This paper demonstrates the reliability, validity, and practical applications of a unique protocol developed to obtain both submaximal steady-state and peak exercise responses in the same test in children and adolescents. The study examined exercise efficiency, cardiovascular fitness, and cardiovascular responses in 237 children, ages 7 to 17, during exercise stress on a cycle ergometer. The graded exercise test was continuous, consisting of three steady-state submaximal stages followed by 30-sec ramp stages to obtain peak values. Intraclass correlation coefficients ranged from r=0.69 to r=0.99, with no significant mean difference for any test parameter. Mean peak heart rate, peak VO2, and 84% of the respiratory exchange ratio (RER) values equal to or greater than 1.1 were comparable to other reported values. The validity for the protocol is substantiated by the results showing normal linear exercise responses, nonsignificant mean difference between the last two 30-sec periods, normal mean peak heart rate and VO2 values, and high mean peak RER values. The protocol is practical, as demonstrated by an optimal test duration and the ability to obtain valid submaximal and peak exercise data in the same test in subjects of varying ages and body size.
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Jane C. Golden, Kathleen F. Janz, William R. Clarke, and Larry T. Mahoney
Kathleen F. Janz, Smita Rao, Hope J. Baumann, and Jaime L. Schultz
Ground reaction forces (GRF) are associated with bone hypertrophy; therefore, they are important to understanding physical activity’s role in children’s bone health. In this study, we examined the ability of accelerometry to predict vertical GRF in 40 children (mean age 8.6 yr) during slow walking, brisk walking, running, and jumping. Correlation coefficients between accelerometry-derived movement counts and GRF were moderate to high and significant during walking and running, but not during jumping. Given a large proportion of children’s daily physical activity involves ambulation, accelerometry should be useful as a research method in bone-related research. However, this method underestimates GRF during jumping, an important physical activity for bone modeling and remodeling.
Kristen M. Metcalf, Elena M. Letuchy, Steven M. Levy, and Kathleen F. Janz
Purpose: Most pediatric physical activity and bone health research has focused on the period immediately around puberty; few have addressed bone structural strength outcomes. This study assessed the magnitude and consistency of the longitudinal relationships between device-measured vigorous-intensity physical activity (VPA) and structural bone strength outcomes across adolescence to emerging adulthood. Methods: Participants with 3 to 5 bone scans between the age of 11 and 19 years were studied (N = 439, 220 females, 1838 records). Dual-energy X-ray absorptiometry scans of the hip (hip structural analysis) and peripheral quantitative computed tomography scans of the tibia were obtained. Outcomes included femoral neck section modulus, femoral neck cross-sectional area, tibial Bone Strength Index, and tibial torsion strength (polar Strength Strain Index). Sex-specific bone mixed growth models were developed using biological age (chronological age − age at peak height velocity) as the time variable, and height, weight, and device-measured VPA as time-varying covariates. Models also included the VPA–biological age interaction. Results: Individual-centered VPA and the VPA–biological age interaction were significantly, positively associated (P < .05) with Bone Strength Index, polar Strength Strain Index, section modulus, and cross-sectional area in males and females, indicating accumulative effects of VPA throughout maturation and beyond. Conclusion: Bone remains responsive to the mechanical loading of physical activity throughout adolescence and into emerging adulthood. Attention should be placed on promoting bone-strengthening physical activity after the prepubertal years when adult exercise patterns are likely formed.
Benjamin J. Darter, Kathleen F. Janz, Michael L. Puthoff, Barbara Broffitt, and David H. Nielsen
A new triaxial accelerometer (AMP 331) provides a novel approach to understanding free-living activity through its ability to measure real time speed, cadence, and step length. This study examined the reliability and accuracy of the AMP 331, along with construction of prediction equations for oxygen consumption and energy cost.
Young adult volunteers (n = 41) wearing two AMP units walked and ran on a treadmill with energy cost data simultaneously collected through indirect calorimetry.
Statistically significant differences exist in inter-AMP unit reliability for speed and step length and in accuracy between the AMP units and criterion measures for speed, oxygen consumption, and energy cost. However, the differences in accuracy for speed were very small during walking (≤ 0.16 km/h) and not clinically relevant. Prediction equations constructed for walking oxygen uptake and energy expenditure demonstrated R 2 between 0.76 to 0.90 and between subject deviations were 1.53 mL O2 · kg-1 · min−1 and 0.43 kcal/min.
In young adults, the AMP 331 is acceptable for monitoring walking speeds and the output can be used in predicting energy cost during walking but not running.
Soyang Kwon, Kathleen F. Janz, Trudy L. Burns, and Steven M. Levy
The purpose of this study was to examine whether the association between daily light-intensity physical activity (LPA) and total body fat mass changes during childhood. The study sample was 577 children participating in the longitudinal Iowa Bone Development Study. Body fat mass and physical activity (PA) were measured using dual energy X-ray absorptiometry (DXA) and accelerometers, respectively, at approximately 5, 8, and 11 years of age. Age- and gender-specific multivariable linear regression models were fit to predict fat mass by LPA, adjusted for actual age, birth weight, fat-free mass, height, moderate- to vigorous-intensity PA, and physical maturity (only for girls). Among boys, LPA was negatively associated with fat mass at age 11, but not age 5 or 8. Among girls, LPA was negatively associated with fat mass at ages 8 and 11, but not at age 5. LPA may have a beneficial effect against excess adiposity among older children.
Alon Eliakim, Bareket Falk, Neil Armstrong, Fátima Baptista, David G. Behm, Nitzan Dror, Avery D. Faigenbaum, Kathleen F. Janz, Jaak Jürimäe, Amanda L. McGowan, Dan Nemet, Paolo T. Pianosi, Matthew B. Pontifex, Shlomit Radom-Aizik, Thomas Rowland, and Alex V. Rowlands
This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.
Kenneth E. Powell, Abby C. King, David M. Buchner, Wayne W. Campbell, Loretta DiPietro, Kirk I. Erickson, Charles H. Hillman, John M. Jakicic, Kathleen F. Janz, Peter T. Katzmarzyk, William E. Kraus, Richard F. Macko, David X. Marquez, Anne McTiernan, Russell R. Pate, Linda S. Pescatello, and Melicia C. Whitt-Glover
Background: The 2018 Physical Activity Guidelines Advisory Committee Scientific Report provides the evidence base for the Physical Activity Guidelines for Americans, 2nd Edition. Methods: The 2018 Physical Activity Guidelines Advisory Committee addressed 38 questions and 104 subquestions selected for their public health relevance, potential to inform public policies and programs, maturity of the relevant science, and applicability to the general US population. Rigorous systematic literature searches and literature reviews were performed using standardized methods. Results: Newly described benefits of physical activity include reduced risk of excessive weight gain in children and adults, incidence of 6 types of cancer, and fall-related injuries in older people. Physical activity is associated with enhanced cognitive function and mental health across the life span, plus improved mental health and physical function. There is no threshold that must be exceeded before benefits begin to accrue; the accrual is most rapid for the least active individuals. Sedentary time is directly associated with elevated risk of all-cause and cardiovascular mortality, incident cardiovascular disease and type 2 diabetes, and selected cancer sites. A wide range of intervention strategies have demonstrated success in increasing physical activity. Conclusion: The 2018 Physical Activity Guidelines Advisory Committee Scientific Report provides compelling new evidence to inform physical activity recommendations, practice, and policy.