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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

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Associations Between Sedentary Time, Physical Activity, and Cardiovascular Health in 6-Year-Old Children Born to Mothers With Increased Cardiometabolic Risk

Linda Litwin, Johnny K.M. Sundholm, Rasmus F.W. Olander, Jelena Meinilä, Janne Kulmala, Tuija H. Tammelin, Kristiina Rönö, Saila B. Koivusalo, Johan G. Eriksson, and Taisto Sarkola

Purpose: To assess associations between sedentary time (ST), physical activity (PA), and cardiovascular health in early childhood. Method: Cross-sectional study including 160 children (age 6.1 y [SD 0.5], 86 boys, 93 maternal body mass index ≥ 30 kg/m2, and 73 gestational diabetes) assessed for pulse wave velocity, echocardiography, ultra-high frequency 48–70 MHz vascular ultrasound, and accelerometery. Results: Boys had 385 (SD 53) minutes per day ST, 305 (SD 44) minutes per day light PA, and 81 (SD 22) minutes per day moderate to vigorous PA (MVPA). Girls had 415 (SD 50) minutes per day ST, 283 (SD 40) minutes per day light PA, and 66 (SD 19) minutes per day MVPA. In adjusted analyses, MVPA was inversely associated with resting heart rate (β = −6.6; 95% confidence interval, −12.5 to −0.7) and positively associated with left ventricular mass (β = 6.8; 1.4–12.3), radial intima-media thickness (β = 11.4; 5.4–17.5), brachial intima-media thickness (β = 8.0; 2.0–14.0), and femoral intima-media thickness (β = 1.3; 0.2–2.3). MVPA was inversely associated with body fat percentage (β = −3.4; −6.6 to −0.2), diastolic blood pressure (β = −0.05; −0.8 to −0.1), and femoral (β = −18.1; −32.4 to −0.8) and radial (β = −13.4; −24.0 to −2.9) circumferential wall stress in boys only. ST and pulse wave velocity showed no significant associations. Conclusions: In young at-risk children, MVPA is associated with cardiovascular remodeling, partly in a sex-dependant way, likely representing physiological adaptation, but ST shows no association with cardiovascular health in early childhood.

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The Effects of Using a Cycling Desk at School on Executive Function, Physical Fitness, and Body Composition in Primary School Children: Impact of Socioeconomic Status

Camille Chambonnière, Lore Metz, Alicia Fillon, Pauline Demonteix, Nicole Fearnbach, Mélina Bailly, Audrey Boscaro, Bruno Pereira, David Thivel, and Martine Duclos

Context: Physical inactivity and sedentary behaviors are associated with adverse health outcomes in both adults and children. The purpose of this study was to investigate the effects of a 9-week program using a Cycle Desk during school time in French primary school children from high or low socioeconomic status (SES) on body composition, physical fitness (PF), and executive function. Methods: Seventy-five (n = 75) children completed a test battery before and after 9 weeks of use of Cycle Desk to evaluate anthropometric characteristics, body composition, PF, and executive function. Results: Body mass index increased significantly (P = .0095), while body fat decreased after the use of Cycle Desks (P < .0001). Specifically, lean mass increased in the high-SES group while it decreased in the low-SES group (P < .0001). After 9 weeks, there was an improvement in motor skills (P < .0001), upper and lower limbs’ strength (P < .0001), and executive function performance (P < .0001). More specifically, the low-SES group had a greater improvement in motor skills and maximal aerobic speed between T0 and T1, compared to the high-SES group (P = .001, P = .023, respectively). In contrast, the high-SES group had a greater improvement in executive function at 9 weeks of use of Cycle Desk compared with the low-SES group (P = .0084). Conclusions: The promotion of low-intensity physical activity with the use of a Cycle Desk at school may help offset some adverse effects of excess sedentary behavior among children. Moreover, this strategy appears to be particularly effective in children from low-SES backgrounds. What’s New: The use of a Cycle Desk during school time has no deleterious effects on PF as well as cognitive executive functions in primary children. Modifications are more beneficial in children from low SES.

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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)