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Maximal Aerobic Power, Quality of Life, and Ejection Fraction in Survivors of Childhood Cancer Treated with Anthracyclines

Maritza Martínez Tagle, Pavel Loeza Magaña, Alma Edith Benito Reséndiz, Iliana Lucatero Lecona, Farina Esther Arreguín González, and Alberto Chávez Delgado

Background: Anthracycline-induced cardiotoxicity is a frequent complication that can occur at any stage of treatment, even in survivors. Objective: To determine maximum aerobic power, quality of life, and left ventricular ejection fraction in childhood cancer survivors treated with anthracyclines. Design: Cross-sectional, observational study. Methods: The left ventricular ejection fraction was obtained from the transthoracic echocardiogram report in the medical records. Each patient underwent a 6-minute walk test, assessment of maximum aerobic power on a cycle ergometer, and evaluation of perceived exertion using the EPInfant scale, and finally, their quality of life was evaluated using the pediatric quality of life inventory model. Results: A total of 12 patients were studied, with an average of 16.2 years of age. All patients exhibited a left ventricular ejection fraction >60%, the mean distance covered in the 6-minute walk test was 516.7 m, and the mean of the maximum aerobic power was 70 W. Low quality of life scores were obtained in the physical and psychosocial aspects. In the Pearson test, a weak correlation without statistical significance was found between all the variables studied. Conclusions: Simultaneously with the detection of cardiotoxicity in childhood cancer survivors, it is pertinent to perform physical evaluations as physical condition and cardiotoxicity seem to be issues that are not necessarily dependent.

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Parental Travel Behaviors and Children’s Independent Mobility: A MultiSite Study

Victoria Hecker, Sebastien Blanchette, Guy Faulkner, Negin A. Riazi, Mark S. Tremblay, François Trudeau, and Richard Larouche

Purpose: Children who are allowed greater independent mobility (IM) are more physically active. This study investigated associations between parents’ current travel mode to work, their own IM and school travel mode as a child, and their child’s IM. Methods: Children in grades 4 to 6 (n = 1699) were recruited from urban, suburban, and rural schools in Vancouver, Ottawa, and Trois-Rivières. Parents reported their current travel mode to work, IM, and school travel mode as a child. Children self-reported their IM using Hillman’s 6 mobility licenses. Multiple imputation was performed to replace missing data. Gender-stratified generalized linear mixed models were adjusted for child age, parent gender, urbanization, and socioeconomic status. Results: The older a parent was allowed to travel alone as a child, the less IM their child had (boys: β = −0.09, 95% confidence interval [CI], −0.13 to −0.04; girls: β = −0.09, 95% CI, −0.13 to −0.06). Girls whose parents biked to work (β = 0.45, 95% CI, 0.06–0.83) or lived in Trois-Rivières versus other sites (β = 0.82, 95% CI, −0.43 to 1.21) had higher IM. IM increased with each year of age (boys: β = 0.46, CI, 0.34–0.58; girls: β = 0.38, 95% CI, 0.28–0.48). Conclusion: Parents who experienced IM later may be more restrictive of their child’s IM. This may help explain the intergenerational decline in children’s IM.

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Volume 36 (2024): Issue 2 (May 2024)

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A 5-Week Guided Active Play Program Modulates Skin Microvascular Reactivity in Healthy Children

Asal Moghaddaszadeh, Emilie Roudier, Heather Edgell, Agnes Vinet, and Angelo N. Belcastro

Purpose: Children’s poor levels of physical activity (PA) participation and early-onset vascular aging are identified as global health challenges. Children’s guided activity play (GAP)-based PA programs have emerged as effective strategies to improve cardiovascular risk factors and health-related fitness. This study proposes to investigate whether GAP improves children’s cutaneous microvascular reactivity and health-related fitness. Methods: Children’s (n = 18; 9.8 [1.5] y) PA during a 5-week (4 d/wk; 1 h/d) GAP program was assessed (accelerometry) with preassessments and postassessments for anthropometric, musculoskeletal fitness, blood pressure, estimated aerobic power, and cutaneous microvascular reactivity. Results: PA averaged 556 (132) kcal·week−1 at 34.7% (7.5%) time at moderate to vigorous intensity. Resting heart rate (−9.5%) and diastolic blood pressure (−7.8%) were reduced without changes in health-related fitness indices. Cutaneous microvascular reactivity to sodium nitroprusside iontophoresis increased the average perfusion (+36.8%), average cutaneous vascular conductance (+30%), the area under the curve (+28.8%), and a faster rise phase (+40%) of perfusion (quadratic modeling; P ≤ .05). Chi-square and crosstabulation analysis revealed significant association between children’s PA levels and sodium nitroprusside average perfusion levels, where children with PA levels ≥205.1 kcal.55 minute−1 were overrepresented in the medium/high levels of sodium nitroprusside perfusion. Conclusion: A 5-week GAP modified the microvascular reactivity in children without changes in body mass, musculoskeletal fitness, or estimated aerobic power.

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Effectiveness of a Preschool Motor Skill Intervention on Body Mass Index and Movement Behavior: 6-, 18-, and 30-Month Findings From a Cluster Randomized Controlled Trial

Line Grønholt Olesen, Anders Grøntved, Jan Christian Brønd, Lise Hestbæk, and Peter Lund Kristensen

Purpose: To study the effectiveness of a preschool staff-delivered motor skills intervention on body composition and physical activity over a 2.5-year time frame. Methods: In this pragmatic parallel cluster randomized controlled trial (16 preschools), outcome data were collected after 6 (body composition only), 18, and 30 months of intervention. The main physical activity outcomes were accelerometer behavior measures summarizing the total percentage of child daily movement (walk, run, cycle, and standing that included minor movements) and preschool movement during preschool attendance. To estimate between-group mean differences in outcomes, mixed-linear regression analyses including baseline value of the selected outcome and a treatment × time interaction term as a fixed effect were applied. In addition, the baseline preschool and child were included as a random effect. Results: For body mass index, a total of 437 children (90%) had at least one valid baseline and one follow-up assessment. The corresponding numbers for preschool movement and daily movement were 163 (55%) and 146 (49%), respectively. No significant between-group mean difference was identified for body mass index, waist-to-height ratio, or any physical activity outcomes. Conclusion: Overall, this preschool motor skills intervention had no effect on either child anthropometry or physical activity, consistent with previous studies.

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Editor’s Notes

Craig A. Williams

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The Associations Between Parental-Reported and Device-Based Measured Outdoor Play and Health Indicators of Physical, Cognitive, and Social–Emotional Development in Preschool-Aged Children

Cody Davenport, Nicholas Kuzik, Richard Larouche, and Valerie Carson

Purpose: Examine in preschool-aged children: (1) the associations between parental-reported and device-measured outdoor play (OP) and health indicators of physical, cognitive, and social–emotional development and (2) whether associations were independent of outdoor moderate- to vigorous-intensity physical activity (MVPA). Methods: This cross-sectional study included 107 participants. Children’s OP was measured via a parental questionnaire and the lux feature of accelerometers. Children’s growth, adiposity, and motor skills were assessed as physical development indicators. Visual–spatial working memory, response inhibition, and expressive language were assessed as cognitive development indicators. Sociability, prosocial behavior, internalizing, externalizing, and self-regulation were assessed as social–emotional development indicators. Regression models were conducted that adjusted for relevant covariates. Additional models further adjusted for outdoor MVPA. Results: Parental-reported total OP, OP in summer/fall months, and OP on weekdays were negatively associated (small effect sizes) with response inhibition and working memory. After adjusting for outdoor MVPA, these associations were no longer statistically significant. OP on weekdays was negatively associated with externalizing (B = −0.04; 95% confidence interval, −0.08 to −0.00; P = .03) after adjusting for outdoor MVPA. A similar pattern was observed for device-based measured total OP (B = −0.49; 95% confidence interval, −1.05 to 0.07; P = .09). Conclusions: Future research in preschool-aged children should take into account MVPA and contextual factors when examining the association between OP and health-related indicators.

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Associations of Serum Irisin and Fibroblast Growth Factor-21 Levels With Bone Mineral Characteristics in Eumenorrheic Adolescent Athletes With Different Training Activity Patterns

Jaak Jürimäe, Liina Remmel, Anna-Liisa Tamm, Priit Purge, Katre Maasalu, and Vallo Tillmann

Purpose: To describe serum irisin and fibroblast growth factor-21 (FGF-21) concentrations in healthy female adolescents with different training activity patterns and their associations with bone mineral properties and metabolic markers. Methods: A total of 62 adolescent girls aged 14–18 years were recruited: 22 rhythmic gymnasts, 20 swimmers, and 20 untrained controls. Bone mineral characteristics by dual-energy X-ray absorptiometry, daily energy intake by dietary recall, serum irisin, FGF-21, undercarboxylated osteocalcin, and C-terminal telopeptide of type I collagen were measured in all girls. Results: Whole body and lumbar spine areal bone mineral density and lumbar spine bone mineral content were higher in the rhythmic gymnasts group compared with swimmers and untrained controls groups (P < .05). Serum irisin, FGF-21, undercarboxylated osteocalcin, and C-terminal telopeptide of type I collagen levels were not significantly different between the groups. In the rhythmic gymnasts group, serum FGF-21 concentration was positively correlated with lumbar spine areal bone mineral density independently of confounding factors (r = .51; P = .027). Conclusions: Serum irisin and FGF-21 levels were not different between adolescent eumenorrheic girls with different training activity patterns. FGF-21 was positively associated with lumbar spine areal bone mineral density, which predominantly consists of trabecular bone in adolescent rhythmic gymnasts.

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Accelerometer and Survey Assessed Physical Activity in Children With Epilepsy: A Case-Controlled Study

Joan Idowu, Natalie Pearson, Collette Meades, J. Helen Cross, Amy Muggeridge, Monica Lakhanpaul, Kerry Robinson, Lauren B. Sherar, and Colin Reilly

Purpose: Anecdotal evidence suggests that children with epilepsy (CWE) are limited in the frequency of their daily physical activity (PA). However, there is limited research utilizing device-based measures of PA. We compared levels of PA and sedentary behavior in CWE (11–15 y) and age- and gender-matched healthy controls. Method: Participants (n = 60 CWE [25 males, 35 females] and n = 49 controls [25 males, 24 females]) wore a Actigraph accelerometer (GT3X or GT3X+) for 7 consecutive days during waking hours and self-reported their PA and sedentary behaviors. CWE were compared with control children on time spent in different intensities of PA and on self-reported PA and sedentary behavior. Factors associated with PA were analyzed using linear regression. Results: CWE spent less time in accelerometer assessed light (189.15 vs 215.01 min/d, P < .05) and vigorous PA (35.14 vs 44.28 min/d, P < .05) on weekdays compared with controls. There were no significant differences between CWE and control participants in accelerometer assessed time spent sedentary or time spent in PA on weekends. Among CWE, older children engaged in more reported sedentary behavior and younger children spent more time in most domains of PA (P < .05). Furthermore, CWE reported less PA than controls (P = .006). Sixteen percent of controls met World Health Organization PA guidelines compared with 10% of CWE. There was a positive relationship between accelerometer assessed PA and quality of life for CWE. Conclusion: CWE spent less time in light and moderate to vigorous PA on weekdays. Further research is needed to understand reasons for these differences.

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Normative Reference Centiles for Sprint Performance in High-Level Youth Soccer Players: The Need to Consider Biological Maturity

Ludwig Ruf, Stefan Altmann, Christian Kloss, and Sascha Härtel

Purpose: To compute reference centiles for 5- and 30-m sprint times relative to chronological and skeletal age in youth soccer players. Subsequently, to compare individual’s sprint performance scores derived from the chronological and skeletal age reference centiles. Methods : Sprint times were collected for a sample of male U11 to U19 soccer players (n = 1745 data points). Skeletal age data were available for a subsample (n = 776 data points). Reference centiles were fitted using generalized additive models for location, scale, and shape. Individual z scores relative to chronological and skeletal age reference centiles were computed and compared for each maturity group (late, on-time, early, and very early) using standardized mean differences (SMD). Results : Reference centiles for chronological age increased more rapidly between 10.5 and 15.5 years, while reference centiles for skeletal age increased more rapidly between 13.0 and 16.5 years. Differences in chronological and skeletal z scores for very early (SMD: −0.73 to −0.43) and late (SMD: 0.58 to 1.29) maturing players were small to large, while differences for early (SMD: −0.30 to −0.19) and on-time (SMD: 0.16 to 0.28) were trivial to small. Conclusion : Reference centiles provide a valuable tool to assist the evaluation of sprint performance in relation to chronological and skeletal age for talent identification purposes in youth soccer players.