- Email: [email protected]
Modified-Shuttle-Test-Paeds: a valid cardiorespiratory fitness measure for children
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237
sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Results: Half (n = 33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, a quarter had prior training specific to working with overweight or obese children. Most physiotherapists used multi-disciplinary models (n = 16, 76%) and provided under 5-hours of obesity-related services each week (n = 29, 88%). Half (n = 16, 49%) used Body-Mass-Index as an outcome measure but more (n = 25, 76%) used bodyweight. Only 14 (42%) assessed motor-skills. The majority of respondents (n = 57, 89%) indicated a need for physiotherapy guidelines to best manage overweight and obese children. Professional development priorities included; ‘Educating children and families’, ‘Assessment methods’ and ‘Exercise prescription’ for overweight and obese children. Conclusion(s): Limited clinical time is allocated by physiotherapists to address the needs of overweight and or obese children in Australia. A large majority of all respondents indicated a need for physiotherapy-specific clinical guidelines to best manage overweight and obese children. Implications: This data provides workforce intelligence to guide future professional training and inform development of clinical guidelines for physiotherapists in prevention and management of children with obesity and related chronic disease. Keywords: Paediatrics; Child obesity; Clinical practice Funding acknowledgements: NIL. Ethics approval: Bond University Human Research Ethics Committee – RO: 1144. http://dx.doi.org/10.1016/j.physio.2015.03.1874 Research Report Platform Presentation Number: RR-PL-3510 Monday 4 May 2015 16:51 Hall 405 MODIFIED-SHUTTLE-TEST-PAEDS: A VALID CARDIORESPIRATORY FITNESS MEASURE FOR CHILDREN N. Milne 1 , M. Simmonds 2 , W. Hng 1 1 Bond
University, Physiotherapy Department, Robina, Australia; 2 Griffith University, Heart Foundation Research Centre, Gold Coast, Australia Background: Over the last 30 years, population-wide surveys have consistently indicated increased adiposity and decreased cardiorespiratory fitness (CRF) in paediatric populations, with approximately 0.5% and 1% per year reductions in performance on field-based CRF tests for children and adolescents respectively. Difficulty performing functional weight-bearing activities limits involvement in recreational physical activity such as lunch-time play, and/or organised sport, further compounding the decreased CRF fitness of
eS1009
these children. With accumulating evidence that exercise capacity decreases all-cause mortality independent of adiposity, there are clear benefits to be gained through the development of CRF measures that are specifically and sensitively designed for use with paediatric populations. Such tools could assist with detecting children who would benefit from early intervention to improve CRF and prevent subsequent health impairments. Peak oxygen uptake (VO2peak), is widely accepted as a valid marker of CRF in children but requires expensive equipment and specialist skills to collect and analyse the data. The 20-Metre-Multistage-shuttlerunning-test (20mMSRT) is popular due to its practical use for simultaneous measurement but take’s up to 20 min to complete and its “drop-out” nature, exposes children who are less fit to potential for stigmatisation by peers. The ModifiedShuttle-Test-Paeds (MSTP) has been sensitively designed to address the limitations of current CRF testing methods. It involves a task-oriented approach while the child runs a 10-metre shuttle, picking up a hand-held bean bag, turning around and returning to the start point to place the bean bag in a tray. This is repeated as many times as possible in 3 minutes. The test can be performed individually or in class groups, whereby all children are instructed to perform at maximal effort for the full 3-minutes. Purpose: This study aimed to: (1) Test the concurrent and predictive validity of the Modified Shuttle Test-Paeds (MSTP) as a newly designed measure of cardiorespiratory fitness in children that does not require ‘drop-out’ for completion, against the gold standard reference – peak oxygen uptake (VO2 peak) and; (2) Contrast the strength of the relationship between the MSTP and VO2 peak, with that of the commonly used 20 m Multi-Stage-Running-Test (20m-MSRT). Methods: A concurrent validation study design utilising a convenience sample of 25 school-aged children (age: 6–16 yr; male/female: 19/5; BMI: 21 ± 9 kg/m2 ) was employed. Physical measures included: Bruininks–Oseretsky Test of Motor Proficiency-2nd Edition (BOT2), VO2 peak, 20m-MSRT and MSTP, body composition and basic anthropometry. Results: Mean cardiorespiratory fitness results included: VO2 peak: 43.8 ± 11.2 (mL/kg/min); 20 m MSRT: 5.48 ± 2.96 (level); MSTP: 22.10 ± 3.05 (no.). A significant and strong correlation existed between VO2 peak and MSTP (r2 = 0.749, p < 0.01). The relationship between VO2 peak and 20m-MSRT was significant and moderately strong (r2 = 0.486, p < 0.001). Conclusion(s): The MSTP is a valid measure of cardiorespiratory fitness with a high predictive validity for estimating VO2 peak in children, using a simple equation that is clinically applicable. Implications: The MSTP may be considered an alternative measure for predicting VO2 peak, especially in environments where there are sensitivities to measuring cardiorespiratory fitness in children with diverse fitness abilities (e.g. school environments) or limited space is available.
eS1010
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237
Keywords: Children; Cardiorespiratory fitness; Assessment Funding acknowledgements: Nil. Ethics approval: Bond University Human Research Ethics Committee – RO1601. http://dx.doi.org/10.1016/j.physio.2015.03.1875 Research Report Poster Presentation Number: RR-PO-09-11-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 FACTORS ASSOCIATED WITH KNEE PAIN FROM OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS K. Minamiarita, R. Tanaka, N. Kito Hiroshima International University, Higashihiroshima, Japan Background: Knee osteoarthritis (knee OA) is a leading cause of functional impairment and pain. A main symptom of knee OA is pain during movement, which results in limitations of activities and participation. Physical therapy is often used in daily clinical practice. However, the pain is not reduced in some patients, even with physical therapy. The mechanism underlying knee pain from OA is unclear. Purpose: The aim of this systematic review and metaanalysis was to determine factors that are associated with pain evidence-based medicine. Methods: The study design was a meta-analysis of observational studies. The search strategy was conducted using the electronic databases: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and PubMed databases. A study was included if (1) study participants were adults (ages >18 years, sex, and any symptom duration) with knee OA that was classified by clinical or radiographic reference standards (e.g., American College of Rheumatology), (2) outcomes were physical factors, which were measured by questionnaires and pain reports that were evaluated with recognized instruments, such as the Western Ontario and McMaster Universities Osteoarthritis Index or visual analog scales, (3) it was observational, (4) statistical analyses were performed on the relationships between physical factors and pain intensity, (5) all measures used in the study can be used in clinical settings and do not require sophisticated equipment or complex analyses. The outcome measurements were assessed by Pearson product-moment correlation coefficients. Statistically significant analyses of the correlation coefficients were interpreted with p values and 95% confidence intervals, and where p
values of <0.05 were considered as statistically significant. Statistical heterogeneity was assessed using the I2 . Results: In total, 22 studies were considered eligible after the review of 576 studies. The factors examined in this study included body functions (14 items), structures (two items), activities and participation (six items), and personal and other factors (six items). The outcomes that were significantly associated with pain were three body functions items (hip joint internal rotation range of motion, knee flexion range of motion, and knee extension muscular strength), two structure items [lower limb alignment and body mass index (BMI)], three activity and participation items (stairs up, stairs down, and total activity), and two personal factor items (age and sex). In particular, knee flexion range of motion, knee extension muscular strength, lower limb alignment, BMI, stairs up, stairs down, total activity, age, and sex were included in the meta-analysis. The meta-analysis results indicated the following moderate correlations that were statistically significant: knee flexion range of motion, −0.272 (−0.402 to 0.133, 0%); knee extension muscular strength, −0.302 (−0.510 to 0.06, 63%); BMI, 0.228 (0.070–0.375, 56%); stairs up, 0.439 (0.259–0.590, 0%); and stairs down, 0.447 (0.268–0.596, 0%). Conclusion(s): The results demonstrated the potential factors that are associated with knee pain from OA. Implications: Objective factors that are related to knee pain from OA can be used to choose appropriate interventions and use medical resources efficiently. Furthermore, these findings provide information for more accurate clinical decision-making for clinicians. Keywords: Knee osteoarthritis; Pain; Meta-analysis Funding acknowledgements: Our review was not funded. Ethics approval: This study was undertaken with the approval of the Ethics Committee of Human Research, Hiroshima International University (No. 14-73). http://dx.doi.org/10.1016/j.physio.2015.03.1876 Research Report Poster Presentation Number: RR-PO-21-21-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 SEX DIFFERENCES IN LOWER LIMB ALIGNMENT, RANGE OF JOINT MOTION AND SPORTS INJURIES IN UNIVERSITY ATHLETES IN JAPAN Y. Mitani Kansai University of Welfare Sciences, Osaka, Japan Background: Lower limb alignment and the range of joint motion are believed to affect the occurrence of sports injuries. The characteristics of alignment and range of joint motion of the lower limb in both sexes are conceivably factors that can
sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Results: Half (n = 33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, a quarter had prior training specific to working with overweight or obese children. Most physiotherapists used multi-disciplinary models (n = 16, 76%) and provided under 5-hours of obesity-related services each week (n = 29, 88%). Half (n = 16, 49%) used Body-Mass-Index as an outcome measure but more (n = 25, 76%) used bodyweight. Only 14 (42%) assessed motor-skills. The majority of respondents (n = 57, 89%) indicated a need for physiotherapy guidelines to best manage overweight and obese children. Professional development priorities included; ‘Educating children and families’, ‘Assessment methods’ and ‘Exercise prescription’ for overweight and obese children. Conclusion(s): Limited clinical time is allocated by physiotherapists to address the needs of overweight and or obese children in Australia. A large majority of all respondents indicated a need for physiotherapy-specific clinical guidelines to best manage overweight and obese children. Implications: This data provides workforce intelligence to guide future professional training and inform development of clinical guidelines for physiotherapists in prevention and management of children with obesity and related chronic disease. Keywords: Paediatrics; Child obesity; Clinical practice Funding acknowledgements: NIL. Ethics approval: Bond University Human Research Ethics Committee – RO: 1144. http://dx.doi.org/10.1016/j.physio.2015.03.1874 Research Report Platform Presentation Number: RR-PL-3510 Monday 4 May 2015 16:51 Hall 405 MODIFIED-SHUTTLE-TEST-PAEDS: A VALID CARDIORESPIRATORY FITNESS MEASURE FOR CHILDREN N. Milne 1 , M. Simmonds 2 , W. Hng 1 1 Bond
University, Physiotherapy Department, Robina, Australia; 2 Griffith University, Heart Foundation Research Centre, Gold Coast, Australia Background: Over the last 30 years, population-wide surveys have consistently indicated increased adiposity and decreased cardiorespiratory fitness (CRF) in paediatric populations, with approximately 0.5% and 1% per year reductions in performance on field-based CRF tests for children and adolescents respectively. Difficulty performing functional weight-bearing activities limits involvement in recreational physical activity such as lunch-time play, and/or organised sport, further compounding the decreased CRF fitness of
eS1009
these children. With accumulating evidence that exercise capacity decreases all-cause mortality independent of adiposity, there are clear benefits to be gained through the development of CRF measures that are specifically and sensitively designed for use with paediatric populations. Such tools could assist with detecting children who would benefit from early intervention to improve CRF and prevent subsequent health impairments. Peak oxygen uptake (VO2peak), is widely accepted as a valid marker of CRF in children but requires expensive equipment and specialist skills to collect and analyse the data. The 20-Metre-Multistage-shuttlerunning-test (20mMSRT) is popular due to its practical use for simultaneous measurement but take’s up to 20 min to complete and its “drop-out” nature, exposes children who are less fit to potential for stigmatisation by peers. The ModifiedShuttle-Test-Paeds (MSTP) has been sensitively designed to address the limitations of current CRF testing methods. It involves a task-oriented approach while the child runs a 10-metre shuttle, picking up a hand-held bean bag, turning around and returning to the start point to place the bean bag in a tray. This is repeated as many times as possible in 3 minutes. The test can be performed individually or in class groups, whereby all children are instructed to perform at maximal effort for the full 3-minutes. Purpose: This study aimed to: (1) Test the concurrent and predictive validity of the Modified Shuttle Test-Paeds (MSTP) as a newly designed measure of cardiorespiratory fitness in children that does not require ‘drop-out’ for completion, against the gold standard reference – peak oxygen uptake (VO2 peak) and; (2) Contrast the strength of the relationship between the MSTP and VO2 peak, with that of the commonly used 20 m Multi-Stage-Running-Test (20m-MSRT). Methods: A concurrent validation study design utilising a convenience sample of 25 school-aged children (age: 6–16 yr; male/female: 19/5; BMI: 21 ± 9 kg/m2 ) was employed. Physical measures included: Bruininks–Oseretsky Test of Motor Proficiency-2nd Edition (BOT2), VO2 peak, 20m-MSRT and MSTP, body composition and basic anthropometry. Results: Mean cardiorespiratory fitness results included: VO2 peak: 43.8 ± 11.2 (mL/kg/min); 20 m MSRT: 5.48 ± 2.96 (level); MSTP: 22.10 ± 3.05 (no.). A significant and strong correlation existed between VO2 peak and MSTP (r2 = 0.749, p < 0.01). The relationship between VO2 peak and 20m-MSRT was significant and moderately strong (r2 = 0.486, p < 0.001). Conclusion(s): The MSTP is a valid measure of cardiorespiratory fitness with a high predictive validity for estimating VO2 peak in children, using a simple equation that is clinically applicable. Implications: The MSTP may be considered an alternative measure for predicting VO2 peak, especially in environments where there are sensitivities to measuring cardiorespiratory fitness in children with diverse fitness abilities (e.g. school environments) or limited space is available.
eS1010
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237
Keywords: Children; Cardiorespiratory fitness; Assessment Funding acknowledgements: Nil. Ethics approval: Bond University Human Research Ethics Committee – RO1601. http://dx.doi.org/10.1016/j.physio.2015.03.1875 Research Report Poster Presentation Number: RR-PO-09-11-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 FACTORS ASSOCIATED WITH KNEE PAIN FROM OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS K. Minamiarita, R. Tanaka, N. Kito Hiroshima International University, Higashihiroshima, Japan Background: Knee osteoarthritis (knee OA) is a leading cause of functional impairment and pain. A main symptom of knee OA is pain during movement, which results in limitations of activities and participation. Physical therapy is often used in daily clinical practice. However, the pain is not reduced in some patients, even with physical therapy. The mechanism underlying knee pain from OA is unclear. Purpose: The aim of this systematic review and metaanalysis was to determine factors that are associated with pain evidence-based medicine. Methods: The study design was a meta-analysis of observational studies. The search strategy was conducted using the electronic databases: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and PubMed databases. A study was included if (1) study participants were adults (ages >18 years, sex, and any symptom duration) with knee OA that was classified by clinical or radiographic reference standards (e.g., American College of Rheumatology), (2) outcomes were physical factors, which were measured by questionnaires and pain reports that were evaluated with recognized instruments, such as the Western Ontario and McMaster Universities Osteoarthritis Index or visual analog scales, (3) it was observational, (4) statistical analyses were performed on the relationships between physical factors and pain intensity, (5) all measures used in the study can be used in clinical settings and do not require sophisticated equipment or complex analyses. The outcome measurements were assessed by Pearson product-moment correlation coefficients. Statistically significant analyses of the correlation coefficients were interpreted with p values and 95% confidence intervals, and where p
values of <0.05 were considered as statistically significant. Statistical heterogeneity was assessed using the I2 . Results: In total, 22 studies were considered eligible after the review of 576 studies. The factors examined in this study included body functions (14 items), structures (two items), activities and participation (six items), and personal and other factors (six items). The outcomes that were significantly associated with pain were three body functions items (hip joint internal rotation range of motion, knee flexion range of motion, and knee extension muscular strength), two structure items [lower limb alignment and body mass index (BMI)], three activity and participation items (stairs up, stairs down, and total activity), and two personal factor items (age and sex). In particular, knee flexion range of motion, knee extension muscular strength, lower limb alignment, BMI, stairs up, stairs down, total activity, age, and sex were included in the meta-analysis. The meta-analysis results indicated the following moderate correlations that were statistically significant: knee flexion range of motion, −0.272 (−0.402 to 0.133, 0%); knee extension muscular strength, −0.302 (−0.510 to 0.06, 63%); BMI, 0.228 (0.070–0.375, 56%); stairs up, 0.439 (0.259–0.590, 0%); and stairs down, 0.447 (0.268–0.596, 0%). Conclusion(s): The results demonstrated the potential factors that are associated with knee pain from OA. Implications: Objective factors that are related to knee pain from OA can be used to choose appropriate interventions and use medical resources efficiently. Furthermore, these findings provide information for more accurate clinical decision-making for clinicians. Keywords: Knee osteoarthritis; Pain; Meta-analysis Funding acknowledgements: Our review was not funded. Ethics approval: This study was undertaken with the approval of the Ethics Committee of Human Research, Hiroshima International University (No. 14-73). http://dx.doi.org/10.1016/j.physio.2015.03.1876 Research Report Poster Presentation Number: RR-PO-21-21-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 SEX DIFFERENCES IN LOWER LIMB ALIGNMENT, RANGE OF JOINT MOTION AND SPORTS INJURIES IN UNIVERSITY ATHLETES IN JAPAN Y. Mitani Kansai University of Welfare Sciences, Osaka, Japan Background: Lower limb alignment and the range of joint motion are believed to affect the occurrence of sports injuries. The characteristics of alignment and range of joint motion of the lower limb in both sexes are conceivably factors that can