Physical Performance In Children Research Articles

Investigating the association between the lunar cycle and sleep, physiological, cognitive, and physical performance in children with Down syndrome.

Children with Down syndrome (DS) offer a compelling context within the fieldof human biology for examining potential lunar influences. While the exact mechanisms governing lunar effects are still under investigation, a growing body of scientific inquiry suggests possible connections between lunar phases and physiological, physical, and cognitive parameters. This investigation holds promise for uncovering the intricate interplay between lunar cycles (LCs) and the unique biology of children with DS. This study investigated the potential influence of the LC on physiological, physical, and cognitive parameters in children with DS, focusing on sleep patterns, physical performance, and cognitive abilities. Seventeen children with DS participated in this study. Sleep data, physical performance metrics, and cognitive test results were collected throughout the LC, including the new moon (NM), first quarter, full moon (FM), and third quarter. Statistical analyses were conducted to assess the differences in these parameters across lunar phases. Significant differences were observed in sleep patterns, with reduced total sleep time (P < 0.01) and sleep efficiency (P < 0.001) during the FM phase. Heart rates (HRs) before (P < 0.001) and after (P < 0.01) exercise also displayed pronounced changes during LC. Additionally, the reaction time (RT) exhibited a significant difference (P < 0.01) across the lunar phases. However, physical performance metrics, including squat jump (SJ), sprint, and 6-minute walk distance (6MWD), did not show significant variations. This study suggests that LC may have a moderating effect on sleep patterns, HR, and cognitive performance in children with DS. These findings have practical implications for caregivers and educators and highlight the importance of considering lunar-associated variations in planning schedules and interventions for children with DS.

Lighting the way: Exploring diurnal physical performance differences in school-aged visually impaired children and adolescents

ABSTRACT Circadian rhythms play a pivotal role in governing various physiological processes, including physical performance. However, in individuals deprived of light perception, such as the blind, these circadian rhythms face disruption. This study aimed to explore the influence of disturbed circadian rhythms on short-term maximal physical performance in children and adolescents with visual impairment. Forty-five volunteers participated in this study, comprising 17 blind, 13 visually impaired, and 15 sighted participants. The participants underwent a series of tests assessing maximal isometric strength performance across two days. To mitigate the influence of morning session fatigue on the evening results, each participant group performed in two separate testing sessions (i.e. in the morning (7:00 h) and in the evening (17:00 h)) on non-consecutive days in a randomized and counterbalanced setting, with approximately 36 h of recovery time between sessions. To mitigate the impact of inter-individual differences on mean values and to account for the influence of age and sex on the studied variables, data were normalized. The outcomes revealed a significant diurnal variation in maximal isometric strength performance among sighted individuals, with peak performance observed in the evening. This pattern aligns with their well-entrained circadian rhythm. In contrast, blind and visually impaired individuals did not display significant diurnal variation, signaling disrupted circadian rhythms due to the absence of light perception. These findings emphasize the crucial consideration of circadian rhythms in assessments of physical performance, especially among participants with visual impairments.

Effects of Manohra Dance, the Cultural Heritage of UNESCO, on Physical Performance in Children

The characteristics of Manohra dance are delicate because of the high physical performance specific posture, which can communicate the meaning. The purpose of this study is to study the effects of exercise with Manohra dance on physical performance, which were postural balance, muscle strength, and flexibility. Twenty-four female students aged 12-13 years old were included in the training program. They were randomly divided into two groups, experimental and control groups, twelve in each group. All subjects were trained with a strength and flexibility program as circuit training, only the experimental group was additionally trained with eight specific postures of the Manohra dance. All subjects were performed 3 times a week for 8 weeks continuously. The study involved three testing sessions pre-training, after 4-weeks and 8-weeks intervention. Compared between groups by using an independent t-test, significant at p&amp;lt;0.05. The results of experimental group showed higher significant difference in postural balance in all directions during the performance of YBT (p&amp;lt;0.05; YBT 1 p=0.044, YBT 2 p=0.004 and YBT 3 p=0.017) and flexibility (p&amp;lt;0.05; p=0.047) than the control group at week 8th. While there was no significant difference between groups of leg muscle strength (p&amp;gt;0.05). As a result, it was determined that the Manohra dance shows advantages, which are charming, conservation, and good for health, it can be suggested to use the Manohra dance posture in a training program to improve postural balance and flexibility in children.

Physical capacity in children and adolescents with newly diagnosed cancer: A systematic review and meta-analysis.

To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. Thirteen studies, embodying 594 participants within 1month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n=2), muscle strength (n=5), physical performance (n=10), and adverse events (n=1) were analyzed. Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence.

Skeletal muscle mass, muscle strength, and physical performance in children and adolescents with obesity.

Sarcopenic obesity (SO) is defined as obesity with low skeletal muscle function and mass. This study aimed to evaluate the presence of sarcopenic obesity according to different diagnostic criteria and assess the elements of sarcopenia in children and adolescents with obesity. A total of 95 children and adolescents with obesity (diagnosed with the use of International Obesity Task Force (IOTF) criteria) with a mean age of 12.7( ± 3) years participated in the study. Body composition was assessed with the use of bioelectrical impedance-BIA (Tanita BC480MA) and dual-energy X-ray absorptiometry-DXA (Hologic). Fat mass (FM) and appendicular skeletal muscle mass (SMMa) were expressed as kilograms (kg) and percentage (%). Muscle-to-fat ratio (MFR) was defined as SMMa divided by FM. A dynamometer was used in order to measure grip strength. Six-minute walk test (6MWT) and a timed up-and-go test (TUG) were used to assess physical performance. The presence of SO ranged from 6.32% to 97.89%, depending on the criteria used to define sarcopenia. Children with sarcopenia, defined as a co- occurrence of low skeletal muscle mass % (SMM%) measured by DXA (≤9th centile) according to McCarthy et al. and weak handgrip strength (≤10th centile) according to Dodds et al., had significantly lower SMMa measured by both DXA and BIA, lower maximal handgrip strength, and lower physical performance. Maximal handgrip was positively correlated with SMMa (kg) and SMMa% derived from both DXA and BIA and BIA-MFR. Maximal handgrip was negatively correlated with waist-to-height ratio (WHtR). The distance of 6MWT correlated positively with BIA-measured SMMa% and BIA-MFR. 6MWT distance correlated negatively with BIA-FM% and body mass index (BMI) z-score. TUG was positively correlated with BIA-FM%, BMI z-score, WHtR, and IOTF categories and negatively correlated with BIA-SMMa% and BIA-MFR. The presence of sarcopenia in our study varied depending on the diagnostic criteria used. This is one of the first studies evaluating muscle mass, muscle strength, and physical performance in children and adolescents with obesity. The study highlighted the need for the implementation of a consensus statement regarding SO diagnostic criteria in children and adolescents.

Different Protocols for Low Whole-Body Vibration Frequency for Spasticity and Physical Performance in Children with Spastic Cerebral Palsy.

Whole-body vibration (WBV) is a therapeutic exercise tool that can be used in children with cerebral palsy (CP). A low vibration frequency with different protocols has been suggested, but no optimal dose has been explicitly indicated. We aimed to determine the superiority of a gradually increased 7-18 Hz WBV protocol over a static 11 Hz WBV and the immediate and short-term effects of WBV training on improving spasticity, functional strength, balance, and walking ability in children with spastic CP. Twenty-four participants with CP (mean age: 11.5 ± 2.9 years) were randomly allocated into protocols of a static 11 Hz vibration frequency group (SVF) or one that increased from a 7 to an 18 Hz vibration frequency (IVF) (n = 12/group). The WBV programmes were completed for 30 min/session/day to identify immediate effects, and the short-term programme then continued for four days/week for eight weeks. Modified Ashworth Scale scores significantly and immediately improved in the IVF group (hip adductor and knee extensor, p < 0.05), and after eight weeks showed significant improvement in the SVF group (ankle plantar flexor, p < 0.05). Within groups, the Five Times Sit to Stand Test (FTSTS), the Time Up and Go Test and the Functional Reach Test significantly improved in the SVF group, whereas only the FTSTS improved in the IVF group (p < 0.05). There were no significant between-group differences at the eight-week postintervention, except reduced spasticity. A protocol of 7-18 Hz WBV seems to offer superior immediate results in terms of improved spasticity; however, a static 11 Hz protocol appears to offer superior results after eight weeks, although the two protocols did not differ significantly in effects on physical performance. This finding may facilitate preparations to normalise muscle tone before functional mobility therapy. The study results may support future studies about the dose-response of WBV frequency.

The Effect of Extended Reality Exercise on Physical Activity and Physical Performance in Children and Youth: A Scoping Review

Physical activity is vital for children’s and youth’s healthy growth and development. Despite the physical, psychological, and social benefits, many children and youth are not physically active enough. Extended reality exercise (XRE), which incorporates virtual, augmented, and mixed reality exercise-based gaming, has been touted as a possible tool for not only promoting physical activity but also developing physical performance. Accordingly, we conducted a five-stage scoping review to identify themes and gaps in the literature pertaining to the application of XRE in physical activity-related research. We identified a positive impact of XRE on physical activity and performance in children and youth, including those with and without impairments, with a predominant preference for nonimmersive virtual reality in the majority of studies. There is a paucity of studies that specifically investigate the effects of XRE on physical activity in impaired children and youth. Likewise, more research is needed to determine how XRE can be leveraged to develop physical performance in nonimpaired children and youth. There is also a need for more large-sample studies that incorporate fully immersive XRE.

Changes in Body Composition and Physical Performance in Children with Excessive Body Weight Participating in an Integrated Weight-Loss Programme.

The problem of overweight and obesity is a growing phenomenon in the entire population. Obesity is associated with many different metabolic disorders and is directly associated with an increased risk of death. The aim of the study was to assess the changes in body composition and physical fitness in children participating in an integrated weight-loss programme and to analyse the possible relationship between changes in body composition and improvements in fitness. Participants of the study were recruited from the “6–10–14 for Health”-multidisciplinary intervention programme for children aged 6 to 15 years old. A total of 170 patients qualified for the study, and 152 patients were enrolled. Statistically significant changes in body composition were found after the end of the intervention program, as measured by both BIA (bioimpedance) and DXA (Dual Energy X-ray Absorptiometry). The differences in KPRT (Kasch Pulse Recovery Test) results at baseline and after intervention are positively correlated with the difference in fat mass between baseline and the after-intervention measure. Improving physical fitness is positively correlated with a decrease in FM (fat mass) and an increase in FFM (fat-free mass) measured in both absolute values and %. Both BIA and DXA methods proved to be equally useful for measuring body composition.

The relative contributions of adiposity and activity levels to physical performance in children with excess weight.

This study examined predictors of physical performance, a key aspect of quality of life, in children with excess weight. Participants were 269 children aged 6-12 years with a body mass index above the 85th percentile. Children completed a standardized physical performance task capturing lower extremity strength, balance, and gait speed. Height, weight, and waist circumference were objectively measured, and daily moderate-vigorous physical activity (min/day) and sedentary time (% of day) were assessed with a 7-day accelerometer protocol. Physical performance task completion averaged 15.0 (SD=2.5) seconds. Children with higher body mass index z-scores and waist circumferences had significantly longer task completion times. The task took 1.8 additional seconds per 1.0 body mass index z-score (p <.001), and 1.2 additional seconds for every 20 cm higher waist circumference (p <.001). Daily moderate-vigorous physical activity and sedentary time were unrelated to physical performance, and did not moderate its associations with the adiposity measures. Among children with excess weight, physical performance declines with increasing levels of total and central adiposity. Daily activity levels do not moderate this association. Interventions that directly target weight reduction would likely yield the greatest improvement in physical performance in children with overweight or obesity.

Effects of three 8-week strength training programs on jump, speed and agility performance in prepubertal children

BACKGROUND: Supervised strength training has been shown to promote physiological adaptations in children and youth that can be beneficial to the process of physical growth and developed, and general health status. METHODS: Sixty-three children (9.2 ± 0.5 years old) were randomly assigned to training groups: multi jumps (MJ) (n= 20), sled towing (ST) (n= 21), or uphill running (UR) (n= 22). The following tests were applied before and after each intervention: vertical jump (ABK, CMJ, SJ), standing broad jump (SBJ), velocity/agility 4 × 10 m, and 20 m sprint test (ST20m). RESULTS: After 8 weeks of training, statistically significant changes were found in all study variables for all groups, but with different effect sizes. In the ABK jump, the largest effect size was observed in UR (1.40, 0.97–1.85), while in ST and MJ it was medium (0.67, 0.44–0.98 and 0.48, 0.17–0.82, respectively). Similarly, the effect size in the SJ jump was large for the UR and ST groups (1.10, 0.78–1.51 and 1.30, 0.98–1.64, respectively) and medium in MJ (0.56, 0.24–0.97). However, the magnitude of the effect registered in SBJ was large in MJ (0.80, 0.55–1.15) and medium in UR and ST (0.56, 0.32–0.86 and 0.64, 0.42–1.013, respectively). CONCLUSIONS: All three training programs improve jumping and velocity/agility performance but based on clinical significance, UR and ST methods can be considered more efficient to improve physical performance in children.

Effects of vitamin D supplementation and aerobic exercises on balance and physical performance in children with Down syndrome

Background/Aims Children with Down syndrome are prone to vitamin D deficiency. Vitamin D supplements are commonly used to treat and prevent vitamin D deficiencies. There is growing evidence that support the role of vitamin D improving muscles and central nervous system function. The aim of this study was to investigate the interaction effects of vitamin D supplementation combined with aerobic exercises and conventional physical therapy on balance and physical performance in children with Down syndrome. Methods A randomised controlled trial was conducted for 38 children with Down syndrome, with ages ranging from 8 to 12 years. They were divided randomly into two groups. The control group (n=19) received conventional physical therapy and aerobic exercises, while the study group (n=19) received conventional physical therapy, aerobic exercises and vitamin D in the form of an oral daily dose of vitamin D3 400 IU (cholecalciferol). The children in both groups participated in the same physical therapy for 45 minutes, 3 days a week for 12 weeks, and undertook 15 minutes of aerobic exercise after the physical therapy sessions. Balance was evaluated by using the Biodex Stability System and physical performance was evaluated by using the 6-Minute Walk Test. Results All groups showed a significant improvement in the medial-lateral stability index, the anterior-posterior stability index, the overall stability index and the 6-Minute Walk Test after treatment (P&lt;0.05). The study group showed a significant improvement in the measured variables compared with that of the control group (P&lt;0.05). Conclusions Vitamin D supplements, combined with aerobic exercises and conventional physical therapy, could improve balance and physical performance in children with Down syndrome. Therefore, vitamin D and aerobic exercises should be considered as an adjunctive to physical therapy.

Assessment of the physical performance in children with asymptomatic pre-excitation.

Pre-excitation syndrome can lead to recurrent supraventricular tachycardias (SVTs) and carries a risk of sudden cardiac death (SCD). However, an underestimated consequence of antegrade conduction through an accessory pathway is fusion of intrinsic and accessory conduction that causes asynchronous activation and myocardial contraction that could be a cause for cardiac dysfunction and dilation. It is not known to what extent pre-excitation affects myocardial and physical performance in those patients. The aim of the study was to assess to what degree ventricular pre-excitation affects physical performance in children, using cardio-pulmonary exercise testing (CPET). The study group consisted of 30 asymptomatic children, aged 8-17 years, with pre-excitation and no history or documentation of SVT compared to 31 healthy controls matched according to sex and age. All patients underwent routine cardiology assessment and then CPET. Echocardiography showed there were no differences in the left ventricular size and function between the study and control group. During the CPET both, patients and controls achieved maximal effort. Patients in the study group showed significantly lower values of VO2max and anaerobic threshold when compared to controls. The most affected subgroup was patients with persistent pre-excitation throughout the exercise. Physical performance is affected in children with pre-excitation. This effect is stronger in patients with persistent delta wave observed throughout the exercise.

Investigation of surface electromyography amplitude values during stair climbing task in children with Duchenne muscular dystrophy.

The aims of this study were (a) to examine the surface electromyography (sEMG) amplitude values of the lower limb muscles during stair climbing both between different functional levels of Duchenne muscular dystrophy (DMD), in comparison with healthy children, and (b) to investigate the relationships between sEMG amplitudes and physical performance. sEMG amplitudes of the lower limbs of twenty-one children with DMD between levels I and III according to the Brooke Lower Extremity Functional Classification Scale and eleven healthy peers were evaluated by using sEMG during stair climbing task. Physical performance was evaluated by 6-min walk test and ascending 4-step timed performance test. The lower limb sEMG amplitude values of children with DMD were statistically higher than healthy children (p < 0.001). sEMG amplitudes of the right (p = 0.01) and left (p = 0.003) biceps femoris, the right (p < 0.001) and left (p = 0.001) gastrocnemius medialis, and the right vastus lateralis (p = 0.02) muscles were higher in children with levels 2-3 than those in level 1. Moderate-to-strong relations were found between the gastrocnemius medialis and biceps femoris sEMG amplitudes and physical performance assessments (p < 0.05). Increased sEMG amplitude values in the lower limbs during stair climbing task are thought to be caused by the effort to compensate for progressive muscle weakness and are associated with lower physical performance in children with DMD. Further, sEMG amplitude values are determined to increase as the functional level deteriorates. NCT04287582 ( https://clinicaltrials.gov/ct2/show/NCT04287582?term=merve+bora&draw=2&rank=1 ).

The Effect of Growth Hormone Treatment on Physical Performance Indices in Children With Idiopathic Short Stature.

To examine the effect of growth hormone (GH) treatment on physical performance in children with idiopathic short stature and normal GH secretion. A total of 24 children participated in the study (13 GH-treated, 11 non-treated, aged 8-13y, 11 males and 13 females, Tanner stage 1-2). Participants performed a battery of motor skill performance tests (Eurofit), as well as the Wingate anaerobic test. No statistically significant differences in any of the Eurofit physical fitness test results (eg,20-m shuttle run 33.0 [15.1] vs 25.1 [21.0] laps in treated and nontreated participants, respectively, P = .25) or the Wingate anaerobic test were found between the groups (eg,peak power 5.0 [2.9] vs 3.9 [2.6]watts/kg in treated and nontreated participants, respectively, P = .2). Therapeutic usage of exogenous GH for pre and early pubertal children with idiopathic short stature and normal GH secretion was not associated with beneficial effects on physical performance indices. This suggests that the use of GH as a potential performance enhancing agent, in this age group, at least at commonly used doses, is not advantageous.

Physical performance outcome measures used in exercise interventions for adults with childhood-onset disabilities: A scoping review.

People with childhood-onset disabilities face unique physical and social challenges in adulthood. Exercise interventions may improve physical performance in children, but there is a lack of research on adults. To describe studies that investigate exercise interventions and to evaluate the quality of physical performance outcome measures for adults with childhood-onset disabilities. Eligible studies reported on exercise interventions for adults (ages 16+) with cerebral palsy, spina bifida, or acquired brain injuries. Only randomized controlled trials published in English from 2008 to 2019 were included. MEDLINE, CINAHL, PEDro, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Two reviewers independently screened studies and abstracted data. This scoping review included 4 trials reporting on cerebral palsy only. Three strength training programs found significant improvements in gait, and one mixed training program found significant improvements in strength and fitness. Only two outcome measures used are valid/reliable for adults (6 Minute Walk Test and Borg-20 Grades). Certain interventions may improve physical performance, but there is a lack of research on appropriate exercise interventions and physical performance outcome measures for adults with childhood-onset disabilities. Different exercise interventions should be investigated using larger sample sizes and outcome measures should be standardized.

Effectiveness of a Multidisciplinary Lifestyle Intervention to Reduce Obesity among Children and Adolescents

Background: Now a days unhealthy lifestyle primarily responsible for the dramatic increase obesity among children and adolescents.&#x0D; Objective: The purpose of the study is to see the effects of a multidisciplinary lifestyle intervention to reduce obese children and adolescents. The main outcome was cardiometabolic risk based on the waist-to-height ratio (WHTR) measurement. Secondary outcomes were (1) changes in body composition; (2) adherence to a Mediterranean diet; and (3) physical performance.&#x0D; Methods: The study involved 64 overweight/obese children or adolescents conducted at Dhaka Shishu Hospital from October 2017 to September 2018. The intervention was multidisciplinary including nutrition, exercise, and psychological aspects based on a family-based approach; it was delivered for six months for children and three months for adolescents. Before and after the intervention, several anthropometric measures height, body weight, body mass index (BMI), waist circumference, and body composition, cardiometabolic risk index waist-to-height ratio (WHTR), and dietary habits of the participants and their families were evaluated. In addition, a set of functional motor fitness tests was performed to evaluate physical performance measures.&#x0D; Results: After the intervention both children and adolescents showed a significant reduction in body weight, BMI, waist circumference, fat mass, and WHTR index and an improvement of fat-free mass, adherence to the Mediterranean diet, and physical fitness performance.&#x0D; Conclusion: A short term family-based multidisciplinary approach is effective in ameliorating the health status, dietary habits, and physical performance in children and adolescents.&#x0D; DS (Child) H J 2019; 35(2) : 111-118

Effects of Peer Encouragement on Efficacy Perceptions and Physical Performance in Children.

Social interactions are theorized to inform relation-inferred self-efficacy (RISE), which, in turn, may influence self-efficacy and behavior. This study investigated the effects of peer encouragement on RISE, task self-efficacy, and physical performance. Children (N = 84) were assigned to dyads and randomized to provide peer encouragement to one another or not (control group). Participants completed two endurance handgrip trials, separated by a cognitively demanding task intended to induce mental fatigue and increase the salience of the peer encouragement manipulation. Participants in the experimental group exchanged words of encouragement prior to the second endurance trial, whereas those in the control group did not. The peer encouragement group reported higher RISE and showed increased performance across trials compared with controls. Providing peer encouragement prior to a challenging physical task was associated with more positive RISE perceptions and improved physical performance.

Vitamin D Supplementation Improves Health-Related Quality of Life and Physical Performance in Children with Sickle Cell Disease and in Healthy Children.

No study determined if vitamin D supplementation improves health-related quality of life (HRQL) using pediatric Patient-Reported Outcomes Measurement Information System or physical functioning in type SS sickle cell disease (HbSS). Subjects with HbSS (n = 21) and healthy subjects (n = 23) were randomized to daily oral doses (4,000 vs. 7,000 IU) of cholecalciferol (vitamin D3) and evaluated at 6 and 12 weeks for changes in serum 25 hydroxyvitamin D (25(OH)D), HRQL, and physical functioning. In subjects with HbSS, significant reductions in pain, fatigue, and depressive symptoms and improved upper-extremity function were observed. In healthy subjects, significant reductions in fatigue and improved upper-extremity function were observed. Significant improvements in peak power and dorsiflexion isometric maximal voluntary contraction torques were observed in both groups. In subjects with HbSS, improved plantar flexion isometric maximal voluntary contraction torques were observed. Both groups saw significant improvement in their total Bruininks-Oseretsky Test of Motor Proficiency score. Daily high-dose vitamin D supplementation for African American children with and without HbSS improved HRQL and physical performance.

Playing games can improve physical performance in children with autism

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by deficits in social communication, interaction, and stereotypical behaviours. Children with ASD have not enough opportunities to participate in physical activity (PA), which lead to increase fitness and health problem. The aim of this study was to compare two programs on motor skills. In the current investigation, 30 high functioning autistic children were diagnosed by a psychiatrist and randomly divided into control and experimental groups. The evaluation tools included the Brininx-Oresetsky Test (BOT) and a program named “I can have physical literacy” (ICPL) and Sport, Play, and Active Recreation for Kids (SPARK). The experimental intervention groups received sixteen sessions of 60 min, while the control group did not receive any treatment. Analysis of covariance was used to determine the difference between the groups. Post-hoc test was used to compare pairs of groups. Results showed that the experimental ICPL and Spark groups had increased motor skills (MS). There were significant differences between groups on gross motor skills. There were significant differences between the control and experimental ICPL groups, and between the experimental Spark and experimental ICPL groups. Both of these programs increased MS. ICPL program that address the characteristics of children with ASD, have a positive effect on their MS.

Deficits in Muscle Strength and Physical Performance Influence Physical Activity in Sarcopenic Children After Liver Transplantation.

Sarcopenia is a muscle disease characterized by reduced skeletal muscle mass (SMM), muscle strength, and physical performance. Reduced SMM has been identified in children after liver transplantation (LT), but no information related to muscle strength/physical performance or lifestyle factors contributing to sarcopenia is available. We hypothesized that sarcopenia, as determined by measures of SMM, muscle strength, and physical performance, is highly prevalent in children after LT and is related to poor diet quality (DQ) and physical inactivity. A cross-sectional study in post-LT children (n=22) and age-matched healthy controls (n=47) between the ages of 6 and 18 years examining body composition (dual energy X-ray absorptiometry and multiple skinfold), measures of muscle strength (handgrip, sit-to-stand, and push-ups), physical performance (6-minute walk test and stair climb test), diet (3-day food intake), and physical activity (accelerometer) was conducted. Low muscle strength/physical performance and SMM (SMM z scores≤-1.5) were defined by values 2 standard deviations below the mean values for age- and sex-matched controls. Sarcopenia occurred in 36% of children who underwent LT, and they had significantly lower scores for muscle strength (sit-to-stand and push-up tests) and physical performance (stair climb test) than controls (P<0.05). Deficits in physical performance in children with sarcopenia were predominantly revealed by longer stair climbing times (P=0.03), with no differences in other muscle tests. Low SMM, muscle strength, and physical performance were associated with a lower amount of time spent in fairly and very active physical activity, but no associations with DQ were found. Sarcopenia is highly prevalent in children after LT and is related to lower moderate-to-vigorous physical activity. Development of effective rehabilitation strategies to treat sarcopenia are needed in post-LT children.