Childhood Obesity (9/25b) [Examination/Intervention]

Question 1

Data shows that the more education a caregiver has, they are generally…

Answer 1

less likely to have overweight/obese children

due to more access to health options, health education

Question 2

Adults - Overweight vs Obese

Answer 2

HEALTHY
BMI 18.5 - 24.9

OVERWEIGHT
10-19% over “ideal”
BMI 25 - 29.9

OBESE
BMI over 30
Class 1 – 30 - 34
Class 2 – 35 - 39.9
Class 3 - over 40 (morbid)

Question 3

Children - Overweight vs Obese

Answer 3

OVERWEIGHT
BMI ≥ 85th % for age/sex

OBESE
BMI ≥ 95th % for age/sex

Question 4

We can also clinically measure obesity via

Answer 4

Waist circumference

Body composition

Fitness and performance

Examine change with intervention

Question 5

Why are Americans getting larger?

Answer 5

Cafeteria choices

Vending machine income

Advertising

Food accessibility/insecurity

Portion distortion

Question 6

Current trends causing obesity

Answer 6

Decreased physical education (some have 0 days/week)

Limited after-school programming

Increased “screen time”

Urban sprawl, decreased outdoor play

Parents aren’t exercising

Question 7

Obesity Complications - Musculoskeletal

Answer 7

Slipped capital femoral epiphysis (SCFE)

Blount’s disease (tibia vara)

Spine

Fracture

Pains, Sprains, Strains

Gait impairment

Question 8

Obesity Complications - Cardiovascular/Pulmonary

Answer 8

Early markers of cardiovascular disease

Dyslipidemia

Hypertension

Metabolic syndrome

Sleep apnea

Asthma

Question 9

Obesity Complications - Integumentary

Answer 9

Acanthosis nigricans (dark patches)

Acrochordons (skin tags)

Ulceration and cellulitis

Stretch marks (rapid weight gain)

Question 10

Obesity Complications - Neuro/Neuromuscular

Answer 10

Migraine (?)

Pseudotumor cerebri/Idiopathic Intracranial HTN

Obesity as a comorbidity – impulsivity, overeating disorders

Change in peripheral neuropathy

AchR changes at NM junction

Question 11

Obesity Complications - Gastrointestinal/Reproductive

Answer 11

GERD

Gallstones

Non-Alcoholic Fatty Liver Disease

Early-onset Type 2 diabetes mellitus

Early onset of menses/development

Reproductive disorders (EX: PCOS)

Changes in leptin

Question 12

Obesity Complications - Psychological

Answer 12

Self-esteem and Self-Image

Quality of Life

Depression

Anxiety

Question 13

Impact of Pediatric Obesity on PT Practice

Answer 13

Altered gait pattern (biomechanics, gait speed)

Dynamic and static standing balance (wider base of support)

Endurance with physical activity and in the community

Question 14

Clinical Exercise Testing in Pediatrics - Special Considerations

Answer 14

Size – stationary cycle may not work

Treadmill safety

Question 15

Clinical Exercise Testing in Pediatrics - Protocols

Answer 15

2-3 minute increments

Constant or incremental load based on height, BMI or body surface area

Question 16

Clinical Exercise Testing in Pediatrics - Effort/Exertion

Answer 16

Understanding of maximal effort

OMNI Scale of Perceived Exertion

Question 17

Clinical Exercise Testing in Pediatrics - Exercise Response

Answer 17

(compared to adults)

Baseline: higher HR, higher RR, lower BP

Recovery: quicker recovery, less sweat, higher body surface area relative to mass

Question 18

Promoting physical activity for kids

Answer 18

Preschool aged children should be active through the day

Ages 6-17 should be doing at least an hour of moderate-vigorous activity daily

Safe areas for physical activity

Promote healthy diet

Question 19

Evidence for health benefits from physical activity

Answer 19

Improved bone health

improved weight

reduced risk of depression

improved cardiometabolic health

etc.