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An 8-Week Virtual Exercise Training Program for Pediatric Solid Organ Transplant Recipients

Nikol K. Grishin, Astrid M. De Souza, Julie Fairbairn, A. William Sheel, E. Puterman, Tom Blydt-Hansen, James E. Potts, and Kathryn R. Armstrong

Purpose: Musculoskeletal strength can be impaired in pediatric solid organ transplant recipients. Exercise training programs can be beneficial but in-person delivery can be challenging; virtual exercise programs can alleviate some of these challenges. This feasibility study aimed to deliver an 8-week virtual exercise program in pediatric solid organ transplant recipients. Method: Program delivery occurred 3 times per week for 30 minutes. An exercise stress test was completed prior to program start. The Bruininks-Oseretsky Test of Motor Proficiency strength subtest and self-report surveys were used to assess musculoskeletal strength, quality of life, fatigue, and physical activity. Contact was maintained through a text messaging platform. Z scores were calculated using standardized normative data. Medians (interquartile range) are reported for all other data. Results: Eleven participants completed the program (2 liver, 5 kidney, 4 heart; 58% females; median age = 11.5 [10.3–13.8] y). Six participants attended ≥60% of classes, 5 participants attended <50% of classes. After 8 weeks, strength scores improved (Z score, Pre: −1.0 [−1.65 to −0.60] to Post: −0.2 [−1.30 to 0.40]; P = .007) with no change in other outcome measures. Conclusion: The virtual exercise program was delivered without technical issues and received positive participant feedback. Engagement and costs need to be considered.

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Physical Activity and Children’s Episodic Memory: A Meta-Analysis

Daphne G. Schmid, Nathan M. Scott, and Phillip D. Tomporowski

Purpose: The purpose of this review was to evaluate the effects of physical activity on children’s free recall, cued recall, and recognition episodic memory and to explore potential moderating factors. Methods: The following databases were searched: PubMed, ERIC, APA Psych Info, CINHAL, SPORTDiscus, and Google Scholar. Studies were included if: (1) participants were aged 4–18 years, (2) participants were typically developed, (3) participants were randomized to groups, (4) interventions employed gross movements, (5) sedentary group was used for control, (6) memory tests were quantitative, and (7) employed acute or chronic intervention. Results: 14 studies met inclusion criteria resulting in the analysis of data from 7 free recall, 7 cued recall, and 8 recognition memory tests. Physical activity was found to have a positive influence on tests free (g = 0.56), cued recall (g = 0.67), and no influence on tests of recognition (g = 0.06). While some moderator analyses were significant, the authors do not consider these results to be meaningful in application. Conclusions: The effects of acute and chronic physical activity enhance specific aspects of long-term episodic memory. These findings suggest physical activity interventions developed for children may be expected to benefit some, but not all, types of memory processing.

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Youths Are Less Susceptible to Exercise-Induced Muscle Damage Than Adults: A Systematic Review With Meta-Analysis

John F.T. Fernandes, Lawrence D. Hayes, Amelia F. Dingley, Sylvia Moeskops, Jon L. Oliver, Jorge Arede, Craig Twist, and Laura J. Wilson

Purpose: This meta-analysis aimed to (1) provide a comparison of peak changes in indirect markers of exercise-induced muscle damage (EIMD) in youths versus adults and (2) determine if the involved limb moderated this effect. Method: Studies were eligible for inclusion if they (1) provided a human youth versus adult comparison; (2) provided data on muscle strength, soreness, or creatine kinase markers beyond ≥24 hours; and (3) did not provide a recovery treatment. Effect sizes (ES) were presented alongside 95% confidence intervals. Results: EIMD exhibited larger effects on adults than in youths for muscle strength (ES = −2.01; P < .001), muscle soreness (ES = −1.52; P < .001), and creatine kinase (ES = −1.98; P < .001). The random effects meta-regression indicated that the effects of upper- and lower-limb exercise in youths and adults were significant for muscle soreness (coefficient estimate = 1.11; P < .001) but not for muscle strength or creatine kinase (P > .05). As such, the between-group effects for muscle soreness (ES = −2.10 vs −1.03; P < .05) were greater in the upper than lower limbs. Conclusion: The magnitude of EIMD in youths is substantially less than in their adult counterparts, and this effect is greater in upper than lower limbs for muscle soreness. These findings help guide practitioners who may be concerned about the potential impact of EIMD when training youth athletes.

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Volume 35 (2023): Issue 4 (Nov 2023)

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The Effect of Sex, Maturity, and Training Status on Maximal Sprint Performance Kinetics

Adam Runacres, Kelly A. Mackintosh, and Melitta A. McNarry

Purpose: The development of sprint running during youth has received renewed interest, but questions remain regarding the development of speed in youth, especially the influences of sex, training, and maturity status. Methods: One hundred and forty-seven team sport trained (69 girls; 14.3 [2.1] y) and 113 untrained (64 girls; 13.8 [2.7] y) youth completed two 30-m sprints separated by 2-minute active rest. Velocity was measured using a radar gun at >46 Hz, with power and force variables derived from a force–velocity–power profile. Results: Boys produced a significantly higher absolute peak power (741 [272] vs 645 [229] W; P < .01) and force (431 [124] vs 398 [125] N; P < .01) than girls, irrespective of maturity and training status. However, there was a greater sex difference in relative mean power and peak velocity in circa peak height velocity adolescents (46.9% and 19.8%, respectively) compared with prepeak height velocity (5.4% and 3.2%) or postpeak height velocity youth (11.6% and 5.6%). Conclusions: Sprint development in youth is sexually dimorphic which needs considering when devising long-term training plans. Further research is needed to explore the independent, and combined, effects of sex, training, and maturity status on sprint performance kinetics in youth.

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Factors That Influence Physical Activity Behavior in Children and Adolescents During and After Cancer Treatment: A Qualitative Systematic Review of the Literature

Laura Kappelmann, Miriam Götte, Arno Krombholz, Jan Hüter, and Britta Fischer

Purpose: The aim of this systematic review is to reveal the social, personal, and contextual factors that influence physical activity (PA) in children and adolescents during and after cancer treatment. Method: SPORTDiscus, Cochrane, Web of Science, PubMed, and FIS Education electronic database were systematically searched. Results: The 13 included studies show that social support (parents, siblings, and friends) in particular is rated as important by cancer survivors; for example, doing PA together. Depending on the treatment status and state of health, particularities arise. During the acute treatment phase, parents issued more prohibitions regarding PA than after treatment. The state of health and concern about infections are described as inhibiting factors. Not all hospitals generally offer special exercise programs for cancer patients, and in some cases, only sporadic exercise sessions were conducted by specialized staff. In addition, the hospital atmosphere, such as cramped rooms, tends to be associated with demotivating effects. Conclusions: Both inhibiting and promoting factors in the area of social, personal, and contextual factors could be identified. The most fundamental factor for PA is the physical condition. Social factors, such as parents or friends, often have a motivating effect and can promote PA. Inhibiting factors are mainly context-related, such as an environment unsuitable for PA. Although the review highlights interesting aspects, further treatment-related and longitudinal studies could provide deeper insights.

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Abstracts From the XXXIII Pediatric Work Physiology Conference Hosted by Swansea University (September 2023, Chepstow, Wales)

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Volume 35 (2023): Issue S1 (Oct 2023)

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Editor’s Notes

Craig A. Williams

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Association of Recess Provision With Accelerometer-Measured Physical Activity and Sedentary Time in a Representative Sample of 6- to 11-Year-Old Children in the United States

Kimberly A. Clevenger, Katherine L. McKee, Melitta A. McNarry, Kelly A. Mackintosh, and David Berrigan

Purpose: To assess the association between the amount of recess provision and children’s accelerometer-measured physical activity (PA) levels. Methods: Parents/guardians of 6- to 11-year-olds (n = 451) in the 2012 National Youth Fitness Survey reported recess provision, categorized as low (10–15 min; 31.9%), medium (16–30 min; 48.0%), or high (>30 min; 20.1%). Children wore a wrist-worn accelerometer for 7 days to estimate time spent sedentary, in light PA, and in moderate to vigorous PA using 2 different cut points for either activity counts or raw acceleration. Outcomes were compared between levels of recess provision while adjusting for covariates and the survey’s multistage, probability sampling design. Results: Children with high recess provision spent less time sedentary, irrespective of type of day (week vs weekend) and engaged in more light or moderate to vigorous PA on weekdays than those with low recess provision. The magnitude and statistical significance of effects differed based on the cut points used to classify PA (eg, 4.7 vs 11.9 additional min·d−1 of moderate to vigorous PA). Conclusions: Providing children with >30 minutes of daily recess, which exceeds current recommendations of ≥20 minutes, is associated with more favorable PA levels and not just on school days. Identifying the optimal method for analyzing wrist-worn accelerometer data could clarify the magnitude of this effect.