ACTIVITIES OF DAILY LIVING AND PARTICIPATION LIMITATION IN ADOLESCENTS WITH OBESITY

Abstract

Purpose: Childhood obesity is one of the most severe public health problems in recent years. We aimed to compare physical fitness and activities of daily living (ADL)-participation limitations in adolescents with obesity and peers without obesity and investigate whether the differences in these parameters are affected by gender in this study. Methods: Fifteen adolescents with obesity and 16 adolescents without obesity included in this cross-sectional study. Physical fitness was determined using the Munich Physical Fitness Test (MFT) and Modified Shuttle Walk test (MSWT). ADL were determined using the TGlittre-P test, quality of life and participation was assessed using the Pediatric Outcomes Data Collection Instrument (PODCI). Results: The MSWT distance, peak oxygen consumption, and MFT total score were decreased in adolescents with obesity regardless of gender (p<0.05). TGlittre-P test time was significantly longer in girl adolescents with obesity than girls without obesity (p=0.019). PODCI-physical function and sports, happiness/satisfaction, and global function scores were decreased in adolescents with obesity compared to peers without obesity (p<0.05). Conclusion: Peripheral muscle strength, endurance, power and cardiorespiratory/physical fitness are negatively affected by obesity in adolescents. Gender affects the ADL performance and participation limitations increase due to restriction in sports and physical function, happiness, and global function in adolescent obesity. Further studies need to focus on the effectiveness of enjoyable and suitable activities or exercise interventions on these parameters and also cardiovascular risk levels in adolescents with obesity.

Keywords

• Adolescent Obesity
• Activities of Daily Living
• Physical Fitness
• Quality of Life
• Adolescent Health

OBEZİTESİ OLAN ADOLESANLARDA GÜNLÜK YAŞAM AKTİVİTELERİ VE KATILIM LİMİTASYONU

Öz

Amaç: Çocukluk çağı obezitesi, son yılların en ciddi halk sağlığı sorunlarından biridir. Bu çalışmada; obezitesi olan adolesanlarda ve obezitesi olmayan akranlarında fiziksel uygunluk ve günlük yaşam aktiviteleri (GYA)-katılım limitasyonlarını karşılaştırmayı ve bu parametrelerdeki farklılıkların cinsiyetten etkilenip etkilenmediğini araştırmayı amaçladık. Yöntem: Bu kesitsel çalışmaya obezitesi olan 15 ve obezitesi olmayan 16 adolesan dahil edildi. Fiziksel uygunluk, Münih Fiziksel Uygunluk Testi (MFT) ve Modifiye Mekik Yürüme Testi (MMYT) kullanılarak belirlendi. GYA, TGlittre-P testi kullanılarak belirlendi, yaşam kalitesi ve katılım Pediatrik Veri Toplama Aracı (PVTA) kullanılarak değerlendirildi. Sonuçlar: Obezitesi olan adolesanlarda cinsiyetten bağımsız olarak MMYT mesafesi, zirve oksijen tüketimi ve MFT toplam skoru azalmıştı (p<0,05). TGlittre-P test süresi, obezitesi olan adolesan kızlarda, obezitesi olmayan kızlara göre anlamlı olarak daha uzundu (p=0,019). Obezitesi olan adolesanlarda, obezitesi olmayan akranlarına göre PVTA- fiziksel fonksiyon ve spor, mutluluk/ memnuniyet ve global fonksiyon skorları azalmıştı (p<0,05). Tartışma: Adolesanlarda periferik kas kuvveti, dayanıklılık, güç ve kardiyorespiratuar/fiziksel uygunluk obeziteden olumsuz etkilenmektedir. Adolesan obezitesinde cinsiyet GYA performansını etkilemekte ve fiziksel fonksiyon ve spor, mutluluk/memnuniyet ve global fonksiyonda kısıtlama nedeniyle katılım limitasyonu artmaktadır. Obezitesi olan adolesanlarda eğlenceli ve uygun aktivitelerin veya egzersiz müdahalelerinin bu parametreler ve ayrıca kardiyovasküler risk düzeyleri üzerindeki etkinliğine odaklanan ileri çalışmalar gereklidir.

Anahtar Kelimeler

• Adolesan Obezite
• Günlük Yaşam Aktiviteleri
• Fiziksel Uygunluk
• Yaşam Kalitesi
• Adolesan Sağlığı

References

1. Referans 1. Parizkova J, Hills A. Childhood Obesity: Prevention and Treatment. 2nd ed. Florida: CRC Press; 2019.
2. Referans 2. Ozcebe H, Yardim MS, Bagci Bosi T, Yardim N, eds. Turkey Childhood (Elementary 2nd Grade Students) Obesity Surveillance Initiative (Cosi-Tur) 2016. Ankara: Republic of Turkey Ministry of Health, Republic of MEB, Hacettepe University, Publication No: 1080; 2017.
3. Referans 3. Gregory JW. Prevention of obesity and metabolic syndrome in children. Front Endocrinol (Lausanne). 2019; 10: 669.
4. Referans 4. Hansen D, Marinus N, Remans M, Courtois I, Cools F, Calsius J, et al. Exercise tolerance in obese vs. lean adolescents: a systematic review and meta-analysis. Obes Rev. 2014; 15 (11): 894-04.
5. Referans 5. Deforche B, Lefevre J, De Bourdeaudhuij I, Hills AP, Duquet W, Bouckaert J. Physical fitness and physical activity in obese and nonobese Flemish youth. Obes Res. 2003; 11 (3): 434-41.
6. Referans 6. Neyzi O, Bundak R, Gokcay G, Gunoz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol. 2015; 7 (4): 280-93.
7. Referans 7. Monteiro F, Ponce DA, Silva H, Carrilho AF, Pitta F. Validity and reproducibility of the glittre adl-test in obese and post-bariatric surgery patients. Obes Surg. 2017; 27 (1): 110-14.
8. Referans 8. Guidoti AB, Cattani ÂP, de Araujo CL, Costa Delacoste FB, Hentschke GS, Dal Lago P, et al. Glittre ADL test in eutrophic, overweight and obese elderly. Fisioter Bras 2020; 21 (1): 49-58.

9. Referans 9. Merder-Coskun D, Uzuner A, Kenis-Coskun O, Celenlioglu AE, Akman M, Karadag-Saygi E. Relationship between obesity and musculoskeletal system findings among children and adolescents. Turk J Phys Med Rehabil. 2017; 63 (3): 207-14.
10. Referans 10. Yasar Cesur, Kaba S, Dogan M, Dogan M, Bala KA, Arı Yuca S, et al. Prognostic importance of anthropometrics in obesity related cardiovascular risk factors in children. Van Med J. 2016; 23 (4): 324-29.
11. Referans 11. Fuller N, Elia M. Potential use of bioelectrical impedance of the'whole body'and of body segments for the assessment of body composition: comparison with densitometry and anthropometry. Eur J Clin Nutr. 1989; 43 (11): 779-91.
12. Referans 12. Bohannon RW, Wang YC, Bubela D, Gershon RC. Handgrip strength: a population-based study of norms and age trajectories for 3- to 17-year-olds. Pediatr Phys Ther. 2017; 29 (2): 118-23.
13. Referans 13. Beam WC, Adams GM. Exercise Physiology: Laboratory Manual. 8th ed. New York: McGraw-Hill Education; 2019.
14. Referans 14. Martins R, Assumpção MSd, Bobbio TG, Mayer AF, Schivinski C. The validity and reliability of the ADL-Glittre test for children. Physiother Theory Pract. 2019; 35 (8): 773-80.
15. Referans 15. Martins R, Bobbio TG, Mayer AF, Schivinski CI . Reference equations for the ADL-Glittre Test in pediatric subjects. Respir Care. 2019: 64 (8): 937-44.
16. Referans 16. de Assumpcao PK, Heinzmann-Filho JP, Isaia HA, Holzschuh F, Dalcul T, Fagundes Donadio MV. Exercise capacity assessment by the modified shuttle walk test and its correlation with biochemical parameters in obese children and adolescents. Indian J Pediatr. 2018; 85 (12): 1079-85.
17. Referans 17. Bradley J, Howard J, Wallace E, Elborn S. Validity of a modified shuttle test in adult cystic fibrosis. Thorax. 1999; 54 (5): 437-39.
18. Referans 18. Klijn PH, van der Baan-Slootweg OH, van Stel HF. Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test. BMC Pediatr. 2007; 7: 19.
19. Referans 19. Bös K, Tittlbach S. Motorische Tests: für Schule und Verein, für jung und alt. 1st ed. Wiebelsheim: Limpert, 2002.
20. Referans 20. Keskin Dilbay N, Kerem Gunel M, Aktan T. Reliability and validity of Turkish version of Pediatric Outcome Data Collection Instrument (PODCI) for people with cerebral palsy. Physiother Rehabil. 2013; 24 (1): 118-26.
21. Referans 21. Hayran M, Hayran M. Sağlık Araştırmaları İçin Temel İstatistik. 1st ed. Ankara: Omega Yayınları; 2011.
22. Referans 22. Monteiro F, Ponce DA, Silva H, Pitta F, Carrilho AJF. Physical function, quality of life, and energy expenditure during activities of daily living in obese, post-bariatric surgery, and healthy subjects. Obes Surg. 2017; 27 (8): 2138-44.
23. Referans 23. Bovet P, Auguste R, Burdette H. Strong inverse association between physical fitness and overweight in adolescents: a large school-based survey. Int J Behav Nutr Phys Act. 2007; 4: 24.
24. Referans 24. Ceschia A, Giacomini S, Santarossa S, Rugo M, Salvadego D, Da Ponte A, et al. Deleterious effects of obesity on physical fitness in pre-pubertal children. Eur J Sport Sci. 2016; 16 (2): 271-78.
25. Referans 25. Alberga AS, Sigal RJ, Goldfield G, Prud'homme D, Kenny GP. Overweight and obese teenagers: why is adolescence a critical period? Pediatr Obes. 2012; 7 (4): 261-73.
26. Referans 26. Wind AE, Takken T, Helders PJ, Engelbert RHH. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? Eur J Pediatr. 2010; 169 (3): 281-87.
27. Referans 27. Matsudo VKR, Matsudo SM, Machado de Rezende LF, Vagnor R. Handgrip strength as a predictor of physical fitness in children and adolescents. Rev Bras Cineantropom Desempenho Hum. 2015; 17 (1): 1-10.
28. Referans 28. Castro-Pinero J, Gonzalez-Montesinos JL, Mora J, Keating XD, Girela-Rejón MJ, Sjöström M, et al. Percentile values for muscular strength field tests in children aged 6 to 17 years: influence of weight status. J Strength Cond Res. 2009; 23 (8): 2295-310.
29. Referans 29. Buttitta M, Iliescu C, Rousseau A, Guerrian A. Quality of life in overweight and obese children and adolescents: a literature review. Qual Life Res. 2014; 23 (4): 1117-39.
30. Referans 30. Podeszwa DA, Stanko KJ, Mooney JF, Cramer KE, Mendelow MJ . An analysis of the functional health of obese children and adolescents utilizing the PODC instrument. J Pediatr Orthop. 2006; 26 (1): 140-43.