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Unit 1 > 9/25b Childhood Obesity (Examination, Evaluation, Intervention) > Flashcards

9/25b Childhood Obesity (Examination, Evaluation, Intervention) Flashcards

1
Q

BRFSS Charts of obesity trends over time for adults

A

steadily increasing over the course of 30-40 years (start date was in 1985)

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2
Q

Obesity BMI

A

over 30

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3
Q

Prevalence of childhood obesity and overweight

A

slight drop for all, but not really true for majority of the children.
the only age range that may acutally have a decrease is the 2-5 age range because parents are becoming more aware

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4
Q

Weight status of the child based on BMI for age**

A
  • age range
  • male/female
  • education levels of the parents
  • federal poverty line
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5
Q

difference between overweight and obese

A

Measured in BMI (weight in kg/(height in meters)^2)

  • healthy = 18.5-24.9
  • Overweight = 25-29.9
  • Obese = over 30
  • -Class I = 30-34
  • -Class II = 35-39.9
  • -Class III = over 40 (morbid)
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6
Q

what are the percentages of underweight, normal weight, overweight, and obese children age 10-17 y/o nationwide?

A

Underweight - 6.3% (less than 5th percentile)
Normal Weight - 62.6% (5th to 84th percentile)
Overweight - 15% (85th to 94th percentile)
Obese - 16.1% (95th percentile)

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7
Q

what is the difference between weight status of children based on BMI for male vs female?

A

there are more obese and underweight males, but there are more normal weight and overweight females

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8
Q

what is the impact of a parent’s education status on the weight status of their children (BMI for children ages 10-17)

A

The highest number of normal weight children is with parents who have a college degree or higher, and the lowest number of normal weight children is for parents who have less than a highschool education.

While it is the inverse for obese children. Obese children are more prevalent when the parent has less than high school education vs a college degree or higher

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9
Q

what is the impact on childhood obesity for families that fall within the federal poverty line

A

the FPL was $24k for a family of 4 (low)

correlation between income generating potential and food accessibility and safe places for play and exercise

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10
Q

BMI for age charts - for children and adolescents

A

Overweight >= 85th percentile for age and sex

Obese >= 95th percentile for age and sex

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11
Q

Quantifying childhood obesity

A

limitations of BMI alone, clinically we can also measure:

  • waist circumference
  • body composition
  • fitness and performance
  • examine change with intervention
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12
Q

current trends on why americans are getting larger?

A

current trends:

  • cafeteria choices
  • vending machine income
  • advertising
  • food accessibility: certain parts of the city just have quickmarts and there is not access to a fresh food restaurant
  • portion distortion
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13
Q

Role of the BMI for age charts for children

A

good indication for screening

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14
Q

portion distortion

A
  • Portion sizes are expanding
  • “value” menu
  • consumer desires
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15
Q

goal for a obese patient who is getting PT

A

can’t make goal weight loss, but can make it energy expenditure

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16
Q

reasons for the current trends in the increase in obesity in children

A
  • decreased PE time
  • limited after school programming
  • increased screen time(b/c of access to safe places outside and parents want their kids to stay in doors)
  • urban sprawl, decreased outdoor play
  • mom and dad aren’t exercising either: modelling good behavior for children
17
Q

number of days that children are spending engaged in vigorous physical activity

A
  • 1-3 days is the most common nation wide
  • boys complete more activity daily, while females complete more activity 1-3 days a week
  • 6-11 year olds exercise more every day than 12-17 years old. Kids stop playing when sports get more competitive as you get older. High school kids are more likely to spend more sedentary activity
18
Q

Percentage of high school students who met intentional strength training/aerobic exercise

A

30% of boys met guidelines and even lower for girls

19
Q

Complications of obesity

A 
Musculoskeletal
cardio/pulm
integumentary
Neuromuscular/neurological
GI/Reproductive
Psychologic
20
Q

Musculoskeletal complications of obesity

A

Pediatric Orthopedic Disorders Related to Increased
BMI:
– Slipped Capital Femoral Epiphysis (SCFE)
– Tibia Vara (Blount’s Disease)
– Spine (compression fractures, back pain)
– Fractures

21
Q

cadio/pulm complications of obesity

A

• Early markers of cardiovascular disease
– Endothelial function
– Biomarkers of inflammation
• Dyslipidemia (high level of lipids in the blood)
• Hypertension
• Metabolic syndrome (syndrome x, central adiposities, increased abdominal girth, high bp, low HDL, high LDL, pre-diabetic and insulin resistance

22
Q

integumentary complications of obesity

A

• Dermatological Changes (many can occur with obesity,
but not only in obese patients) Indicators more than anything:
– Acanthosis nigricans: darkened thickened skin around axilla (b/c of insulin resistance)
– Acrochordons (skin tags): in folds where there may be increased adipose tissue
– Ulceration and cellulitis: skin breakdown, infection of the adipose tissue
– Stretch marks (rapid weight gain)

23
Q

neuromuscular and neurological complications of obesity

A 
• Migraine - conflicting data
• Psuedotumor cerebri/Idiopathic Intracranial HTN (increased pressure in the brain and CNS, reversible with management of weight)
• Obesity as a comorbidity – impulsivity, overeating
disorders
• Changes in patients with obesity and
diabetes:
- peripheral neuropathy
- AchR changes at NM junction
24
Q

GI system complications of obesity

A
  • GERD (gastroesophageal reflux disease)
  • Gallstones
  • Non-Alcoholic Fatty Liver Disease: reversible
25
Q

endocrine and reproductive system complications of obesity

A 
• Role of adipokines (ex. leptin helps with satiety)
• Early-onset Type 2 diabetes mellitus
• Hormonal changes and regulation
– Early onset of menses/development
– Reproductive disorders, ex. PCOS
26
Q

Pains, Sprains, and Strains with obesity

A 
Hard to tease out if they are overweight or sedentary or both
• Overuse
• Tendonitis
• Bursitis
• Back Pain
• Muscle/body weight imbalance
27
Q

Gait impairment with obesity

A

• Decreased relative velocity
• Increased stance time (time spent on both legs in contact with the ground)
• Wider base of support
• Foot flat weight acceptance (heel-toe progression normally, but obese children have more of a flat foot because of weight shift)
• Risk of later development of OA with increased medial
knee joint loading

28
Q

pulmonary impairment with obesity

A

obstructive sleep apnea
asthma
both improve with weightloss programs

29
Q

pulmonary impairment with obesity

A

-obstructive sleep apnea
-asthma
both improve with weightloss programs

30
Q

psychological system complications of obesity

A 
• Potential impact on:
– Self-esteem and Self-Image
– Quality of Life
– Depression
– Anxiety
• Causality?
– Example: a hallmark of depression is a decreased interest in
activity, but obesity may lead to poor self-image which may
lead to a mood disorder
31
Q

impact of pediatric obesity on PT practice

A
  • altered gait pattern
  • endurance
  • standing balance/base of support
32
Q

clinical exercise testing in pediatrics

A 
• Referral base
• Special Considerations
– Size of equipment
– Treadmill safety
• Protocols
– 2-3 minute increments
– Constant or incremental load based on height, BMI or
body surface area
• Getting patient to understand of maximal effort = use OMNI scale of perceived exertion
33
Q

Exercise response in pediatrics

A 
• Baseline Values Relative to Adults:
– Higher HR
– Higher RR
– Lower BP
• Recovery:
– Quicker recovery (HR, BP, etc) than adults
– Children do not sweat as much, but higher BSA relative
to mass
34
Q

Exercise response in pediatrics

A

• Baseline Values Relative to Adults:
– Higher HR
– Higher RR
– Lower BP
• Recovery:
– Quicker recovery (HR, BP, etc) than adults
– Children do not sweat as much, but higher Body surface area relative to mass

35
Q

how to intervene with pediatric obesity

A

PAG Guidelines with children

  • 3 year old - physical activities throughout the day
  • school age children (6-17): 60 minutes daily
36
Q

how to intervene with pediatric obesity

A

PAG Guidelines with children

  • 3 year old - physical activities throughout the day
  • school age children (6-17): 60 minutes daily
37
Q

ecological systems theory interaction with children who are obese

A

Individual > interpersonal > environment > society/public policy

Unit 1 (28 decks)

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