ABSTRACT
BACKGROUND: The data regarding prospective associations between physical activity (PA) and adiposity in youth are inconsistent. OBJECTIVE: The objective of this study was to investigate associations between baseline levels of objectively measured PA and changes in adiposity over 2.5 years from mid-to-late adolescence. METHODS: This was an observational cohort study in 728 school students (43% boys) from Cambridgeshire, United Kingdom. Fat mass index (FMI, kg m(-2) ) was estimated at baseline (mean ± standard deviation age: 15 ± 0.3 years) and follow-up (17.5 ± 0.3 years) by anthropometry and bioelectrical impedance. Habitual PA was assessed at baseline by ≥3 d combined heart rate and movement sensing. Average daily PA energy expenditure (PAEE) and the time (min d(-1) ) spent in light, moderate and vigorous intensity PA (LPA, MPA and VPA, respectively) was estimated. Multilevel models were used to investigate associations between baseline PA and change in FMI (ΔFMI). Adjustment for baseline age, sex, follow-up duration, area-level socioeconomic status, season of PA assessment, sedentary time, energy intake and sleep duration was made; baseline FMI was also added in a second model. RESULTS: FMI increased significantly over follow-up (0.6 ± 1.2 kg m(-2) , P < 0.001). Baseline PAEE and LPA positively predicted ΔFMI in overfat participants (P ≤ 0.030), as did VPA in initially normal fat participants (P ≤ 0.044). There were further positive associations between PAEE and ΔFMI in normal fat participants, and between MPA and ΔFMI in both fat groups, when adjusted for baseline FMI (P ≤ 0.024). CONCLUSIONS: Baseline PAEE and its subcomponents were positively associated with small and unlikely clinically relevant increases in ΔFMI. These counter-intuitive findings may be explained by behavioural changes during the course of study follow-up.
Subject(s)
Adiposity , Adolescent Behavior , Child Behavior , Energy Intake , Motor Activity , Physical Fitness , Weight Gain , Adipose Tissue , Adiposity/physiology , Adolescent , Body Mass Index , Child , Child, Preschool , Female , Humans , Leisure Activities , Longitudinal Studies , Male , Motor Activity/physiology , Physical Fitness/physiology , Prospective Studies , Sedentary Behavior , United Kingdom/epidemiology , Weight Gain/physiologyABSTRACT
OBJECTIVE: To investigate whether birth weight acts as a biological determinant of later aerobic fitness, and whether fat-free mass may mediate this association. METHODS: The European Youth Heart Study (EYHS) is a population-based cohort of two age groups (9 and 15 years) from Denmark, Portugal, Estonia and Norway. Children with parentally reported birth weight >1.5 kg were included (n = 2 749). Data were collected on weight, height, and skinfold measures to estimate fat mass and fat-free mass. Aerobic fitness (peak power, watts) was assessed using a maximal, progressive cycle ergometer test. Physical activity was collected in a subset (n = 1 505) using a hip-worn accelerometer and defined as total activity counts/wear time, all children with >600 minutes/day for ≥3 days of wear were included. RESULTS: Lower birth weight was associated with lower aerobic fitness, after adjusting for sex, age group, country, sexual maturity and socio-economic status (ß = 5.4; 95% CI: 3.5, 7.3 W per 1 kg increase in birth weight, p < 0.001). When fat-free mass was introduced as a covariate in the model, the association between birth weight and aerobic fitness was almost completely attenuated (p = 0.7). Birth weight was also significantly associated with fat-free mass (ß = 1.4; 95% CI: 1.1, 1.8, p < 0.001) and fat-free mass was significantly associated with aerobic fitness (ß = 3.6; 95% CI: 3.4, 3.7, p < 0.001). Further adjustment for physical activity did not alter the findings. CONCLUSION: Birth weight may have long-term influences on fat-free mass and differences in fat-free mass mediate the observed association between birth weight and aerobic fitness.
Subject(s)
Birth Weight , Body Composition , Physical Fitness , Actigraphy/instrumentation , Adolescent , Age Factors , Analysis of Variance , Body Height , Body Mass Index , Body Weight , Child , Europe , Exercise Test , Female , Humans , Linear Models , Male , Motor Activity , Sex Factors , Skinfold ThicknessABSTRACT
Burns around the mouth frequently result in contractures or microstomia. Orthoses used in the past have usually been designed to stretch the mouth horizontally. Finding a comfortable effective way to stretch the mouth vertically proved to be a challenge. A jaw positioner was used for vertical mouth stretching in two case studies and was evaluated for effectiveness of preventing mouth contractures and for comfort, durability, ease of use, adaptability for children, and ease of measuring results. Vertical and horizontal passive range of motion increased with initial use and then was maintained in both patients. The jaw positioner was comfortable and easy to use. This orthosis could be adapted to fit in a child's mouth and was impossible to swallow. Progress was easy to monitor with the numeric scale on the orthosis. Though no single orthosis will be ideal for every oral burn, this jaw positioner is recommended for pediatric and adult patients with extensive circumoral burns who demonstrate fair to good compliance.
Subject(s)
Mouth , Orthotic Devices , Burns/complications , Child , Child, Preschool , Contracture/etiology , Contracture/prevention & control , Equipment Design , Evaluation Studies as Topic , Female , Humans , Jaw , Male , Microstomia/etiology , Microstomia/prevention & control , Pain MeasurementABSTRACT
A prospective study was performed to determine whether patterns of burn scar maturation varied among different pediatric age groups. Patients were divided into three groups according to age at the time of burn injury: birth to 3 years, 4 to 11 years, and 12 to 18 years. Scarring of sheet grafts on an extremity was assessed throughout the maturation process in three areas: vascularity, pliability, and height. A 1-inch square was selected on the graft edge adjacent to unburned skin. Two experienced therapists independently evaluated the test area and averaged their scores. There were no significant differences in rate of scar maturation between age groups. Burn scar maturation of sheet skin grafts in the pediatric patient with burns demonstrated a rapid peak of scarring (1 to 2 months) and scar maturation (9 to 13 months).
Subject(s)
Burns/physiopathology , Cicatrix/physiopathology , Skin Transplantation/physiology , Wound Healing , Adolescent , Age Factors , Bandages , Burns/epidemiology , Burns/surgery , Child , Child, Preschool , Cicatrix/epidemiology , Humans , Infant , Prospective Studies , Time FactorsABSTRACT
Serial casting is a fast, relatively simple, and inexpensive way to effectively correct burn scar contractures. Plaster casts provide circumferential pressure and a prolonged stretch to contracted tissue and cannot be removed by the patient. When casts are applied well and padded appropriately, there is little risk of pressure areas, since the casts are conforming and do not slip distally. Serial casting may be a successful alternative when low-force dynamic splinting cannot be sized small enough for a child, or when patient compliance is unreliable. A case study of a 2-year-old male patient with severe plantar-flexion contractures of the ankles is presented.
