Leveraging the construct of physical literacy to promote physical activity for youth with obesity - A qualitative analysis of physical therapists' perceptions.

Background: Promoting physical activity has been identified as a pillar of obesity treatment and prevention. However, youth with obesity often present with physical, affective, and environmental barriers to physical activity engagement. The construct of physical literacy, which has garnered international attention as a holistic approach to understanding human movement, may improve physical activity promotion strategies for youth with obesity. However, literature has shown that healthcare providers are not engaged with the construct of physical literacy. Methods: This qualitative study utilized a phenomenological approach and interpretivist epistemology. Three phases of data collection included member checks, semi-structured interviews, and a focus group with physical therapists treating youth with orthopedic and sport injuries. Simultaneous data collection and inductive analysis was designed to identify themes reflecting how participants utilized the construct of physical literacy to promote physical activity in a clinical setting. Results: Four overarching themes were identified in our analysis as strategies for promoting activity and physical literacy development: 1) Movement Experience, 2) Individualized Care, 3) Movement Momentum, and 4) External Factors. Conclusion: The findings from this study highlight the usefulness of applying a physical literacy lens within physical activity promotion efforts among youth, which may be particularly important for youth with obesity. A high value was placed on the affective and behavioral determinants of physical activity. By applying a physical literacy lens, healthcare providers treating youth with obesity may be better equipped to address barriers and promote participation in physical activities that are enjoyable and build confidence. The findings from this study provide a foundation for future studies examining how healthcare providers can leverage the construct of physical literacy to improve physical activity outcomes among youth.

Investigating the Social Network Structure of Physical Literacy Scholars to Advance a Paradigm for Physical Activity Promotion.

Purpose: Physical literacy has quickly gained global attention as a holistic approach to combat physical inactivity and obesity. However, research silos may limit the growth and application of the physical literacy paradigm for effective physical activity promotion. The purpose of this study was to measure the underlying network structure of scholars publishing on physical literacy (focusing on empirical research) through co-authorship analysis. Methods: Data collection resulted in 1,070 documents related to physical literacy retrieved. A total of 198 articles met inclusion criteria and were included in the full network, with authors operationalized as actors in the network. A total of 75 empirical studies were included in the sub-network for critical appraisal and further analysis. Social network analysis was then conducted at the macro- and component-level, using quantification and visualization techniques. Results: Results revealed a collaborative, yet fragmented physical literacy network with sub-groups representing substantive and geographically diverse scholars. The majority of scholarship lacked empirical evidence, suggesting a research-practice gap. Conclusion: Recommendations for advancing physical literacy research and practice include strategic collaborations that transcend geographic and disciplinary boundaries, cooperative efforts across scholars and practitioners, and productive discourse through professional avenues to progress knowledge generation, dispersion, and application.

Biomechanical variations in children who are overweight and obese during high-impact activities: A systematic review and meta-analysis.

Youth who are obese or overweight demonstrate evidence of poor lower extremity joint health and alterations in gait characteristics compared with youth who are healthy weight. However, there is no consensus if altered movement patterns are still present during high-impact activities. The purpose of this review was to determine if spatiotemporal and kinematic and kinetic variables during high-impact activities were significantly different between youth who are overweight and obese compared with youth who are healthy weight. An electronic search of five databases was conducted, and a meta-analysis and qualitative evidence synthesis was performed to determine the level of evidence, analyzing three tasks: running, jumping, and hopping. The findings of this review include the following: (1) overweight/obese (OW/OB) had higher stance phase time during running, (2) OW/OB had decreased hip flexion angles during running and stationary running, (3) OW/OB had decreased knee flexion angles during landing phase of jumping and hopping, and (4) OW/OB had increased hip abduction moments during running and jumping. These altered kinematic and kinetic variables at the hip and knee may result in mechanical inefficiency with high-impact activities, as well as potentially increased risk of joint degradation and poor joint health into adulthood.

Obese Youth Demonstrate Altered Landing Knee Mechanics Unrelated to Lower-Extremity Peak Torque When Compared With Healthy Weight Youth.

Obese (OB) youth demonstrate altered knee mechanics and worse lower-extremity performance compared with healthy weight (HW) youth. Our objectives were to compare sagittal plane knee landing mechanics between OB and HW youth and to examine the associations of knee and hip extension peak torque with landing mechanics in OB youth. Twenty-four OB and 24 age- and sex-matched HW youth participated. Peak torque was measured and normalized to leg lean mass. Peak knee flexion angle and peak internal knee extension moment were measured during a single-leg hop landing. Paired t tests, Pearson correlation coefficients, and Bonferroni corrections were used. OB youth demonstrated worse performance and lower knee extension (OB: 12.76 [1.38], HW: 14.03 [2.08], P = .03) and hip extension (OB: 8.59 [3.13], HW: 11.10 [2.89], P = .005) peak torque. Furthermore, OB youth demonstrated lower peak knee flexion angles (OB: 48.89 [45.41 to 52.37], HW: 56.07 [52.59 to 59.55], P = .02) and knee extension moments (OB: -1.73 [-1.89 to -1.57], HW: -2.21 [-2.37 to -2.05], P = .0001) during landing compared with HW youth. Peak torque measures were not correlated with peak knee flexion angle nor internal knee extension moment during landing in either group (P > .01). OB youth demonstrated altered landing mechanics compared with HW youth. However, no associations among peak torque measurements and knee landing mechanics were present.