Translation, validity and reliability of the fall risk scale for older adults.

INTRODUCTION: Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. RESULTS: The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). CONCLUSION: The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population.

Association of leisure time and occupational physical activity with obesity and cardiovascular risk factors in Chile.

The aim of this study was to investigate the association between physical activity (PA), both occupational (OPA) and during leisure time (LTPA), with obesity and cardiovascular risk factors in Chilean adults. 5,157 participants from the Chilean National Health Survey 2009-2010 were included in this study. OPA and LTPA levels were assessed using the Global Physical Activity Questionnaire. The association between both PA with obesity and cardiovascular risk factors was determined using logistic regression. Our findings showed a significant trend between higher LTPA and lower odds for obesity (OR 0.64 [95% CI: 0.53; 0.76], central obesity 0.52 [0.44; 0.61]) and other cardiovascular risk factors including diabetes (OR: 0.72 [0.55; 0.94]), hypertension (OR: 0.59 [0.50; 0.71]) and metabolic syndrome (OR: 0.62 [0.50; 0.78]). In contrast, OPA was only associated with lower odds of diabetes (OR: 0.79 [0.65; 0.98]) and hypertension (0.85 [0.74; 0.98]). In conclusion, LTPA was associated with a lower risk of all major cardiovascular risk factors, whereas OPA was only associated with a lower risk of diabetes and hypertension.

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students.

BACKGROUND: Maintaining and building healthy bones during the lifetime requires a complicated interaction between a number of physiological and lifestyle factors. Our goal of this study was to analyze the association between hand grip strength and the maximum peak expiratory flow with bone mineral density and content in adolescent students. METHODS: The research team studied 1427 adolescent students of both sexes (750 males and 677 females) between the ages of 11.0 and 18.9 years in the Maule Region of Talca (Chile). Weight, standing height, sitting height, hand grip strength (HGS), and maximum peak expiratory flow (PEF) were measured. Furthermore, bone mineral density (BMD) and total body bone mineral content (BMC) were determined by using the Dual-Energy X-Ray Absorptiometry (DXA). Hand grip strength and PEF were categorized in tertiles (lowest, middle, and highest). Linear regression was performed in steps to analyze the relationship between the variables. Differences between categories were determined through ANOVA. RESULTS: In males, the hand grip strength explained 18-19% of the BMD and 20-23% of the BMC. For the females, the percentage of variation occurred between 12 and 13% of the BMD and 17-18% of the BMC. The variation of PEF for the males was observed as 33% of the BMD and 36% of the BMC. For the females, both the BMD and BMC showed a variation of 19%. The HGS and PEF were divided into three categories (lowest, middle, and highest). In both cases, significant differences occurred in bone density health between the three categories. CONCLUSIONS: In conclusion, the HGS and the PEF related positively to the bone density health of both sexes of adolescent students. The adolescents with poor values for hand grip strength and expiratory flow showed reduced values of BMD and BMC for the total body. Furthermore, the PEF had a greater influence on bone density health with respect to the HGS of the adolescents of both sexes.

Secular trends of physical growth and abdominal adiposity of school children and adolescents living at a moderate altitude in Peru.

OBJECTIVE: Identify changes in physical growth and abdominal adiposity at an interval of 14 years in children and adolescents living at a moderate altitude in Peru. MATERIALS AND METHODS: The data comes from two cross-sectional studies carried out in the city of Arequipa, Peru, located at a moderate altitude of 2,320 meters. In 2001, 473 males and 482 females were assessed, and in 2015, 432 males and 403 females between 6.0 and 12.9 years old were evaluated. Data were collected in public state schools and measured using the anthropometric variables for weight, height, and waist circumference. Body mass index (BMI) was calculated according to age and sex. RESULTS: Positive trends for weight were identified for both males and females at all ages (p < .001). For height, significant increases were observed in males for all ages. No significant increases (p > .05) occurred in height for females between the ages of 6 and 8 years. However, commencing at age 9 until 12 years, females showed positive and significant increases (p < .001) in height. In 2015, BMI and waist circumference increased significantly for both sexes at all ages. DISCUSSION: Between 2001 and 2015, positive trends in physical growth and abdominal adiposity were identified for children and adolescents living in Arequipa, Peru. These changes may be associated with the rapid economic development in the country.

[Physical activity patterns of school adolescents: Validity, reliability and percentiles proposal for their evaluation]. / Patrones de actividad física de adolescentes escolares: validez, confiabilidad y propuesta de percentiles para su evaluación.

Regular physical activity (PA) during childhood and adolescence is important for the prevention of non-communicable diseases and their risk factors. OBJECTIVES: To validate a questionnaire for measuring patterns of PA, verify the reliability, comparing the levels of PA aligned with chronological and biological age, and to develop percentile curves to assess PA levels depending on biological maturation. SUBJECTS AND METHOD: Descriptive cross-sectional study was performed on a sample non-probabilistic quota of 3,176 Chilean adolescents (1685 males and 1491 females), with a mean age range from 10.0 to 18.9 years. An analysis was performed on, weight, standing and sitting height. The biological age through the years of peak growth rate and chronological age in years was determined. Body Mass Index was calculated and a survey of PA was applied. The LMS method was used to develop percentiles. RESULTS: The values for the confirmatory analysis showed saturations between 0.517 and 0.653. The value of adequacy of Kaiser-Meyer-Olkin (KMO) was 0.879 and with 70.8% of the variance explained. The Cronbach alpha values ranged from 0.81 to 0.86. There were differences between the genders when aligned chronological age. There were no differences when aligned by biological age. Percentiles are proposed to classify the PA of adolescents of both genders according to biological age and sex. CONCLUSION: The questionnaire used was valid and reliable, plus the PA should be evaluated by biological age. These findings led to the development of percentiles to assess PA according to biological age and gender.

[Physical fitness in children and adolescents categorized by fat mass level]. / Aptitud física en niños y adolescentes categorizados por nivel de masa grasa.

Physical fitness is one of the important health markers as a predictor of cardiovascular disease mor bidity and mortality. OBJECTIVES: To evaluate the relationship between fat mass with anthropome tric indicators and, secondly, to compare the performance of physical fitness among children and adolescents categorized with adequate and excess fat mass. SUBJECTS AND METHOD: A descriptive cross-sectional study was conducted with 863 schoolchildren aged 6 to 17.9 years. Weight, height, and waist circumference were measured. physical fitness [speed (20m), agility (10x5m), and ho rizontal jump] was evaluated. Fat mass was calculated by anthropometric equation, body mass index, ponderal index, and waist to height ratio. Data were grouped into 6 age groups. RESULTS: Children of both sexes categorized as having adequate levels of fat mass had lower values of body mass index, ponderal index, and waist to height ratio than children with high levels of fat mass. In physical fitness, children with adequate fat mass were better than the ones with elevated fat mass. In girls with adequate fat mass, better results were observed in horizontal jump and agility during adolescence. There were no differences in the speed test. CONCLUSION: Fat mass can be considered as a valuable tool for determining excess body fat and categorizing children and adolescents with adequate and excess fat mass. In addition, having acceptable levels of fat mass may contribute to better physical fitness in boys in horizontal jump, agility, and speed and, in girls, only in horizontal jump and agility.

[Development of anthropometric equations for predicting total body fat percentage in Chilean children and adolescents]. / Desarrollo de ecuaciones antropométricas para predecir el porcentaje de grasa corporal total en niños y adolescentes chilenos.

Introduction: Introduction: studying the percentage of body fat (%BF) in children and adolescents is very relevant, since a high level of body fat in childhood and adolescence represents overweight and obesity. Objective: to identify the anthropometric indicators related to %BF and to validate regression equations to predict %BF in children and adolescents using dual-energy X-ray absorptiometry (DXA) as a reference method. Methods: a descriptive study (cross-sectional) was designed in 1126 schoolchildren (588 males and 538 females) from the Maule region (Chile). The age range ranged from 6.0 to 17.9 years. Weight, height, two skinfolds (tricipital and subscapular and waist circumference (WC) were evaluated. Body mass index (BMI), triponderal mass index (TMI), waist height index (WHtR) were calculated. Body fat percentage (%BF) was assessed by DXA scanning. Results: the relationships between Σ (Tricipital + Subscapular), TMI and WHtR with %BF (DXA) ranged from R2 = 52 % to 54 % in men, and from R2 = 41 % to 49 % in women. The equations generated for men were: %BF = 9.775 + [(0.415 * (Tr + SE)] + (35.084 * WHtR) - (0.828 * age), R2 = 70 %, and %BF = 20.720 + [(0.492 * (Tr + SE)] + (0.354 * TMI) - (0.923 * age), R2 = 68 %], and for women: %BF = 8.608 + [(0.291 * (Tr + SE)] + (38.893 * WHtR) - (0.176 * age), R2 = 60 %, and %BF = 16.087 + [(0.306 * (Tr + SE)] + (0.818 * TMI) - (0.300 * age), R2 = 59 %. Conclusion: this study showed that the sum of tricipital and subscapular skinfolds, IP and WHtR are adequate predictors of %BF. These indicators allowed the development of two regression equations acceptable in terms of precision and accuracy to predict %BF in children and adolescents of both sexes.

Introducción: Introducción: estudiar el porcentaje de grasa corporal (%GC) en niños y adolescentes es muy relevante, puesto que un elevado nivel de grasa corporal en la infancia y la adolescencia representa sobrepeso y obesidad. Objetivo: identificar los indicadores antropométricos que se relacionan con el %GC y validar ecuaciones de regresión para predecir el %GC de niños y adolescentes a partir del uso de la absorciometría de rayos X de doble energía (DXA) como método de referencia. Métodos: se diseñó un estudio descriptivo (transversal) en 1126 escolares (588 hombres y 538 mujeres) de la región del Maule (Chile). El rango de edad oscila desde los 6,0 hasta los 17,9 años. Se evaluaron el peso, la estatura, dos pliegues cutáneos (tricipital y subescapular) y la circunferencia de la cintura (CC). Se calcularon el índice de masa corporal (IMC), el índice ponderal (IP) y el índice cintura-estatura (ICE). Se evaluó el porcentaje de grasa corporal (%GC) por medio del escaneo DXA. Resultados: las relaciones entre Σ (Tricipital + Subescapular), IP e ICE con el %GC (DXA) fueron de R2 = 52-54 % en hombres y R2 = 41-49 % en mujeres. Las ecuaciones generadas para los hombres fueron: %GC = 9,775 + [(0,415 * (Tr + SE)] + (35,084 * ICE) - (0,828 * edad), R2 = 70 %, y %GC = 20,720 + [(0,492 * (Tr + SE)] + (0,354 * IP) - (0,923 * edad), R2 = 68 %; y para mujeres: %GC = 8,608 + [(0,291 * (Tr + SE)] + (38,893 * ICE) - (0,176 * edad), R2 = 60 %, y %GC = 16,087 + [(0,306 * (Tr + SE)] + (0,818 * IP) - (0,300 * edad), R2 = 59 %. Conclusión: este estudio demostró que la sumatoria de los pliegues cutáneos tricipital y subescapular, el IP y el ICE son adecuados predictores del %GC. Estos indicadores permitieron desarrollar dos ecuaciones de regresión aceptables en términos de precisión y exactitud para predecir el %GC en niños y adolescentes de ambos sexos.

[Body adiposity and abdominal muscle resistance in young people with Down syndrome]. / Adiposidad corporal y resistencia muscular abdominal en jóvenes con síndrome de Down.

OBJECTIVE: to verify the relationship between abdominal muscle endurance and the level of body fat, measured through the waist-to-height ratio, in young people with Down syndrome (DS). SUBJECT AND METHOD: A comparative descriptive study was carried out in 115 young people with DS (n = 65 men and n = 50 women) aged between 10 and 18 years, from the Maule Region. Age, weight, height, and waist circumference were evaluated. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The abdominal muscle endurance test (AME) was evaluated in 60 seconds and clas sified into two categories (low AME and acceptable AME). RESULTS: Subjects of both sexes classified with adequate levels of AME showed lower WHtR and BMI values (p < 0.05), while those classified with low levels of AME showed higher values of WHtR and BMI (p < 0.05). The correlations between adiposity and AME were negative and ranged in both sexes from r = 0.20 to 0.25, p < 0.05. Conclu sion: The study showed that young people of both sexes with DS classified with adequate levels of AME, presented decreased values of WHtR.

Ultrasound reference values for the calcaneus of children and adolescents at moderate altitudes in Peru.

OBJECTIVE: a) Establish reference values for bone parameters by using the speed of sound (SOS, m/s) of broadband ultrasound attenuation (BUA, dB/MHz) and establish a bone quality index (BQI=αSOS+ßBUA) for children and adolescents living in a region of moderate altitude, b) compare bone parameters with an international standard (with different ethnic, socio-economic, and lifestyle backgrounds) by using ultrasound of the calcaneus (heel bone) (QUS). METHODS: A descriptive cross-sectional study was carried out with children and adolescents between the ages of 6.0 and 16.9 years old. The sample was selected randomly. A total of 1322 subjects were studied. Weight, height, and bone parameters, using ultrasound of the calcaneus, were evaluated SOS, BUA, and BQI. Body Mass Index BMI was calculated. RESULTS: The average age of males was 11.44±0.35 years old, and for females, it was 11.43±0.35 years old. The students in this research showed slightly higher values of SOS, BUA, and BQI for both sexes when compared with the international reference (the 50th percentile). Percentiles were generated (P3, P10, P25, P50, P75, P90, and P97) using the LMS method [median (M), standard deviation (S), and power of the Box-Cox transformation (L)] by age and sex. CONCLUSION: The students living at a moderate altitude showed slightly higher values in bone parameters in relation to the international reference. This pattern depicted a population with a better state of bone health. The proposed percentiles may be used to categorize adequate to at risk bone parameters based on age and sex.

Muscle Mass in Children and Adolescents: Proposed Equations and Reference Values for Assessment.

Objectives: The goal of this study was to develop regression equations to estimate LM with anthropometric variables and to propose percentiles for evaluating by age and sex. Methods: A cross sectional study was conducted with 2,182 Chilean students (1,347 males and 835 females). Ages ranged from 5.0 to 17.9 years old. A total body scan was carried out with the double energy X-ray anthropometry (DXA) to examine and measure lean muscle mass of the entire body. Weight, height, and the circumference of the relaxed right arm were also measured. Results: Four anthropometric equations were generated to predict lean mass for both sexes (R 2 = 83-88%, SEE = 3.7-5.0%, precision = 0.90-0.93, and accuracy = 0.99). The Lambda-mu-sigma method was used to obtain the sex-specific and age-specific percentile curves of lean mass (p3, p5, p10, p15, p25, p50, p75, p85, p90, p95, and p97). Conclusion: The four proposed equations were acceptable in terms of precision and accuracy to estimate lean mass in children and adolescents. The percentiles were created by means of anthropometric equations and real values for DXA. These are fundamental tools for monitoring LM in Chilean children and adolescents of both sexes.

Physical Growth and Body Adiposity Curves in Students of the Maule Region (Chile).

Objectives: Physical growth and body adiposity patterns provide relevant information to infer the nutritional and health status of students. Our objectives were (a) to compare the variables of body adiposity and physical growth of Chilean children and adolescents with data from the CDC-2012 and international studies, and (b) to develop regional reference curves to evaluate growth and body adiposity. Methods: 8,261 children and adolescents were studied. We evaluated the weight, height, and waist circumference (WC). The Body Mass Index (BMI) was calculated. Their physical growth and body adiposity were compared with the CDC-2012 references as well as with other international references. Percentile curves for weight, height, BMI, and WC were constructed with the LMS method. Results: The Chilean students showed reduced weight and height during adolescence when compared with the CDC-2012 reference. During early ages, the BMI for the Chilean sample was lower while at advanced ages, the WC values were greater in comparison to the CDC-2012 reference. Graphic comparisons with international studies indicated that Chilean students weighed more at all ages. However, height was slightly greater until age 14 for males and age 11 for females. Body adiposity (BMI and WC) for the Chilean students was slightly higher at early ages while at later ages, adiposity values were relatively similar for both sexes. Conclusions: Discrepancies were observed between the physical growth and body adiposity trajectories and the American CDC-2012 references and the international studies. The proposed percentiles for weight, height, BMI, and WC for each age and sex may be useful for health sciences professionals and researchers.

El deporte paralímpico en Chile: resultados históricos de las participaciones en los juegos paralímpicos de invierno y verano / Paralympic sport in Chile: historical results of participation in summer and winter paralympic games / O esporte paralímpico no Chile: resultados históricos das participações em jogos paralímpico de inverno e verão

Esta investigación tuvo como objetivo relatar la evolución del movimiento paralímpico y su vínculo con el escenario político nacional e internacional. Los Juegos Paralímpicos de Verano hicieron su debut en 1960, mientras que Chile participó por primera vez en 1992. Por otro lado, los Juegos Paralímpicos de Invierno comenzaron en 1976, y la primera participación chilena en este evento se produjo en 2002. Para el desarrollo del estudio se utilizó un análisis documental, donde se analizaron las convocatorias oficiales de las delegaciones chilenas, junto con las planillas de resultados generales obtenidos en los Juegos Paralímpicos, se extrajo de los documentos: el número de atletas participantes de ambos sexos y deportes, información que posteriormente fue agrupada en presencia o no de medallas y tipo de medalla obtenida y, a partir de aquello, se analizó por tipo de discapacidad y año de participación. A través de los años, Chile vivenció constantes procesos y cambios en los periodos de gestión, a esto se suma la promulgación de leyes, tanto nacionales como internacionales, junto con la constante ayuda recibida de distintas agrupaciones privadas y gubernamentales, resultando en un paulatino incremento de deportistas paralímpicos, situación que colaboró en gran medida con el desarrollo integral del movimiento paralímpico chileno hasta lo que es en la actualidad; este crecimiento facilitó resultados exitosos, como el obtenido en el año 2012 con la conquista de la primera medalla paralímpica de Chile, llegando a un total de siete medallas distribuidas en cuatro deportes en los Juegos Paralímpicos Tokio 2020, quedando situado en el ranking paralímpico en la cuadragésima quinta posición.

The aim of this paper was to describe the evolution of the Paralympic movement and its connection with the national and international political scenario. The Summer Paralympic Games made their debut in 1960, while Chile first participated in 1992. On the other hand, the Winter Paralympic Games began in 1976, and Chile's first participation in this event occurred in 2002. A documentary analysis was conducted for the study, in which the official documents of the Chilean delegations were analyzed, along with the overall results obtained in the Paralympic Games. The documents provided information on the number of participating athletes of both genders, results and sports. This information was later grouped based on the presence or absence of medals and the type of medal obtained. It was further analyzed by type of disability and year of participation. Over the years, Chile experienced constant processes and changes in management, in addition to the enactment of laws, both national and international. The constant support received from various private and governmental organizations contributed to the gradual increase in paralympic athletes, which greatly facilitated the overall development of the Chilean Paralympic movement to its current state. This growth led to successful outcomes, such as Chile's 1st Paralympic medal in 2012, and the country has now achieved a total of 7 medals in 4 disciplines in Paralympic Games Tokyo 2020, placing it in the 45th position in paralympic medal board.

O presente trabalho tem como objetivo relatar a evolução do movimento paralímpico e sua relação com o cenário político nacional e internacional. Os Jogos Paralímpicos de Verão fizeram sua estreia em 1960, enquanto o Chile participou pela primeira vez em 1992. Por outro lado, os Jogos Paralímpicos de Inverno começaram em 1976, e a primeira participação chilena neste evento ocorreu em 2002. O estudo foi realizado através de análise documental, de onde foram extraídas informações sobre as delegações chilenas, juntamente com as planilhas de resultados gerais obtidos dos Jogos Paralímpicos. As variáveis registradas foram número de atletas participantes de ambos os sexos, modalidades e esportes. As informações posteriormente foram agrupadas em quantidade de medalhas e tipo da medalha obtida, sendo analisadas por tipo de deficiência e ano de participação. Ao longo dos anos, o Chile experimentou constantes processos e mudanças nos períodos de gestão, como a promulgação de leis, tanto nacionais como internacionais, juntamente com a ajuda constante recebida de diferentes grupos privados e governamentais, resultando em aumento de atletas paralímpicos, situação que contribuiu com o desenvolvimento integral do movimento paralímpico chileno. Este crescimento facilitou resultados exitosos, como o obtido em 2012 com a conquista da primeira medalha paralímpica do Chile, alcançando hoje um total de 7 medalhas distribuídas em 4 disciplinas em Tóquio 2022, colocando-se na quadragésima quinta posição do quadro de medalhas.

Relación entre la salud física y salud mental psicológica en estudiantes educación física pertenecientes a distintas universidades de Chile / Relationship between physical and Mental health in physical education students belonging to different universities in Chile / Relação entre saúde física e psicológica em estudantes de educação física pertencentes a diferentes universidades no Chile

El objetivo de este estudio fue relacionar los efectos del confinamiento (COVID-19), en la salud física y psicológica, en universitarios de Educación física de Chile. La metodología es cuantitativa, transversal y descriptiva; la muestra estuvo constituida por 254 estudiantes pertenecientes a siete universidades chilenas. El 63% de la muestra fueron hombres (n = 160) y 37% mujeres (n = 94). La recogida de la información fue por medio del cuestionario auto informe del Impacto Psicológico del Coronavirus. Los resultados muestran que la variable Actividad Física en confinamiento se relacionó de forma negativa y significativa con la variable de IMC y Uso de Medios de Comunicación. Al relacionarse con Conductas Asociadas al Confinamiento y Escala de Experiencias Positivas ante la Adversidad, fue positiva y significativa; en relación a la Escala de Distres, se correlacionó negativa significativamente, de igual manera con la Escala de interferencia por el Coronavirus y Cuestionario de Impacto Psicológico del Coronavirus. Se concluye que existen efectos negativos para la salud física y psicológica de los estudiantes de Educación física producto del confinamiento y algunos positivos como el autocuidado y sistemas de protección.

The objective of this study was to relate the effects of confinement (COVID-19) on physical and mental health in physical education undergraduate students in Chile. The methodology is quantitative, cross-sectional, and descriptive. The sample consisted of 254 students belonging to seven Chilean universities. Sixty-three percent of the sample were men (n = 160), whereas 37% were women (n = 94). The information was collected through the self-report questionnaire on the Psychological Impact of Coronavirus. The results show that the variable Physical Activity in confinement was negatively and significantly related to the variable of BMI and use of communication media. When relating to behaviors associated with confinement and the Scale of Positive Experiences in the Face of Adversity (EEPA, by its initials in Spanish), it was positive and significant. Concerning the Distress Scale, it was significantly negatively correlated, in the same way with the Coronavirus Interference Scale and the Coronavirus Psychological Impact Questionnaire. It is concluded that there are negative effects on the physical and psychological health of Physical Education students as a result of confinement and some positive ones, such as self-care and protection systems.

O objetivo deste estudo foi relacionar os efeitos do confinamento (COVID-19) na saúde física e psicológica em estudantes universitários de educação física no Chile. A metodologia é quantitativa, transversal, descritiva; A amostra foi composta por 254 estudantes pertencentes a 7 universidades chilenas. 63% da amostra eram homens (n = 160) e 37% mulheres (n = 94) As informações foram coletadas por meio do questionário de autorrelato sobre o Impacto Psicológico do Coronavírus. Os resultados mostram que a variável Atividade Física em confinamento esteve negativa e significativamente relacionada com a variável IMC e Uso de Meios de Comunicação. Quanto aos Comportamentos Associados ao Confinamento e à Escala de Experiências Positivas Face à Adversidade, foi positivo e significativo; em relação à Escala de Aflição, apresentou correlação negativa significativa, da mesma forma com a Escala de Interferência do Coronavírus e o Questionário de Impacto Psicológico do Coronavírus. Conclui-se que existem efeitos negativos na saúde física e psicológica dos alunos de Educação Física decorrentes do confinamento e alguns positivos como o autocuidado e os sistemas de proteção.

Barreras y facilitadores para la práctica de actividad física en niños y jóvenes con parálisis cerebral: una revisión sistemática / Barriers and facilitators for the practice of physical activity in children and young people with cerebral paralysis: a systematic review / Barreiras e facilitadores para a prática de atividade física em crianças e jovens com paralisia cerebral: uma revisão sistemática

Objetivo: describir los principales facilitadores y barreras presentados en la población con parálisis cerebral (PC) y cómo estos ayudan o dificultan la práctica de actividad física. Metodología: se realizó una revisión sistemática de los últimos 10 años siguiendo lo expuesto en la declaración PRISMA, para lo que se utilizaron las bases de datos Web of Science, Scopus y PubMed. La estrategia de búsqueda arrojó un total de 99 documentos de los que finalmente fueron seleccionados 11 estudios. Resultados: los estudios establecen que existe una variedad de factores fisiológicos, psicológicos, sociales y macro ambientales que actúan tanto para promover como inhibir la participación en el deporte y el ejercicio en adolescentes con PC. Por otro lado, los facilitadores que más se dan a conocer, son la familia como foco principal, acompañada de su entorno y la estimulación temprana realizada desde que son pequeños. Conclusión: las barreras son un aspecto modificable y que pueden ser disminuidas con el objetivo de potenciar los facilitadores para aumentar la práctica de actividad física siendo duradera en el tiempo. Las principales barreras son la falta de acceso, los cambios en su cuerpo respecto a la práctica de actividad física, factores medioambientales, falta de profesionales que estén relacionados con el área, y el acceso a la actividad física en ambientes y espacios seguros. La familia juega un rol fundamental desde edades tempranas para incentivar a los niños, niñas o adolescentes con PC a realizar actividades físicas y/o deportivas.

Objective: To describe the main facilitators and barriers presented in population with cerebral palsy (PC) and how they help or hinder the practice of physical activity. Methods: A systematic review of the last 10 years was carried out, following what was stated in the PRISMA declaration, for which the Web of Science, Scopus and PubMed databases were used. The search strategy yielded a total of 99 documents where 11 studies were finally selected. Results: Studies have established that there are a variety of macro physiological, psychological, social, and environmental factors that both promote and inhibit participation in sport and exercise in adolescents with PC. On the other hand, the most common facilitators in the research are the family as the main focus, accompanied by their environment and the early stimulation that they get from an early age. Conclusion: Barriers are a modifiable aspect which can be reduced to empower facilitators that increase the practice of physical activity, being sustainable over time. The main barriers are lack of access, changes in the body regarding the practice of physical activity, environmental factors, lack of professionals who are related to the field, and access to physical activity in safe environments and spaces. Family plays a fundamental role from an early age in encouraging children or adolescents with CP to carry out physical and/or sports activities.

Objetivo: Descrever os principais facilitadores e barreiras que ocorrem na população com paralisia cerebral (PC) e como eles auxiliam ou dificultam a prática de atividade física. Metodologia: Realizou-se uma revisão sistemática dos últimos 10 anos seguindo o estabelecido na declaração PRISMA, para a qual foram utilizadas as bases de dados Web of Science, Scopus e PubMed. A estratégia de busca lançou um total de 99 documentos dos quais 11 estudos foram finalmente selecionados. Resultados: Os estudos estabeleceram que há uma variedade de fatores fisiológicos, psicológicos, sociais e macroambientais que atuam tanto para promover quanto para inibir a participação em esportes e exercícios em adolescentes com PC. Por outro lado, os facilitadores mais conhecidos na variedade de estudos têm como eixo principal a família, acompanhada de seu ambiente e da estimulação precoce que desenvolveram desde a infância. Conclusão: As barreiras são um aspecto modificável que pode ser reduzido com o objetivo de capacitar os facilitadores para aumentar a prática de atividade física de forma duradoura. As principais barreiras são a falta de acesso, as alterações em seus corpos devido à prática de atividade física, fatores ambientais, a falta de profissionais relacionados à área e o acesso à atividade física em ambientes e espaços seguros. A família desempenha desde cedo um papel fundamental para estimular as crianças e adolescentes com PC a realizarem atividades físicas e/ou esportivas.

Assessment of self-perception of physical fitness and proposal for standards among Chilean adolescent students: the EAPAF study. / Evaluación de la autopercepción de la aptitud física y propuesta de normativas en adolescentes escolares chilenos: estudio EAPAF.

INTRODUCTION: Physical fitness may be assessed among children and adolescents in a quantitative and qualitative manner. At present, in Chile, there are no tools available to assess self-perception of physical fitness. Therefore, the purpose of this study was to develop a valid and reliable instrument that would allow to assess selfperception of physical fitness among adolescents and propose standards for age and sex. MATERIALS AND METHODS: A survey was administered among adolescent students from six public schools in the Maule Region, Chile, selected in a probabilistic (stratified) fashion. To measure self-perception of physical fitness, a qualitative instrument was developed: the Self-Perception of Physical Fitness Scale (EAPAF, escala de autopercepcion de la aptitud fisica), which is made up of four dimensions and 18 questions. The LMS method (L: Box-Cox coefficient, M: median curve, and S: variation coefficient) was used to establish percentiles and propose references by dimension, age and sex. RESULTS: A total of 3060 adolescents (1702 boys and 1358 girls) aged 11.0 to 18.9 years old were included. The factor analysis evidenced four factors. Saturation values were above 0.40. The percentage of instrument explanation reached 54.24%. In terms of reliability, the 18 questions reflected that Cronbach's alpha was between 0.82 and 0.85. Percentiles (p15, p50 and p85) were developed to classify self-perception of physical fitness by dimension, age and sex. Boys showed higher scores in the self-perception of physical fitness scale when compared to girls (p 〈 0.001). CONCLUSION: The instrument developed in this study was valid and reliable. In addition, the standards proposed may become a useful tool to classify adolescents in relation to their selfperception of physical fitness.

INTRODUCCIÓN: La aptitud física en niños y adolescentes puede ser evaluada cuantitativa y cualitativamente. En la actualidad, en Chile, no existen herramientas que permitan evaluar la autopercepción de la aptitud física, por lo que el propósito de este estudio fue construir un instrumento válido y confiable que permitiera evaluar la autopercepción de la aptitud física de adolescentes y proponer valores normativos según edad y sexo. MATERIAL Y MÉTODOS: Se encuestaron a adolescentes escolares de 6 escuelas públicas de la región del Maule, Chile, seleccionadas de forma probabilística (estratificada). Para medir la autopercepción de la aptitud física, se construyó un instrumento cualitativo, la escala de autopercepción de la aptitud física(EAPAF) con 4 dimensiones y 18 preguntas. Se utilizó el método LMS (L= coeficiente Box-Cox; M= mediana; S= coeficiente de variación) para desarrollar percentilos y proponer las referencias según dimensión, edad y sexo. RESULTADOS: Se estudió a 3060 adolescentes (1702 hombres y 1358 mujeres) entre 11,0 y 18,9 años. El análisis factorial evidenció cuatro factores. Los valores de saturación fueron superiores a 0,40. El % de explicación del instrumento ascendió a 54,24%. En relación con la confiabilidad, las 18 preguntas reflejaron un alfa de Cronbach entre 0,82 y 0,85. Se construyeron percentilos (p 15, p 50 y p 85) para clasificar la autopercepción de la aptitud física según dimensión, edad y sexo. Los hombres evidenciaron puntuaciones superiores en la escala de autopercepción de la aptitud física, en comparación con las mujeres (p 〈 0,001). CONCLUSIÓN: El instrumento construido fue válido y confiable. Además, la propuesta de normativas puede ser una herramienta útil para clasificar a los adolescentes en relación con la autopercepción de la aptitud física.

Ultrasound reference values for the calcaneus of children and adolescents at moderate altitudes in Peru

Abstract Objective: a) Establish reference values for bone parameters by using the speed of sound (SOS, m/s) of broadband ultrasound attenuation (BUA, dB/MHz) and establish a bone quality index (BQI = αSOS + βBUA) for children and adolescents living in a region of moderate altitude, b) compare bone parameters with an international standard (with different ethnic, socio-economic, and lifestyle backgrounds) by using ultrasound of the calcaneus (heel bone) (QUS). Methods: A descriptive cross-sectional study was carried out with children and adolescents between the ages of 6.0 and 16.9 years old. The sample was selected randomly. A total of 1322 subjects were studied. Weight, height, and bone parameters, using ultrasound of the calcaneus, were evaluated SOS, BUA, and BQI. Body Mass Index BMI was calculated. Results: The average age of males was 11.44 ± 0.35 years old, and for females, it was 11.43 ± 0.35 years old. The students in this research showed slightly higher values of SOS, BUA, and BQI for both sexes when compared with the international reference (the 50th percentile). Percentiles were generated (P3, P10, P25, P50, P75, P90, and P97) using the LMS method [median (M), standard deviation (S), and power of the Box-Cox transformation (L)] by age and sex. Conclusion: The students living at a moderate altitude showed slightly higher values in bone parameters in relation to the international reference. This pattern depicted a population with a better state of bone health. The proposed percentiles may be used to categorize adequate to at risk bone parameters based on age and sex.

Preparación deportiva en el goalball: una revisión sistemática / Sports preparation in goalball: a systematic review

Resumen Fernández Muñoz, M.P., Campos Campos, K., Luarte Rocha, C. y Castelli, L.F. (2021). Preparación deportiva en el goalball: una revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-24. El objetivo del estudio fue describir el conocimiento científico producido en los últimos 10 años respecto a la preparación deportiva (PD), con énfasis en el sistema de entrenamiento en atletas de Goalball de diferentes niveles competitivos. Para eso, fue realizada una revisión sistemática en las principales bases de datos: Web Of Science, Scopus, PubMed, SciELO y LILACS entre enero de 2010 hasta enero de 2021. Se identificó un total de 136 estudios donde, posterior a la eliminación de duplicados, aplicación de los criterios de exclusión e inclusión y conforme a los procedimientos presentados en el flujograma PRISMA, se seleccionaron 15 artículos originales para su análisis cualitativo. Los principales resultados evidenciaron que el metabolismo anaeróbico aláctico es determinante en la modalidad y existe una fuerte relación entre la fuerza/potencia de extremidades superiores e inferiores con el lanzamiento del balón. Por otro lado, existen patrones repetitivos en la técnica de lanzamiento según sexo, así como también efectividad según tipo de lanzamiento; se recalca que la velocidad del lanzamiento es necesaria para la consecución de un gol. De igual forma, existen funciones predominantes según las posiciones dentro del campo de juego que es necesario considerar. Finalmente, el entrenamiento mental favorece la adquisición de técnicas que ayudan a superar obstáculos imprevistos durante una competición. Se observa la necesidad de mayores evidencias y conocimientos acerca de la PD en dicha modalidad, ya que constituyen factores imprescindibles que deben ser contemplados por los entrenadores, en función de optimizar el rendimiento competitivo de sus atletas.

Abstract Fernández Muñoz, M.P., Campos Campos, K., Luarte Rocha, C. & Castelli, L.F. (2021). Sports preparation in goalball: a systematic review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-24. The objective of this study was to describe the scientific knowledge generated in the past 10 years in terms of sports preparation (SP), with emphasis on the training system of goalball athletes in different competitive levels. For this purpose, a systematic review was carried out on the major data bases—Web of Science, Scopus, PubMed, SciELO and LILACS, from January, 2010, to January, 2021. A total 136 studies were identified, from which, after eliminating duplicates and applying exclusion and inclusion criteria, and in accordance with the procedures shown on the PRISMA flowchart, 15 original articles were selected for qualitative analysis. The main results showed that anaerobic alactic metabolism is critical in this sports modality, and that a strong link exists between strength/power of upper and lower extremities and ball throw. On the other hand, repetitive patterns exist in throwing techniques depending on gender, as well as effectiveness depending on the type of throw. The study highlights the fact that throw speed is key for scoring a goal. Similarly, dominant functions exist according to the positions within the play field, and these need to be taken into account. Finally, mental training favors the acquisition of techniques that will help to overcome unforeseen obstacles during a game. The study observes the need for greater evidence and knowledge about SP in this modality, as these are indispensable factors that must be contemplated by trainers in order to optimize the competitive performance of their athletes.

Resumo Fernández Muñoz, M.P., Campos Campos, K., Luarte Rocha, C. e Castelli, L.F. (2021). Preparação esportiva no goalball: uma revisão sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-24. Este estudo teve como objetivo descrever o conhecimento científico produzido nos últimos 10 anos com relação à preparação esportiva (PE), enfatizando o sistema de treinamento em atletas de Goalball de diferentes níveis competitivos. Para isso, foi realizada uma revisão sistemática nas principais bases de dados: Web Of Science, Scopus, PubMed, SciELO e LILACS entre janeiro de 2010 e janeiro de 2021. Identificou-se um total de 136 estudos dos quais, posterior à eliminação de duplicatas, à aplicação dos critérios de exclusão e inclusão e conforme os procedimentos apresentados no fluxograma PRISMA, foram selecionados 15 artigos originais para uma análise qualitativa. Os principais resultados evidenciaram que o metabolismo anaeróbico alático é determinante na modalidade e existe uma forte relação entre a força/potência de extremidades superiores e inferiores e o lançamento da bola. Por outro lado, existem padrões repetitivos na técnica de lançamento segundo o sexo, assim como a efetividade segundo o tipo de lançamento; destaca-se que a velocidade do lançamento é necessária para a realização de um gol. Igualmente, existem funções predominantes de acordo às posições dentro do campo de jogo que é preciso considerar. Por último, o treinamento mental favorece a aquisição de técnicas que ajudam a superar obstáculos imprevistos durante uma competição. Observa-se a necessidade de maiores evidências e conhecimentos sobre a PE nessa modalidade, pois constituem fatores imprescindíveis que os treinadores devem ter em mente, à vista de otimizar o desempenho competitivo dos atletas.

Effectiveness of goalball athletes throwing in the chilean national league / Efectividad del lanzamiento de los atletas de goalball en la Liga Nacional de Chile

Abstract Campos Campos, K.I., Castelli Correia de Campos, L.F., Pereira Morato, M., Fernández Muñoz, M., Tosim, A., Alarcón Segura, K. & Luarte Rocha, C. (2021). Effectiveness of goalball athletes throwing in the Chilean National League. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-16. Goalball is a collective Paralympic sport with oppositional characteristics but without invasion by the athletes that, despite requiring great physical condition in offensive and defensive actions, is also identified as a tactical sport, where the administration of technique in the various game situations determines success in competition. The objective of the study was to analyze the effectiveness of the attack of the Chilean National Goalball League, according to type of shot and trajectory. Four Goalball matches of the final phase of a national tournament were filmed. For this, a digital camera was used behind an arch located in height. The matches were analyzed following the diagrams proposed by Morato et al. (2016) and Morato (2012). The front throw (FRO) was used the most (88.9%) with an effectiveness rate of 6.2%. Longer trajectories were made in short diagonals (SD) and parallel (PA) (31.3% and 23.2%, respectively). The FRO throw was directed in SD (34.5%) and PA (22.4%), while on the other hand, the spinning throws (SP) were directed preferably in PA (30.4%) and SD (29.1%). The FRO throw was more effective in PA (10.6%), whereas the SP throw was more effective in the middle diagonal (MD) (12.5%). The lateral positions execute throws, preferably FRO, but in defense the central positions are protagonists. Throws are most effective when they are directed in PA and SD.

Resumen Campos Campos, K.I., Castelli Correia de Campos, L.F., Pereira Morato, M., Fernández Muñoz, M., Tosim, A., Alarcón Segura, K. y Luarte Rocha, C. (2021). Efectividad del lanzamiento de los atletas de goalball en la Liga Nacional de Chile. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-16. El goalball es un deporte paralímpico colectivo con características de oposición, pero sin invasión por parte de los atletas que, a pesar de requerir gran condición física en las acciones ofensivas y defensivas, también se identifica como un deporte táctico, en donde la administración de la técnica en las diversas situaciones del juego determina el éxito en la competencia. El objetivo del estudio fue analizar la efectividad del ataque de la Liga Nacional de goalball de Chile, según tipo de lanzamiento y trayectoria. Se filmaron cuatro partidos de goalball de la fase final de un torneo nacional. Para ello, se utilizó una cámara digital posicionada detrás de un arco ubicado en altura. Para el análisis de los partidos se utilizaron los diagramas propuestos por Morato et al. (2016) y Morato (2012). Los datos se transcribieron de forma computacional a una planilla, para luego ser analizados descriptivamente. El lanzamiento frontal (FRO) fue el que más se utilizó (88.9%), con una tasa de efectividad del 6.2%. Se realizaron trayectorias más largas en diagonales cortas (SD) y paralelas (PA) (31.3% y 23.2%, respectivamente). El lanzamiento de FRO se dirigió en SD (34.5%) y PA (22.4%), mientras que, por otro lado, los lanzamientos con giro (SP) se dirigieron preferentemente en PA (30.4%) y SD (29.1%). El lanzamiento FRO fue más efectivo en PA (10.6%), mientras que el lanzamiento SP fue más efectivo en diagonales medias (MD) (12.5%). Las posiciones laterales ejecutan lanzamientos, preferentemente FRO; pero en defensa, las posiciones centrales son protagonistas. Los lanzamientos son más efectivos cuando se dirigen en PA y SD.

Resumo Campos Campos, K.I., Castelli Correia de Campos, L.F., Pereira Morato, M., Fernández Muñoz, M., Tosim, A., Alarcón Segura, K. e Luarte Rocha, C. (2021). Eficácia do arremesso de atletas de goalball na Liga Nacional do Chile. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-16. O Goalball é um esporte coletivo paraolímpico com características de oposição, mas sem invasão dos atletas que, apesar de exigir grande condição física nas ações ofensivas e defensivas, também é identificado como um esporte tático, onde a administração da técnica nas diversas situações de jogo determina o sucesso na competição. O objetivo do estudo foi analisar a eficácia do ataque da Liga Nacional de Goalball do Chile, segundo o tipo de arremesso e trajetória. Foram filmadas quatro partidas de goalball da fase final de um torneio nacional. Para isso, foi utilizada uma câmera digital posicionada atrás de um arco localizado em altura e, para a análise das correspondências, os diagramas propostos por Morato et al. (2016) e Morato (2012). Os dados foram transcritos de forma computacional a uma planilha para, posteriormente, serem analisados descritivamente. O arremesso frontal (FRO) foi o mais utilizado (88,9%), com taxa de eficácia de 6,2%. Trajetórias mais longas foram feitas em diagonais curtas (SD) e paralelas (PA) (31,3% e 23,2%, respectivamente). O arremesso FRO foi direcionado em SD (34,5%) e PA (22,4%), enquanto, por outro lado, os arremessos giratórios (SP) foram direcionados preferencialmente em PA (30,4%) e SD (29,1%). O arremesso FRO foi mais eficaz no PA (10,6%), enquanto o arremesso SP foi mais eficaz nas diagonais médias (MD) (12,5%). Posições laterais executam arremessos, preferencialmente FRO; mas na defesa, as posições centrais são protagonistas. Os arremessos são mais eficazes quando dirigidos em PA e SD.

[TRENDS TO INCREASED BODY FAT AND BLOOD PRESSURE OF UNIVERSITY STUDENTS IN TWO COHORTS (2009-2014)]. / TENDENCIAS AL INCREMENTO DE LA ADIPOSIDAD CORPORAL Y LA PRESIÓN ARTERIAL DE JÓVENES UNIVERSITARIOS EN DOS COHORTES (2009-2014).

OBJECTIVE: a) describe changes in body adiposity, b) quantify the increase in blood pressure and c) verify if blood pressure increases according to the categories of body fatness in two cohorts (2009-2014) in university students. METHODS: two transverse measurements made in 2009 and 2014. The 2009 sample consisted of 309 university students (138 men and 171 women) and 2014 by 319 young people (136 men and 183 women) were compared. Weight, height, body mass index, waist circumference and systolic and diastolic blood pressure were evaluated. RESULTS: males were significantly increased body adiposity (BMI = 1.9 kg/m2 and CC = 6.4 cm), (p < 0.001), while women increased blood pressure (DBP = 5.7 mmHg and SBP = 6.6 mmHg) as a function of body fat in a range of 5 years (p < 0.001). CONCLUSION: males increased their body fat, while women increased blood pressure. The results suggest the adoption of healthy lifestyles to combat excess weight and the presence of hypertension in young students.

Objetivo: a) describir los cambios de la adiposidad corporal, b) cuantificar el incremento de la presión arterial y c) verificar si la presión arterial aumenta en función de las categorías de la adiposidad corporal en dos cohortes (2009-2014) en jóvenes universitarios. Métodos: se comparó dos mediciones transversales efectuadas en el año 2009 y 2014. La muestra del 2009 estuvo constituida por 309 universitarios (138 varones y 171 mujeres) y la del 2014 por 319 jóvenes (136 varones y 183 mujeres). Se evaluó peso, estatura, índice de masa corporal (IMC), circunferencia de la cintura (CC) y presión arterial diastólica (PAD) y sistólica (PAS). Resultados: los varones aumentaron significativamente en la adiposidad corporal (IMC = 1,9 kg/m2 y CC = 6,4 cm), (p < 0,001), mientras que las mujeres incrementaron la presión arterial (PAD = 5,7 mmHg y PAS = 6,6 mmHg) en función de la adiposidad corporal en un intervalo de 5 años (p < 0,001). Conclusión: los varones incrementaron su adiposidad corporal, mientras que las mujeres aumentaron la presión arterial. Los resultados sugieren la adopción de estilos de vida saludables para combatir el exceso de peso y la presencia de hipertensión arterial en los jóvenes universitarios.

Physical Growth, Biological Age, and Nutritional Transitions of Adolescents Living at Moderate Altitudes in Peru.

BACKGROUND: Peru is experiencing a stage of nutritional transition where the principal characteristics are typical of countries undergoing development. OBJECTIVES: The objectives of this study were the following: (a) compare physical growth patterns with an international standard; (b) determine biological age; and (c) analyze the double nutritional burden of adolescents living at a moderate altitude in Peru. DESIGN: Weight, standing height, and sitting height were measured in 551 adolescents of both sexes (12.0 to 17.9 years old) from an urban area of Arequipa, Peru (2328 m). Physical growth was compared with the international standard of the CDC-2000. Biological age was determined by using a non-invasive transversal technique based on years from age at peak height velocity (APHV). Nutritional state was determined by means of weight for age and height for age. Z scores were calculated using international standards from the CDC-2000. RESULTS: Body weight for both sexes was similar to the CDC-2000 international standards. At all ages, the girls' height (p < 0.05) was below the standards. However, the boys' height (p < 0.05) was less at ages, 15, 16, and 17. Biological age showed up in girls at age 12.7 years and for boys at 15.2 years. Stunted growth (8.7% boys and 18.0% girls) and over weight (11.3% boys and 8.8% girls) occurred in both groups. A relationship existed in both sexes between the categories of weight for the age and stunted growth by sex. CONCLUSIONS: Adolescents living at a moderate altitude exhibited stunted linear growth and biological maturation. Furthermore, adolescents of both sexes showed the presence of the double nutritional burden (stunted growth and excessive weight).