scholarly journals Neuromusculoskeletal Health in Pediatric Obesity: Incorporating Evidence into Clinical Examination

2021 ◽  
Author(s):  
Grace C. O’Malley ◽  
Sarah P. Shultz ◽  
David Thivel ◽  
Margarita D. Tsiros
Keyword(s):  
Physical Activity ◽  
Pediatric Obesity ◽  
Healthcare Professionals ◽  
Clinical Importance ◽  
Evidence Base ◽  
Obesity Treatment ◽  
Obesity Management ◽  
Exercise Interventions ◽  
Exercise Barriers ◽  
Impaired Balance

Abstract Purpose of Review The study aims to highlight the clinical importance of assessing and managing neuromusculoskeletal health in pediatric obesity and to support translation of evidence into practice. Recent Findings A growing evidence base suggests that children with obesity experience neuromusculoskeletal impairments and physical complications including increased pain, reduced muscle strength, impaired balance and motor skill, gait deviations, postural malalignment, greater fatigue, and potentially reduced flexibility and sub-optimal bone health. Such evidence supports the need to screen, assess, and optimize neuromusculoskeletal health as part of pediatric obesity management. Summary The likelihood of children with obesity experiencing neuromusculoskeletal impairments is high and can impact the way a child moves, and their interest or capacity to engage in physical activity and exercise. Barriers to movement should be minimized to promote optimal development of the neuromusculoskeletal system and to support engagement in sufficient physical activity for weight management. Healthcare professionals should screen for neuromusculoskeletal impairments as well as personalize interventions and modify standardized exercise interventions to optimize obesity treatment. Further research should explore whether neuromusculoskeletal impairments influence the success of obesity treatment or whether they improve following obesity treatment.

scholarly journals Practice review: Evidence-based and effective management of fatigue in patients with advanced cancer

2021 ◽  
pp. 026921632110467
Author(s):  
Emma J Chapman ◽  
Erica Di Martino ◽  
Zoe Edwards ◽  
Kathryn Black ◽  
Matthew Maddocks ◽  
...  
Keyword(s):  
Energy Conservation ◽  
Advanced Cancer ◽  
Healthcare Professionals ◽  
Nutritional Intervention ◽  
Evidence Base ◽  
Exercise Interventions ◽  
Fatigue Exercise ◽  
Cochrane Database ◽  
Pubmed Search ◽  
The Impact

Background: Fatigue affects most patients living with advanced cancer and is a symptom that healthcare professionals can find difficult to manage. Aim: To provide healthcare professionals with a pragmatic overview of approaches to management of fatigue in patients with advanced cancer that are commonly recommended by guidelines and to evaluate evidence underpinning them. Design: Scoping review methodology was used to determine the strength of evidence supporting use of interventions recommended in management of fatigue in patients with advanced cancer. Data sources: National or international guidelines were examined if they described the management of fatigue in adult cancer patients and were written within the last 6 years (2015–2021) in English. The Cochrane Database of Systematic Reviews (January 2011–December 2021) was searched for ‘cancer’ AND ‘fatigue’ in title, abstract or keywords. A PubMed search was also made. Results: Evidence indicates physical exercise interventions are effective and patients may benefit from energy conservation tactics. Evidence does not support use of psychostimulants such as methylphenidate. Limited data were found on efficacy of corticosteroids, psychological interventions, nutritional intervention, sleep optimization or complementary therapies for management of fatigue in advanced cancer. Conclusion: We recommend regular assessment, review and acknowledgement of the impact of fatigue. Exercise and energy conservation should be considered. Pharmacological interventions are not endorsed as a routine approach. Many interventions currently recommended by guidelines are not supported by a robust evidence base and further research on their efficacy is required.

familyPower: A Referral-Based Pediatric Obesity Treatment Program that Connects Clinic to Family

2016 ◽  
Vol 6 (5) ◽  
Author(s):  
Craig W. Moscetti ◽  
◽  
Jane K. Haws ◽  
Craig Malm ◽  
Nicolaas P. Pronk ◽  
...  
Keyword(s):  
Treatment Program ◽  
Pediatric Obesity ◽  
Obesity Treatment ◽  
Pediatric Obesity Treatment

The Evolution of Physical Activity on Prescription (FaR) in Sweden

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Healthcare Professionals ◽  
Systems Approach ◽  
Ecological Model ◽  
Controlled Trial ◽  
Professional Associations ◽  
Successful Implementation ◽  
Surgeon General ◽  
Positive Effects

In 1996, the first Report of the US Surgeon General on Physical Activity and Health provided an extensive knowledge overview about the positive effects of physical activity (PA) on several health outcomes and PA recommendations. This contributed to an enhanced interest for PA in Sweden. The Swedish Professional Associations for Physical Activity (YFA) were appointed to form a Scientific Expert Group in the project “Sweden on the Move” and YFA created the idea of Physical Activity on Prescription (FaR) and the production of a handbook (FYSS) for healthcare professionals. In Swedish primary care, licensed healthcare professionals, i.e. physicians, physiotherapists and nurses, can prescribe PA if they have sufficient knowledge about the patient’s current state of health, how PA can be used for promotion, prevention and treatment and are trained in patient-centred counselling and the FaR method. The prescription is followed individually or by visiting local FaR providers. These include sport associations, patient organisations, municipal facilities, commercial providers such as gyms, sports clubs and walking clubs or other organisations with FaR educated staff such as health promoters or personal trainers. In clinical practice, the FaR method increases the level of PA in primary care patients, at 6 and at 12 months. Self-reported adherence to the prescription was 65% at 6 months, similar to the known compliance for medications. In a randomised controlled trial, FaR significantly improved body composition and reduced metabolic risk factors. It is suggested that a successful implementation of PA in healthcare depends on a combination of a systems approach (socio-ecological model) and the strengthening of individual motivation and capability. General support from policymakers, healthcare leadership and professional associations is important. To lower barriers, tools for implementation and structures for delivery must be readily available. Examples include handbooks such as FYSS, the FaR system and the use of pedometers.

scholarly journals SAT0620-HPR INACTIVITY BEHAVIOR AND EXERCISE BARRIERS IN PATIENTS WITH BEHÇET’S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1270.1-1270
Author(s):  
S. Baglan Yentur ◽  
D. C. Saraç ◽  
N. G. Tore ◽  
F. Sarİ ◽  
N. Atas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Behçet’S Disease ◽  
Physical Activity Level ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Activity Level ◽  
Behcet's Disease ◽  
Exercise Barriers

Background:Behçet’s Disease (BD) is a chronic, inflammatory, rheumatic disease that is characterized by mucocutaneous lesions and can be seen major organ involvement such as eyes, musculoskeletal system, gastrointestinal system and central nervous system. Impaired quality of life, aerobic capacity, respiratory function and life satisfaction, sleep disorders, depression, anxiety and fatigue are seen commonly in BD patients like the other rheumatic diseases. Considering that regular physical activity effects survival for patients and healthy people, it is important to determine the factors affecting physical activity level and exercise barriers.Objectives:The aim of this study is to investigate physical activity level and exercise barriers in patients with BD.Methods:45 patients were included in the study. Physical activity level, exercise barriers, fatigue, depression, pain, quality of life and aerobic capacity were evaluated with International Physical Activity Questionnaire (IPAQ), Exercise Barriers and Benefits Scale (EBBS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Visual Analog Scale (VAS), Behçet’s Disease Quality of Life Questionnaire (BDQoL) and 6 minutes walk test, respectively. Spaerman’s Correlation Coefficient were used to investigate the relationships between exercise barriers and other parameters.Results:IPAQ demonstrated that 22 (48.8%) of the patients had low level physical activitiy. Additionally, physical activity levels significantly correlated with both exercise barriers (rho= -0.345) and exercise benefits (rho= 0.320) (p<0.05). BDQoL scores also correlated significantly with exercise barrier scores (rho= 0.338), (p<0.05). No significant relationships were observed for other parameters.Conclusion:Exercise and physical activity are of great importance because of its positive contribution to the musculoskeletal system for BD patients’ rehabilitation. Thinking of negative effects of physical inactivity, patients with Behçet disease should be encouraged to exercise. Also, reasons of physical inactivity should be investigated and treated.References:[1]Ilhan B, Can M, Alibaz-Oner F, Yilmaz-Oner S, Polat-Korkmaz O, Ozen G et al. Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity. International journal of rheumatic diseases. 2018;21(12):2139-45.[2]Alder NM, Fisher M, Yazici Y. Behçet’s syndrome patients have high levels of functional disability, fatigue and pain as measured by a Multi-dimensional Health Assessment Questionnaire (MDHAQ). Clin Exp Rheumatol. 2008;26(Suppl 50):S110-3.Disclosure of Interests:None declared

scholarly journals Body composition outcomes of Healthy Fit and the role of acculturation among low-income Hispanics on the US-Mexico border

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Diane I. Lopez ◽  
Lauren Chacon ◽  
Denise Vasquez ◽  
Louis D. Brown
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Nutrition Education ◽  
Low Income ◽  
Vegetable Consumption ◽  
Overweight And Obesity ◽  
Foreign Born ◽  
Exercise Interventions ◽  
Mexico Border

Abstract Background Hispanic immigrants continue to experience higher rates of overweight and obesity compared to their non-Hispanic counterparts. Acculturation may contribute to unhealthy weight gain among immigrant populations by shifting dietary patterns from high fruit and vegetable consumption to unhealthier high fat diets. Healthy Fit, a culturally tailored community health worker (CHW) intervention, aims to reduce obesity related outcomes by providing physical activity and nutrition education and resources in a low-income Hispanic population. This study aims to evaluate outcomes of Healthy Fit participants and examine changes in body composition in relation to level of acculturation at baseline and follow-up. Method In this longitudinal observational study, CHWs recruited 514 participants from community events and agencies serving low-income Hispanic populations in El Paso, Texas from 2015 to 2016. Following an in-person health screening, eligible participants received nutrition and physical activity education guided by fotonovelas, comic-like educational books. Telephone follow-ups made at 1, 3, and 6 months by CHWs encouraged follow-through on referrals. 288 participants completed the screening again during the 12-month follow-up. Results The sample was predominantly Hispanic (96%), female (82%), uninsured (79%), had a household income of less than $19,999 (70%), foreign-born (79%), preferred Spanish (86%) and few rated themselves as good or excellent for English proficiency (27%). Overall, Healthy Fit participants significantly improved (i.e., decreased) BFP by 0.71% (t = 2.47, p = 0.01) but not BMI (b = .01, t = − 0.14, p = .89). Contrary to expectations, acculturation was not associated with lower BMI (b = 0.09, p = 0.84) or BFP (b = 0.13, p = 0.85) at baseline. However, acculturation predicted changes in both BMI (b = 0.30, p = 0.03) and BFP (b = 1.33, p = 0 .01) from baseline to follow-up. Specifically, the low acculturation group improved in body composition measures over time and the high acculturation group did not improve in either measure. Conclusion Findings suggest Healthy Fit was most effective among less acculturated individuals. The influence of acculturation on the efficacy of nutrition and exercise interventions suggests that Hispanics should not be treated as a homogenous subgroup.

Effects of Exercise Interventions on Habitual Physical Activity and Sedentary Behavior in Adolescents With Cerebral Palsy

2019 ◽  
Vol 31 (4) ◽  
pp. 416-424 ◽  
Author(s):  
Simona Bar-Haim ◽  
Ronit Aviram ◽  
Anat Shkedy Rabani ◽  
Akram Amro ◽  
Ibtisam Nammourah ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cerebral Palsy ◽  
Resistance Training ◽  
Sedentary Behavior ◽  
Motor Function ◽  
Classification System ◽  
Habitual Physical Activity ◽  
Progressive Resistance Training ◽  
Exercise Interventions ◽  
Progressive Resistance

Purpose:Exercise interventions have been shown to increase motor capacities in adolescents with cerebral palsy; however, how they affect habitual physical activity (HPA) and sedentary behavior is unclear. The main objective was to correlate changes in HPA with changes in mobility capacity following exercise interventions.Methods:A total of 54 participants (aged 12–20 y) with bilateral spastic cerebral palsy at Gross Motor Function Classification System (GMFCS) levels II and III received 4 months of group progressive resistance training or treadmill training. Mobility measurements and HPA (averaged over 96 h) were made before and after interventions.Results:Averaged baseline mobility and HPA measures and improvements in each after both interventions were positively correlated in all participants. Percentage of sedentary/awake time decreased 2%, with significant increases in HPA measures of step count (16%), walk time (14%), and upright time (9%). Mobility measures and HPA changes were quite similar between Gross Motor Function Classification System levels, but improvement in HPA after group progressive resistance training was greater than after treadmill training (12% vs 4%) and correlated with mobility improvement.Conclusions:Mobility capacity improved after these interventions and was clearly associated with improved HPA. The group progressive resistance training intervention seems preferable to improve HPA, perhaps related to greater social interaction and motivation provided by group training.

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