Week 8 (EXAM 2)

Question 1

What is a mobility gross motor milestone for ages 13-16?

Answer 1

males and females continue to increase running speed, jumping distance, females stabilizing at ~14 years, males at ~16 years.

Reaction time and peak sports performance may occur at ~16 years old.

Question 2

What are the gender differences based on?

Answer 2

Gender differences are based on large studies and should be taken as epidemiological data, remember to treat what you see!

Question 3

When does peak growth occur?

Answer 3

◦Peak growth (think puberty) for Females at ~11.5 years, for males at ~13.5 years

◦Growth spurts may lead to that “awkward” stage as proprioceptive awareness “catches up”

Question 4

How does fine motor develop at this age range (13-21)?

Answer 4

Fine motor skills develop based on need and practice at this point.

Question 5

What are some social & emotional milestones (13-21)?

Answer 5

(All the emotions)

◦ Strongly influenced by peer group, insecure
sense of individuality (especially early teens)
◦ Likely spends more time with friends that family, seeking emotional autonomy from parents
◦ Intimate friendships form, sexual relationships
form, may begin to “thrill” seek and explore illicit substances.
◦ Sensation of the “thrill” may influence more than the cognitive understanding of the negative consequences
◦ Insecurity about body image, balancing the need for independence and privacy with the continued need for parental support are common struggles.
◦ Emotional control (i.e. frontal lobe development) continues to mature, but won’t be fully developed yet (more on the next slide)

Question 6

What are some cognitive & language milestones (13-21)?

Answer 6

(13-21 years: MAY demonstrate formal operational thinking (back to Piaget) as early as 13)

• Know that many people’s contention with Piaget’s stages of cognitive development stem from the age ranges of his stages. Some argue that teenagers only just begin formal operational thinking, and that there should be another, more “advanced” stage for adults.
• Meta-cognition and study skills will develop over this period, dependent on…..
• Abstract thought, skepticism, social awareness all begin to develop and mature here.
• Ability to effectively argue both sides of an issue
• Refer to your neuroscience course here for development timeframe of the frontal lobe
• Decision making, appreciating delayed gratification, “maturity” continues to improve
• Unless you’re 26, you’re not done developing yet!

Vocabulary, sentence structure, reading comprehension including complex metaphors and multiple levels of meaning develop and become more refined in the teen and young adult.
* Still a skill!

Question 7

Define fitness

Answer 7

Fitness: The American College of Sports Medicine (ACSM) : Physical fitness is defined as a set of attributes that people have or achieve that relates to the ability to perform physical activity.
◦Oxford: The condition of being physically fit and healthy

Question 8

Define wellness

Answer 8

Wellness: The Global Wellness Institute defines wellness as the active pursuit of activities, choices and lifestyles that lead to a state of holistic health.
◦Merriam Webster: the quality or state of being in good health especially as an actively sought goal

Question 9

Define health

Answer 9

Health: World Health Organization (WHO) Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
◦“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without
distinction of race, religion, political belief, economic or social condition”-WHO constitution.
◦Merriam Webster: the condition of being sound in body, mind, or spirit. Especially: freedom from physical disease or pain. A condition in which someone or something is thriving or doing well.

Question 10

What is the fitness, health, and wellness recommendations for children 3-5

Answer 10

◦ Be physically active throughout the day for growth and development.
◦ Adult caregivers should encourage children to be active when they play

Question 11

What is the fitness, health, and wellness recommendations for children 6-17

Answer 11

◦ 60 minutes or more of moderate-to-vigorous intensity physical activity each day.
◦ Aerobic activity: Most of the daily 60 minutes should include activities like walking, running, or anything that makes their hearts beat faster.
At least 3 days a week should include vigorous-intensity activities.
◦ Muscle-strengthening: Includes activities like climbing or doing push-ups, at least 3 days per week.
◦ Bone-strengthening: Includes activities such as jumping or running, at least 3 days per week.

Question 12

What is the fitness, health, and wellness recommendations for children 18-64

Answer 12

◦ At least 150 minutes a week of moderate intensity activity such as brisk walking.
◦ At least 2 days a week of activities that strengthen muscles.
◦ CAVEATE!! “Aim for the recommended activity level but be as active AS YOU ARE ABLE”

Question 13

List health benefits for physical activity of children

Answer 13

1) brain health (reduces risk of depression)
2) academic performance (improves attention & memory)
3) muscle fitness (improved strength & endurance)
4) heart, lung (improve aerobic fitness)
5) bone strength
6) bodyweight & fat
7) maintains blood sugar levels
8) reduces risk of several chronic diseases (type 2 diabetes & obesity)

Question 14

Describe presidential fitness test

Answer 14

(Stopped 2013)

The Presidential Fitness Test was a physical fitness program introduced in U.S. schools to assess students’ physical health. It included activities like sit-ups, push-ups, running, and flexibility tests, measuring strength, endurance, and agility. Students were ranked based on their performance, with the goal of encouraging physical activity and healthy living among children and teens.

Question 15

what fitness assessments replaced the presidential fitness test?

Answer 15

1) FitnessGram Assessment (K-12 grade, though some tests are omitted for younger students):
It evaluates aerobic capacity, muscular strength, endurance, flexibility, and body composition through various tests like the PACER, curl-ups, push-ups, and sit-and-reach. The goal is to encourage lifelong fitness habits by focusing on personal improvement rather than competition.

2) Brockport Physical Fitness Test (5-17yrs):
(Can be used on typically developing children and children with disabilities)
It assesses health-related physical fitness in areas such as aerobic functioning, muscular strength and endurance, flexibility, and body composition. The BPFT is adapted to meet the needs of students with varying abilities, allowing for individualized testing and fitness goals. It aims to promote physical activity and healthy lifestyles for youth with disabilities.

Question 16

List some health assessments

Answer 16

1) Kaiser Peramante:

conducts health assessments as part of its integrated healthcare services, offering personalized evaluations for members. These assessments gather information on lifestyle factors, medical history, and current health status to identify risks and guide preventive care. By focusing on holistic well-being, Kaiser Permanente helps members manage chronic conditions, improve health outcomes, and develop tailored health plans that emphasize preventive care, mental health, and overall wellness.

2) American College Health Association- The National College Health Assessment:

is a comprehensive survey that collects data on the health behaviors, habits, and perceptions of college students across the U.S. It covers various aspects such as mental health, physical health, substance use, nutrition, and sexual health. The assessment helps colleges and universities identify health trends and challenges, guiding them in developing programs to improve student well-being and support healthier campus environments.

3) UNE Center for excellence in public health-Assessment guidelines and assessments linked to physician competencies:

focuses on developing assessment guidelines and tools that align with physician competencies. These assessments are designed to evaluate essential skills such as communication, medical knowledge, patient care, professionalism, and systems-based practice. By integrating public health principles, the assessments help ensure that physicians are prepared to address broader health issues, including population health, preventive care, and community-based interventions. The guidelines emphasize interdisciplinary collaboration and evidence-based practice, contributing to the development of competent healthcare professionals capable of addressing both individual and public health challenges.

Question 17

How do you assess wellness?

Answer 17

A) Dr Peggy Swarbrick OT (8 dimensions of wellness)

1) emotional (coping with life & satisfying relationships)
2) financial (current and future situations)
3) social (sense of connection and support system)
4) spiritual (sense of purpose)
5) occupational (satisfaction from work)
6) physical (activity sleep, nutrition)
7) intellectual (creative abilities & knowledge)
8) environmental (pleasant & stimulating environment)

Question 18

What is Global Wellness Institute assessment of wellness?

Answer 18

(6 dimensions) “no financial or occupational”

1) emotional (coping with life & satisfying relationships)
2) social (sense of connection and support system)
3) spiritual (sense of purpose)
4) physical (activity sleep, nutrition)
5) intellectual (creative abilities & knowledge)
6) environmental (pleasant & stimulating environment)

Question 19

What is the Airforce assessment?

Answer 19

Air Force emphasizes a holistic approach to well-being known as Comprehensive Airman Fitness (CAF). This model addresses:

1.	Spiritual Wellness: Encouraging a sense of purpose, core values, and resilience through personal beliefs, religious faith, or a strong sense of meaning in life.
2.	Emotional Wellness: Fostering mental health through stress management, coping strategies, and emotional resilience in the face of challenges.
3.	Physical Wellness: Maintaining fitness through regular physical activity, nutrition, and health habits that support mission readiness and overall well-being.
4.	Social Wellness: Building strong relationships and support networks, both within the Air Force and in personal lives, to enhance communication, teamwork, and a sense of belonging.

Question 20

As we grow from adolescence to early adulthood, what are many of our “milestones” highly dependent on?

Answer 20

practice

Question 21

As young adults, what is a big focus during maturation of this stage?

Answer 21

focused in the cognitive, social, and emotional domains of development. This is strongly linked to the maturation of the frontal lobe and experiential learning.

Question 22

What are gait changes associated with normal aging?

Answer 22

Decreased gait velocity

Decreased stride length

Decreased peak knee extension range of motion

Decreased peak knee flexion in swing Slightly increased ankle dorsiflexion

Decreased ankle plantar flexion power

Question 23

What are gait changes associated with decreased strength?

Answer 23

Increased pelvic tilt, may be related to decreased abdominal muscle strength

Decreased vertical displacement of body during gait

Decreased gait velocity

Decreased cadence, may be related to decreased dorsiflexion strength

Question 24

What are gait changes associated with decreased balance?

Answer 24

Increased base of support

Decreased gait velocity

Increased time in double limb support

Increased use of visual scanning

Question 25

Define running

Answer 25

Running is defined as a pattern of movement that has a stance phase and a swing phase but, more importantly, a flight phase, a period of nonsupport. The stance phase of running is 40% of the gait cycle, whereas the swing phase is 60%. When running, a longer time is spent in the swing phase than in walking—when 60% of the gait cycle was spent in stance phase and 40% was spent in swing phase. As with walking, the temporal phasing of running is such that halfway through the cycle of one limb, the other limb begins its cycle—50% phasing.

Question 26

Presentation: mental health & wellness

Answer 26

• Leading cause of death for 3-17 yo is mental health related. 1 in 5 has been diagnosed with a mental health issue while only 15-20% get treated
  
  • Exercise has been shown to improve outcomes over medication/therapy alone.
  • Incidence: 15-20% of U.S. children experience a mental disorder yearly, with mental health challenges being a leading cause of death and disability among ages 3-17.
  • Risk Factors: Stress, trauma, genetics, undiagnosed disorders, developmental delays, and environmental factors can disrupt a child’s daily life.
  • Interdisciplinary: Different mental health professionals, including pediatric psychologists, counselors, and psychiatrists, provide care through assessments, therapy, and medication.
  • Role of Physical Therapy (PT): PT can improve physical health, which positively affects mental health. PTs work alongside mental health professionals in a holistic care approach that includes social, emotional, motor, and cognitive aspects.

Question 27

presentation: homeless health & wellness

Answer 27

• Homelessness in Houston: 3,280 people are experiencing homelessness, with 34% facing serious mental illness. Primary causes include job loss, lack of income, and family conflict.
  
  • Homelessness definition: Includes various categories such as literal homelessness, imminent risk, and fleeing domestic violence.
  • Health and wellness basics: Programs should assess the population’s needs, educate them, ensure service access, involve the community, and continually evaluate the program’s success.
  • Immediate priorities: Address basic needs like food, shelter, and hygiene first. Flexibility in hours and collaboration with existing services is crucial.
  • Physical therapy considerations: Address musculoskeletal injuries, educate on chronic disease management, and collaborate with other professionals like psychiatrists and social workers.
  • Barriers: Homeless individuals often face transportation issues, psychosocial barriers, and lifestyle constraints. Programs need to focus on improving accessibility and building trust.

Recommendations:

1.	Priority: Address immediate needs (basic hygiene, food, shelter) before introducing exercise programs.
2.	What to recommend: Simple, accessible exercises with low-cost equipment (e.g., resistance bands) that can be done in shelters or public spaces.
3.	What not to recommend: Intensive exercise routines or expensive treatments that are difficult to access or maintain.

Question 28

presentation: SOCIAL DETERMINANTS OF HEALTH AND FAMILY CENTERED CARE

Answer 28

(PT should: affordable, accessible services, promoting community engagement, and incorporating cultural sensitivity into care. It also stresses the importance of family-centered care in improving communication, literacy, and involvement in health management.)

   *	Economic Stability: Limited economic resources lead to health conditions like obesity and musculoskeletal issues due to inactivity and poor nutrition. PTs can help by offering affordable physical activity options.
*	Education Quality and Access: Poor education correlates with low health literacy and bad health decisions. PTs should engage in health education campaigns to improve health literacy.
*	Health Care Quality and Access: Limited access to quality care delays diagnosis and treatment. PTs can provide free screenings to identify early issues and reduce the impact of untreated conditions.
*	Social/Community Influence: Lack of social support and community engagement contributes to poor physical and mental health outcomes. PTs can offer community-based programs to foster a sense of well-being.
*	neighborhood and built environment: Unsafe living conditions, lack of exercise spaces, and poor infrastructure lead to poor health outcomes. PTs should advocate for the development of safe environments like parks and walking paths.
*	Cultural Sensitivity: Cultural beliefs and practices influence health behavior and access to care. PTs must be culturally sensitive and respect diverse family needs to improve health outcomes and build trust.

Limited Access = Problems: When access to education, healthcare, and safe environments is limited, individuals face higher risks of chronic conditions, delayed care, and poor health outcomes. PTs can mitigate these issues by providing accessible, community-centered, and culturally sensitive care

Question 29

presentation: impacts of screen time

Answer 29

Average screen time:
* Children (4-7 years): 2-4 hours per day
* Children (8-12 years): 4-6 hours per day
* Teens (13-18 years): ~9 hours per day
* Impacts of excessive screen time:
* Physical: Decreased physical activity, increased risk of obesity, musculoskeletal issues due to poor posture.
* Psychological: Increased risks of anxiety, depression, sleep disturbances, and attention problems.
* Cognitive: Decreased memory retention and impaired academic performance due to overstimulation from screens.
* Recommendations for screen time by age:
* Children under 2 years: Avoid screen time altogether.
* Children aged 2-5 years: Limit to no more than 1 hour per day.
* Older children and teens: Encourage breaks every 30 minutes of screen use and promote a balance with physical activity.
* Concerns about too much screen time: If children are not physically or mentally active, they are at higher risk for health problems such as obesity, postural issues, and mental health conditions. Excessive passive screen use can also lead to decreased social interaction and emotional functioning.
* Cultural Sensitivity: Tailor recommendations to specific family practices and beliefs to improve adherence to screen time limits and encourage healthier habits.

Question 30

Presentation: food insecurity

Answer 30

• Prevalence:
  
  • In 2023, 13.5% of U.S. households were food-insecure.
  • 17.9% of households with children experienced food insecurity.
  • Food insecurity can vary in severity, from reduced food quality to disrupted eating patterns.
  • Appearance of Food Insecurity:
  • Food deserts (areas lacking access to healthy food) and food swamps (areas flooded with unhealthy food) are prevalent, particularly in low-income and minority communities.
  • It can manifest as anxiety over food availability, reduced food variety, and disruptions in eating patterns.
  • Link to Obesity:
  • Food insecurity is paradoxically linked to increased risk of obesity. Families may rely on cheaper, calorie-dense, and nutrient-poor foods, leading to malnutrition and excess weight gain.
  • Malnutrition:
  • Malnutrition does not always mean someone is underweight. Individuals with food insecurity may consume unhealthy diets that are high in calories but low in essential nutrients, leading to hidden malnutrition despite appearing to be at a healthy or even overweight size.
  • Impact of Excessive Screen Time:
  • There are also correlations between food insecurity and lower physical activity, which can further exacerbate health issues like obesity and chronic conditions.

Question 31

Presentation: women health

Answer 31

• Maternal Mortality:
  
  • In Texas, the maternal mortality rate is 27.7% per 100,000 births within 2 months after birth.
  • This rate is 2-3 times worse for Black women compared to other groups, highlighting racial disparities in maternal health.
  • Disparities in Women’s Health and PT:
  • Racial disparities in access to healthcare and maternal outcomes.
  • Black women face higher risks of complications during and after pregnancy.
  • PT services can help address issues like pelvic floor dysfunction and postpartum recovery, which are common but often under-addressed in minority populations.
  • Focus on Chronic Conditions:
  • Women are more prone to conditions like osteoporosis, pelvic floor dysfunction, and breast cancer. PT plays a role in managing these conditions through strength training, balance exercises, and post-operative care (e.g., for mastectomy patients).
  • Pelvic Floor Therapy (PFPT):
  • A significant area for women’s health, PFPT helps address postpartum incontinence, pelvic pain, and organ prolapse, with treatments including exercises, biofeedback, and manual therapy.

(women’s health concerns are often dismissed as general or unexplained pain, when in fact, they may be signs of underlying conditions such as endometriosis, pelvic floor dysfunction, or hormonal imbalances. These conditions frequently go undiagnosed or are delayed in diagnosis, with women’s pain being minimized or attributed to normal life changes.)

Question 32

presentation: single sport specialty

Answer 32

• Definition: Single-sport specialization is characterized by intensive training in one sport for more than 8 months a year, often excluding participation in other sports, particularly in prepubertal children.
  
  • Risks:
  • Increases the likelihood of overuse injuries and burnout.
  • Leads to decreased athletic development over time due to lack of diverse movement patterns and muscle group engagement.
  • Associated with higher dropout rates and mental health issues, such as anxiety and lack of enjoyment.
  • Statistics:
  • Athletes from higher-income families are more likely to specialize early.
  • Those who specialize before age 12 have a greater risk of injury and lower overall athletic performance in adulthood.
  • Benefits:
  • Some sports, like gymnastics and dance, where peak performance occurs at a younger age, can benefit from early specialization by developing niche skills through repetition.
  • Is it beneficial?:
  • Not typically beneficial for most sports. Single-sport specialization before age 12 increases the risk of overuse injuries, burnout, and mental health issues like anxiety and lack of motivation.
  • It can be beneficial for sports that peak early (e.g., gymnastics, dance, hockey), allowing athletes to develop niche skills through repetition.
  • When is it beneficial/not beneficial?:
  • Beneficial: In sports requiring early peak performance (e.g., gymnastics, figure skating), where early specialization helps develop advanced skills.
  • Not beneficial: For most other sports, as early specialization can hinder overall athletic development and expose children to higher risks of injury and burnout.
  • Recommendations for rest:
  • Athletes should have scheduled rest periods to reduce the risk of overuse injuries. It’s recommended to limit training to less than 8 months a year in a single sport and incorporate off-seasons to allow recovery.
  • Encouraging multi-sport participation is recommended to enhance overall motor skills, reduce repetitive stress, and promote long-term physical activity.

Question 33

Presentation: childhood obesity

Answer 33

• Prevalence: Obesity rates are highest among Hispanic children (26.2%) and non-Hispanic Black children (24.8%). Children from lower-income families are more likely to be obese.
  
  • Genetics: Genetics contribute significantly, with research showing that 50% of childhood obesity cases have a genetic component, linked to up to 500 specific genes.
  • Not just overeating: While overeating plays a role, obesity is not solely caused by food intake. Children with obesity must also be mindful of what they are eating, as nutrition quality is key.
  • Multidisciplinary treatment: Addressing childhood obesity requires a multidisciplinary approach, involving physical activity, nutrition, family support, and medical interventions such as FDA-approved medications or surgeries in severe cases.
  • Recommendations for rest and activity: Physical activity is crucial in managing obesity, but rest and monitoring (e.g., for asthma, diabetes) during exercise are important for safety.