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Gamification to Promote Physical Activity in Youth and Mothers With Obesity

Elizabeth Prout Parks, Kelly C. Allison, Yasmeen Bruton, Timothy Khalil, and Jonathan A. Mitchell

Purpose: Physical inactivity and sugar-sweetened beverage (SSB) consumption are associated with obesity. Gamification and self-monitoring to promote physical activity in youth is unknown, but evidence of effectiveness is present in adults. This study examined the effects of a gamification intervention on increased steps per day among parent–adolescent dyads with obesity compared with digital self-monitoring and if self-monitored SSB intake differed between these arms. Methods: Youth ages 10–16 years and their mothers (N = 39 pairs), both with obesity, were randomized to a self-monitoring (N = 18) or a self-monitoring plus gamification arm (N = 21) for 9 weeks. The step goal was set and incrementally increased each week and was measured with Fitbit devices. Mixed effects linear regression examined changes in steps and SSB consumption per day, per week by study arm. Results: During run-in, mothers averaged 8317 and youth 7508 steps per day. Compared with self-monitoring alone, gamification did not increase daily steps in mothers or youth beyond baseline levels. On average, SSB intake decreased in mothers by approximately 0.5 servings per day; occurred in both arms and persisted throughout the intervention. Conclusion: Gamification did not promote physical activity levels in mother–youth dyads with obesity. SSB intake declined in mothers with obesity in both study arms.

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Volume 36 (2024): Issue 1 (Feb 2024)

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Reference Values in the 6-Minute Walk Test in Chilean Children Aged 3–10 Years and Relationship With Cardiometabolic Risk

Pedro A. Latorre Román, Cristian Martínez Salazar, Juan A. Párraga Montilla, José Carlos Cabrera-Linares, Karina E. Andrade-Lara, Alejandro Robles Fuentes, and José Miguel Espinoza Silva

Purpose: The aim of this study was to evaluate the performance of healthy Chilean children aged 3–10 years in the 6-minute walking test (6MWT) and cardiometabolic risk variables and to determine sex- and age-specific reference values. Methods: This study involved 1165 healthy children (age = 6.36 [1.70] y old). The 6MWT was used to evaluate exercise performance. Furthermore, anthropometric measures were collected, like weight, height, body mass index, waist circumference, and skin folds. Resting heart rate and blood pressure (BP) were also evaluated. Results: The prevalence of overweight and obesity was 35.0% and 25.4% in preschoolers and 29.0% and 36.2% in school-age children, respectively, showing significant differences (P < .05) between age groups. The distance walked (6-min walk distance) increased significantly year on year at ages from 3 to 10 years. According to the regression analysis, 6MWT performance was positively related to age, systolic BP, and height, whereas it was negatively related to ∑4 skinfold fat, resting heart rate, diastolic BP, and waist circumference. Conclusions: This study provides a reference equation and an age- and sex-adjusted percentile curve to assess the predicted 6MWT performance in a cohort of prepubertal Chilean children. The 6-minute walk distance depends mainly on age; however, other variables, such as resting heart rate, BP, skinfold fat, and waist circumference, add significant information and should be taken into account.

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Physical Activity, but Not Body Mass Index Is Associated With Blood Pressure in Young Children

Katrina D. DuBose, Kathryn Beaman, Christine Habeeb, and Deirdre Dlugonski

Purpose: This study examined associations between physical activity (PA) and obesity with blood pressure (BP) in young children. Furthermore, a possible moderating effect of obesity status was examined. Methods: A cross-sectional study was completed with 121 children (3.96 [1.14] y). BP, weight, and height were measured, and body mass index (BMI) was calculated. Z scores were calculated for BMI, systolic, and diastolic values. Accelerometry measured time spent in PA intensities. Correlations and regressions examined relationships among PA intensities, BMI z scores, and BP z scores and to determine if obesity status moderated these relationships. Results: On average, the children spent 52 minutes per day in moderate-to-vigorous physical activity, 31% were considered overweight/obese, and 15% were considered hypertensive. After adjusting for confounders, participation in moderate, vigorous, and moderate-to-vigorous physical activity was related with lower systolic and diastolic BP z scores (P < .05). BMI z score was not related to BP values. Obesity status did not moderate the relationships between time spent in PA and BP. Conclusions: Participation in PA, but not obesity, was related to lower BP levels in young children. The impact PA has on BP is the same regardless of obesity status. Thus, young children should be encouraged to be active in different intensities to benefit the cardiovascular system.

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Child Soccer Players’ Perceptions of Strength and Conditioning Training: A Multimethod Approach Using Write, Draw, Show and Tell

Ricardo Martins, Emma Eyre, Matteo Crotti, Rhys Morris, Will Pattison, and Michael Duncan

Purpose: The use of strength and conditioning training in childhood is a hot topic surrounded by myths and misconceptions. Despite scientific evidence supporting the safety and benefits of this training for children, the lack of representation of their voices poses a challenge in designing training programs that meet their specific needs and requirements. Methods: Children’s views, experiences, and perceptions of strength and conditioning training were explored by Write, Draw, Show and Tell techniques. Sixteen grassroots soccer players aged 11–12 years took part in one of 3 focus groups exploring the topic. Data were analyzed following an inductive approach enabling themes to be explored and later deductive analyses using the Youth Physical Activity Promotion model to create pen profile diagrams. Results: Strength and conditioning were frequently associated with muscle growth, coordination, endurance, and rest. Enabling factors included autonomy, resilience, physical development, and training opportunities. Reinforcing factors included social support, social interference, coaches’ communication, role models, and the ways of implementation. Conclusions: Participants favor integrating strength and conditioning into their soccer training rather than conducting it as a separate session, which is reflected in their enjoyment. Nonetheless, children remain apprehensive about the potential effects of this type of training on their growth.

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Postural Balance in Boys With Intellectual Disabilities Who Participate in Soccer Training

Ghada Jouira, Haithem Rebai, Dan Iulian Alexe, and Sonia Sahli

Purpose: The aim of this study is to investigate the postural balance in children with intellectual disabilities who participate in soccer training compared with their sedentary peers. Method: Two groups of boys with intellectual disabilities aged 8–10 years participated in this study: a soccer group (n = 12) and a sedentary group (n = 12). Postural balance was assessed using a force platform under 4 different conditions: open eyes, and closed eyes, on firm and foam surfaces. The Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test were also conducted. Results: The soccer group had significantly lower (P < .05) center of pressure values compared with the sedentary group, on both firm and foam surfaces, but only under the open eyes condition. They were significantly faster (P < .05) in the Timed Up and Go Test, 10-m Walking Test, and Four-Square Step Test compared with their sedentary peers. However, there were no significant differences between the 2 groups on the sit-to-stand and turn-to-sit phases of the Timed Up and Go Test. Conclusion: Soccer participation may have a positive effect on postural balance in boys with intellectual disabilities. These findings may have implications for the development of exercise programs to improve postural balance and reduce the risk of falls in this population.

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Validation and Calibration for Embedding Rating of Perceived Exertion Into High-Intensity Interval Exercise in Adolescents: A Lab-Based Study

Yong Liu, Craig A. Williams, Kathryn L. Weston, Stephanie L. Duncombe, Adam A. Malik, and Alan R. Barker

Purpose: Rating of perceived exertion (RPE) is a convenient and cost-effective tool that can be used to monitor high-intensity interval exercise (HIIE). However, no methodological study has demonstrated the validity of RPE in this context. Therefore, the aim of this study was to validate and calibrate RPE for monitoring HIIE in adolescents. Methods: RPE, heart rate (HR), and oxygen uptake ( V ˙ O 2 ) data were retrospectively extracted from 3 lab-based crossover studies, with a pooled sample size of 45 adolescents, performing either cycling-based or running-based HIIE sessions. Within-participant correlations were calculated for RPE-HR and RPE- V ˙ O 2 , and receiver operator characteristic curve analysis was used to establish RPE cut points. Results: The results showed that RPE-HR demonstrated acceptable criterion validity (r = .53–.74, P < .01), while RPE- V ˙ O 2 had poor validity (r = .40–.48, P < .01), except for HIIE at 100% peak power (r = .59, P < .01). RPE cut points of 4 and 5 were established in corresponding to HR / V ˙ O 2 based thresholds. Conclusion: RPE has some utility in evaluating intensity during lab-based running or cycling HIIE in adolescents. Future studies should expand the validation and calibration of RPE for prescribing and monitoring HIIE in children and adolescents in field-based contexts.

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Children With Cardiac Disease and Heat Exposure: Catastrophic Converging Consequences?

Luc Souilla, Pascal Amedro, and Shawnda A. Morrison

The detrimental impact of extreme heat exposure on the health and well-being of children is widely acknowledged. The direct and indirect effects of climate change have led to an increased risk of certain cardiovascular events which may be particularly harmful to children who are born with, or develop, heart disease. Purpose: To highlight the worrying paucity of investigative research aimed at differentiating how higher ambient temperatures further tax an already compromised cardiovascular system in children. Methods: This commentary describes basic thermoregulatory concepts relevant to the healthy pediatric population and summarizes common heart diseases observed in this population. Results: We describe how heat stress and exercise are important factors clinicians should more readily consider when treating children with heart disease. Countermeasures to physical inactivity are suggested for children, parents, clinicians, and policymakers to consider. Conclusions: As sudden, excessive heat exposures continue to impact our rapidly warming world, vulnerable populations like children with underlying heart conditions are at greater heat health risk, especially when coupled with the negative physical activity and fitness trends observed worldwide.

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Quick, Effective Screening Tasks Identify Children With Medical Conditions or Disabilities Needing Physical Literacy Support

Patricia E. Longmuir, Adam Chubbs Payne, Natalie Beshara, Leonardo R. Brandão, F. Virginia Wright, Daniela Pohl, Sherri Lynne Katz, Anna McCormick, Denise De Laat, Robert J. Klaassen, Donna L. Johnston, Jane Lougheed, Johannes Roth, Hugh J. McMillan, Sunita Venkateswaran, Erick Sell, Asif Doja, Addo Boafo, Gail Macartney, Katherine Matheson, and Brian M. Feldman

Purpose: This study evaluated screening tasks able to identify children with medical conditions or disabilities who may benefit from physical literacy. Method: Children completed ≤20 screening tasks during their clinic visit and then the Canadian Assessment of Physical Literacy (2nd edition) at a separate visit. Total Canadian Assessment of Physical Literacy scores <30th percentile were categorized as potentially needing physical literacy support. Receiver operator characteristic curves identified assessment cut points with 80% sensitivity and 40% specificity relative to total physical literacy scores. Results: 223 children (97 girls; 10.1 [2.6] y) participated. Physical activity adequacy, predilection, and physical competence achieved ≥80% sensitivity and ≥40% specificity in both data sets. Adequacy ≤ 6.5 had 86% to 100% sensitivity and 48% to 49% specificity. Daily screen time >4.9 hours combined with Adequacy ≤6.15 had 88% to 10% sensitivity and 53% to 56% specificity. Conclusions: Activity adequacy, alone or with screen time, most effectively identified children likely to benefit from physical literacy support. Adequacy and screen time questionnaires are suitable for clinical use. Similar results regardless of diagnosis suggest physical competence deficits are not primary determinants of active lifestyles. Research to enhance screening specificity is required.

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Editor’s Notes

Craig A. Williams