Meet the Expert: Youth

Fitness programs for children need to be fun and appropriate for young bodies. Interval training, strength training and new technology-based equipment can all play a role in exercise programs for young people.

Childhood obesity in the U.S. continues to increase. And, the trend toward obesity worldwide is upward, with one in three youth overweight or obese. The increasing occurrence of adult diseases in childhood, and the growing awareness of a relationship between adult diseases and the diets of children and adolescents, have led to increased interest in youth eating habits and physical activity opportunities.

Meet The Expert

Stephen A. Black, DSc, PT, ATC/L, NSCA-CPT, is an entrepreneurial expert in the healthcare vocation with 30 years of experience in the health and wellness industry. He currently oversees clinical and research operations at the Rocky Mountain Human Performance Center (RMHPC), an exercise testing and prescription facility located in West Springfield, Mass., and Boulder, Colo.

The Need To Help Overweight Children

Overweight children typically become overweight adults, and overweight adults have significantly higher risks of serious degenerative diseases, including high blood pressure, heart disease, stroke, diabetes, several types of cancer, low-back pain and arthritis.

In addition to the medical concerns associated with childhood obesity, there are many related physiological problems. Overweight youth usually score poorly on fitness tests such as timed runs, vertical jumps, long jumps, push-ups, pull-ups, sit-ups and agility. They generally don't do well in endurance activities such as soccer, or in jumping activities such as basketball. They may not even like to play tag because they are always "it."

Psychologically, research shows that obese children score very low in self-image and self-confidence. They seldom play sports, organized or otherwise, and are less involved socially than their more-fit peers. One recent study revealed that children who are obese and children who suffer from cancer have similar outlooks on life.

Training Children

According to Wayne L. Westcott, Ph.D., for every youth who is overfat, there are at least two who are underfit. With less emphasis on physical education in schools, this sad situation is becoming progressively more prevalent. And, with little opportunities for activity at school and at home, children need help from fitness professionals, either in the facility or out.

Exercise programs for children should match their physical characteristics. Elementary-school-aged children have a distinctly different physiological pattern for performing physical activity. They exercise all-out for 30 to 60 seconds, and then rest. After a minute or so of recovery, they exercise all-out again for 30 to 60 seconds. They basically have an innate ability to exercise in an interval-training manner. Most young people do not fit the adult exercise model of a five-minute warm-up, 30 minutes of continuous exercise and a five-minute cool-down.

An important physical activity for all that matches children's physiological factors is strength training. This can be performed interval style, with 30- to 60-second sets of exercise, a rest for 60 seconds, then another set of strength exercise.

Another advantage of strength training is improved body composition. Strength training builds muscle and bone, resulting in a stronger musculoskeletal system and greater functional capacity. Some skeptics may say that strength training is detrimental to muscle and bone development in children. Lyle Micheli, M.D., director of sports medicine at Boston Children's Hospital, has proven otherwise. A recent nine-month study with nine-year-old-girls showed four times as much bone mineral density increase in girls who performed strength exercises compared to those who performed other types of physical activity. In fact, every research study published on youth strength training has shown positive results, with no reports of injury or developmental delay. These programs need supervision by appropriately trained and credentialed individuals, and a ratio of one instructor per six youth is recommended.

Some facilities have the luxury of using youth-sized strength-training machines. However, not all facilities have the budget for such equipment. Youth can attain excellent results with other types of resistance equipment, including free weights, elastic bands, medicine balls and body-weight activities. Proper technique is critical, and includes good posture, slow exercise speed and full range of motion. Fast reps, short reps and breath holding should be avoided.

The Role Of Technology

Research from the University of Minneapolis and Harvard University suggests that video has efficacy as a learning method for today's adolescents. With that in mind, several programs and vendors are banking on the use of video and video-type equipment to enhance youth fitness and overall approach to activity.

GameCycle. One such device is the GameCycle. Research from the University of California, Davis, indicates that the GameCycle is effective in improving oxygen uptake and maximal work capacity in adolescents. Subjects reported that the video game component was enjoyable and provided a motivation to exercise. The study also demonstrated increased aerobic endurance and peak heart rate, a lower rating of perceived exertion and user satisfaction.

An additional advantage of the GameCycle is the ability to progressively strengthen the upper body with emphasis on the shoulder complex, thoracic and cervical spine. Plus, due to the necessity to stabilize the upper torso and extremities, core stability is achieved, specifically, in the abdominals, pelvic floor and lumbar spine stabilizers. Biomechanically, this is an efficient form of strength and endurance training that is appropriate for youth.

HOPSports. Another program that uses video methods is HOPSports, which delivers physical education to youth with a multi-media program. HOPSports has created innovative, cost-effective fitness programming for schools and community organizations that trains, evaluates, educates and entertains, while also marketing nutritional and career opportunities in a multi-screen, dynamic presentation that captures the attention of children, and speaks their language.

Critical to the HOPSports program it the Team Pod by Suunto. The Pod system uses technology to monitor the heart rates of participants to regulate intensity, measure progress and prevent injury. It allows coaches and instructors to monitor the heart rates and physiology of up to 42 participants simultaneously. The system wirelessly gathers information from participants, and displays the performance data in real-time on a PC screen, which allows data to be captured for later reference and program management.

Three independent universities demonstrated the prospective benefits of the HOPSports program. Study results demonstrated the program's efficacy in combating childhood obesity and providing more efficient use of physical education class time. Girls and those who were overweight benefitted even more.

Polar. Polar uses heart rate monitors and a testing system in its youth fitness program. The program uses technology that enables instructors to objectively assess each student, and to develop personalized health and fitness portfolios. According to Beth Kirkpatrick with Polar, who has more than 30 years of experience in physical education, this is the first time the technology and documented data has been used to evaluate the "effort" portion of a student's grade. This innovative program motivates students to be fit, and gives them a tool that can be used for a lifetime of activity and health.

Trazer. Blending high-tech entertainment with sports science and simulation not only makes exercise fun, but more effective, according to Alan Davis, M.D., a member of the board of directors at Traq 3D. Traq 3D is aligned with Cybex to market the Trazer. This piece of equipment is a simulator that combines constant, real-time, three-dimensional tracking of the body's position with virtual reality techniques to deliver game-like, interactive simulations. Calories are expended, balance and coordination are stimulated, and strength/endurance/cardiovascular efficiency are enhanced, all in a fun, interactive and exciting environment.

While playing Trazer, the body essentially becomes a high-resolution computer-input device. The user's position controls the on-screen character. Users dodge, block, cut, duck and jump while the Trazer measures and reports reaction time, acceleration, speed, power, balance, agility, endurance and heart rate. Points are scored, tracked and stored for a variety of purposes, including non-threatening competition.

Evaluate, Then Embrace, Technology

Truly, the video and technology era has arrived. Children now are technologically advanced, so why not play to their learning styles and preferences? However, don't take the technology at face value. Look for non-biased, evidence-based prospective studies to validate the methods and technology that continue to emerge and evolve. Embrace them, and incorporate them into your facility, and especially into your youth programs.

1. Black, S.A., Nutrition knowledge modification following a brief educational intervention on middle and junior high school students. Pending publication.
2. Faigenbaum, A.D., and W.L. Westcott. Strength &Power for Young Athletes. Human Kinetics: Champaign, Ill., 2000.
3. Neumark-Sztainer, D., M. Story and P.J. Hannan. Weight-related concerns and behaviors among overweight and non-overweight adolescents. Pediatric Adolescent Medicine 156: 171-178, February 2002.
4. Widman, L.M. Effectiveness of an upper-extremity exercise device integrated with computer gaming for aerobic training in adolescents with spinal cord dysfunction. Journal of Spinal Cord Medicine 29: 1-8, 2006.
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