Comprehensive cardiac evaluation to maximal exercise in a contemporary population of prepubertal children.

BACKGROUND: Heart rate (HR) is a biomarker used to measure physiological function, health status and cardiovascular autonomic function. The purpose of this study was to determine sex- and age-specific reference values for cardiac autonomic function at rest, during maximal exercise and the recovery phase in prepubertal children. METHODS: Five hundred and twelve healthy children 7-11 years of age performed a Léger test. A heart RR-interval monitor recorded the heart data and a specific software analysed the cardiac autonomic response through HR and HR variability (HRV). It analysed HR before the test (resting HR, RHR), during the test (HRpeak) and HR recovery (HRR) in the first minute (HRR1) and the fifth minute (HRR5). The values are mean ± SD. RESULTS: Collectively, 91.2% of girls and 92.3% of boys were within the recommended ranges regarding RHR. The average HRpeak was 199 ± 10.83 b.p.m. and 96.8% of girls and 95.3% of boys were within the minimum threshold value recommended (180 b.p.m.). Boys showed lower values of RHR than girls (p < 0.001) and larger values of HRR 1 and HRR5 (p < 0.001). CONCLUSIONS: This study comprehensively provides a reference set of data for the most important HR variables that can be obtained during exercise testing in prepubertal children regarding age and sex and in a field setting. IMPACT: This is the first study to provide reference values of autonomic cardiac function at rest, during maximal exercise and during the recovery period in prepubertal children aged 7-11 years. Despite the early age of participants, cardiorespiratory fitness, RHR and HRR are different according to sex. Aerobic performance and HRpeak have a negative correlation with body mass index and cardiometabolic risk.

Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back pain. A controlled clinical trial.

OBJECTIVE: To determine the effects of a two-month intensive aquatic therapy programme on back pain, disability, quality of life, body composition and health-related fitness in sedentary adults with chronic low back pain. DESIGN: Controlled clinical trial. SETTING: Community. SUBJECTS: Forty-nine sedentary patients with chronic low back pain. INTERVENTIONS: Patients were allocated into active group (n = 24, two months, five times/week) or waiting list, control group (n = 25) according to space on the programme. MAIN MEASURES: Outcomes variables were pain (visual analogue scale), disability (Oswestry Disability Index), quality of life (Quality Short-Form Health Survey 36), body composition (weight, body mass index, body fat percentage and skeletal muscle mass) and health-related fitness (sit-and-reach, handgrip strength, curl-up, Rockport 1-mile test). RESULTS: The active group significantly improved low back pain (-3.83 ± 0.35 mm on the visual analogue scale ), disability (-12.7 ± 1.3 points for the Oswestry Disability Index) and the standardized physical component (10.3 ± 1.4 points for the Quality Short-Form Health Survey 36) of quality-of-life domains (P < 0.001), with no significant changes on the standardized mental component (P = 0.114). In relation to body composition and fitness, the active group showed significant improvements (all P-values < 0.01). The control group presented no significant change in any parameter. CONCLUSIONS: A two-month intensive aquatic therapy programme of high-frequency (five times/week) decreases levels of back pain and disability, increases quality of life, and improves body composition and health-related fitness in sedentary adults with chronic low back pain.

Reference Values of Spatial and Temporal Gait Parameters in a Contemporary Sample of Spanish Preschool Children: A Cross-Sectional Study.

The aim of this study was to analyze the influence of age and sex on kinematic gait parameters in preschool children, and derive reference values for this population. A total of 383 preschool children (age 3-5 years; 207 girls, 176 boys) participated in this study. We used the OptoGait system to assess the kinematics of gait at a comfortable and self-determined speed. No significant differences between the sexes were found for the main gait parameters. Among the participants, there was a significant increase in double support, reductions in absolute cadence and the coefficient of variation (CV) of cadence, an increase in absolute step length (SL), and an increase in the walk ratio (WR) from 3 to 5 years of age. However, the normalized SL and normalized WR displayed a significant reduction in both sexes. Partial correlation indicated a significant association of age with SL and normalized SL, and WR. Additionally, WR showed a significant correlation with the CV of cadence. To summarize, no relevant differences in gait performance were found according to sex; however, age was found to influence gait maturation. The normative values established for Spanish preschool children can be used to monitor healthy gait development.

Analysis of dynamic balance in preschool children through the balance beam test: A cross-sectional study providing reference values.

BACKGROUND: dynamic balance (DB) is a complex ability at an early age and balance deficits are related to numerous disorders. There are several balance measures but wide variation in their use has restricted the capacity to synthesise references values. The main purpose of this study was to analyse the performance of the Balance beam test (BBT) in preschool children, according to age and sex providing BBT reference values, and also to analyse its reliability and validity. RESEARCH QUESTION: could the BBT be a reliable test for measuring dynamic balance in preschool children? METHODS: 593 preschool children (3-6 years) participated in this study. The BBT was used to evaluate DB by measuring distance reached, time spent, and number of steps. Differences between sex and age groups were analysed using the Mann-Whitney U and Kruskal-Wallis tests. Test-retest reliability analysis was performed using intraclass correlation coefficients and the Bland-Altman graphic. Convergent validity was investigated with the Stork Balance stand test (SBST). RESULTS: no significant differences were found for sex in any components of the BBT. Age had positive effects on BBT performance in distance (χ2 = 63.474, p < 0.001), time (χ2 = 46.441, p < 0.001), and step numbers (χ2 = 40.967, p < 0.001). Younger children performed more poorly than older children. No significant interactions between age groups and sex were found. The BBT showed adequate validity and reliability. SIGNIFICANCE: the reference values established for Spanish preschool children in the current study could be used to monitor DB development. It is necessary to take into account distance reached, time spent, and the steps taken to obtain a more precise measure of DB in this population.

Reaction Times of Preschool Children on the Ruler Drop Test: A Cross-Sectional Study With Reference Values.

Reaction time (RT) tasks assess several brain functions, and a slow RT can be due to various brain diseases, disorders, and acquired conditions. This study examined age and gender differences in RTs of Spanish preschool children on the ruler drop test (RDT) and presents norm-referenced results. Participants were 3,741 children (1,845 girls and 1,896 boys; mean [M] age = 55.93, standard deviation [ SD] = 11.14 months; M body mass index = 15.94, SD = 1.91 kg/m2), selected from 51 schools in southern Spain. We measured RT with the RDT, and we collected both right- and left-hand data. We expressed normative mean RDT values of both hands according to gender and age in percentiles. Based on mean RDT scores, girls exhibited a poorer performance than boys aged 4 years ( p = .032, Cohen's d = - 0.122) and 5 years ( p = .001, Cohen's d = -0.194). For the whole group, RDT performance was faster with increased age, from the age of five years.

Reference Values of Static Balance in Spanish Preschool Children.

The purpose of this study was to examine age and sex differences in static balance (SB) and to determine norm-referenced values for Spanish preschool children. A total of 3,575 children, aged 3-6 years (age = 56.08 ± 11.11 months; body mass index = 15.94 ± 1.91 kg/m2; 1,759 girls and 1,816 boys) were selected from 51 schools in southern Spain. To measure SB, we used the Stork Balance Stand Test, averaging both right and left foot data for determining SB normative values, expressed in percentiles. Girls exhibited a better performance than boys at four years of age ( p = .010, Cohen's d = -0.165), but a poorer performance at six years ( p = .002, Cohen's d = 0.247). SB performance of the entire sample was higher with increased age, except for 5-6 years.

Disability predictors in chronic low back pain after aquatic exercise.

The physical and psychological factors associated with reduction of disability after aquatic exercise are not well understood. Sixty participants (30 men and 30 women; age, 50.60 [9.69] yrs; body mass index, 27.21 [5.20] kg/m²) with chronic low back pain were prospectively recruited. The 8-wk aquatic therapy program was carried out in an indoor pool sized 25 × 6 m, with 140-cm water depth and 30°C (1°C) of water temperature, where patients exercised for 2-5 days a week. Each aquatic exercise session lasted 55-60 mins (10 mins of warm-up, 20-25 mins of aerobic exercise, 15-20 mins of resistance exercise, and 10 mins of cooldown). Demographic information, disability (Oswestry Disability Index), back pain (visual analog scale), quality-of-life (Short Form 36), abdominal muscular endurance (curl-up), handgrip strength, trunk flexion and hamstring length (sit and reach), resting heart rate, and body mass index were outcomes variables. Significant correlations between change in disability and visual analog scale (at rest, flexion, and extension), curl-up and handgrip (r ranged between -0.353 and 0.582, all Ps < 0.01) were found. Changes in pain and abdominal muscular endurance were significant predictors of change in disability after therapy.