Explainers

Physical Activity in Children and the Role of the Healthcare Professional


Introduction

Regular physical activity promotes the growth and development of children and has multiple benefits on their physical, mental and psychosocial health. It is becoming increasingly evident that the promotion of health-enhancing behaviours must start early in life, as they carry many short and long-term health benefits (Hallal et al. 2006).

Physical activity not only improves the physical fitness of an individual, but it has also been shown to influence many developmental processes associated with maturation (Institute of Medicine et al . n.d.). Here, physical activity has a positive effect on the skeleton, muscles, fat distribution and respiratory system, showing that structural and functional adaptations in children can be benefitted with regular bouts of physical activity.

Physical activity also actively benefits the mental and cognitive health of a child. Research has shown that physical activity positively benefits emotional wellbeing, and may help reduce symptoms of depression and anxiety in children (Ahn et al. 2011). Through practice and instruction during physical activity, a child can also better learn the fundamental movement skills as well as improving learning and attention abilities (Fisher et al. 2005).

The Effect of a Sedentary Childhood

Technological advances of modern society have contributed to a sedentary lifestyle with the children of today having higher body mass indexes (BMIs) than their peers of just a generation earlier (Ogden et al. 2012). If a child has a body composition that is high in fat then there is a tendency for this to follow them through to adolescence and into adulthood. A child’s increased fat mass is undoubtedly due to the mismatch between energy intake and energy expenditure.

Population surveys have shown that very few children meet recommended levels of daily physical activity. An ideal weight can be simply maintained by regular physical activity: this reduces body fat and increases fat-free mass. Even in the absence of significant weight loss, exercise has the benefit of reducing the risk of developing cardiometabolic disease later in life.

Sedentary behaviour can also influence the mental health of children. Children who are sedentary are consistently associated with poorer mental health scores (Biddle et al. 2011). This includes higher rates of anxiety, depression, sleep disturbances and attention deficit problems. Sedentary behaviours can also negatively affect the development of creativity, which can have a knock-on effect on their academic performance in school.

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Role of the Healthcare Worker

Healthcare professionals are well placed to support general practitioners in relation to undertaking coordinated screening programs to help develop and maintain healthy child development within a population. The evidence for the health benefits of physical activity is irrefutable and there is growing evidence that there are long-term effects on morbidity and mortality rates in later life. Therefore, the promotion of health-enhancing behaviours must start early in life.

Healthcare professionals are in a position to stimulate good lifestyle practices and encourage understanding of the basics of aerobic fitness and its relationship with overall health. Physical activity programmes should have physical education at the core, and be supplemented with factors to improve psychosocial outcomes such as social behaviours, goal orientation, and self-efficiency.

Skills and Knowledge

Healthcare workers are on the front line and should be adequately trained on the relationships between physical health and wellbeing and how best to maximise a child’s potential. Continued professional development within the medical profession in the area of developmental health is key. Medical, health and welfare policies within general practice should champion physical education to improve services for children and their families.

Aerobic exercise programs that involve vigorous aerobic activity for 60 minutes at least three days per week should result in observable health-related improvements (Strong et al. 2005). These include favourable associations between aerobic endurance and measures of insulin sensitivity, blood pressure, BMI and measures of fatness. Although physical activities come with a risk of injury, this can be reduced if age-appropriate guidelines are followed.

However, these physical activity programmes must be aligned with the developmental status of a child—such as level of motor skills and exercise capacity. This is to encourage and maintain engagement as well as preventing injury. In addition, through the inclusion of aerobic and resistance exercises these will both address different healthcare concerns as well as providing variation to maintain mental stimulation.

Summary

A child’s aerobic fitness and exercise capacity is well documented to be the foundation of good health, with many chronic adult lifestyle diseases having their origins in childhood. Physical activity in children has also been shown to improve some aspects of mental and cognitive health including learning, academic performance, and mood. In summary, a comprehensive physical activity plan that includes physical education can help reduce sedentary behaviour and improve overall health and wellbeing. Healthcare professionals are ideally placed to meet this need as long as the right training and policies are in place to do so.

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References

  • Ahn, S & Fedewa, AL 2011, ‘A Meta-Analysis of the Relationship Between Children’s Physical Activity and Mental Health’, Journal of Pediatric Psychology, vol. 36, no. 4, pp. 385-97, viewed 3 November 2016, https://www.ncbi.nlm.nih.gov/pubmed/21227908
  • Biddle, SJH & Asare, M 2011, ‘Physical Activity and Mental Health in Children and Adolescents: A Review of Reviews’, British Journal of Sports Medicine, vol. 45, no. 11, pp. 886-95, viewed 3 November 2016, http://bjsm.bmj.com/content/45/11/886.abstract
  • Fisher, A, Reilly, JJ, Kelly, LA, Montgomery, C, Williamson, A, Paton, JY & Grant S 2005, ‘Fundamental Movement Skills and Habitual Physical Activity in Young Children’, Medicine and Science in Sports and Exercise, vol. 37, no. 4, pp. 684-8, viewed 3 November2016, https://www.ncbi.nlm.nih.gov/pubmed/15809570
  • Hallal, PC, Victora, CG, Azevedo, MR & Wells, JC 2006, ‘Adolescent Physical Activity and Health: A Systematic Review’, Sports Medicine (Auckland N.Z.), vol. 36, no. 12, pp. 1019-30, viewed 3 November 2016, https://www.ncbi.nlm.nih.gov/pubmed/17123326
  • Institute of Medicine, Food and Nutrition Board, Committee on Physical Activity and Physical Education in the School Environment, Kohl, WH & Cook, HD (eds) n.d., Educating the Student Body: Taking Physical Activity and Physical Education to School, The National Academies Press, Washington, DC.
  • Ogden, CL, Carroll, MD, Kit, BK & Flegal, KM 2012, ‘Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents 1999-2010’, JAMA: Journal of the American Medical Association, vol. 307, no. 5, pp. 483-90, 3 November 2016, https://www.ncbi.nlm.nih.gov/pubmed/22253364
  • Strong, WB, Malina, RM, Blimkie, CJ, Daniels, SR, Dishman, RK, Gutlin, B, Hergenroeder, AC, Must, A, Nixon, PA, Pivamik, JM, Rowland, T, Trost, S & Trudeau, F 2005, ‘Evidence Based Physical Activity for School-Age Youth’, The Journal of Pediatrics, vol. 146, no. 6, pp. 732-7, viewed 3 November 2016, https://www.ncbi.nlm.nih.gov/pubmed/15973308

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