Presented at the ACSM's 61st Annual Meeting, 5th World Congress on Exercise is Medicine® and World Congress on the Role of Inflammation in Exercise, Health and Disease, May 2014.
Cincinnati Children's Hospital Medical Center, Children's Hospital Boston, Children's National Medical Center, Helen DeVos Children's Hospital, Children's Hospital Association
Emerging research indicates the critical importance of physical fitness in preventing and/or treating obesity and its co-morbidities. Intervention is essential in the pediatric overweight and obese population to reverse early signs of metabolic disruption, prevent irreversible damage and preserve life expectancy. Our goal was to develop clear recommendations for the implementation of the physical activity component of clinical pediatric weight management programs.
FOCUS on a Fitter Future (FFF), a group created in 2008 by the Children's Hospital Association, has worked to examine the state of care for overweight and obese children and adolescents with a goal of building consensus on performance measurement and quality improvement for pediatric weight management programs. FFF is comprised of a multidisciplinary team of pediatric health care professionals from 23 children's hospitals. The physical activity subgroup of FFF surveyed all members about their respective programs' exercise and physical activity practices, including testing, assessment, counseling and intervention.
With 100% of sites responding to the survey, we noted consistency in general practice but variability in implementation of the various components of member weight management programs. All programs include some component of physical activity assessment and counseling. A majority of programs also focus on measuring aerobic fitness and providing group exercise sessions. Slightly more than half of the programs evaluate other parameters associated with physical fitness. Programs differ in availability of specific resources, assessment tools, interventions, and outcome measures.
Based on this survey, available research, and current practice, the focus group recommends including the following components, when designing and implementing the physical activity element of a pediatric weight management program:
- Exercise testing and assessment
- Body composition assessment
- Measure of physical activity and sedentary behaviors
- Individual exercise counseling sessions
- Group exercise programming
Recommendations for specific elements of each component are also included.