Pediatric Obesity and Sports Medicine: A Narrative Review and Clinical Recommendations.

OBJECTIVE: To review what is known about sports medicine and pediatric obesity, with a focus on injuries and MSK concerns. DATA SOURCES: Systematically searched MEDLINE (PubMed) for all years, using search combinations to best identify potential publications. Manuscripts were reviewed, summarized, and discussed in detail. Experienced clinicians in sports medicine and pediatric obesity reviewed the final searches for substantive content. Inclusion criteria include English language publications, children ≤18 years old, related to the practice of sports medicine and pediatric obesity. Publications excluded that dealt with non-sports medicine aspects of pediatric obesity, such as increasing physical activity or exercise, or the prevention or treatment of obesity. MAIN RESULTS: Twenty-eight publications were included for review. Papers fell into 5 groupings: (1) MSK-increased incidence of MSK injury in children with obesity, hypothesized to be a result of changes in biomechanics; (2) weight management-gradual loss while maintaining proper hydration and nutrition for sports performance; (3) fitness/conditioning-children with overweight/obese showed decreased fitness measures and cardiopulmonary conditioning; (4) exertional heat illness-a concern for adolescent athletes with obesity, specifically in football; and (5) differential diagnoses-3 key differential diagnoses were identified for increased awareness: slipped capital femoral epiphysis, Blount's disease, and pes planus. Clinical topics pertinent to sports medicine and pediatric obesity were discussed. CONCLUSIONS: Sports medicine clinicians should be aware of the common MSK and sports-related conditions in children with obesity. Few studies have focused investigations on issues related to children with obesity participating in sports and other physical activities.

Delayed motor skills associated with pediatric obesity.

OBJECTIVE: To review the literature regarding associations between developmental motor delay (DMD) and pediatric obesity. We hope to identify potential interventions that can improve motor coordination at an early age, thereby minimizing the deterring factors of physical activity down the road. DESIGN: An integrative review was undertaken using search combinations to best identify potential publications. Manuscripts were reviewed, summarized, and discussed in detail. An experienced clinician in pediatric obesity reviewed the final searches for substantive content. CRITERIA: Inclusion criteria include English language studies or publications, children ≤18 years old, publication/study relates to DMD and pediatric obesity. Excluded publications regarded topics of pediatric obesity that have been extensively studied such as maternal and family histories of obesity, isolated nutritional or physical interventions to improve obesity without discussion of DMD. RESULTS: 21 publications were included for review. Papers fell into three main categories regarding the association between pediatric obesity and DMD: 1) Motor function - negative association with motor function and obesity 2) Motor Development - lower levels of motor function are associated with decreased levels of exercise, and 3) Role of Intervention - specific physical activity intervention showed improvements in motor function. CONCLUSIONS: Motor function deficits appear to be associated with obesity. However, it is not well understood if children with obesity have delayed motor skills as a consequence of their weight or if the DMD is a risk factor for the development of obesity; existing studies do not provide an answer.