II. PHYSICAL ACTIVITY: MEASUREMENT AND BEHAVIORAL PATTERNS IN CHILDREN AND YOUTH

The Relationship of the PROMIS® Pediatric Physical Activity Measure with Cardiorespiratory Fitness

A The PROMIS® Pediatric Physical Activity (PA) measure is a new instrument with established validity that measures a child self-report on short bouts of moderate to rigorous physical activity. The purpose of this study was to explore the relationship of the PROMIS® Pediatric PA item bank with cardiorespiratory fitness and self-efficacy. The study was conducted at the Minnesota State Fair. Youth ages 8 to 18 years completed the PROMIS® Pediatric PA and the Self-Efficacy for PA measures on an iPad. Participants performed 3-min step test with heart rates measured 1 min posttest. Participants (N = 182) were 53% female. The PROMIS® Pediatric PA had a weak, significant negative correlation with the step test measurement (r = -0.23, p = 0.001) and a weak, significant positive correlation with self-efficacy (r = 0.27, p < 0.001). Measurements did not differ between groups by sex or age group (school-age and adolescent). Youth who were obese had significantly higher heart rates post step test (p = 0.004); BMI percentile groups did not differ in other measures. Self-report of PA and the physiologic measure of heart rate are from two related but different physical fitness domains which supports their significant but weak relationship.

Physical function in children and adolescents pre- and 1-year post-liver transplant

BACKGROUND

Several studies describe poorer motor developmental motor outcomes post-liver transplant (LT) in younger children. Limited studies examine physical function in older children and adolescents pre- and post-LT.

METHODS

Retrospective review of standard of care physical function outcome measures pre- and 1-year post-LT in children ≥6 years at LT. Measures include: 6-minute walk test (6MWT), grip strength, Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) components, Physical Activity Questionnaire (PAQ), and Paediatric Quality of Life Multidimensional Fatigue Scale. Association of medical variables with outcomes was explored.

RESULTS

The study cohort included 23 (8 male, median (interquartile range) age 11.67 (8.25, 13.92) years at LT) participants. Top two primary diagnoses included biliary atresia (30.4%) and fulminant hepatic failure (21.7%). At 1-year post-LT, over one-third (36%) were overweight or obese. Compared with healthy norms, children had significantly lower pre-LT PAQ scores (p = .002), pre- and post-6MWT scores (p < .001) and post-LT BOT-2 strength and agility scores (p < .001). Pre-LT, lower balance scores were associated with abdominal distention/ascites (p = .009) and splenomegaly (p = .017). Lower pre-LT platelet count correlated with poorer balance (r = .532, p = .017) and lower strength and agility scores (r = .446, p = .043). Significant moderate inverse correlations were found between weight/body mass index z-scores and BOT-2 components. Post-LT children continue to demonstrate decreased levels of motor proficiency and functional capacity but report less fatigue and increased physical activity.

CONCLUSIONS

Older children and adolescents undergoing LT are at risk of decreased physical function, highlighting the need for pre- and post-LT rehabilitation to optimize long term outcomes.

Desempeño neuropsicológico e indicadores de frecuencia, duración y tiempo de la sesión del ejercicio físico

Objetivo. El ejercicio físico (EF) se relaciona con estructuras cerebrales y funcionamiento cognitivo; sin embargo, se desconocen indicadores de frecuencia, duración e intensidad del EF asociados a procesos neuropsicológicos. Estudiar la relación y las posibles diferencias entre las funciones ejecutivas (FE) y los indicadores del EF (frecuencia, duración y tiempo que lleva practicando EF). Método. Se seleccionó una muestra intencional de treinta sujetos físicamente activos, pareados por sexo (Medad = 22.9, DE = 8.5). Se aplicó la totalidad de la Batería de Funciones Ejecutivas y Lóbulos Frontales (Banfe). Resultados. El desempeño neuropsicológico se relacionó con la frecuencia del EF en tareas que evalúan capacidades de control inhibitorio, seguimiento de límites y normas, memoria de trabajo visoespacial y anticipación de acciones de orden progresivo y regresivo. La duración y el tiempo de entrenamiento presentaron relación con la planeación, respeto por los límites y la inhibición. Aquellos participantes que se ejercitan más de seis veces por semana presentaron mejor desempeño en los aciertos y menor número de errores en el control inhibitorio. No se diferencia el desempeño neuropsicológico en función a indicadores y tipo de EF. Conclusión. Se confirma la hipótesis acerca de que el EF se asocia con procesos neuropsicológicos. Se abren posibles implicaciones científicas, educativas y clínicas.

Physical activity experiences in children post-liver transplant: Developing a foundation for rehabilitation interventions

Physical Activity (PA) plays an important role in the physical and psychosocial health of children and is beneficial in the treatment and prevention of comorbidities associated with transplantation. Despite this, PA participation in pediatric liver transplant recipients remains low compared to healthy peers. This qualitative-focused mixed-methods study explored the PA experiences and parental perception of these experiences, including perceived facilitators and barriers to PA in children post-liver transplant. Eighteen participants (9 children [median age 10.8 years] and 9 parents) took part in semi-structured interviews and completed the PedsQL Multidimensional Fatigue Scale and PAQ. Most children reported they were physically active (PAQ median 3.08 [IQR] 2.60-3.51), participating in PA for its enjoyment, regardless of their level of motor proficiency. Levels of fatigue (median 65.28 [IQR] 56.25-90.97) were higher than healthy norms and impacted PA participation in some children. Children and parents perceived PA as central to post-transplant recovery and valued its social and mental health benefits; however, parents struggled with ongoing uncertainty and perceived physical vulnerability of their child. This study indicates the need for continuing PA support and education and provides valuable information for family-centered interventions to increase PA and improve health outcomes in children post-transplant.

Impact and Moderating Variables of an Intervention Promoting Physical Activity Among Children: Results From a Pilot Study

This pilot study pursued three objectives: to assess the effect of a 1-month multilevel intervention on the PA of children, to assess the impact of the intervention on the theory of planned behavior (TPB) variables, and to evaluate the extent to which the impact of the intervention on PA and TPB variables varied according to personal (i.e., gender and age) and situational (i.e., class and school) moderating variables. Children were aged 7 to 11 years ( n = 306). Analyses revealed a significant increase of PA practice and TPB variables ( ps < .001). Age (i.e., being a younger child) was associated with a higher increase on attitude and perceived control ( ps < .01). The class or the school levels explained a meaningful variance in the evolution of PA or TPB variables (intraclass correlation coefficients > .10). The present study reports the interest and feasibility of a multilevel intervention to increase PA and TPB variables in children.

Impact of mobile apps to combat obesity in children and adolescents: A systematic literature review

PURPOSE

This review examines the impact of mobile app technology on obesity-related anthropometric, psychosocial, and behavioral outcomes in children and adolescents.

CONCLUSIONS

Nine research articles retrieved from a systematic review of the literature met criteria. Evidence is limited and mixed, but argues for an impact of mobile app use on motivation and goal-setting behavior, and supports further study of the impact on childhood obesity-related outcomes such as attitudes, perceptions, physical activity, and dietary habits.

PRACTICE IMPLICATIONS

Nurses can use this evidence to discuss potential benefits of health promotion mobile apps with parents, children, and adolescents to combat childhood obesity.