Final Exam Pediatrics Flashcards
Height and Weight Change not Synchronized: Males vs. Females
Females: height = 12 yrs, weight = 12.5 yrs
Males: height = 14 yrs, weight = 14. 5 yrs
Muscle Growth: %fat differences between men and women and hormones that play a role, peak muscle mass occurs at what age for each
Muscle mass:
- 25% BW at birth
- 30 to 35% BW in women (estrogen)
- 40 to 45% BW in men (testosterone)
- peaks at 16 to 20yrs for girls, 18 to 25yrs for boys
How is fat stored? At maturity, fat content averages % in males, % in females.
- fat is stored by increasing the size and number of fat cells, but cells can only increase to a certain max volume and then new cells are formed.
- 15% in males, 25% in females
Physiological Changes with Growth: strength, blood volume, heart size, BP, HR, economy, lung volume and peak flow
- strength increases
- blood volume, heart size, BP increase
- HR decreases
- economy increases
- lung volume and peak flow increase
Strength per Unit of BW for boys vs. girls
- boys increase drastically throughout puberty because of major increase in testosterone
- girls don’t increase as drastically because they gain more body fat
Physiological Responses to Acute Exercise: BP, SV, HR, CO, a-vO2
- BP is lower but increases to adult levels in late teens; due to smaller hearts and lower peripheral resistance
- SV is lower due to smaller heart and blood volume
- HR is higher to compensate for low SV
- CO is slightly lower
- a-vO2 is higher to compensate for lower SV
Absolute vs. Relative Rates of Work in Children vs. Adults for oxygen delivery
- At relative rates of work, there is no difference and oxygen delivery capacity does not limit performance
- At absolute rates of work, oxygen delivery capacity limits performance
Peaks of absolute VO2max in males and females
Males = age 17 to 21 Females = age 14 to 15, although leveling off or decrease may be due to females being less physically active than males
VO2max is not a good indicator of CR endurance performance in children due to….
lower running economy
Anaerobic Capacity in Children
- ability to perform anaerobic activities is lower
- glycolytic capacity is lower
- produce less lactate and can’t attain high RER values during max exercise
Changes in Motor Ability
increase through the first 18 years, females tend to plateau around puberty
Thermal Stress and Children
-less able to respond to cold environments and protect from hot environments due to body surface area to body weight being much greater in children
Which injuries are more incident boys vs. girls
boys- fractures, contusions, strains
girls- overuse injuries
Incidence of Injuries- new vs. reinjury, practice vs. competition
- 90% hs injuries are new injuries
- greater number of injuries occur in practice, but injury rates are higher in competition
Top 4 Types of Injuries in Children
- Growth plate or epiphyseal fractures
- Articular Cartilage/Osteochondritis Dissecans (lower resistance to repetitive loading)
- Osgood-Schlatter disorder
- Avulsion fractures (bone and epiphyseal plates weaker than tendons and ligaments
Major Elements of Injury Risk Management (5)
- Preparticipation Exam
- Conditioning & Training
- Proper Supervision
- Protection of the Body
- Environmental Control
Purposes of Preparticipation Exam
- determine general health and detect conditions that place the participant at additional risk
- ID medical contraindications to participation
- ID sports that may be played safely
- assess maturity and overall fitness
- educate the athlete
ACSM estimates % of all injuries sustained by youth while playing sports could be prevented if more emphasis was placed on developing fundamental fitness abilities prior to sport participation
50%
Post-season, Off-season, Pre-season, In-season
Post-season: up to 4 weeks after end of competitive season
Off-season: end of post-season to 8 weeks before competition
Pre-season: 8 weeks prior to competition
In-season: first competition to last
Conditioning and Training should include what elements
energy system training strength and power training speed agility flexibility skill development- team and individual nutrition
Proper Supervision- primary and secondary levels of supervision
Volunteer coaches with varying level of expertise = first level in injury prevention and first aid/CPR
Qualified Officials and Medical Personnel at games = second level to provide game control and immediate injury containment
According to National Children and Youth Study, at least % children 5-12 do not get enough vigorous activity necessary to maintain or improve CR fitness
50%
Students are graduating from our schools without knowledge of:
- how to evaluate their fitness levels
- how to design an individualized exercise program to enhance or maintain any or all of the 5 components of health related fitness (muscular endurance, aerobic endurance, strength, flexibility, body comp)
- what the benefits of exercise are
- why fitness is important to everyone
Definition of Fitness Educated Person
an individual who can make responsible decisions about their health and welfare based on scientific information; they are fit and can monitor and adjust their own fitness program based on their own fitness goals and evals
Is there a minimal age for a child to safely begin a resistance training program?
no, as long as the child is mature enough to follow directions
Is strength improvement possible before puberty? Prepubescent boys acute serum testosterone, muscle mass
- yes
- prepubescent boys do not get acute increases in serum testosterone as they do in adult men (women get GH increases)
- increases in muscle mass beyond normal growth are generally not seen (more research); hypertrophy may be possible with high intensity long duration
Strength Increases and Detraining in Children
- Strength increases typically due to neural factors up to 6 months
- Detraining after 3 months, child’s strength is lost but previous untrained children are at same level due to influence of testosterone with growth
Resistance Training and Bone in Children
- mechanism to increase BMD
- increase muscle strain acting on bone
- increase compression of bone (impact loading, short term loading)
- bone modeling process responds best to mechanical loading
Bone Remodeling
bone circumference increases as the bone builds on the outside and takes away calcium from the lumen
Injuries and Resistance Training: are they common? what injury is the most common?
- very rare, more danger in sports
- strain is the most common injury (from not warming up properly)
Possibility of injuries to children’s growth cartilage is valid concern. Growth cartilage located at what 3 sites?
- epiphyseal plate
- joint surfaces
- apophyseal insertion (tendon insertion)
Cases of epiphyseal plate fracture in young weight training have been reported, but a majority of these involved overhead lifts with near maximal resistance. This points out 2 precautions for prepubescent and adolescent programs…
- maximal or near maximal lifts should be discouraged, especially in unsupervised settings (lift weights that can be lifted for at least 6 reps)
- Because improper form is a contributing factor to many injuries, proper technique in all exercises, especially in overhead lifts, should be emphasized
Location and Percentage of Injuries from Weight Training: Child vs. Adults
Child- 77.2% accidental, hand 33%, foot 30%, head 13%
Adult- 27% accidental, trunk 42%, arm 21%, hand 14%
*hints to proper supervision and technique
Proposed Mechanisms for Injury Reduction from Resistance Training
- increased BMD
- increased strength of tendons and ligaments
- increased muscle bulk to absorb or disperse more force from impact
- increased ability to tolerate greater activity or sport stressed through increased fitness
- improved motor control, coordination, speed
General Guidelines for Resistance Training for Children: most important, warm up/cool down, reps, sets, days per week, spotters, technique, keep program interesting
- proper instruction and supervision!
- start at 10 to 15 reps (reduce load on growth cartilage, enhance neural adaptations)
- start with 1 to 2 sets per exercise
- progress to 6 to 15 reps and 2 to 3 sets depending on goals
- 2 to 3 days per week on nonconsecutive days
Rates of Change in Height and Weight: birth-2yrs, 2 yrs-puberty, puberty, midpuberty to late teens
birth-2yrs: fast
2yrs-puberty: slow
puberty onset: fast
midpuberty to late teens: slow
