Balance Skills and Obesity in Children

Appetite published research on whether balance skills and quality of life are influenced by childhood obesity.  Eighty seven children who were classified as Class 1 obese (BMI SDS 2.0-2.49) and Class 2 obese (BMI SDS > 2.5) were evaluated using the BOT-II to measure balance and the PedsQL to determine quality of life.  Statistical analysis indicated the following:

1.  the mean balance was 26.52 ± 5.2 out of a maximum of 37 on the BOT-II


2.  overall 71.26% of the children had impaired balance


3. C2 obese children (BMI > 2.5) had lower balance scores compared to C1 obese children


4. the mean quality of life score was 59.0% ± 19.8% (C1 60.7% ± 19.1; C2 57.44 ± 19.8)


5. the children with balance impairment had lower quality of life

The researchers concluded that balance was impaired in children who were obese and that those children had a lower quality of life. The researchers recommend conducting a physiotherapy assessment in children who are obese.

Reference: O’Malley, G. et al. Are balance and quality of life impaired in children who are obese? Appetite Volume 76, 1 May 2014, Pages 198

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Title of Electronic Book: Cross the Beam Game
By: Your Therapy Source

Summary: Download of game that encourages balance skills and visual perceptual skills.  Find out more at http://www.yourtherapysource.com/beam.html

Best Exercise for Overweight Teens

JAMA Pediatrics published a research study on The Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) that included 304 overweight teens between the ages of 14 to 18. All were given the same four weeks of diet counseling to promote healthy eating and weight loss before being randomly placed into four groups: 1) resistance training involving weight machines and some free weights; 2) only aerobic exercise on treadmills, elliptical machines and stationary bikes; 3) combined aerobic and resistance training; and 4) no exercise training.

The following results were recorded:
1. each type of exercise reduced body fat significantly and similarly.
2. all three exercise programs caused significantly more fat loss than in the diet-only control group.
3. the teens who completed at least 70 per cent of the study's exercise sessions (4x/week for 22 weeks), the percentage of body fat decreased significantly more in those who did combined aerobic and resistance exercise than in those who only did aerobic exercise. In addition, waist circumference decreased close to seven centimeters in the combined aerobic plus resistance exercise group, versus about four centimeters in the groups with only one type of exercise, with no change in those randomized to diet only.

Reference: University of Calgary. Research study analyzes best exercise for obese youths. Retrieved from the web on 9/27/14 at http://www.ucalgary.ca/utoday/issue/2014-09-23/research-study-analyzes-best-exercise-obese-youths

Association Between Strength and Body Weight in Children

Pediatrics published research on strength and body weight in 1224 US children and adolescents in order to provide reference values on 4 core, upper, and lower body measures of muscle strength and to determine the association between these measures of strength and weight status.  The 4 measures of muscle strength were plank, modified pull-up, knee extension, and grip strength.

The following results were reported:
1.  mean and median estimates are provided by gender, age, and weight status.
2. there were significant positive trends with age for each of the strength tests except the modified pull-up among girls.
3.  the length of time the plank was held decreased as weight status increased for both girls and boys
4.  as weight status increased the number of modified pull-ups decreased for boys and girls
5.  scores on the knee extension increased as weight status increased
6.  grip strength increased as weight status increased

The researchers concluded that "increasing weight status had a negative association with measures of strength that involved lifting the body, but was associated with improved performances on tests that did not involve lifting the body".

Reference: Ervrn, RB et al. Strength and Body Weight in US Children and Adolescents. Published online August 25, 2014 Pediatrics Vol. 134 No. 3 September 1, 2014. pp. e782 -e789
(doi: 10.1542/peds.2014-0794)

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Play Strong: Activities to Promote Muscle Strengthening in Children through Play

This is a collection of 40+ activities that promote muscle strengthening in children. The activities are great for your pediatric occupational and physical therapy sessions for children with varying abilities. This is an excellent resource for pediatric therapists.

Find out more information.

Lack of Sleep Increases Obesity and Body Fat in Children

Pediatrics has published a large study linking reduced sleep and childhood obesity.  The children who consistently received less than the recommended hours of sleep during infancy and early childhood had increases in both obesity and in adiposity or overall body fat at age 7.

Insufficient sleep was defined as less than 12 hours per day from ages 6 months to 2 years, less than 10 hours per day for ages 3 and 4, and less than 9 hours per day from age 5 to 7.

The results of the study indicated the following:

1. children with the lowest sleep scores had the highest levels of all body measurements for obesity and adiposity, including abdominal fat which is considered to be particularly hazardous.


2. association was consistent at all ages, indicting there was no critical period for the interaction between sleep and weight.

The researchers recommend that parents and children should be educated on good sleep habits.

Reference:  Medical Express.  Chronic insufficient sleep increases obesity, overall body fat in children. Retrieved from the web on 5/21/14 at http://medicalxpress.com/news/2014-05-chronic-insufficient-obesity-body-fat.html#nwlt.

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Autism Sleeps™ serves as a thorough resource of sleep sensory strategies and suggestions for preparing the “sleep environment”. Sample bedtime and wake-up routines are provided as templates, especially to guide parents of children with sleep difficulties.

Find out more at http://yourtherapysource.com/autismsleeps.html

Developmental Coordination Disorder and Risk of Obesity

The Canadian Medical Association Journal published research on a study of over 2000 children from 4th through 6th grades. The children were screened for coordination disorders. One hundred eleven children had a potential diagnosis of developmental coordination disorder (DCD). The 111 children exhibited a higher body mass index and waist circumference in 4th grade which persisted throughout the two years they were followed. In addition, the children with potential DCD were at greater risk of being overweight or obese.

As pediatric therapists, we can help to educate parents and teachers on the signs and risks of DCD. In additional to providing therapeutic treatment for children with DCD, therapists can suggest modifications, accommodations and suitable sports/ recreational/leisure activities to encourage physical activity in this population of children.

Reference: Cairney, John, Hay, John, Veldhuizen, Scott, Missiuna, Cheryl, Mahlberg, Nadilein, Faught, Brent E Trajectories of relative weight and waist circumference among children with and without developmental coordination disorder CMAJ 2010 0: cmaj.091454

More Research on Why You Should Turn Off TV

Two recent studies once again recommend that television and screen time should be limited for all children. Pediatrics recently published research on Vitamin D deficiencies in children. Over 6,000 children were studied with 9% being Vitamin D deficient and 61% being Vitamin D insufficient. Low levels of vitamin D are associated with a higher risk of bone and heart disease. Children should consume foods/drinks high in vitamin D such as milk and fish. In addition, some children should take vitamin D supplements. The researchers recommend that children turn off the TV and go outside at least 15-20 minutes a day.

Archives of Pediatric and Adolescent Medicine published research indicating that certain sedentary activities in children (ages 3-8) resulted in an increased risk of high blood pressure. Television viewing and screen time, but not computer use, was associated with elevated blood pressure regardless of body composition.

Here are some fun ideas for outside play - Rock Smash or how about Put Out the Fire.

References:
Albert Einstein College of Medicine (2009, August 3). Millions Of U.S. Children Low In Vitamin D. ScienceDaily. Retrieved August 7, 2009, from http://www.sciencedaily.com­ /releases/2009/08/090803083633.htm

JAMA and Archives Journals (2009, August 4). TV And Computer Screen Time May Be Associated With High Blood Pressure In Young Children. ScienceDaily. Retrieved August 7, 2009, from http://www.sciencedaily.com­ /releases/2009/08/090803173127.htm

Benefits of Short Bouts of Physical Activity

A recent study in the International Journal of Pediatric Obesity offers some exciting research regarding physical activity in boys. The researchers studied physical activity levels in 47 boys(ages 8-10 years old)using accelerometry for seven days. After the seven days they measured waist circumference, aerobic fitness and microvascular function. The researchers discovered that the boys performed short physical bouts of activity rather than long, sustained periods. This was consistent with previous research which indicated that children normally perform short bouts of physical activity. The frequency of short bouts of physical activity was associated with waist circumference, aerobic fitness and microvascular health. There was no correlation with blood pressure. The researchers recommend further studies to determine if overtime the results remain and if the physical activity patterns are the same for girls.

Here are some suggestions to apply this research:
1. Encourage children to participate in any amount of physical activity (short or long).

2. Research has shown that children normally move in short bursts therefore keep that in mind during sporting practices if children are losing their focus.

3. Break up sedentary time with movement breaks whenever possible. Try our Mini Movement Breaks - this is a collection of physical activity breaks for children that can be performed with no equipment indoors or outdoors. Below is a video of how to create the mini movement break notebooks or shoe boxes. Download the breaks and create these notebooks to pass out to teachers and parents. Even better, have the children help to create the notebooks or shoe boxes to include fine motor skill development practice!



References:
Stone et al. The pattern of physical activity in relation to health outcomes in boys. International Journal of Pediatric Obesity, 2009; 1 DOI: 10.1080/17477160902846179

University of Exeter (2009, May 13). Sporadic Play Activity As Beneficial To Child Health As Continuous Bouts Of Exercise, Study Suggests. ScienceDaily. Retrieved May 15, 2009, from http://www.sciencedaily.com­ /releases/2009/05/090511101652.htm

Self Regulation and Obesity

Archives of Pediatrics and Adolescent Medicine published research that indicated children who lack self regulation exhibit excessive weight gain. This was a longitudinal study of 1061 children. The children participated in self regulation tasks at ages 3 and 5 years old. They were then followed until 12 years of age with body mass index (BMI) being measured 6 times throughout that time. The children who exhibited a decrease in the ability to self regulate had the highest BMI and the most rapid weight gain.

Curious to know do you observe this trend in children with a lack of self regulation?

Reference: Lori A. Francis; Elizabeth J. Susman
Self-regulation and Rapid Weight Gain in Children From Age 3 to 12 Years
Arch Pediatr Adolesc Med. 2009;163(4):297-302.

Water and Risk of Being Overweight

Brain Gym proponents as well as some pediatric therapists have been promoting the concept that drinking water can help learning. One of the 4 components of the PACE program from Brain Gym is to drink water to provide energy for the brain. The current issue of Pediatrics reports on another benefit of water for school age children - preventing obesity. This study was done in Germany with 2950 students. The experimental group received four lessons to promote water consumption. Water fountains were installed and water consumption was measured. The results showed that the children in the water group decreased their risk of being overweight by 31% compared to the control group. There was no difference in body mass index. The intervention group drank 1.1 more glasses of water per day than the control group.

Reference: Muckelbauer, Rebecca, Libuda, Lars, Clausen, Kerstin, Toschke, Andre Michael, Reinehr, Thomas, Kersting, Mathilde Promotion and Provision of Drinking Water in Schools for Overweight Prevention: Randomized, Controlled Cluster Trial Pediatrics 2009 123: e661-e667