The Benefits and Risks of Disclosure Exercise for Kids and Adults - PowerPoint PPT Presentation

12/12/2015 The Benefits and Risks of Disclosure Exercise for Kids and Adults I, Cindy J. Chang MD, do not have any relevant financial relationships with a commercial interest to disclose. Cindy J. Chang, MD Associate Clinical Professor of Orthopaedic Surgery Associate Clinical Professor of Family and Community Medicine Past President, American Medical Society for Sports Medicine Definitions Objectives • Physical activity : any body • Educate primary care providers so that you movement that results in feel competent in promoting exercise in your energy expenditure patient population ( exercise, ADLs, active • Discuss the many benefits and some potential transportation ) • Exercise : physical activity risks of exercise in your patient population that is planned, • Feel confident that the benefits of physical structured, repetitive with activity far outweigh the possibility of adverse objective to improve or outcomes maintain physical fitness. Physical Activity ≈ Exercise ACSM Position Stand on Prescribing Exercise, MSSE 2011. 1

12/12/2015 How Physically Active Are High School How Much Do 9- to 13-Year-Olds Students? Participate in Physical Activity? 100 Organized 80 Race/Ethnicity Free-Time Activity Activity 60 Percent Black, non-Hispanic 24% 75% 40 Hispanic 26% 75% 23.7 17.1 18.5 White, non-Hispanic 47% 79% 20 15.5 14.9 10.5 Total 39% 77% 0 Total Female Male White Black Hispanic • Were physically active doing any kind of physical activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes/day during the 7 days before the survey. • Source: MMWR 2003;52(33):785–8. Source: National Youth Risk Behavior Survey, 2007. 2

12/12/2015 Physical Activity Guidelines for Physical Activity Guidelines for Children and Adolescents Children and Adolescents • Promotes health and fitness • Builds healthy bones and muscles • Reduces the risk of developing obesity and risk factors for diseases such as type 2 diabetes and heart disease • Reduces the symptoms of anxiety and depression • Can positively affect concentration, Be Active and Play, 60 minutes, every day! memory, and classroom behavior HHS. Physical Activity Guidelines Advisory Committee Report 2008 Strong WB et al. J Pediatr 2005 Types of Moderate- and Vigorous- Physical Activity Guidelines for Intensity Aerobic Activities Children and Adolescents Type of Age Group • 60 minutes or more of physical activity daily Physical Activity Children Adolescents – Aerobic : Most of the 60 or more minutes should be either • • Moderate- Active recreation, such as hiking, Active recreation, such as canoeing, skateboarding, rollerblading hiking, skateboarding, rollerblading intensity moderate or vigorous intensity aerobic physical activity. • • Bicycle riding Brisk walking aerobic • • Brisk walking Bicycle riding (stationary or road bike) Include vigorous intensity at least 3 days per week • Housework and yard work, such as – Muscle strengthening: Include these on at least 3 days of sweeping or pushing a lawn mower • Games that require catching and throwing, such as baseball and softball the week as part of the 60 or more minutes – Bone strengthening: Include these on at least 3 days of • • Active games involving running and Active games involving running and Vigorous- chasing, such as tag chasing, such as flag football intensity • • the week as part of the 60 or more minutes Bicycle riding Bicycle riding aerobic • • Jumping rope Jumping rope • • Martial arts, such as karate Martial arts, such as karate • • Running Running • • Sports such as soccer, ice or field Sports such as soccer, ice or field hockey, basketball, swimming, tennis hockey, basketball, swimming, tennis • • Cross-country skiing Vigorous dancing Cross-country skiing Activities should be age-appropriate, enjoyable, and offer variety! 3

12/12/2015 Types of Bone-Strengthening Activities Types of Muscle-Strengthening Activities Age Group Type of Physical Activity Age Group Type of Physical Children Adolescents Activity Children Adolescents • • Games such as tug-of- Muscle-strengthening Games such as tug-of- war war • Games such as • Hopping, skipping, Bone-strengthening • • Push-ups and pull-ups Modified push-ups (with hopscotch jumping knees on the floor) • Resistance exercises • Hopping, skipping, • Jumping rope • Resistance exercises with exercise bands, jumping • Running using body weight or weight machines, hand- • Jumping rope • Sports such as resistance bands held weights • Running • • Climbing wall gymnastics, Rope or tree climbing basketball, • Sports such as • • Sit-ups (curl-ups or Sit-ups (curl-ups or volleyball, tennis crunches) crunches) gymnastics, • basketball, Swinging on playground volleyball, tennis equipment/bars How Physically Active Are How Physically Active Are High School Students? High School Students? 70 60 60 50 50 40 40 Total Male White 30 30 21.9 Black Female 20 20 Hispanic 15.3 16.9 15 11.8 8.4 10 10 0 Aerobic MMStrength Both 0 aerobic MM Both Strengthening CDC MMWR June 2011, National Youth Physical Activity and Nutrition Study CDC MMWR June 2011, National Youth Physical Activity and Nutrition Study 4

12/12/2015 How Physically Active Are Meeting the Guidelines High School Students? 60 • Youth Who Don’t Meet the Guidelines – Slowly increase activity in small steps 50 – Participate in enjoyable activities 45.2 40 • Youth Who Meet the Guidelines Underwt/Nl – Continue being active on a daily basis 30 Overweight – Work toward becoming more active Obese 20 • Youth Who Exceed the Guidelines 10.7 10 7.3 – Maintain activity level – Vary the kinds of activities to reduce the risk of injury 0 Aerobic MM Strength Both CDC MMWR June 2011, National Youth Physical Activity and Nutrition Study C.H. as an 8 year old child C.H. as a 13 year old child • Walks to and from school • • Walks to and from school Total physical activity time = • Total physical activity – 5 minutes round trip 170-200 min/day – 2 miles (40 minutes) round trip • – Vigorous intensity: PE class time = 70-170 min/day • PE class – Excused due to extracurricular – Mod-Vigorous intensity: • Soccer, basketball – Jumping jacks, kickball for 20 • Soccer, tag, biking sports – Muscle strengthening: • – Muscle strengthening: minutes 2x/wk Lunchtime • Core strengthening • Recess and lunchtime – Plays basketball 15 min/day • Monkey bars, swinging – Bone strengthening: • – Bone strengthening: – Plays tag, climbs on playground set, • Volleyball, basketball, Afterschool sports – Volleyball, basketball or softball 60- • Jumping jacks, gymnastics, running (soccer) monkey bars, swingset every day soccer (running) for 20 minutes total a day 90 min/day (practices or games) • Soccer on club team 5d/wk • Soccer on club team – 90 minutes 2x/wk practice – 90 minutes 3x/wk practice – 40 minutes 1/wk game (weekend) – 60 minutes 1-2x/wk games • Recreational gymnastics (weekend) – • 90 minutes 2x/wk Rec basketball (winter) or rec softball • Bicycle riding (spring) – 90 min 2x/wk practices, 1 90 min – 60 minutes 1/wk (weekend) game per weekend 5

12/12/2015 Overuse Injuries and *Is this too much? Burnout in Youth Sports *How much is too much? • Which young athletes • What risk factors and *What is the balance between sport are at risk for overuse symptoms are specialization and sport diversification? injuries? associated with • Which risk factors and burnout? *What about the risk of overtraining and • How can we prevent injuries are unique? burnout? The risk of overuse injuries? • Which specific high-risk overuse injuries? *What happened to free play? overuse injuries can present as management *Is there anyone to free play with? challenges and/or can lead to long-term health consequences? Are the parents nuts???? AMSSM Consensus Statement BJSM 2014 Apophyseal Injuries What is an overuse injury? • Specific tendon attachment • An injury of the musculoskeletal system due to associated with underlying growth plate repetitive submaximal loading, when rest is • Weaker than muscle-tendon not adequate to allow for structural unit adaptation to take place. • Acute – muscle-tendon unit, bursa, neurovascular – Sudden forceful contraction or eccentric contraction structure, articular cartilage, bone and physis • Chronic – Apophyseal injuries and physeal stress injuries are – Repetitive stress to maturing unique to young athletes apophysis • Growth Spurts AMSSM Consensus Statement BJSM 2014 6