Endurance In Children Research Articles

P.7.19 Effects of upper extremity exercise training on upper extremity endurance in patients with Duchenne Muscular Dystrophy

To investigate the effects of 8 weeks upper extremity aerobic and strengthening exercises on upper extremity endurance in children with Duchenne Muscular Dystrophy (DMD). 24 children with DMD who have similar physical characteristics between 8 and 15 years of age included in the study. Children randomly divided into two groups. 12 DMD children whose functional status were between Grade 1 and 3 according to the Brooke Upper Extremity Functional Classification were included in each study and control group Minnesota Hand Dexterity Test (MHDT) was used to assess the upper extremity endurance and hand dexterity of children. Children in the study group received 45-min exercise sessions with electronic arm ergometer, 3 days a week for 8 weeks. 8-weeks home program including strengthening exercises for the upper extremity were given to the patients in control group. The number of elbow flexion–extension were recorded before and after each exercise sessions in study group. Asssessments were repeated after 8 weeks training and results were compared within and between groups. There were statistically significant decrease in unilateral placing (z = −2.354) and bilateral turning (z = −2.786) parameters of MHDT in study group (mean ages 9.5 ± 1.4) while only bilateral turning (z = −2.354) in control group (mean ages 9.3 ± 1.4) after training, compared to baseline (p

Effects of a Circuit Training Program on Muscular and Cardiovascular Endurance and their Maintenance in Schoolchildren

The purpose of this study was to evaluate the effects of a circuit training program along with a maintenance program on muscular and cardiovascular endurance in children in a physical education setting. Seventy two children 10-12 years old from four different classes were randomly grouped into either an experimental group (n = 35) or a control group (n = 37) (two classes for each group). After an eight-week development program carried out twice a week and a four-week detraining period, the experimental group performed a four-week maintenance program once a week. The program included one circuit of eight stations of 15/45 to 35/25 seconds of work/rest performed twice. Abdominal muscular endurance (sit-ups in 30 seconds test), upper-limbs muscular endurance (bent arm hang test), and cardiovascular endurance (20-m endurance shuttle run test) were measured at the beginning and at the end of the development program, and at the end of the maintenance program. After the development program, muscular and cardiovascular endurance increased significantly in the experimental group (p < 0.05). The gains obtained remained after the maintenance program. The respective values did not change in the control group (p > 0.05). The results showed that the circuit training program was effective to increase and maintain both muscular and cardiovascular endurance among schoolchildren. This could help physical education teachers design programs that permit students to maintain fit muscular and cardiovascular endurance levels.

Developmental biomechanics of neck musculature

Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6–23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects' ability to maintain 70% of peak force over 30s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (p<0.0001) increase with age. The MVC force, averaged across all directions and normalized to the adult values, exhibits the following maturation curve: %MVC Force=−0.0879(age)2+6.018(age)+8.120. Neck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions.

The assisted 6‐minute cycling test to assess endurance in children with a neuromuscular disorder

For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne muscular dystrophy (DMD). Ninety-nine healthy boys and 30 boys with DMD (12 wheelchair-dependent) performed the A6MCT. Seventy healthy boys also performed the 6-minute walk test (6MWT), and 23 boys performed the A6MCT twice within 2 weeks. Boys with DMD also performed the Motor Function Measure (MFM). The A6MCT was feasible for >90% of all boys. Boys with DMD achieved fewer cycling revolutions than controls. The A6MCT was positively correlated with the 6MWT and was reproducible in healthy boys, and it correlated with disease severity in boys with DMD. The A6MCT is a promising outcome measure for the follow-up of non-ambulant children with a neuromuscular disorder.

The impact of an after-school physical activity program on health-related fitness of mother/daughter pairs: CASPIAN study

ObjectiveTo examine the effectiveness of parental support and involvement in a low-cost intervention for the improvement of health-related fitness of high school girls through an after-school physical activity (PA) program. MethodsThis multi-site study was conducted in 2006–2007 in 7 provinces in Iran. The study population comprised of two groups of children. The first group consisted of 206 children who were randomly selected from female students (7th–10th grade) and their mothers (n=204). Another 60 children (without their mothers) were randomly selected as the control group. Overall, during 12weeks, 24 sessions of after-school aerobic exercise were held. Health-related fitness data were collected pre- and post-intervention. ResultsThe findings are based on 470 participants. The after-school PA significantly improved body mass index, resting heart rate, cardiorespiratory fitness, flexibility and muscle strength and endurance in children in both groups, and in mothers. Improvement in the physiological measures of the children in the mother/daughter group was significantly better than the control group. ConclusionThe findings suggest that after-school PA may provide an effective model for improving the health-related fitness of high school girls and their mothers. Our data show that family support, including mother's participation, contributes to enhanced health-related achievements in adolescent girls.

Micronutrient Supplementation Improves Physical Performance Measures in Asian Indian School-Age Children

Micronutrients are important in physical work capacity and therefore performance. The impact of a multi-micronutrient–fortified nutritional beverage on physical performance measures among clinically healthy school-age children was assessed in a double-blind (for test and placebo groups), placebo-controlled, randomized trial in children aged between 7 and 10.5 y ( n = 300). The participants with height- and weight-for-age Z-scores between 0 and = -3 were randomized to 1 of 3 study arms: fortified choco-malt beverage powder (F), matched energy equivalent unfortified placebo (U), and untreated control (C). Participants in the F and C groups were given 40 g fortified (19 key vitamins and minerals) and unfortified choco-malt beverage, respectively, daily for 120 d. Primary efficacy outcomes included endurance and aerobic capacity using a 20-m shuttle test and step test. Other physical performance measures included speed (40-m sprint), visual reaction time, maximal hand grip, and forearm static endurance. Micronutrient status included thiamin, riboflavin, folate, niacin, iron, pyridoxal phosphate, and vitamins B-12 and C. All measurements were made at baseline and the end of the intervention. There was a within-subject increase in aerobic capacity and whole body endurance ( P < 0.05) accompanied by a significant improvement in the status of iron thiamin, riboflavin, pyridoxal phosphate, folate, and vitamins C and B-12 in the F group compared to the within-subject changes in the other 2 groups ( P < 0.05). The study suggests that multiple micronutrient supplementation in similar populations may be beneficial in improving micronutrient status and enhancing aerobic capacity and endurance in children.

Aerobic capacity and skeletal muscle function in children with asthma

BackgroundPeripheral muscle strength and endurance are decreased in patients with chronic pulmonary diseases and seem to contribute to patients' exercise intolerance. However, the authors are not aware of any studies...

Comparison of Development of Physical Fitness Parameters in different Summer School Programs

Comparison of Development of Physical Fitness Parameters in different Summer School Programs The purpose of this study was to compare body composition and physical fitness development of children participating in soccer and different education programs. Nineteen adolescence children (age=12.8±0.3) participated in soccer training and eleven adolescence children (age=13.4±1) participated in multi-purpose physical education program for three weeks. Physical fitness tests were applied for determining the motor fitness, flexibility, agility, explosive power, general balance and endurance of children. Tests were applied before and after two educational programs and paired t-tests were applied between pre- and post-tests of the group. According to results, the weight of children who participated in the multi-purpose physical education program did not change significantly, whereas the weight of children in the soccer training program changed significantly (p&lt;0.05). Standing-broad jump performance, 10 × 5 m speed shuttle run performance, flamingo balance test, abdominal sit-ups and medicine ball performance were significantly increased after two multi-purpose education programs (p&lt;0.05). Furthermore, strength endurance of abdominal muscle group performance increased in only the soccer training group (p&lt;0.05). In conclusion, both training programs had positive effects on performance. However, soccer training is more effective for development of strength and endurance of the abdominal muscle group, because soccer training is more specific for development of motor abilities.

The long term effects of different training models on power, speed, ability and anaerobic capacity of 13–16 years old female basket ball players

The aim of this study is to investigate the 16-week different training models in terms of power, speed, ability and aerobic capacity in 13–16 years old female basketball players. 20...

The effect of endurance exercise on the power, speed, talent and anaerobic capacities of teenage female basketball players

The aim of this study is to investigate a 16-week endurance exercise in terms of power, speed, ability and aerobic capacity in 13–16-year-old female basketball players. Twenty female basketball players...

Efficacy of Partial Body Weight–Supported Treadmill Training Compared With Overground Walking Practice for Children With Cerebral Palsy: A Randomized Controlled Trial

Willoughby KL, Dodd KJ, Shields N, Foley S. Efficacy of partial body weight–supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial. Objective To evaluate the efficacy of 9 weeks of twice-weekly partial body weight–supported treadmill training (PBWSTT) for children with cerebral palsy (CP) and moderate to severe walking difficulty compared with overground walking. Design Randomized controlled trial. Setting Metropolitan Specialist School for children with moderate to severe physical and/or intellectual disabilities. Participants Thirty-four children classified level III or IV by the Gross Motor Function Classification System were recruited and randomly allocated to experimental or control groups. Of these, 26 (15 girls, 11 boys; mean age 10y, 10mo ± 3y, 11mo [range, 5–18y]) completed training and testing. Interventions Both groups completed 9 weeks of twice-weekly walking training. The experimental group completed PBWSTT, and the control group completed overground walking practice. Main Outcome Measures Ten-meter walk test (self-selected walking speed), 10-minute walk (walking endurance), School Function Assessment. Results The overground walking group showed a trend for an increase in the distance walked over 10 minutes (F=3.004, P=.097). There was no statistically significant difference in self-selected walking speed over 10 meters or in walking function in the school environment as measured by the School Function Assessment. Conclusions PBWSTT is safe and feasible to implement in a special school setting; however, it may be no more effective than overground walking for improving walking speed and endurance for children with CP. Continued emphasis on progressive reduction of body weight support along with adding concurrent overground walking practice to a treadmill training protocol may increase the intensity of training and assist with carryover of improvements to overground walking. Treadmill training programs that include concurrent overground walking as an additional key feature of the training protocol need to be rigorously evaluated for children with CP.

Cardiopulmonary fitness and endurance in children with developmental coordination disorder

The purpose of this study was to compare cardiopulmonary fitness and endurance in 9–11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this study. The cardiopulmonary tests included the 800-m run test and the peak oxygen consumption (peak VO 2) test using the Bruce treadmill protocol. No significant differences in age, body height, body weight, body mass index, and percentage of body fat between children with DCD and without DCD were found. However, there were significant differences in the cardiopulmonary endurance tests between children with DCD and without DCD. Children with DCD had significantly lower peak VO 2 results than children without DCD. In addition, children with DCD ran 800 m in a slower time than children without DCD. A significant negative correlation ( r = −0.437) was found between the peak VO 2 results and time to completion for the 800-m run test. Based on the results, cardiopulmonary endurance in children with DCD was worse than that of children without DCD. Due to the small sample size in this study, the results may not be a direct reflection of the entire population.

Effects of Partial Body Weight Supported Treadmill Training on Children with Cerebral Palsy

The purpose of this literature review was to investigate the effects of partial body weight supported treadmill training (BWSTT) on gross motor function, balance, gait speed, and endurance in children with cerebral palsy (CP). Larger numbers of preschool and school-aged children have been studied compared with infants and toddlers. More evidence exists regarding the efficacy of BWSTT on endurance, gait speed, and gross motor function related to ambulation than on balance in children with CP. Longer and more intense BWSTT protocols may lead to better results. BWSTT has not been studied extensively in children with CP. Current evidence suggests that intensive and prolonged BWSTT may be a safe, effective, and beneficial treatment intervention for the attainment of walking, improvement of gait speed, and improvement of endurance for children with different types and degrees of CP.

T.P.1.11 Respiratory muscle endurance in children

T.P.1.11 Respiratory muscle endurance in children

The endurance of children’s working memory: A recall time analysis

We analyze the timing of recall as a source of information about children’s performance in complex working memory tasks. A group of 8-year-olds performed a traditional operation span task in which sequence length increased across trials and an operation period task in which processing requirements were extended across trials of constant sequence length. Interword pauses were longer than are commonly found in immediate serial recall tasks yet shorter than for reading span. These pauses increased with the demands of recall, decreased across the output sequence, and were to some extent predictive of scholastic ability. Overall, timing data illustrate that recall in working memory tasks involves subtle processes of item access rather than simple readout of information from an immediate store.

Partial body‐weight‐supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial

This matched-pairs, clinical controlled trial evaluated the effects of a school-based, partial body-weight-supported treadmill training (PBWSTT) programme, conducted twice a week for 6 weeks, on the walking speed and endurance of children with cerebral palsy (CP). Pairs of children (10 males, four females; mean age 8 y 10 mo [SD 2 y 6 mo], range 5-14 y) matched for sex, age, type of CP (athetoid quadriplegia, n=6; spastic quadriplegia, n=6; spastic diplegia, n=2), and Gross Motor Function Classification System level (10 at Level I V, four at Level III) were allocated to the experimental or control group. Compared with the control group, the seven treadmill-training participants increased their self-selected walking speed over 10 metres (Mann-Whitney U=9.00, z=-1.98, p=0.048; mean difference 4.21 m/min). A trend was also found for increased distance walked over ground in 10 minutes (t[12]=1.88, p=0.083; mean difference 19.81 m). A relatively short PBWSTT programme can improve the walking speed of children with CP and moderate to severe disabilities. Walking endurance might also improve in some children. Treadmill training seems to be a useful gait training option for children with C P, and it seems feasible to conduct such a programme within a school environment.

The Effect of Interval Training in Children With Exercise-Induced Asthma Competing in Soccer

A lot of emphasis has been placed in screening individuals with exercise-induced bronchospasm in order to avoid persistence bronchial hyperactivity and consequent chronic silent inflammation of the respiratory tract. The purpose of this study was to evaluate the effect of interval training on the respiratory function and endurance in children with exercise-induced asthma (EIA) participating in the sport of soccer. Twenty-nine boys ages 10-14, who developed EIA after a 6-minute free running test (decline in forced expiratory volume in 1 second: FEV(1)10%), participated in the study. They were divided into 2 groups (experimental: n = 18, and control: n = 11), fulfilling the same criteria (i.e., age, body height and weight, and severity of asthma). The experimental group exercised with the interval training method for a period of 8 weeks, (3 sessions per week), whereas the control group exercised with the usual football program. Measurements were made for FEV(1) and endurance in both groups, before and after the application of training (8 weeks). Following the implementation of the training program, a significant improvement in FEV(1) and endurance was documented in the experimental group, as well as significant differences between the 2 groups. In conclusion, duration and aerobic training via the interval method seems to be beneficial to soccer players with EIA.

Validity of the 6‐minute walking test in juvenile idiopathic arthritis

Lower physical activity levels and decreased physical fitness levels have been reported in children with juvenile idiopathic arthritis (JIA) (1). Physical fitness includes 4 components: muscular endurance and strength, flexibility, body composition, and cardiorespiratory endurance or aerobic fitness (2). Cardiorespiratory endurance or aerobic fitness is most strongly associated with health benefits in the general population and is therefore the primary focus of most exercise programs (3,4). Children with JIA have a moderate to large impairment in aerobic fitness as represented by peak oxygen uptake (VO2peak) compared with healthy children (5). VO2peak has been described as the golden standard for aerobic fitness and is frequently examined using symptom limited bicycle ergometry (SLBE) in combination with a metabolic cart to analyze respiratory gases (6). However, bicycle ergometry and metabolic measurements are not always feasible in pediatric patients. It may be difficult to motivate nonathletic children to an exhaustive effort, intensive exercise may pose a risk to children with cardiopulmonary or musculoskeletal disease, and metabolic measurements systems may not be available, particularly in a field setting (7). Therefore, there is need for simple and inexpensive measurement tools to measure aerobic fitness. The 6-Minute Walking Test (6MWT), a simple and inexpensive measurement tool, is a good candidate (8). The 6-MWT is a self-paced and submaximal endurance test. In adult patients the 6-MWT has been widely used, most often in patients with pulmonary or cardiac diseases (9,10). Literature provides support for the reliability, validity, and responsiveness of the 6-MWT for a wide spectrum of adult individuals (9). In addition, the 6-MWT is described as easy to administer, better tolerated, and more reflective of activities of daily living than other walking tests and has therefore been described as the test of choice when using a functional walk test for clinical or research purposes (10). In pediatric patients, only 2 studies report the use of the 6-MWT (11,12). Gulmans et al found that for this group the 6-MWT is a valid and useful test to assess the exercise tolerance and endurance in children with cystic fibrosis (11). Nixon et al suggested that the 6-MWT might provide an alternative method for assessing functional exercise capacity in severely ill children (12). Despite these promising results, the validity of the 6-MWT in children with rheumatic disease has, to our knowledge, never before been examined. Validity refers to the question as to whether an instrument appears to measure what it purports to measure, i.e., endurance. In addition, validity indicates whether a variable can be correlated with the “gold standard” for cardiorespiratory endurance, i.e., VO2peak. The aim of the present study was to examine the validity of the 6-MWT in children with JIA.

Validation and clinical significance of the Childhood Myositis Assessment Scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies.

To examine the measurement characteristics of the Childhood Myositis Assessment Scale (CMAS) in children with juvenile idiopathic inflammatory myopathy (juvenile IIM), and to obtain preliminary data on the clinical significance of CMAS scores. One hundred eight children with juvenile IIM were evaluated on 2 occasions, 7-9 months apart, using various measures of physical function, strength, and disease activity. Interrater reliability, construct validity, and responsiveness of the CMAS were examined. The minimum clinically important difference (MID) and CMAS scores corresponding to various degrees of physical disability were estimated. The intraclass correlation coefficient for 26 patients assessed by 2 examiners was 0.89, indicating very good interrater reliability. The CMAS score correlated highly with the Childhood Health Assessment Questionnaire (C-HAQ) score and with findings on manual muscle testing (MMT) (r(s) = -0.73 and 0.73, respectively) and moderately with physician-assessed global disease activity and skin activity, parent-assessed global disease severity, and muscle magnetic resonance imaging (r(s) = -0.44 to -0.61), thereby demonstrating good construct validity. The standardized response mean was 0.81 (95% confidence interval 0.53, 1.09) in patients with at least 0.8 cm improvement on a 10-cm visual analog scale for physician-assessed global disease activity, indicating strong responsiveness. In bivariate regression models predicting physician-assessed global disease activity, MMT remained significant in models containing the CMAS (P = 0.03) while the C-HAQ did not (P = 0.4). Estimates of the MID ranged from 1.5 to 3.0 points on a 0-52-point scale. CMAS scores corresponding to no, mild, mild-to-moderate, and moderate physical disability, respectively, were 48, 45, 39, and 30. The CMAS exhibits good reliability, construct validity, and responsiveness, and is therefore a valid instrument for the assessment of physical function, muscle strength, and endurance in children with juvenile IIM. Preliminary data on MID and corresponding levels of disability should aid in the clinical interpretation of CMAS scores when assessing patients with juvenile IIM.

Respiratory muscle testing in children.

The range of techniques available to assess respiratory muscles weakness has greatly expanded over recent years. Respiratory muscle tests can be divided into non-invasive tests, such as lung function parameters, maximal static pressures and sniff nasal pressure and invasive tests, such as transdiaphragmatic pressures during crying, maximal static pressures and magnetic stimulation of the phrenic nerves. Sniff nasal pressure and magnetic stimulation should have increasing relevance in children in the coming years. However, probably the most important message is to arrange for the evaluation of respiratory muscles in children with unexplained or disproportionate breathlessness such as in patients with neuromuscular diseases. Improvements are needed to evaluate respiratory muscle endurance in children, which is more difficult but complementary to the assessment of respiratory muscle strength.