Psychosocial and Motor Characteristics of Patients With Hypermobility.

Objectives: To identify psychosocial and motor aspects related to joint hypermobility (JH) in a sample from almost all Brazilian states by age range and sex; to characterize JH by the Beighton total score ≥4, ≥5, and ≥6 according to sex and age and atypicality in the sitting position and in the hands; identify, in the total sample, manifestations of "growing pain" and its location, fatigue, attention deficit, anxiety, insomnia, drowsiness, apathy, depression, delay in walking, not crawling or crawling differently, school performance, spatial orientation and/or temporally impaired, social isolation, and being stigmatized as "lazy/clumsy/apathetic". Methods: This retrospective, observational, quantitative, and cross-sectional study used data obtained through analyses of descriptive and inferential crossings between 2012 and 2020 of 482 medical records of individuals between 1 and 76 years of age, from most Brazilian states. All patients previously diagnosed with "joint hypermobility syndrome" (JHS) and "Ehlers-Danlos syndrome hypermobility type" (EDS-HT) had their medical records reassessed, following the guidelines established in 2017. The analysis of GJH was performed using the updated method by Beighton method; atypical characteristics were investigated in the hands and the ability to sit in the "W" and the "concave" positions. The characteristics and manifestations of "growing pain" and its location were analyzed in the total sample, fatigue, insomnia, drowsiness, apathy, depression, social isolation, attention deficit, anxiety, stigmatization as "lazy," clumsy/restless, impaired school performance, and spatial and/or temporal orientation. Descriptive and inferential statistical methods were used, such as Mean, Median, Mode, Standard Deviation, Standard Error, Maximum Value, Minimum Value, Komolgorov-Smirnov, Significance, Relative Value, Absolute Value, Mann-Whitney U, and Correlation of Spearman. Results: JH in the total sample predominated in the upper limbs, the majority were women, represented by 352 (73.02%), 15 years old or older with 322 (66.80%), 312 (64.73%) had a Beighton total score ≥6, which decreased as the age increased. Always sitting in the "concave" position was represented by 54.15% and the ability to sit in the "W" position by 39.21%; signs on the hands totaled between 27.59 and 44.19% with a significant correlation between the variables. Among the characteristics, fatigue predominated, followed by an awkward/clumsy/restless individual, attention deficit, anxiety and stigmatized as "lazy," insomnia, drowsiness, apathy, depression, impaired spatial and/or temporal orientation, and social isolation. From the total sample, pain in the lower limbs was reported by 55.81% and having or having had "growing pain" was reported by 36.93%, delay in walking occurred in 19.92%, 15.35% did not crawl or crawled differently, and for 12.86%, school performance was impaired. Higher Beighton total scores showed a trend towards motor implications and correlation between variables. Ability to still sit in the "concave" position was possible for 54.15% and to sit in the "W" position for 39.21%. Conclusion: In the total sample, the JH characteristic prevails in the upper limbs of female children, adolescents and adults, with a total Beighton score ≥6. Most sit in the "concave" position and less than half also sit in the "W" position and with atypical hand postures. The higher Beighton scores, which include the upper limbs, show a tendency to not crawl or crawl differently, delayed ambulation, and impaired school performance. The predominance of JH in the upper limbs is suggestive of a justification for not crawling or crawling differently. Characteristics of atypical motor performance in hands and sitting posture, in addition to fatigue, pain since childhood, anxiety, apathy, depression, sleep disorders, stigmatization, attention deficit, spatial and/or temporal orientation impairment, and social isolation are characteristics. suggestive of psychosocial implications at different ages. Future studies with motor and psychosocial aspects of people with JH will help to identify the phenotype of this population and consequent guidance for clinical management based on the motor and psychosocial aspects of people with JH.

The environment contribution to gender differences in childhood obesity and organized sports engagement.

OBJECTIVE: This study aims to analyze gender-specific associations between sports activity outside of school and obesity, observing to what extent the local built environment contributes to the patterns found. METHODS: A total of 2253 children aged 6.0-11.0 years were assessed: 49.3% girls and 50.7% boys. Children's weight and height were measured, age and sex-specific BMI cut-off points were used to define normal vs overweight/obesity. Children's organized sports (OS) activity was assessed by questionnaire, and local facilities for children's engagement in OS were analyzed. Logistic regression models were computed, adjusted for confounding variables. RESULTS: Results showed greater overweight and obesity (25.1% vs 20.1%) and lower OS engagement (66.5% vs 73.8%) in girls as well as greater impact of OS engagement on weight status in girls (OR for having a normal weight = 1.434 in girls vs 1.043 in boys). Additionally, opportunities to engage in OS were scarce for girls. CONCLUSIONS: The gender gap in children's weight status and OS engagement might be enhanced by an environmental mismatch that undermines girls' opportunities to play sports. There should be more opportunities for girls to engage in their favorite sports as a means to tackle the obesity epidemic and to promote gender equality.

Socio-demographic and behavioral risk factors associated with the high prevalence of overweight and obesity in Portuguese children.

OBJECTIVES: Childhood obesity is a public health concern in Portugal. Socio-demographic and behavioral factors are highly associated with obesity but are not clearly understood. This article aims to update the prevalence of overweight and obesity in Portuguese children and to explore the influence and risks of socio-demographic factors and behavioral factors. METHODS: A cross-sectional study of Portuguese children aged 3-10 years from all 18 mainland districts took place between March 2009 and January 2010. The sample was composed by 17,136 children, 3-10 years of age (8,455 boys; 8,681 girls). Height, weight, and other anthropometric measurements were obtained by trained technicians. Body mass index (BMI) was calculated along with other anthropometric variables. Data analyses took place between April and September 2012. The overweight/obesity classification was established by age-and sex-specific BMI cut-off points as defined by the International obesity task force (IOTF). Parents completed questionnaires about socio-demographic and behavioral characteristics of the family. RESULTS: Almost 28% of the Portuguese children were overweight or obese (19.7% overweight; 8.2% obese). Prevalence was greater in girls than in boys. Logistic regression models found that the odds of childhood obesity were significantly affected by biological, socio-demographic, and behavioral factors. CONCLUSIONS: The protective factors against childhood overweight/obesity in this sample of Portuguese children are: (i) being male; (ii) having been breastfeed; (iii) having been born from mothers who did not smoke during pregnancy; (iv) engaging in little sedentary behaviors (TV, PC, and playing electronic games); (iv) performing at least 1 h of moderate physical activity every day; and (v) having parents with higher educational levels who also have their BMI within the healthy ranges.

Association between parental perceptions of residential neighbourhood environments and childhood obesity in Porto, Portugal.

BACKGROUND: Portugal has one of the highest rates of childhood obesity in Europe. Few studies have explored the relationship between parents' perceptions of their residential neighbourhood (safety concerns and amenities of the built environment) and their children's weight status. This study aims to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. METHODS: Anthropometric measures of height and weight were taken for 2690 children in preschools and elementary schools in Porto. Body mass index (kg/m(2)) was calculated, and the International Obesity Taskforce (IOTF) cut-offs were used. Parents completed the 'Environmental Module' standard questionnaire of the International Physical Activity Prevalence Study. Chi-square tests and the logistic regression model adjusted for age, gender, maternal education and school cluster were used to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. RESULTS: In this sample, 31.8% of the children were overweight (including obese). Significant associations were found between child obesity and the following residential environmental characteristics: the odds of children being obese were lower if their parents believed that it was safe (low/no crime rate) to walk/cycle at night (OR = 0.65, 95% CI = 0.54-0.79) and during the day (OR = 0.70, 95% CI = 0.55-0.86) and that it was easy and pleasant (pedestrian safety) to walk in their neighbourhoods (OR = 0.73, 95% CI = 0.58-0.90) and when local sidewalks were well maintained and unobstructed (OR = 1.18, 95% CI = 1.01-1.40). CONCLUSION: Parental perceptions of neighbourhood safety and the quality of local sidewalks are significantly associated with obesity values.