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Abstracts From the 2024 North American Society for Pediatric Exercise Medicine Conference: Giving Kids a Chance Through Exercise (August 2024, Louisville, Kentucky, USA)

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Evaluation of Exercise Program for Overweight and Obese Pediatric Participants in a Single Tertiary Center in Singapore

Kylie Leong, Muhammad Munir Tohid, Bernard Xian Wei Liew, Siao Hui Toh, Mohammad Ashik Zainuddin, Fadzlynn Fadzully, Brandon Guoqiang Feng, Muhammad Alif Bin Abu Bakar, and Benny Kai Guo Loo

Purpose: Pediatric obesity is rising in prevalence. We audited the results of an exercise program for overweight and obese pediatric participants in a tertiary pediatric hospital. The main aim was to determine the program’s effectiveness, with the main outcome of change in body mass index (BMI). Method: Retrospective review of data from all pediatric participants attending the program between January 2017 and December 2022. Inclusion criteria for analysis were BMI ≥90th centile, ages 6–15, attendance in at least 2 sessions and for at least 1 week. Statistical analysis was done using Generalized Additive Modeling. Results: One hundred thirty seven participants were included. The average duration in the program was 16 months (min = 1 wk, max = 57 mo). Majority (66%, n = 94) attended at intervals of >4 weeks. Only 7% (n = 9) attended weekly. The shorter the visit intervals, the more likely the BMI loss. The greatest decrease in BMI (−0.275; 95% confidence interval, −0.381 to −0.17) was in 15-year-old obese participants with visit intervals of <1 week. At the last visit, 84.7% maintained, 12.4% improved and 2.9% worsened in BMI category, respectively. Conclusion: Participants who attended an exercise program at least weekly demonstrated the best outcomes. Most did not adhere to the recommended frequency and thus had poorer outcomes. We have since made improvements to our program to increase visit frequency.

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Physical Determinants of Sprint and Long Jump Performance in Male Youth Track-and-Field Athletes With Differing Maturity Statuses

James Baker, Paul Read, Philip Graham-Smith, Mauricio Monaco, Evdokia Varamenti, Marco Cardinale, and Thomas W. Jones

Purpose: This study examined the physical determinants of 60-m sprint and long jump (LJ) performance and differences between maturity groups in physical characteristics in young male track-and-field athletes. Methods: Competition results, countermovement jump, isometric leg press, 10-5 repeated jump test, and 50-m sprint were collected over 3 seasons for 54 male athletes (age 13 [1] y; stature 160.0 [8.9] cm; body mass, 48.0 [9.8] kg; percentage predicted adult height 92.2% [5.5%]) grouped by maturity status: approaching- (n = 16), circa- (n = 19), and post-peak height velocity (PHV) (n = 19). Results: There were significant between-group differences in 60 m, LJ, and all physical testing variables (P < .001, g = 0.88–5.44) when comparing the approaching- and circa-PHV groups with the post-PHV group. Significant differences were identified between the approaching- and circa-PHV groups in 40-m (P = .033, g = 0.89), 50-m (P = .024, g = 1.64), and 60-m (P < .001, g = 0.89) sprint times. Countermovement jump and 50-m sprint variables were consistently important for projection of 60 m and LJ performance across the valid multivariate models. Conclusions: Large differences in performance across maturity groups highlight the importance of understanding athletes’ maturity status to accurately interpret performance. Several physical performance variables were important for projecting competition 60 m and LJ performance.

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The Benefits of Acute Aerobic Exercise on Preadolescent Children’s Learning in a Virtual Classroom

Lauren B. Raine, Rachel J. Hopman-Droste, Abigail N. Padilla, Arthur F. Kramer, and Charles H. Hillman

Purpose: Today’s children are increasingly inactive, with >50% not meeting the recommended 60 minutes of daily physical activity (PA). Recent reports suggest scores in reading and mathematics have also declined. Virtual reality (VR) is a technology that can be used to simulate real-world scenarios, like classroom learning. This study investigated whether a single dose of walking benefits learning in a VR classroom (measured via quiz performance). Method: Forty-seven children (15 females, 9.64 [0.12] y) completed 2, randomized and counterbalanced 20-minute interventions on separate days: acute PA (walking) and seated rest (control), followed by a stationary educational lesson in a distracting VR classroom. Children then completed a quiz on the lesson. Results: Children had higher quiz performance following PA (z-score = 0.16 [0.13]) compared with following rest (z-score = −0.18 (0.14); F 1,45 = 6.17, P = .017), indicating that PA enhanced learning. Children with average intelligence quotient had quiz performance that was higher after PA (z-score = 0.04 [0.20]) compared with after rest (z-score = −0.60 [0.19]), t(22) = 3.34, P = .003. Higher intelligence quotient children did not demonstrate differences in quiz performance after PA compared with after rest. Conclusions: Learning in a VR classroom may be improved following acute PA, particularly for children with average intelligence quotient. These findings support public health guidelines promoting PA across the day.

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Comparison of Exercise Protocols for Diagnosing Pediatric Unexplained Dyspnea on Exertion

Elliott Brown, Karla Foster, Iesha Gover, Adam Powell, and William D. Hardie

Purpose: Clinicians evaluating pediatric patients with unexplained dyspnea on exertion (DOE) often obtain exercise testing with a treadmill-based exercise-induced bronchospasm (EIB) protocol measuring only changes in spirometry. We modified the EIB protocol to collect metabolic and lung volume endpoints as obtained in a cardiopulmonary exercise test (CPET). We tested the hypothesis that measuring metabolic data with the EIB protocol (EIB-CPET) would yield greater diagnostic information than the EIB protocol. Methods: Exercise test diagnosis for healthy children with DOE referred to the pulmonary exercise lab from January 2011 through July 2023 were retrospectively compared between those performing either the EIB or EIB-CPET protocols. Results: One hundred and twenty-seven patients with unexplained DOE were analyzed. Of the 72 patients tested on the EIB protocol, 49% had stridor and 5% with EIB. Of the 55 patients tested on the EIB-CPET protocol, 42% had stridor, 42% with normal physiologic limitation, 22% with dysfunctional breathing, 5% with deconditioning, 2% with EIB, and 2% with exercise-induced hypoxemia. Patients performing the EIB-CPET protocol had a significantly higher rate of any diagnosis compared with EIB (P = .0002). Conclusions: There is a greater diagnostic yield in children with unexplained DOE performing the EIB-CPET protocol compared with patients performing the EIB protocol.

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Using 2 Versions of the Test of Gross Motor Development to Classify and Screen Young Children’s Motor Skills: A Comparison Study

Kara K. Palmer, Alec McKheen, Stephanie A. Palmer, Aaron P. Wood, David F. Stodden, and Leah E. Robinson

Purpose: The purpose of this study was to examine comparability between 2 editions of the Test of Gross Motor Development (TGMD-second and TGMD-third edition) on (1) how children’s motor skills were categorized as average or below average, and (2) how children are screened for being at-risk for motor delay or with delayed motor skills. Methods: Participants were 226 children (M age = 53.4 mo, 125 boys). All children completed full TGMD-2 and TGMD-3. Children were classified as average or above (>25th percentile) or below average (≤25th percentile) and, when applicable, as developmental delay (≤5th percentile) or at-risk for developmental delay (6–25th percentile). We compared children’s classifications across TGMD editions using percent agreement and chi-squared tests. Results: The TGMD-2 and TGMD-3 had moderate agreement when categorizing children as below average (72.2% for total skills, 76.0% for locomotor skills, and 73% for ball skills). The TGMD-3 was significantly more likely to categorize children’s motor skill performance as average or above (all P < .01). Conclusion: TGMD-2 and TGMD-3 similarly screen children who demonstrate below average skills (≤25th percentile), but not for specific skill level classifications, including above average, at-risk for delays, and delayed.

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Erratum. Light-Intensity Physical Activity and Sedentary Behavior Are Associated With Blood Pressure Levels in Adolescents

Pediatric Exercise Science

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Paving the Path for the Next Generation of Olympic Champions: Development of Youth Athletes Through Pediatric Exercise Science

Alfred Nimmerichter, Kelly Arbour-Nicitopoulos, and Karin A. Pfeiffer

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Multistream Adaptive Attention-Enhanced Graph Convolutional Networks for Youth Fencing Footwork Training

Yongjun Ren, Huinan Sang, Shitao Huang, and Xuelin Qin

Purpose: The popularity of fencing and intense sports competition has burdened adolescents with excessive training, harming their immature bodies. Traditional training methods fail to provide timely movement corrections and personalized plans, leading to ineffective exercises. This paper aims to use artificial intelligence technology to reduce ineffective exercises and alleviate the training burden. Methods: We propose an action recognition algorithm based on the characteristics of adolescent athletes. This algorithm uses multimodal input data to comprehensively extract action information. Each modality is processed by the same network structure, utilizing attention mechanisms and adaptive graph structures. A multibranch feature fusion method is used to determine the final action category. Results: We gathered the fencing footwork data set 2.0. Our model achieved 93.3% accuracy, with the highest precision at 95.8% and the highest F1-Score at 94.5% across all categories. It effectively recognized actions of adolescents with different heights and speeds, outperforming traditional methods. Conclusion: Our artificial intelligence-based training solution improves training efficiency and reduces the training burden on adolescents.

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Agility Ladder Training Combined With Plyometric or Multidirectional Speed Drills: Short-Term Adaptations on Jump, Speed, and Change of Direction Performance in Young Female Volleyball Players

Eleni Bassa, Afroditi C. Lola, Alexandra Melliou, Maria Prassa, Georgia Stavropoulou, and Nikolaos Ziogas

Purpose: The aim of this study was to investigate the effect of agility ladder training combined with plyometric or multidirection speed drills, on performance in young female volleyball players. Methods: Seventy-six young female volleyball players were randomly distributed into 3 maturity-matched groups: (1) the agility ladder + plyometric drills group, (2) the agility ladder + multidirection speed drills group, and (3) the control group. Both experimental groups followed a 6-week training program, twice weekly, in addition to the regular volleyball training sessions, while the control group participated only in the regular volleyball training sessions. Assessments pretraining and posttraining included countermovement jump, 20-m sprint, and agility T test.  Results: Both experimental groups improved T-test performance (P < .005) but only agility ladder + multidirection speed drills group outperformed the control group (P < .05). Conclusions: Agility ladder training programs combined with either plyometric or speed drills can improve change of direction performance in young female volleyball players but only the combination of agility ladder with multidirection speed drills is more effective than volleyball training per se. The small effectiveness of these protocols may be attributed to the short training period, or to the fact that training elements were combined in a single session. This hypothesis remains to be further investigated.