is on a pace to become the third leading cause of mortality and disability worldwide by 2020 ( 64 ), careful consideration needs to be given to the effects of TBI across the life span. Among others, the pediatric brain injury population is one with unique and unmet needs, particularly in relation to
Bhanu Sharma and Brian W. Timmons
For “The Year That Was 2017,” 3 papers have been selected, which contribute to the current debate on the assessment and interpretation of pediatric aerobic fitness (referred to as cardiopulmonary fitness or cardiorespiratory fitness in 2 papers). The first paper critically reviews the importance of
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
Introduction The Expert’s Choice section aims to highlight the most significant or exciting papers in specific areas of pediatric exercise science, published in the preceding year (2018). A “significant” or “exciting” publication is one that either: (a) reveals a new mechanism, (b) highlights a new
Tiffany Toong, Katherine E. Wilson, Anne W. Hunt, Shannon Scratch, Carol DeMatteo, and Nick Reed
Specific to pediatric concussion, Reed et al 8 examined maximal upper and lower body strength performance preconcussion and postconcussion in a group of youth ice hockey players. Following a concussion, youth athletes showed reduced upper and lower body strength performance compared with noninjured
Tamara C. Valovich McLeod, Megan N. Houston, and Cailee E. Welch
Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.
Adam D. G. Baxter-Jones, Joey C. Eisenmann, and Lauren B. Sherar
The process of maturation is continuous throughout childhood and adolescence. In a biological context, the effects of a child’s maturation might mask or be greater than the effects associated with exposure to exercise. Pediatric exercise scientists must therefore include an assessment of biological age in study designs so that the confounding effects of maturation can be controlled for. In order to understand how maturation can be assessed, it is important to appreciate that 1 year of chronological time is not equivalent to 1 year of biological time. Sex- and age-associated variations in the timing and tempo of biological maturation have long been recognized. This paper reviews some of the possible biological maturity indicators that the pediatric exercise scientist can use. As a result, we recommend that any of the methods discussed could be used for gender-specific comparisons. Gender-comparison studies should either use skeletal age or some form of somatic index.
Interest in the physiological responses to exercise unique to the pediatric age group has grown exponentially over the past 50 years. A number of issues surrounding children’s exercise have been particularly responsible for this trend, particularly a) recognition of the health benefits of exercise in youth, b) the growing involvement of young persons in highly intense levels of sports play, and c) the role that exercise may play in the diagnosis and management of children with chronic disease. As a consequence, current research to date has provided a comprehensive picture of the features specific to children’s response to exercise. Future challenges facing the field of pediatric exercise science involve translating this information into practical guidelines which can be applied to the realms of clinical medical practice, preventive health initiatives, and athletic training regimens which are appropriate for this age group.
The Pediatric Exercise Science Year That Was section aims to highlight the most important (to the author’s opinion) manuscripts that were published in 2016 in the field of endocrinology and pediatric exercise science. This year’s selection includes studies showing that 1) Induction of T4 to T3 conversion by type 2 deiodinase following aerobic exercise in skeletal muscles was associated with concomitant increase in peroxisome proliferatoractivated receptor-γ coactivator-1α, and mitochondrial oxidative capacity and therefore plays an important mechanistic role in the muscle adaptation to exercise training. 2) Hypothyroidism in fetal and early postnatal life was associated with impaired spatial learning and memory and with reduced hippocampal brain-derived neurotrophic factor in male and female rat pups. Forced (treadmill) and voluntary (wheel) exercise alleviated all these biochemical and neuro-cognitive deficits. 3) The relationship between different exercise intensities and carbohydrate requirements to maintain euglycemia at basal insulin levels among adolescent and young adults with Type 1 diabetes are nonlinear but rather inverted- U with no exogenous glucose required to maintain stable glucose level at high-intensity exercise (80%). The implication of these studies to the pediatric population, their importance and the new research avenues that were opened by these studies is emphasized.
Sarah L. West, Adam Gassas, Tal Schechter, R. Maarten Egeler, Paul C. Nathan, and Greg D. Wells
Hematopoietic stem-cell transplant (SCT) is increasingly used to treat children with cancer, and survival following SCT is improving. One predominant consequence of childhood cancer therapy is increased physical morbidity, which is worse in pediatric SCT recipients compared with children treated with chemotherapy or radiation alone. There are many factors that contribute to exercise intolerance and reduced physical function during the pretransplant, peritransplant, and posttransplant phases. These include side effects from chemotherapy or radiation, excessive immobility due to bed rest, infections, the negative effects of immunosuppressants, and graft vs host disease, all of which can impair cardiorespiratory fitness, muscle strength, and muscle function. Few studies have investigated the effects of exercise in childhood SCT recipients. In a small number of published studies, exercise interventions have been demonstrated to improve cardiorespiratory fitness, preserve or increase muscle mass, and improve muscle strength in children following SCT. The use of exercise as medicine may be a noninvasive and nonpharmaceutical treatment to target physical complications post-SCT. Researchers and health-care professionals should work together to develop exercise prescription guidelines for this unique and important population.
Bareket Falk, Panagiota Klentrou, Neil Armstrong, Thomas Rowland, and Han C.G. Kemper
The European Group of Pediatric Work Physiology is celebrating the 50th anniversary of its inception in Berlin (Germany), 1967. It was a modest beginning, which placed the field of pediatric exercise physiology “on the exercise physiology map.” We take this opportunity to provide a brief history of