Effect of detraining on bone and muscle tissue in subjects with chronic spinal cord injury after a period of electrically-stimulated cycling: a small cohort study

Objective: To investigate adaptive changes in bone and muscle parameters in the paralysed limbs after de-training or reduced functional electrical stimulation (FES) induced cycling following high-volume FES-cycling in chronic spinal cord injury (SCI). Subjects: Five subjects with motor-sensory complete SCI (age 38.6 years, lesion duration 11.4 years) were included. Four subjects stopped FES-cycling completely after the training phase whereas one continued reduced FES-cycling (2-3 times/week, for 30min). Methods: Bone and muscle parameters were assessed in the legs using peripheral quantitative computed tomography at six and twelve months after cessation of high-volume FES-cycling. Results: Gains achieved in the distal femur by high-volume FES-cycling were partly maintained at one year of detraining: 73.0% in trabecular bone mineral density (BMD), 63.8% in total BMD, 59.4% in bone mineral content and 22.1% in muscle cross-sectional area (CSAmuscle) in the thigh. The subject who continued reduced FES-cycling maintained 96.2% and 95.0% of the previous gain in total and trabecu-lar BMD, and 98.5% in CSAmuscle. Conclusion: Bone and muscle benefits achieved by one year of high-volume FES-cycling are partly preserved after 12 months of detraining whereas reduced cycling maintains bone and muscle mass gained. This suggests that high-volume FES-cycling has clinical relevance for at least 1y after detraining

Association of physical activity with adiposity in preschoolers using different clinical adiposity measures: a cross-sectional study.

More research is needed about the association between physical activity (PA), sedentary behaviour (SB), and adiposity in preschoolers, particularly using more direct clinical measures of adiposity. Therefore, the main objective of this study was to investigate the association between objectively measured PA and different clinical adiposity measures in a large sample of preschoolers. Four hundred sixty-three predominantly normal-weight (77%) 2-6-year-old preschool children participated in the Swiss Preschoolers' Health Study (SPLASHY). Physical activity was measured using accelerometers and was analyzed using 15-s (uni-axial) epoch length using validated cut-offs. Adiposity measures included body mass index (BMI), the sum of four skinfolds, and waist circumference (WC). Multilevel linear regression modeling, adjusted for age, sex and wear time, was used to assess the association between PA and SB with BMI, WC, and skinfold thickness. Total PA and different PA intensities were positively and SB was inversely associated with BMI in the total sample and in the normal-weight children (p < 0.05). Total PA was inversely associated with skinfold thickness in overweight and obese children (p < 0.05), while there was only a weak association for vigorous PA (p > 0.05). Moderate and moderate-to-vigorous PA were positively, and SB was negatively associated with WC in the total sample and in the normal-weight children (p < 0.05). Additional adjustment for potential sociocultural and biological confounding variables attenuated some of the results. In this very young and predominantly normal-weight population, PA is positively related to BMI and WC, but this relationship is not observed in overweight and obese children. In this latter population, PA is inversely, and SB is positively related to skinfold thickness. Skinfold thickness could represent a useful and simple clinical measure of body fat in preschoolers. The role of vigorous PA in the prevention of early childhood obesity should be further investigated in future studies. ISRCTN ISRCTN41045021 . Retrospectively registered 06 May 2014

Emotional eating is related with temperament but not with stress biomarkers in preschool children.

Emotional eating (EE) corresponds to a change in eating behavior in response to distress and results in an increase of food intake (overeating (EOE)) or in food avoidance (undereating (EUE)). EE has been related to temperament (i.e. negative emotionality) and dysregulated stress biomarkers in school-aged children; parenting has been understood to influence this relationship in older children. The aim of the study was to investigate to which extent stress biomarkers and negative emotionality are related to EE and to understand the role of parenting in this relationship. The sample consisted of 271 children aged 2-6 years of the Swiss cohort study SPLASHY. We assessed the child's EE, negative emotionality and parenting by parent based reports. Salivary samples were collected over two days to analyze cortisol and salivary alpha-amylase levels. From the whole sample of children, 1.1% showed EOE and 32.9% EUE. Negative emotionality was related to EOE and EUE (0.13 (CI 0.06, 021), p < 0.001; 0.25 (CI 0.14, 0.35), p < 0.001). There was no relationship between stress biomarkers and EE and parenting had any moderating role (all p > 0.05). Similar to a Danish study, parents reported more often EUE than EOE of their child. Both are related to the temperament. Even though the course of EE has not yet been well documented, we conclude that a certain subgroup of children with difficult temperament could be at-risk for eat and weight regulation problems in later childhood

The relationship of parenting style and eating behavior in preschool children.

Eating behavior represents individual appetitive traits which are related to the individual's regulation of food intake. Eating behavior develops at an early age. There is some evidence that parenting styles might impact on the child's eating behavior. The aim of this study was to investigate the relationship of different dimensions of positive and negative parenting styles with the child's eating behavior at a critical age period of the child's early development. Parents of 511 preschool children (aged 2-6 years) completed the Children Eating Behavior Questionnaire and the Alabama Parenting Questionnaire. Analyses revealed that different dimensions of negative parenting styles were associated with eating behavior of the child. In details, inconsistent parenting showed a consistent association with eating behavior of a child (i.e. higher emotional eating, higher food responsiveness, higher food fussiness, higher satiety responsiveness and more enjoyment of food), whereas corporal punishment was associated with more emotional overeating and more food responsiveness but less satiety responsiveness. Further, powerful implementation was related to higher food responsiveness and less enjoyment of food and low monitoring was associated with higher emotional overeating and more slowness in eating. There was no such consistent association of positive parenting and eating behavior. More negative parenting styles were associated with eating behavior which is more often related to potential weight problems in a long term, whereas positive parenting did not show such a consistent relationship with eating behavior. Negative parenting should be in the focus of prevention and treatment of eating behavior problems in young children. ISRCTN41045021 (06/05/2014)

Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children.

Regional differences in physical activity in school-aged children and adults even within one country with the same political and health care system have been observed and could not be explained by sociodemographic or individual variables. We analysed whether such differences were already present in preschool children. Swiss children from 84 childcare centres in five cantons (Aargau, Bern, Fribourg, Vaud, Zurich) comprising about 50% of the population of the country participated. Physical activity was quantified with accelerometers (ActiGraph, wGT3X-BT) and potential correlates were assessed with measurements at the childcare centre or questionnaires. Mixed regression models were used to test associations between potential correlates of total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) or sedentary behaviour with a special focus on regional differences. 394 of 476 children (83%) provided valid physical activity data (at least 2 weekdays and 1 weekend day with 10 h recording; mean age 3.9 ± 0.7 years, 54% boys) with 26% and 74% living in the French- and German-speaking parts of Switzerland, respectively. Days consisted of (mean ± standard deviation) 1.5 ± 0.5 h MVPA, 5.0 ± 0.6 h LPA, and 6.3 ± 0.8 h sedentary behaviour with an average of 624 ± 150 counts/min TPA. TPA and MVPA (but not sedentary behaviour or LPA) increased with age, were higher in boys and children with better motor skills. Despite controlling for individual characteristics, familial factors and childcare exposure, children from the French-speaking part of Switzerland showed 13% less TPA, 14% less MVPA, 6% less LPA and 8% more sedentary behaviour than German-speaking children. Beside motor skills and non-modifiable individual factors, the regional sociocultural difference was the most important correlate of phyical activity and sedentary behaviour. Therefore, regionally adapted public health strategies may be needed

Correlates of preschool children's objectively measured physical activity and sedentary behavior: a cross-sectional analysis of the SPLASHY study.

Identifying ways to promote physical activity and decrease sedentary time during childhood is a key public health issue. Research on the putative influences on preschool children's physical activity (PA) and sedentary behavior (SB) is limited and has yielded inconsistent results. Our aim was to identify correlates of PA and SB in preschool children. Cross-sectional data were drawn from the Swiss Preschoolers' Health Study (SPLASHY), a Swiss population-based cohort study. Of 476 two to six year old children, 394 (54% boys) had valid PA data assessed by accelerometry. Information on exposure data was directly measured or extracted from parental questionnaires. Multilevel linear regression modeling was used to separately assess associations between 35 potential correlates and total PA (TPA), moderate-to-vigorous PA (MVPA) and SB. In total, 12 correlates from different domains were identified. TPA and MVPA were greater in boys than girls, increased with age and were positively associated with gross motor skills. Children from single parent families had a higher level of TPA and spent less time sedentary than those living with two parents. Time spent outdoors was positively associated with TPA and negatively with SB. The child's activity temperament was related all three outcomes, whereas parental sports club membership, living area per person and neighborhood safety were associated with SB only. Fixed and random factors in the final models accounted for 28%, 32% and 22% of the total variance in TPA, MVPA and SB, respectively. Variance decomposition revealed that age, sex and activity temperament were the most influential correlates of both, TPA and MVPA, whereas the child's activity temperament, time outdoors and neighborhood safety were identified as the most important correlates of SB. A multidimensional set of correlates of young children's activity behavior has been identified. Personal factors had the greatest influence on PA, whereas environmental-level factors had the greatest influence on SB. Moreover, we identified a number of previously unreported, potentially modifiable correlates of young children's PA and SB. These factors could serve to define target groups or become valuable targets for change in future interventions. Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.14)

Predictors of Executive Functions in Preschoolers: Findings From the SPLASHY Study.

Executive functions (EFs) have been reported to play a crucial role in children's development, affecting their academic achievement, health, and quality of life. This study examined individual and interpersonal predictors for EFs in 555 typically developing preschool children aged 2-6 years. Children were recruited from 84 child care centers in the German- and French-speaking parts of Switzerland within the Swiss Preschoolers' Health Study (SPLASHY). A total of 20 potential predictors were assessed at the first measurement (T1). These included eight demographic/biological predictors, such as socioeconomic status, preterm birth, physical activity, and motor skills; six psychological predictors, such as hyperactivity, visual perception, and emotionality; and six interpersonal predictors, such as parenting style and stress, presence of siblings, and days spent in the child care center. The predictive value of these variables on EFs 1 year later (T2) was assessed using both standard multiple regression analysis and penalized regression to avoid overfitting due to the number of potential predictors. Female sex (β = 0.14), socio-economic status (β = 0.15), fine motor skills (β = 0.17), visual perception at T1 (β = 0.16), and EFs at T1 (β = 0.30) were all associated with EFs at T2, exhibiting small to medium effect sizes. All predictors together accounted for 31% of the variability in EFs. However, none of the interpersonal predictors were significant. Thus, we conclude that most of the factors that can predict EFs in preschool age are individual variables, and these tend to be more difficult to influence than interpersonal factors. In fact, children from families with low socio-economic status may be particularly vulnerable to poor EFs. Furthermore, encouraging fine motor skills early in life may support the development of EFs

The validity of parental reports on motor skills performance level in preschool children: a comparison with a standardized motor test.

Motor skills are interrelated with essential domains of childhood such as cognitive and social development. Thus, the evaluation of motor skills and the identification of atypical or delayed motor development is crucial in pediatric practice (e.g., during well-child visits). Parental reports on motor skills may serve as possible indicators to decide whether further assessment of a child is necessary or not. We compared parental reports on fundamental motor skills performance level (e.g., hopping, throwing), based on questions frequently asked in pediatric practice, with a standardized motor test in 389 children (46.5% girls/53.5% boys, M age = 3.8 years, SD = 0.5, range 3.0-5.0 years) from the Swiss Preschoolers' Health Study (SPLASHY). Motor skills were examined using the Zurich Neuromotor Assessment 3-5 (ZNA3-5), and parents filled in an online questionnaire on fundamental motor skills performance level. The results showed that the answers from the parental report correlated only weakly with the objectively assessed motor skills (r = .225, p < .001). Although a parental screening instrument for motor skills would be desirable, the parent's report used in this study was not a valid indicator for children's fundamental motor skills. Thus, we may recommend to objectively examine motor skills in clinical practice and not to exclusively rely on parental report. What is Known: • Early assessment of motor skills in preschool children is important because motor skills are essential for the engagement in social activities and the development of cognitive abilities. Atypical or delayed motor development can be an indicator for different developmental needs or disorders. • Pediatricians frequently ask parents about the motor competences of their child during well-child visits. What is New: • The parental report on fundamental motor skills performance level used in this study was not a reliable indicator for describing motor development in the preschool age. • Standardized examinations of motor skills are required to validly assess motor development in preschoolers

Childcare Correlates of Physical Activity, Sedentary Behavior, and Adiposity in Preschool Children: A Cross-Sectional Analysis of the SPLASHY Study.

The childcare (CC) environment can influence young children's physical activity (PA), sedentary behavior (SB), and adiposity. The aim of the study was to identify a broad range of CC correlates of PA, SB, and adiposity in a large sample of preschoolers. 476 preschool children (mean age 3.9 yrs; 47% girls) participated in the Swiss Preschoolers' Health Study (SPLASHY). PA and SB were measured by accelerometry. Outcome measures included total PA (TPA), moderate-to-vigorous PA (MVPA), SB, body mass index (BMI), and skinfold thickness (SF). PA measures consisted of both daily PA during CC attendance days and overall daily PA (CC and non-CC days). We identified the following CC correlates for higher TPA and/or higher MVPA or lower SB during CC attendance days: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, and the presence of a written PA policy in the CC (all p ≤ 0.02). The CC correlates for overall TPA and/or MVPA or lower overall SB including both CC and non-CC days were the following: older age, sex (boys), more frequent child-initiated interactions during CC, mixing different ages within a group, less parental PA involvement in the CC, and having a larger surface area in CC (all p ≤ 0.046). Correlates for lower SF were sex (boys) and parental PA involvement in the CC (all p ≤ 0.02), and, for lower BMI, only increased age (p=0.001) was a correlate. More frequent child-initiated interactions and mixing different ages in CC, the presence of a written PA policy, and a larger CC surface are correlates of PA and SB during CC attendance days and/or of overall PA. Parental involvement in CC PA projects was a correlate for reduced body fat. These novel factors are mostly modifiable and can be tackled/addressed in future interventions