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Paediatrics in Exercise Physiology > W1 - Growth & Maturation > Flashcards

W1 - Growth & Maturation Flashcards

1
Q

Growth

A

Involves the increase in body size.

Whether that be its entirety or segments.

Incl. hyperplasia, hypertrophy and accretion.

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2
Q

What does the growth trajectory of a child depend on?

A

Tempo (rate of change)

Timing characteristics (Size at a given age).

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3
Q

Why should growth be plotted on a reference curve?

A

To capture variability + allow for assessment of the ind status over time.

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4
Q

Is stature growth a linear process?

A

no

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5
Q

What are the 4 patterns of growth that tissues and systems of the body follow?

A

Neurological

Genital

General

Lymphoid

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6
Q

What study designs are used in paediatrics growth studies?

A

Cross-sectional

Longitudinal

Mixed-longitudinal

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7
Q

Cross-sectional paediatrics growth study design

A

Single measurement from ind who differs in chronological age

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8
Q

Longitudinal paediatrics growth study design

A

Measure same ind over time with at least 3 serial measures on each individual.

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9
Q

Mixed-longitudinal paediatrics growth study design

A

Number of relatively short longitudinal studies interlocked to cover a wide age range.

OR

Some ind are repeatedly measured + others are only measured once.

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10
Q

Which study design can NOT provide info on an ind timing and tempo of growth?

A

Cross-sectional

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11
Q

What does BMI correlate well with for children?

A

Correlated well with estimates of body fatness in children but there is large variability present (r=~0.3-0.8)

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12
Q

BMI equation for growth

A

BMI = Body mass (kg) / stature^2 (m^2).

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13
Q

Maturation

A

Continous process of becoming fully mature until a defined endpoint.

Characterised by timing and tempo.

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14
Q

What are the most universally used indicators of biological maturity?

A

Maturation of the skeleton

Secondary sex characteristics

Age at peak height velocity (PHV)

Menarcheal status

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15
Q

What comes under secondary sex characteristics?

A

Genitals

Breasts

Pubic hair

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16
Q

Which indicators of maturation are moderately to highly correlated during adolescence?

A

Skeletal

Sexual

Somatic

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17
Q

Can just 1 indicator give a complete description of the tempo of growth and maturation?

A

NO

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18
Q

What does the discord among growth and maturation indicators reflect?

A

Ind variation in the timing and tempo of sexual and somatic maturation

+

Methodological concerns in assessment

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19
Q

What growth + maturation indicators should be used in studies making gender comparisons?

A

Skeletal age

or one of the somatic indicators

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20
Q

Why should biological maturation be considered in studies?

A

Due to the effects of a childs biological maturation potentially masking or being greater than the effects associated with exposure to physical activity or exercise.

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21
Q

What can almost correct when age misclassifies weight status?

A

Adjustment for maturity.

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22
Q

List the sexual maturation stages proposed by Tanner

A

Prepubertal

Peripubertal

Pubertal

Mature

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23
Q

Tanners Sexual Maturation Stages

Prepubertal

A

No pubic hair

No genital or breast growth

24
Q

Tanners Sexual Maturation Stages

Peripubertal

A

Initiation of pubic hair, breast + genital growth.

25
Tanners Sexual Maturation Stages Pubertal
Continued development of pubic hair, breast + genital growth
26
Tanners Sexual Maturation Stages Mature
Adult like development of all characteristics
27
What does individual growth + maturation depend on?
Genotype Phenotype
28
What happens to activity levels as you advance in the Tanner stages?
Declines
29
Pros to the Tanner Stages
Quick Non-invasive Allows participant to be classified with specific characteristics Self-assessment is close to clinician assessment No longitudinal analysis needed
30
Cons to the Tanner stages
Invasion of privacy Limited to the pubertal phase Requires training Concerns about reliability within + between ind
31
Where in the Tanner stages would the Age of Menarche Marker occur?
In the midrange
32
How would the most accurate determination of the age of menarche marker be?
Through longitudinal analysis
33
How are most pubertal events initiated + regulated?
By the stimulation of ovaries + testes by gonadotropins (FSH + LH) secreted by the anterior pituitary + the elevated production of the sex steroids by the gonads.
34
Pros to Peak height velocity (PHV)
Non-invasive Little training req Reflects timing + magnitude of somatic maturation Common benchmark within + between ind
35
Cons to PHV
Requires serial measures of stature + age Only suitable for longitudinal studies Computed retrospectively
36
What is the most common landmark of somatic maturity?
Age at peak height velocity (APHV)
37
Auxology
Understanding of the general principles of human growth, maturation + development.
38
When does a sudden increase in the velocity of the growth occur?
Pubertal period, second to the growth rate observed in the 1st yr of life.
39
What is meant by development?
The acquisition of behavioural competence i.e learning the appropriate behaviours expected by society. It's culturally specific
40
What are the suggested techniques to be used for body size adjustments
Allometry + regression analysis
41
Advantage of longitudinal over cross-over sectional designs for controlling for the confounding effects of maturity
Within-ind variance can be obtained, meaning tempo + timing of an ind pattern of growth can be ID.
42
What could a pure longitudinal design look like?
Cohort of children born in the asme year are followed continuously for 3 or + years,
43
Why is longitudinal research often impractical for paediatric exercise research?
Process is laborious, expensive + time consuming for both participants + investigators.
44
What does the skeletal age assessment require?
X-ray of the hand + wrist or knee
45
What is the only method that spans the entire growth period?
Skeletal age assessment
46
How does the skeletal age assessment work?
Based on the observation that a person more advanced in maturity will have greater bone development + smaller amount of cartilage than a less mature person.
47
What is the most commonly used somatic milestone in longitudinal studies of childhood growth?
Age at Peak height velocity
48
How can the age when max velocity in statuary growth occurs be identified?
By plotting whole year height-velocity increments + curve-fitting procedures
49
At what biological age is a child at at the age of PHV?
Biological age of 0.0 from PHV.
50
What biological age from PHV will a child have if at 11.8 years they reach a PHV of 13.8yrs?
-2.0 yrs from PHV
51
PHV for early maturers
PHV is 1 year or more less than the mean age of PHV
52
PHV for late maturers
PHV is 1 year or more than the mean age of PHV
53
Predicting Age at PHV What did Mirwald et al do?
Developed a gender-specific multiple regression equations based on segmental growth patterns to predict the maturity offset age parameter. Allows for between-gender comparisons
54
What did Mirwald et al equations require?
Measures of: - Stature - Trunk length - Leg length - Body mass - Chronological age
55
What are the 3 methods commonly used to establish age at menarche?
Prospective Status quo Recall - simple questionnaire
56
What does the status quo method for menarcheal status involve?
Large number of girls. Birth date + whether they've started their menstrual flow. == Calculate mean + SD for age of menarche
57
What did 1study find about the correlation coefficient between skeletal age + age at PHV?
0.83 The strength + direction of this indicates a maturity commonality between the 2 methods.

Paediatrics in Exercise Physiology (8 decks)

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