Pediatric Physical Therapy:
Clinical Bottom Line
The authors declare no conflicts of interest.
“How should I apply this information?”
The authors included valid and reliable measurements that were feasible, portable, and could be easily administered in a school setting for children who are overweight (OW)/obese. They propose that understanding differences in muscular strength in children who are OW/obese and of healthy weight (HW) is essential when designing safe and effective interventions for these children. According to the authors, handgrip is one of the most reliable clinical measures of strength, is an indicator of general health, and closely represents total body strength. The lack of significant differences in this measurement between children who are OW/obese and those who are of HW may indicate that overall decreased strength is not a prevalent finding related to obesity at this age. The differences found in step width, one-leg balance, and propulsive strength may indicate that focus on these areas of assessment and intervention in young children who are OW/obese is warranted. However, changes in step width may reflect the typical gait for subjects with these anthropomorphic characteristics. That is, working on this feature of gait may not yield change if step width is a function of the children's anthropomorphic characteristics.
“What should I be mindful about in applying the in formation?”
Although this study included a total of 29 children in the OW/obese category, only 7 were classified as obese. Thus, these findings may not apply to the obese young population. In addition, using the vertical jump as a measure of propulsive strength may not adequately take into account body weight of a child, underestimating lower extremity strength when the difference is really in the child's strength-to-weight ratio. Finally, although these findings may indicate decreased strength or postural control, it is unknown whether the weight of the child is contributing to these findings or whether these findings are contributing to the outcome of OW/obesity.
Deanne Fay, PT, DPT, MS, PCS
A.T. Still University
Linda Fetters, PT, PhD, FAPTA
University of Southern California
Los Angles, California
© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.