Functional Performance Of Children Research Articles

Executive function performance in children and adolescent patients with narcolepsy type 1

ObjectiveThe executive function profile in patients with narcolepsy type 1 (NT1) has been mentioned; however, limited research exists on children and adolescent patients with NT1.This study aims to assess executive function in children and adolescent patients with NT1 in China, examine potential influencing factors and evaluate the short-term treatment effect on executive function. Methods53 NT1 patients (36 males, age 12.2 ± 3.4 years) and 37 healthy controls (23 males, age 12.2 ± 2.5 years) underwent self-reported measures assessing subjective sleepiness, depression, anxiety and sleep quality. A comprehensive neuropsychological test was administered to assess executive function domains, including processing speed, inhibitory control, cognitive flexibility and working memory. These assessments were repeated in NT1 patients after three-day regular drug treatment. ResultsNT1 patients exhibited higher levels of excessive daytime sleepiness, depression, anxiety, and poor sleep quality compared to healthy controls. Patients showed impaired processing speed, inhibitory control and cognitive flexibility (p < 0.05), whereas working memory was unaffected (p > 0.05). Regression analysis revealed that parameters from sleep monitoring, such as sleep efficiency and sleep latency, were correlated with executive function performance after controlling for age, gender, and education years. The short-term treatment led to improvements in inhibitory control, cognitive flexibility, and working memory. ConclusionThe findings showed that executive function was impaired among children and adolescent patients with narcolepsy, which was associated with objective sleep parameters. Furthermore, this study emphasizes the necessity of neuropsychological assessments and early interventions among children and adolescent NT1 patients.

The Association Between Lumbar Lordosis and Functional Performance in Children with Duchenne Muscular Dystrophy

Purpose: The aims of this study were to compare the lumbar lordosis measured with flexible ruler between healthy peers and children with Duchenne Muscular Dystrophy (DMD) and to investigate the relationship between lumbar lordosis and functional performance in children with DMD. Material and Methods: This study included 20 children with DMD (median age: 8.29 years) and 10 healthy peers (median age: 7.96 years). Lumbar lordosis and postural alignment were assessed with flexible ruler and New York Posture Rating (NYPR), succesively. Functional performance was evaluated with Motor Function Measure and timed performance tests. Results: Demographic characteristics of children with DMD and healthy peers were similar (p&gt;0.05). Children with DMD (median angle: 46.58 degrees) had a higher degree of lumbar lordosis than their healthy peers (median angle: 36.10 degrees) (p

Relationship between severity of concussion’s symptoms and functional performance in children

ABSTRACT Introduction Concussion is a common brain injury that has significant effects on multiple functional domains in children. However, limited research exists on the relationship between concussion severity and functional performance in this population. This study aimed to examine the relationship between the severity of concussion symptoms and children’s balance and functional performance. Methods This cross-sectional study recruited 23 children (9 males and 14 females; mean age 13.9 ± 2.2 years) with clinically diagnosed concussions from a tertiary balance center in 2016. Participants underwent clinical and functional evaluations by specialized physical therapists. Symptom severity was assessed using the Post-Concussion Symptom Scale (PCSS), while functional performance was measured using the Functional Gait Assessment (FGA). Results There was a trend suggesting a negative correlation between symptom severity (PCSS) and functional performance (FGA), indicating potentially better performance in individuals with milder symptoms. However, this trend was not significant (rs (21) = –.072, p = 0.744). Furthermore, no significant correlation was found between FGA scores and the severity of individual symptoms. Conclusion The findings suggest that concussion symptom severity may not be directly related to functional performance in children. Therefore, it is crucial to incorporate functional performance measures alongside symptom assessment for comprehensive concussion management.

The relation between teacher–student interaction and executive function performance in children: A cross-cultural meta-analysis

Executive function (EF) is critical to students’ academic behaviors and well-being. Environmental influences, particularly teacher-student interaction (TSI), play a key role in enhancing EF development. Previous studies have linked TSI quality to children’s EF, yet the relationships between subdimensions of TSI—such as closeness, conflict, dependency, emotional support, classroom management, and instructional support—and EF outcomes remain unclear. Moreover, it is unclear whether these relations hold true across different cultural contexts. From an initial pool of 14,915 articles, in this meta-analysis, we considered 84 empirical studies across 18 cultural regions, revealing that TSI subdimensions are consistently related to EF with small-to-medium effect sizes. The analysis also identified statistically significant moderating factors, such as individualism, power distance, EF type, EF instrument, and socioeconomic status. Notably, stronger TSI-EF correlations were found among children from cultures with low-individualism and high-power-distance, as well as among children from higher socioeconomic backgrounds. These patterns were particularly pronounced in studies measuring hot EF through adult-reported data. This comprehensive meta-analysis bridges knowledge gaps in TSI-EF dynamics, and supporting theories, such as attachment theory, social learning theory, and socio-cultural theory within educational settings. Crucially, it provides cross-cultural perspectives showing how cultural and contextual factors may intertwine with TSI-EF interactions.

Effects of Plyometric-Based Hydro-Kinesiotherapy on Pain, Muscle Strength, Postural Stability, and Functional Performance in Children with Hemophilic Knee Arthropathy: A Randomized Trial

Aim To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA). Methods Forty-eight children with HKA (age: 8–16 years) were randomly allocated to the Plyo-HKT group (n = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group (n = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 o/sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention. Results In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain (p = .028, η 2 p = 0.10), peak torque of quadriceps [120°/sec (p = .007, η2 P = 0.15); 180°/sec (p = .011, η2 P = 0.13)] and hamstring [120°/sec (p = .024, η2 P = 0.11); 180°/sec (p = .036, η2 P = 0.09)], DLPSdirectional [forward (p = .007, η2 P = 0.15); backward (p = .013, η2 P = 0.12); affected side (p = .008, η2 P = 0.14); non-affected side (p = .002, η2 P = 0.20)], DLPSoverall (p < .001, η2 P = 0.32), and functional performance [FISH (p < .001, η 2 p = 0.26); 6-MWT (p = .002, η 2 p = 0.19)]. Conclusion Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.

The Effect of Web-Based Telerehabilitation Programs on Children and Adolescents With Brain Injury: Systematic Review and Meta-Analysis.

Acquired brain injury (ABI) in children and adolescents can lead to motor and executive impairments that often require long-term treatment. The implementation of web-based telerehabilitation therapy at home is a method to improve the functional status of patients. Therefore, we performed a systematic review of the effects of web-based telerehabilitation programs on functional outcomes in children and adolescents with brain injury and supplemented the findings with a meta-analysis. This study evaluated the therapeutic effect of web-based telerehabilitation training on children and adolescents with brain injury to determine whether web-based telerehabilitation therapy improved motor function, executive function, physical activity level, lower limb strength, hand and upper limb function, visual processing skills, and occupational functional performance in children and adolescents with brain injury. PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched for randomized controlled trials on web-based telerehabilitation programs in children and adolescents with brain injury until December 2022, and the risk of bias was evaluated using the Cochrane Collaboration Tool. Relevant data were extracted, and a meta-analysis was performed using RevMan5.3 software. Overall, 17 studies involving 848 patients were included. Web-based telerehabilitation therapy improved the motor function (standardized mean difference [SMD] 0.29, 95% CI 0.01-0.57; P=.04), physical activity level (SMD 0.42, 95% CI 0.11-0.73; P=.007), lower limb strength (SMD 0.52, 95% CI 0.13-0.90; P=.009), and visual processing skills (SMD 0.26, 95% CI 0.02-0.50; P=.04) of children and adolescents with brain injury. It also improved executive function in letter-number sequencing (SMD 1.26, 95% CI 0.26-2.26; P=.01), attention (SMD 0.38, 95% CI 0.09-0.66; P=.009), and symbol search (SMD 1.18, 95% CI 0.43-1.93, P=.002). Web-based telerehabilitation therapy improved motor function, physical activity level, lower limb strength, letter-number sequencing, attention, and symbol search, which improved the quality of life in children and adolescents with brain injury. Web-based telerehabilitation programs provide great convenience for children and adolescents with ABI who need long-term treatment and allow them to exercise at home for rehabilitation training. The widespread implementation of remote interventions also provides children and adolescents in remote areas with better access to rehabilitation services. This review provides evidence for the effectiveness of web-based telerehabilitation therapy, but there was heterogeneity in some of the results because of different disease types and intervention programs. Future studies can expand the sample size according to disease type and increase follow-up time according to different exercise prescriptions to further refine the long-term effects of this intervention on various functions of children and adolescents with ABI. PROSPERO CRD42023421917; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=421917.

P433 Association of physical activity with quadriceps force and functional performance in children with cystic fibrosis and healthy peers

P433 Association of physical activity with quadriceps force and functional performance in children with cystic fibrosis and healthy peers

The PAY test: a new approach for assessing functional performance in children and adolescents with asthma

ObjectiveTo develop, validate, and test the reproducibility of a new test capable of assessing functional performance in children and adolescents (PAY test: Performance Activity in Youth). Methodsparticipants without and with asthma were included in the development and validation phases, respectively. The PAY test includes five activities: transition from sitting to standing, walking 10 m, step climbing, shoulder extension and flexion, and star jumps. Participants underwent the Pediatric Glittre test (TGlittre-P test time), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). Outcomes: PAY test and TGlittre-P test times, oxygen uptake (VO2peak), and distance walked in the MST. Results8 healthy volunteers, aged 12 (7 - 15) years old were included in the development phase and 34 participants with asthma, aged 11 (7 -14) years old, in the validation phase. The PAY test elicited greater physiological responses (VO2peak 33.5 ± 6.9 mL/kg) than the TGlittre-P (VO2peak: 27.4 ± 9.0 mL/kg), but lower than the MST (VO2peak: 48.9 ± 14.2 mL/kg) and CPET (VO2peak: 42.0 ± 8.8 mL/kg), p < .05. Moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p < .001) and distance walked in the MST (r = -0.72, p < .001). The PAY test time was longer in participants with asthma than in healthy participants (3.1 [3.0 - 3.3] min vs. 2.3 [2.1 – 2.4 min]), p < .001.; and the test was reproducible (ICC 0.78, CI 95% 0.55–0.90, p < .001). ConclusionsThe PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.

Effect of Photobiomodulation Combined with Physiotherapy on Functional Performance in Children with Myelomeningo-Cele-Randomized, Blind, Clinical Trial.

This study aimed to evaluate the electrical activity of the rectus femoris, tibialis anterior, and lateral gastrocnemius muscles during the sit-to-stand task and functional mobility after a neurofunctional physiotherapy protocol associated with PBM. Twenty-five children were randomly allocated to either Active PBM + physiotherapy (n = 13) or PBM sham + physiotherapy (n = 12). PBM was carried out with a LED device (850 nm, 25 J, 50 s per point and 200 mW) at four points over the area with absence of a spiny process. Both groups completed a twelve-week supervised program with two weekly 45-60 min sessions. Pre-training and post-training assessments involved the Pediatric Evaluation of Disability Inventory (PEDI). Muscle activity was assessed using portable electromyography (BTS Engineering) and the electrodes were positioned on the lateral gastrocnemius, anterior tibialis, and rectus femoris muscles. The RMS data were recorded and analyzed. After 24 sessions of the treatment protocol, improvements were found in the PEDI score. The participants presented greater independence in performing the tasks, requiring less assistance from their caregivers. More significant electrical activity was found in the three muscles evaluated between the rest period and execution of the sit-to-stand tasks, both in the more compromised or less compromised lower limbs. Neurofunctional physiotherapy with or without PBM improved functional mobility and electrical muscle activity in children with myelomeningocele.

Goal attainment of children with cerebral palsy participating in multi-modal intervention.

We aimed to determine if there was a significant difference in the functional performance of family requested daily tasks by a heterogeneous group of children with cerebral palsy following a programme of neuro-developmental treatment and in comparison to a randomly control group. There are considerable challenges in conducting research into the functional performance of children with cerebral palsy. These include the highly heterogeneous nature of the population group, poor ecological and treatment fidelity, floor and ceiling effects in assessments, and insensitivity to the diverse functional needs and goals of children and families. Therapists and families identified functional goals and specified all aspects of performance details for each goal on five point goal attainment scales. Children with cerebral palsy were assigned randomly to treatment and alternate treatment groups. Children were video recorded attempting to perform targeted functional skills at pre-test, post-pest and follow-up. Videos were recorded and rated by expert clinicians blind to experimental condition. After the first round of target intervention and alternate treatment had been completed, a significant difference in the goal attainment was noted between the control group and the treatment group at the post test, indicating that intervention was associated with a higher level of goal attainment than that attained by the control group (p = 0.0321) with a large effect size. The study provided evidence of an effective way to investigate and to enhance the available motor capacity of children with moderate to severe cerebral palsy during participation in requested daily task performance, as reflected in goal attainment. Goal attainment scales were a reliable measure that was able to be used to detect changes in functional goals among a highly heterogeneous population group with individualized goals that were meaningful to each child and family.

The effects of rehabilitation on functional independence of Eastern Taiwanese children with rare or genetic diseases.

This study investigated the effects of outpatient rehabilitation therapy (RT) on the functional performance of children from Eastern Taiwan with rare or genetic diseases. This retrospective observational cohort study included 73 children from Eastern Taiwan who were affected with rare or genetic diseases, with an average age of 8.57 ± 5.33 years (47 boys and 26 girls). Each child received the goal-directed therapy known as outpatient RT, which was delivered by a multidisciplinary team of specialists. To assess the effectiveness of RT, the WeeFIM-C questionnaire data were collected and analyzed. After receiving outpatient RT, most of the children only required low-to-moderate assistance with self-care tasks (4.36 ± 2.38), and they could perform mobility-related activities under supervision or independently (5.70 ± 2.29). Moreover, most only required minimal assistance with tasks related to cognitive functioning and tended to complete such tasks under supervision (4.97 ± 2.05). The functional performance was significantly different among three studied groups, in terms of self-care (F[2, 68] = 5.42, P < 0.007), mobility (F[2, 68] = 8.17, P < 0.001), cognitive functioning (F[2, 68] = 3.31, P < 0.042), and overall (F[2, 68] = 6.44, P < 0.003) functional performance. The results of this study demonstrated that the functional status was different among three studied groups in terms of self-care, mobility, and cognitive functioning after receiving outpatient RT.

Effect of circuit training program on functional performance in children with hemiplegic cerebral palsy

Background: There is a plethora of literature with some conflicting findings on the effects of implementing strength and/or aerobic training or circuit training exercises to improve motor function of children with spastic hemiplegic cerebral palsy (CP). Circuit training is a form of body conditioning that involves endurance training, resistance training, high-intensity aerobics, and exercises performed in a circuit. Purpose: To investigate the effect of circuit training program on gross motor functions and functional capacity in children with hemiplegic CP. Methods: Thirty-two children with hemiplegic CP from both genders (8-12 years) with motor functional level of I and II based on Gross Motor Functional Classification System were assigned into two equal groups (control and study). The control group received a selected conventional physical therapy program for 60 minutes, including 35 minutes directed to lower limb. The study group received circuit training program for 35 minutes. The program for both groups was conducted twice per week for 12 successive weeks. Gross motor functions and functional capacity of both groups were evaluated by the Gross Motor Function Measure (GMFM) version 66 (Domains D and E) and the Six-Minute Walk Test (6MWT) respectively before as well as after the treatment period.

Determinants of hand function in children and adolescent with Down Syndrome-A scoping review

BackgroundDown Syndrome (DS) is a genetic condition. Physical characteristics like short stature, hypotonia, small, and thick hands result in decreased grip and pinch strength and quality of fine motor tasks. PurposeThe purpose of this review is to summarize the evidence of upper extremity physical characteristics and its influence on hand function in DS population. Study DesignA scoping review. MethodologyA comprehensive electronic literature search was conducted through PubMed, CINAHL, Cochrane Library. The search was limited to articles written in English and published between 2010 to 2021. Additionally, books were referred for a better understanding of the hand function in DS. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR) was adopted to develop the protocol. ResultsFollowing a detailed review of 28 articles meeting the inclusion criteria, fetuses with a diagnosis of DS are reported to have shortening of humerus on sonographic markers wherein 9% of fetuses had below 5th percentile shortening. Additionally, literature reports that during reaching there was increased trunk rotation (effect size = 0.88). DS population had 60% less grip strength, 33% less palmar pinch strength ,20% less key pinch strength and poor manual dexterity (CI = 4.5-5.5). ConclusionFindings of this review concludes that physical characteristics of the upper extremity have an influence on hand function performance in children and adolescents with DS.However, only arm length and hand span have been quantified and correlated with grip strength. Further work must focus on correlation of upper extremity anthropometry and overall hand function in children and adolscents with DS.

Assessment of Functional Performance in Children with Cerebral Palsy Receiving Treatment in a Day Care Facility: An Observational Study.

BackgroundThe study assessed changes in functional performance of children with cerebral palsy (CP), immediately following treatment and 2 months later, in addition to investigating the relationship between therapy effect and sex, age, or comorbidities.Material/MethodsFunctional performance of 32 children with spastic diplegia CP, aged 9–16 years, was assessed for: 1) manual function (Box and Block test), motor capacities (Gross Motor Function Measure), sensory capacities (Finger Identification [FI] and Localisation of Tactile Stimuli test [LTC]), and 2) activity and participation, ie, independence in essential and more complex daily activities (Barthel Index; Paediatric Evaluation of Disability Inventory). Measurements were conducted before the start (Month 0), immediately after 6-month rehabilitation program (Month 6), and following a 2-month period with no therapy, ie, 8 months after baseline measurement (Month 8).ResultsComparison of Month 0 and Month 6 scores showed significant differences (P<0.001) in all measures. However, Month 8 scores were significantly worse in all the measures, except for sensory capacities assessed using FI and LTC (P<0.001).ConclusionsFunctional performance of children with CP was positively affected by 6-month therapy, but 2 months later these effects significantly deteriorated, except for the sensory capacities. This suggests that therapy focusing on functional performance should be included as a permanent component of rehabilitation programs. These findings may be important for clinical practice as they show that therapy of children with CP should be continuous and systematic, and this should be taken into account by those designing therapeutic programs.

Executive functions in children and adolescents with hearing loss: A systematic review of case-control, case series, and cross-sectional studies

Introduction. Children with hearing loss have been reported to perform lower in executive function and language tasks than their normal-hearing peers. Objective. To describe EF performance profile in children and adolescents with hearing loss. Method. Using different databases including PubMed, Scopus, and ScienceDirect, we conducted a systematic review of case-control, cross-sectional studies, and case series that evaluated executive function performance in children and adolescents with hearing loss with or without hearing aids, cochlear implants, and/or native sign language, since 2000 until April 2020. Fifteen studies were selected after quality assessment using Critical Appraisal Tools provided by Joanna Briggs Institute. Results. The studies differed in the assessment tools, and the results obtained by different authors were inconsistent. However, these studies revealed that children and adolescents with hearing impairment have lower performance in working memory, inhibition, cognitive flexibility, and attention than their normal-hearing peers. Discussion and conclusion. Executive function assessment tools are used indistinctively for both children with and without hearing loss. Consequently, as tools were designed for normal hearing population, results can significantly vary in the population with hearing impairment. Hence, it is important to establish a standardized protocol specifically adapted for this population.

Effectiveness of Occupational Therapy Using a Sensory Integration Approach: A Multiple-Baseline Design Study.

Occupational therapy using an Ayres Sensory Integration® (ASI) approach is a common intervention that has not been extensively studied in children with idiopathic sensory processing and integration challenges (e.g., without a diagnosis of autism). To test the effectiveness of ASI using measures related to motor coordination and functional performance in children with a sensory-based motor disorder (SBMD). Nonconcurrent, multiple baseline, single subject. Outpatient clinic that was part of a children's hospital in an urban setting. Three boys (ages 5-8 yr) with an SBMD. Each participant received ASI 3 times per week for 10 wk. Outcomes and Measures: Three motor probes were measured weekly. Pre- and posttest assessments included goal attainment scaling (GAS) and the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2). All 3 participants showed improvements in motor probes during the intervention period on the basis of a 2 SD band method of analysis. Statistically significant improvements were noted across GAS goals, and positive changes were found on the BOT-2, with large effect sizes. Findings suggest improved motor performance and high goal achievement using ASI for children with idiopathic sensory processing and integration challenges. What This Article Adds: This study adds to a body of literature suggesting that ASI is effective in increasing functional performance in children with sensory processing and integration challenges. Future studies using multiple baseline designs are feasible in the clinic setting and can help build the evidence base for ASI.

Relationship between modified TUG and WeeFIM in children with cerebral palsy

Background: Cerebral Palsy (CP) refers to permanent, mutable motor development disorders stemming from a primary brain lesion, leading to secondary musculoskeletal alterations, and limitation of activities of daily living. Motor impairment is the main manifestation in children with CP, and it has consequent effects on the biomechanics of the body. The WeeFIM is a short and quick to administer assessment of functional outcome in paediatric rehabilitation. The modified Timed Up and Go test (mTUG) was designed for children with Cerebral Palsy and assesses mobility and requires both static and dynamic balance. Context and Purpose: Determining if a relationship exists between functional mobility and level of functional independence in daily activities will help to design treatment programs which target improvement in functional mobility in order to improve functional independence in children with Cerebral Palsy. The studies done correlating functional balance and functional performance in children with CP have largely yielded inconclusive results. Hence this study was designed with the aim of finding if a relationship exists between functional mobility measured by mTUG and functional independence measured by WeeFIM in children with CP. Methods: It was a correlation study conducted on 20 children with spastic cerebral palsy from different CP centers in and around Mangalore. Participants were evaluated using modified TUG and WeeFIM scales and the scores tabulated and subjected to statistical analysis to determine if there is a relationship exists between mTUG and WeeFIM. Results: When the measured variables were correlated with each other using Pearson’s correlation it was found that the Pearson’s correlation coefficient was - .470, indicating a moderate negative correlation between the mTUG and WeeFIMscores. Conclusion: There exists a positive relationship between functional mobility and functional independence in children with CP. Improving mobility in children with CP can help them to attain better functional independence. KEY WORD: Cerebral Palsy, GMFC, mTUG, WeeFIM.

Relationship between trunk muscle strength, reaching ability and balance in children with Down syndrome – A cross-sectional study

BackgroundChildren with Down Syndrome (DS) present with neuromuscular disturbances leading to delayed developmental milestones, poor quality of movement and poor balance. The aim of this study is to discuss the role of trunk muscle strength in the functional performance of children with DS. Methodology28 children were recruited in the study, 14 with DS and 14 age and gender-matched controls. Trunk muscle strength, reaching ability and balance were assessed using a Handheld Dynamometer, Modified Functional Reach test and Pediatric Balance Scale, respectively. ResultsChildren with DS present with poorer trunk muscle strength, reaching ability and balance as compared to typically developing (TD) children. There was a positive correlation between trunk muscle strength and lateral reaching in children with DS. A strong to moderate correlation was observed between the trunk muscle strength and balance in children with DS. DiscussionChildren with DS demonstrated a significantly weak trunk muscle groups. Lateral reaching distance is reduced due to the poor proximal control and they present with near-normal forward reach distance attributed to compensation using the lower trunk muscles. They exhibit poor balance in the components that require a small base of support. ConclusionChildren with DS exhibit weak trunk muscles along with lesser reaching distance and poor balance. Also, trunk muscle strength influences lateral reaching ability. Trunk muscle strength, mainly trunk extensors impacted functional balance in sitting, standing and while performing transfers.

PEDI-CHAMP© AGILITY TEST VARIES BY AGE, GENDER AND SPORT SPECIALIZATION IN YOUTH ATHLETES

Background:The Pediatric Comprehensive High-Level Activity Mobility Predictor (Pedi-CHAMP©) is a 4-part agility test aimed to assess functional performance in children with and without sports medicine injuries or orthopedic conditions. The Pedi-CHAMP© assesses bilateral single limb balance, lateral agility, directional changes, and acceleration/deceleration.Hypothesis/Purpose:To determine if the Pedi-CHAMP component (Single-Limb-Stance [SLS], modified Edgren Side Step [mESS], L-Test, Illinois Agility Test [IAT]) and composite scores are stratified based on age, sex, and sport-type/specialization in youth athletes.Methods:Youth athletes were recruited to complete the Pedi-CHAMP© either as an independent test or as part of larger battery of tests (Specialized Athlete Functional Evaluation [SAFE] Program). Completion times for each test component were converted to points using age-sex matched scoring algorithms. Each participant also answered questions to determine specialization in organized sports (defined as competition with a referee, umpire, etc.). Kruskal-Wallis was used to assess differences based on age groups (elementary [E, 5-9yrs], preteen [PT, 10-12yrs], early teen [ET, 13-15yrs], late teen/young adult [LT, 16-22yrs]), with Mann-Whitney U pairwise post-hoc comparisons (α<0.05). Independent Mann-Whitney U tests were used to assess differences based on sex, sport type (low vs high impact) and specialization (single vs multi-sport) within each age group.Results:A total of 251 youth athletes (134 females, age 13.7±3.3yrs; BMI 20.9±5.9) completed Pedi-CHAMP© testing. Significant differences were seen with the Pedi-CHAMP© component and composite scores between all ages (p<0.001, Table 1), however, there were no differences between ET and LT groups for the SLS or mESS. When assessing age and sex, elementary-aged girls demonstrated improved SLS balance (p=0.017), and mESS scores were higher in preteen boys compared to girls (p=0.022). However, all 3 agility components (mESS, L-Test, IAT) and the Pedi-CHAMP© composite scores were significantly higher in boys compared to girls for the ET and LT groups. When accounting for age, there were no differences in single-sport vs. multi-sport athletes. ET and LT low-impact athletes scored lower on the L-test compared to high-impact athletes.Conclusion:The Pedi-CHAMP© was able to detect differences based on age, sex and sport impact-type (low- vs. high-impact). Performance improves with age for the L-Test and IAT, however, no differences in SLS and mESS were seen between younger and older teens which may indicate a ceiling effect for these two components. Further research should focus on correlating the Pedi-CHAMP© to other performance measures in youth athletes.Tables/Figures:

Secondary consequences of juvenile idiopathic arthritis in children and adolescents with knee involvement: physical activity, adiposity, fitness, and functional performance.

Secondary consequences of juvenile idiopathic arthritis (JIA) may impact long-term health outcomes. This study examined differences in physical activity, cardiorespiratory fitness, adiposity, and functional performance in children and adolescents with JIA compared to their typically developing (TD) peers. Participants with JIA (n = 32; 10-20years old) and their TD peers (n = 35) volunteered for assessments of: daily moderate-to-vigorous physical activity (MVPA, body-worn accelerometer); peak oxygen consumption (VO2 Peak, incremental bike test); fat mass index (FMI, dual-energy X-ray absorptiometry); and triple-single-leg-hop (TSLH) distance. Statistical analyses were performed in R using four linear mixed-effect models with Bonferroni adjustment (⍺ = 0.0125). Fixed effects were group, sex, and age. Participant clusters based on sex and age (within 1.5years) were considered as random effects. Participants with JIA displayed lower mean daily MVPA than their TD peers [p = 0.006; β (98.75% CI); -21.2 (-40.4 to -2.9) min]. VO2 Peak [p = 0.019; -1.4 (-2.5 to -0.2) ml/kg/min] decreased with age. Females tended to have lower VO2 Peak [p = 0.045; -6.4 (-13.0 to 0.4) ml/kg/min] and greater adiposity [p = 0.071; 1.4 (-0.1 to 3.0) kg/m2] than males. The findings support the need for strategies to promote MVPA participation in children and adolescents with JIA. Sex and age should be considered in research on the consequences of JIA.