Transcript Effects of an exercise and education programme on children

Effects of an exercise and
education programme on children
with obesity
Hussey J, Roche E, Croasdell N,
Heraty E, Brennan A, Gormley J, Bell
C, Hoey H
Background
 Ireland,
along with other European Countries, is
experiencing increasing levels of childhood
obesity.
 Obesity in childhood and adolescence is associated
with cardiovascular risk factors such as low
activity levels, low fitness levels, hypertension and
hyperlipidemia
Previous work in children with obesity
(n=45)
 Physical
activity reduced with 69% reporting
engaging in less than minimal recommendation
 Exercise tolerance below minimal normal values in
69%
 Seventy five percent of this group have at least 2
cardiovascular risk factors
 Treatment needs to focus on these in addition to
weight loss
Aim of the study
 To
evaluate the effect of an eight week exercise
and education programme on cardiovascular risk
factors.
 Children along with their parents attended the
Physiotherapy Department weekly where the
children had an hour of exercise ( circuit training
and hydrotherapy) and the parents received
education in the areas of healthy nutrition and
physical activity.
Measures
 BMI
and waist circumference
 Blood pressure
 Exercise tolerance was measured by the modified
Balke treadmill protocol
 Physical activity measured by the modifiable
activity questionnaire for adolescents. Estimates
time spent in light and vigorous activity, time spent
sedentary, energy expended in regular activity
Results



Nine children entered the programme (5 girls and 4 boys)
mean age ( SD) of 10 +/- 1.1 years
BMI before 29.2 +/-3.2 after 28.8+/-3.6
Results- waist circumference
Change in waist circumference with ex
programme
waist circumference
120
100
80
Waist 1
60
waist 2
40
20
0
1
2
3
4
5
subject
6
7
8
9
Results- physical activity levels
Change in activity levels with exercise programme
120
100
METs
80
METs 1
60
METs 2
40
20
0
1
2
3
4
5
subject
6
7
8
9
Results- exercise tolerance
exercise tolerance
Change in exercise tolerance with exercise
programme
50
40
30
ex tol 1
20
ex tol 2
10
0
1
2
3
4
5
subject
6
7
8
9
Results – systolic blood pressure
Systolic blood pressure
BP changes with ex programme
160
140
120
100
80
60
40
20
0
BP syst 1
BP stst 2
1
2
3
4
5
subjects
6
7
8
9
Results
Before
programme
After
programme
p value
BMI
29.2±3.2
28.8 ± 3.6
NS
Waist cm
95.5 ± 8.8
93.7 ± 9.1
P<0.05
EE in regular
activity MET
hr/week
14.4 ± 12.7
36.3 ± 31.1
P<0.01
Est VO2
33.8 ± 4.6
36.5 ± 6.9
NS
Systolic BP
121.4 ± 12.8
115.1 ± 0.2
NS
Conclusion
 This
eight week programme resulted in a
significant increase in reported energy expenditure
in regular activity as measured by METs and a
significant decrease in waist circumference.
 These short term effects may be followed by
longer lasting changes if activity levels are
maintained