Effects of enhanced physical education on lung volumes of primary school children.

OBJECTIVE: To test the impact of an enhanced physical education programme upon the growth and development of static and dynamic lung volumes of primary schoolchildren. EXPERIMENTAL DESIGN: Quasi-experimental three factor design (treatment x gender x urban vs rural environment) with students evaluated over each of 6 years of primary school. SETTING: Entire classes from State schools in urban and rural environment. PARTICIPANTS: All willing students aged 7-12 years in selected classes; initially 546 students, with 4% drop-out rate per year. INTERVENTION: Five hours of additional physical education per week, taught by specialist. MEASURES: Body dimension (height, body mass), aerobic power (treadmill to exhaustion), forced vital capacity (FVC), one second forced expiratory volume (FEV1.0). RESULTS: Small but statistically significant influences of treatment, gender (M > F) and environment (rural > urban) which could not be explained by body size. Both FVC and FEV1.0 conform closely to cubic functions of height in metres: Boys FVC = 0.93 (H)3, FEV1.0 = 0.79 (H)3. Girls FVC +/- 0.85 (H)3, FEV1.0 = 0.76 (H)3. CONCLUSIONS: A regular physical education programme can enhance lung volumes in primary school students. Norms should allow for gender differences, and reflect the potential attainment of students receiving adequate physical training and living in an area of low air pollution.

Changes of physical performance as indicators of the response to enhanced physical education.

The value of field performance tests in the assessment of a programme of enhanced physical education has been examined in a 3-factor study of students over all 6 primary school grades. The enhanced programme under review offered a one hour of required physical education daily from age 7 to 12 years, taught by a specialist physical educator. Control students from immediately preceding and succeeding classes continued with the standard programme, a standard single period of physical education per week taught by a nonspecialist. Subjects were classed by gender, environment (urban vs rural school) and the experimental intervention to allow analysis by MANOVA. Students in the experimental programme showed small but statistically significant gains in laboratory measures of aerobic power and muscle strength relative to controls. In general, these responses were mirrored by gains in scores on the Canadian Association for Health Physical Education and Recreation (CAHPER) field performance test battery. The latter tests also suggested gains of anaerobic power, coordination and muscular endurance. It is concluded that an enhanced programme of physical education can enhance function in primary school students, but the size of gains is not a strong argument for such programmes. Further, gains in performance test scores indicate the direction, but not necessarily the magnitude of programme responses.

Testing for inter-group contamination in a controlled longitudinal study of added physical education.

OBJECTIVE: This case report examines whether there was any cross-contamination between students enrolled in classes that received additional physical education, and their siblings who were enrolled in preceding and succeeding class-cohorts. EXPERIMENTAL DESIGN: A controlled longitudinal study extending over 6 years of primary school. SETTING: An urban and a rural primary school in Québec. PARTICIPANTS: 546 primary students, comprising approximately equal numbers of boys and girls from the urban and the rural school. INTERVENTION: Entire class-cohorts were given and hour of additional physical education ach day throughout their primary schooling, with immediately preceding and succeeding class-cohorts serving as controls. MEASURES: The measured data included standing height, body mass, maximal oxygen intake (direct treadmill test) and PWC170. RESULTS: We found no evidence of cross-contamination between siblings in experimental and control class-cohorts. CONCLUSION: Although a theoretical possibility, cross-contamination between students in preceding and succeeding class-cohorts does not seem an important source of error in primary school students, presumably because such children prefer to play with friends from their immediate age cohort.

How is anaphylaxis recognized?

Prompt recognition of anaphylaxis may be lifesaving. Although its presentation has been described, there are no criteria for making a rapid diagnosis. A systematic review of the literature was performed to develop objective clinical criteria aimed at improving the recognition of anaphylaxis. A MEDLINE search of the word anaphylaxis over a 1-year period identified all of the reports describing the initial manifestations. Of 160 reviewed articles, 116 contained a clinical description of anaphylaxis. Eighty-nine (77%) of these 116 articles were case reports. Hypotension (84 reports [72%]) and urticaria and/or angioedema (70 reports [60%]) were the most frequently described signs. Of the identified allergens, 73% were diagnostic or therapeutic agents. In 72 of the 80 articles in which a reaction time could be identified, the reaction occurred within 60 minutes. As a result of this analysis, we conclude that anaphylaxis recognition may be improved by the identification of one of the following criteria, which describe the presentation in 82% of the analyzed reports: (1) exposure to an allergen within 1 hour produces one or more systemic signs (hypotension, upper or lower respiratory tract compromise, or increased gastrointestinal tract motility), or (2) urticaria or angioedema accompanies at least one of these systemic signs.

Acquired haemophilia in association with type III von Willebrand's disease: successful treatment with high purity von Willebrand's factor and recombinant factor VIIa.

A patient with autosomal dominant (Type III) von Willebrand's disease (vWd) developed acquired haemophilia post-operatively, possibly due to exposure to amoxycillin. She refused porcine factor VIII (pFVIII) on religious grounds and was managed successfully with recombinant activated factor VII (rFVIIa) together with highly purified von Willebrand factor concentrate (vWf-VHP). In patients with acquired haemophilia rFVIIa appears to be a suitable agent for symptomatic management.

Cohort effects: A possible limitation to the interpretation of longitudinal studies.

The possible limitation that cohort effects could impose upon the interpretation of longitudinal research has been examined, taking data on the standing height and the maximal oxygen intake of 546 primary school students participating in the Trois Rivières mixed-longitudinal study of enhanced physical education programs (295 experimental and 251 control subjects of both sexes). Over the short period of the study (maximum intercohort time span of 4 years), no significant differences in standing height were observed. In the larger urban community of Trois Rivières (population about 100,000), where the program of additional physical education was very successful in augmenting the maximal oxygen intake of the experimental students, a statistically significant intercohort difference of aerobic power developed among control students over the span of 3-4 years. However, in Pont Rouge (population about 5,000), where the added physical education had a smaller impact upon the maximal oxygen intake of the experimental students, there were no significant intercohort differences. Among possible explanations of the intercohort difference seen in Trois Rivières, the most likely seems an indirect effect of the experimental physical education program upon the patterns of habitual physical activity in the control population. © 1993 Wiley-Liss, Inc.

The "unisex phantom," sexual dimorphism, and proportional growth assessment.

The "unisex phantom" tactic of Ross and associates attempts to examine proportional growth, expressing body measurements relative to a phantom created from arbitrary mean dimensions and the observed coefficients of variation for an arbitrary sample of adult men and women. Fundamental assumptions of the model are (1) that data treated in unisex fashion have the normal distribution required of Z-type statistics throughout the period of growth, and (2) that it is reasonable to consider anthropometric measurements in all populations (regardless of ultimate size) as growing toward the common height chosen for the phantom. The validity and possible usefulness of this approach has been tested using anthropometric data collected on 546 francophone primary school children from the Trois Rivières district who had been measured repeatedly from 6 to 12 years of age. Over this age range, the mixing of data for girls and boys does not create a bimodal distribution, and has only a marginal effect upon skewing and kurtosis; however, the requirement of a normal distribution is not satisfied by quite a number of common anthropometric measurements even at this age. Moreover, application of the unisex phantom procedure to the Trois Rivières sample does little to clarify anticipated sex-related differences in regional growth, and it is argued that univariate standardization against a power function of an arbitrary adult height may not provide the best method of examining the multivariate problem of growth. Comparison of results with data from Saskatoon, previously treated by unisex phantom methodology, reveals puzzling inconsistencies; it is suggested that interlaboratory differences of methodology rather than ethnic differences are responsible for apparent discrepancies in growth patterns. It is urged that interlaboratory validation of techniques and landmarks should precede the ascription of apparent differences in body build to constitutional factors.

Body dimensions of Québecois children.

The present study examined the impact of sociocultural factors upon the body dimensions of primary school children (age 6-12 years) living within a uniquely francophone region of Québec. Data was collected prospectively on 546 students, drawn in approximately equal numbers from the two sexes and from urban and rural environments. Habitual activity was modified by allocating a half of the sample to an experimental programme that incorporated an additional five hours of required endurance activity per week into the primary school curriculum. Body dimensions at any given age were less in rural than in urban Québec, probably because of continuing socio-economic constraints. However, an increase of habitual physical activity did not modify body size. Stature was comparable with Demirjian 's Montr eal sample of francophone children, but was less than for anglophone children. Our within-sample variance suggests that socio-economic factors could explain only a part of the discrepancy. Relative to Toronto students, other dimensions such as height were affected less than standing height.

[Bone maturity and physical performance]. / Maturité osseuse et performance physique.

We have examined the relation between physical performance (as measured with the CAHPER tests), bone age (Greulich and Pyl's wrist evaluation) and dental age (Garn's method). Our study included 164 boys and 149 girls aged from 7 to 11. In spite of interesting significant simple correlation between most of the CAHPER tests and bone age measurements for the pre-pubescent period, the latter remains of negligible value in predicting physical performance in the studied children when variables like chronological age, body height and body weight are already included in the prediction equation.