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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
Q

Tanners Sexual Maturation Stages

Pubertal

A

Continued development of pubic hair, breast + genital growth

26
Q

Tanners Sexual Maturation Stages

Mature

A

Adult like development of all characteristics

27
Q

What does individual growth + maturation depend on?

A

Genotype

Phenotype

28
Q

What happens to activity levels as you advance in the Tanner stages?

A

Declines

29
Q

Pros to the Tanner Stages

A

Quick

Non-invasive

Allows participant to be classified with specific characteristics

Self-assessment is close to clinician assessment

No longitudinal analysis needed

30
Q

Cons to the Tanner stages

A

Invasion of privacy

Limited to the pubertal phase

Requires training

Concerns about reliability within + between ind

31
Q

Where in the Tanner stages would the Age of Menarche Marker occur?

A

In the midrange

32
Q

How would the most accurate determination of the age of menarche marker be?

A

Through longitudinal analysis

33
Q

How are most pubertal events initiated + regulated?

A

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
Q

Pros to Peak height velocity (PHV)

A

Non-invasive

Little training req

Reflects timing + magnitude of somatic maturation

Common benchmark within + between ind

35
Q

Cons to PHV

A

Requires serial measures of stature + age

Only suitable for longitudinal studies

Computed retrospectively

36
Q

What is the most common landmark of somatic maturity?

A

Age at peak height velocity (APHV)

37
Q

Auxology

A

Understanding of the general principles of human growth, maturation + development.

38
Q

When does a sudden increase in the velocity of the growth occur?

A

Pubertal period, second to the growth rate observed in the 1st yr of life.

39
Q

What is meant by development?

A

The acquisition of behavioural competence

i.e learning the appropriate behaviours expected by society.

It’s culturally specific

40
Q

What are the suggested techniques to be used for body size adjustments

A

Allometry + regression analysis

41
Q

Advantage of longitudinal over cross-over sectional designs for controlling for the confounding effects of maturity

A

Within-ind variance can be obtained, meaning tempo + timing of an ind pattern of growth can be ID.

42
Q

What could a pure longitudinal design look like?

A

Cohort of children born in the asme year are followed continuously for 3 or + years,

43
Q

Why is longitudinal research often impractical for paediatric exercise research?

A

Process is laborious, expensive + time consuming for both participants + investigators.

44
Q

What does the skeletal age assessment require?

A

X-ray of the hand + wrist or knee

45
Q

What is the only method that spans the entire growth period?

A

Skeletal age assessment

46
Q

How does the skeletal age assessment work?

A

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
Q

What is the most commonly used somatic milestone in longitudinal studies of childhood growth?

A

Age at Peak height velocity

48
Q

How can the age when max velocity in statuary growth occurs be identified?

A

By plotting whole year height-velocity increments + curve-fitting procedures

49
Q

At what biological age is a child at at the age of PHV?

A

Biological age of 0.0 from PHV.

50
Q

What biological age from PHV will a child have if at 11.8 years they reach a PHV of 13.8yrs?

A

-2.0 yrs from PHV

51
Q

PHV for early maturers

A

PHV is 1 year or more less than the mean age of PHV

52
Q

PHV for late maturers

A

PHV is 1 year or more than the mean age of PHV

53
Q

Predicting Age at PHV

What did Mirwald et al do?

A

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
Q

What did Mirwald et al equations require?

A

Measures of:

  • Stature
  • Trunk length
  • Leg length
  • Body mass
  • Chronological age
55
Q

What are the 3 methods commonly used to establish age at menarche?

A

Prospective

Status quo

Recall - simple questionnaire

56
Q

What does the status quo method for menarcheal status involve?

A

Large number of girls.

Birth date + whether they’ve started their menstrual flow.

== Calculate mean + SD for age of menarche

57
Q

What did 1study find about the correlation coefficient between skeletal age + age at PHV?

A

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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