children (p = .024) was observed during the AY only, but not during the SS. Percent BF increased significantly over the AY and SS (p < .001), particularly in girls. Aerobic endurance showed a significant increase over the AY (p < .001), but it did not change over the SS (p = .552).

CONCLUSIONS

Results indicated that the SS might place Hispanic children at increased risk for additional adiposity and lower fitness.