Objectively assessed physical activity and sedentary behaviour does not differ between children and adolescents with and without a congenital heart defect: a pilot examination.

OBJECTIVES: To objectively evaluate and describe physical activity levels in children with a stable congenital heart defect and compare those levels with children who do not have a congenital heart defect. METHODS: We matched 21 pairs of children for gender and grade in school and gave them an accelerometer-based motion sensor to wear for 7 consecutive days. RESULTS: Physical activity levels did not differ between children with and without a congenital heart defect. During the 7 days of monitoring, children in this study spent most of their time in sedentary behaviours, that is, 6.7 hours of the 13 monitored hours, 54 minutes in moderate-intensity physical activity, and 12 minutes in vigorous-intensity physical activity. Less than one-fifth of all participants, with or without a congenital heart defect, accumulated sufficient physical activity to meet current physical activity recommendations for children and adolescents. CONCLUSION: Children with a stable congenital heart defect have activity behaviours that are similar to children without a congenital heart defect. Habitual physical activity in children with a congenital heart defect should be encouraged early on in life to develop strong physical activity habits that will hopefully follow them across their lifespan.

Validity of Physical Activity Monitors in Assessing Energy Expenditure in Normal, Overweight, and Obese Adults.

A comparison of the validity of downloadable motion sensors, which use either a glass-enclosed magnetic reed proximity switch technology, a piezo-electric sensor accelerometer with a horizontal beam technology, or an internal pendulum based mechanism to determine energy expenditure (EE), across different body sizes does not exist. Therefore, the purpose of this study was to determine the validity of three different downloadable motion sensors to estimate EE during walking activity in normal weight, overweight and obese volunteers. Forty-eight participants completed this study. Each participant had their body height and mass measured and completed a treadmill walking protocol. Body mass index (BMI) was calculated. The treadmill walking protocol included six 5-minute stages starting at 1.5 mph and increasing by 0.5 mph, up to 4.0 mph while grade was constant at 0% for the duration of the test. The Kenz Life-Corder EX (LC), the Omron HJ-700IT (OM) and the Sportbrain iStep X1 (SB) were worn during the treadmill walking protocol. Heart rate, oxygen consumption, carbon dioxide production and EE estimated from the motion sensors were monitored throughout the walking protocol. Results showed the OM overestimated net EE in normal, overweight and obese participants. The LC underestimated gross EE in all groups. The SB overestimated net EE in normal BMI participants, was not significantly different from the criterion measure of net EE in overweight participants and underestimated net EE in obese individuals. This study demonstrates that these devices do not offer the accuracy needed to provide precise feedback on EE for individuals with varying BMI levels.

Chest pain: characteristics of children/adolescents.

Chest pain (CP) in children/adolescents is a common referral for the pediatric cardiologist. A group of 263 patients (141 males/122 females, mean age = 13.4 years, range = 5-22 years) with the primary complaint of CP underwent evaluation in the cardiac stress lab at Children's Hospital of Wisconsin. Echocardiograms at rest were obtained in 70% of patients with no significant cardiac abnormalities identified. Endurance time (EXT) and oxygen consumption (VO(2)/kg) were below predicted in 26% and 46%, respectively. Reactive airway disease (RAD) as a preexisting condition was reported in 19% of patients, but abnormal resting pulmonary function (PFTs) were found in 26% (n = 68), with 48/68 never having the diagnosis of RAD. At risk of overweight (BMI >85th percentile), was seen in 28% of the cohort, with 16% identified as being overweight (BMI >95th percentile). A significant difference in RAD (p < 0.01) was seen in African Americans (AA) and decreased EXT (p = 0.01) was seen in Hispanics (H). VO(2)/kg was significantly reduced in both AA and H (p < 0.01). These results identify both racial and age-related differences in the etiology of CP in children. Most importantly, true cardiac pathology is extremely rare. AOW, deconditioning, and respiratory compromise play important roles in CP. The need for comprehensive cardiopulmonary monitoring is emphasized by these findings.