KHS 300 Pediatric Exercise Science Exam 1 Study Guide

What is primordial prevention?

Preventing risk factors from appearing in the first place (must begin early in life)

What is primary prevention?

Manage the risk factors (i.e. personal trainer)

What is adiposity and what is it associated with?

increase in fat and associated with decrease in MVPA

Growth Hormones

- Start of growth spurt (around ages 10-11 years)

- Peak of growth rate (early adolescence) leads to puberty

- Attainment of adult height

Musculoskeletal System

- Osteogenesis begins during fetal development

- Endochondral Ossification (cartilage > bone)

Epiphyseal Plate (growth plate)

- Only found in children and responsible for growth

- It is only open in children who are growing

- Located at each end of a long bone (2 growth plates each)

- Made of cartilage (soft) hyaline cartilage

- If you fracture a growth plate, the limb can stope growing or grow crooked

Bone Remodeling

Replacing old bone with new bone but does happen automatically

Optimizing bone development in youth

- Peak bone mass around age 35 (females + males)

- Bone mass tracks from childhood to adulthood

- Females are at a greater risk for osteoporosis

- Hormones, loading, nutrition needs to be considered

Mechanical Loading & Bone

- Adequate stress: calcium accumulation within bone

- Calcium is leeched from bones

- Diagnosis osteoporosis can only be done with a dexascan

- Low stress leads to insufficient remodeling

- High stress leads to more removal than repair

Physical Activity & Bone

- Weight bearing and weight loaded

- Irregular movement pattern

- Outdoor play

- Most sports

Muscle-Tendon System

Muscle hypertrophy vs. Muscle hyperphasia

- Early life - Growth and development to maximize peak

- Tendons has limited blood supply

- Adult life - maintaining peak

- Older life - minimizing \

piu[

What are the reasons to be active?

1. Have fun

2. Make friends

3. Learn something new

Children are not miniature adults

Must consider

- Chronological age

- Biological age

- Training age

- Response to exercise

- Recovery from exercise

Developmental Physiology

- Nervous system

- Endocrine system

- Musculoskeletal system

- Cardiopulmonary system

- Metabolic system

- Thermoregulation

Nervous System

- Central nervous system

- Brain and spinal cord

- Peripheral nervous system

- Somatic nervous system

- Autonomic nervous system

- Sympathetic

- Parasympathetic

2020 WHO Guidelines (children & adolescents)

- An average of at least 60 minutes of MVPA daily across the week

- On at least 3 days a week

- Limit amount of time being sedentary

Novel Patterns of Physical Activity in Children

- Most MVPA is obtained in spurt like (interval) MVPA with brief rest periods as needed

- Prolonged periods of aerobic training at THR are inconsistent with the developmental needs and interests of young children

What is neoteny?

- Used by Stuart Brown

- The retention of juvenile features in the adult

- One of the hallmarks of this is desire for lifelong play

Physical Activity in Youth

- If 75% of U.S. children exercise 3x a week, $16 billion in debt medical costs, and $23 billion in lost productivity could be avoided

Tracking of Lifestyle Behaviors

- Not guaranteed but likely to carry over

- Spark interest in early ages 6-8, more likely to be a fit adolescent

- Positive and negative behaviors track later in life

Association Between MVPA and Obesity in Children

- The prevalence of obesity goes down when daily MVPA goes up

- Bidirectional relationship (i.e. gain weight when there is less MVPA)

Household Level Correlates of Children's Physical Activity Levels

- 5, 859 nine to eleven year old children

- Accelerometer for 7 days

- Parents reported on household factors

Children with at least one piece of bedroom electronic media had lower MVPA

WHO Issue First Ever Screen Time Guidelines for Young Kids

- Infants less than 1 year old should NOT be exposed to electronic screens

- Children ages 2-4 years old should not have more than 1 hour of "sedentary screen time" each day

Is our current approach working?

- Parents knowledge of youth physical activity guideline

- 23% of parents are aware of youth physical activity guidelines

Fitness as a clinical vital sign

- The decline in death is when you go from no physical activity to some physical activity

- CRF: cardiorespiratory fitness

What are the health related components of fitness?

- Aerobic fitness

- Muscular strength

- Muscular endurance

- Flexibility

What are the skill related components of physical fitness?

- Agility

- Balance

- Coordination

- Muscular power

- Speed

- Reaction time

What is MVPA?

Moderate to vigorous physical activity

What is physical literacy?

The confidence, competence, and motivation to participate in a variety of activities

What is athleticism?

The ability to move with style and grace

Questions to ask

- Age to start

- Program design?

- Assessments?

What are the potential benefits of MVPA?

- Improve movement skills

- Increase bone mineral density (bones of children can improve 5%)

- Increase cardiometabolic health (insulin sensitivity)

- Improve injury resistance

- Improved academic performance

- Improve social development

- Improve classroom behavior (more breaks is better)

- Improve sleep quality

- Improve concentration

- Improve self esteem and mental health

What are the Fundamental Movement Skills (FMS)

1. Locomotor (running, jumping, hopping, etc)

2. Object Control (kicking, catching, throwing, etc)

3. Stability (balance, can you stand on one leg?)

What is kinesiophobia?

The IRRATIONAL fear of movement

- Perceptions of discomfort

Neuromuscular Dysfunction

- Low muscular fitness

- Poor fundamental movement skills

Physical Illiteracy

- Reduced movement competence and confidence

- Disinterest in physical activity

Unhealthy Behaviors

- Increase screen time (related to increased in junk food in take)

- Poor sleep hygiene

Injury & Illness

- Activity related injury

- Chronic disease (obesity + type II diabetes

Physical Activity Guidelines (Infants)

Age: Infant (0-12 months)

Activities: Playful activities, movement exploration, skill development, at lease 30 minutes of tummy time (accumulated daily)

Example: Toys making noise with movement, reaching grabbing toys

Physical Activity Guidelines (Toddlers)

Age: Toddler (12-36 months)

Activities: At least 30 minutes of structured physical activity, at least 60 minutes of unstructured physical activity, and develop movement skills

Example: Park/playground play, outdoor play, push/pull toys

Physical Activity Guidelines (Preschooler)

Age: Preschooler (3-6 years)

Activities: At least 60 minutes of structured and unstructured physical activity, different settings

Example: Outdoor playground with climbing, tunnels, and throwing/kicking ball games

Physical Activity Guidelines (Children)

Age: Children (6-12 years)

Activities: At least 60 minutes of MVPA daily

Examples: Physical education/recess, outdoor free play, and organized sports

Physical Activity Guidelines (Adolescents)

Age: Adolescents (13-18 years)

Activities: Physical education/recess, jogging, biking, swimming, and organized sports

Define the construct of physical literacy and describe the components of physical literacy. What strategies can enhance physical literacy in youth?

The combination of participating in multiple activities as well

Cognition: knowledge and understanding

How do you get cardiac output?

Heart rate x Stroke Volume = Cardiac Output

Cardiopulmonary and metabolic responses to acute bout of vigorous exercise in children vs adult

Heart rate: Higher in the child

Stroke volume: Lower in the child (heart size is smaller)

Cardiac Output: Lower in the child (HR is high, but stroke volume is so low children have small left ventricles)

Minute Ventilation (air you can breathe each min): Lower in the child

Breathing Frequency (# of breaths some one takes per minute at rest): Higher in the child (mv is lower)

Tidal Volume: Lower in the child (child has smaller lungs)

ATP Breakdown: same

Glycolytic Activity: Lower (less developed system)

Lactate production: Lower (less intensity, less lactate in children)

Fat metabolism: Higher (child uses more fat than carbohydrates) due to changes in maturity

Metabolic Fatigue: Lower in the child

What are some questions that you could ask to understand if a child is physically active?

- What kinds of activities do you do after school?

- Do you have a favorite sport that you like to play?

- What do you do in gym class?

- How often do you have gym class?

- What kinds of activities do you like to do during recess?