children exercise physiology

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Children Exercise Physiology

byMoch.Yunus

(EXERCISE PHYSIOLOGY)

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The study of the human body during exercise

Offers ability to study the body out of homeostasis

Exercise Physiology

Stimulus Response

Acut exercise Response Chronic Exercise Adaptation

HOMEOSTASIS

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• Homeostasis,, is the property of a system in which variables are regulated so that internal conditions remain stable and relatively constant. Examples of homeostasis include the regulation of temperature and the balance between acidity and alkalinity (pH). It is a process that maintains the stability of the human body's internal environment in response to changes in external conditions

Children and Adolescents Exercise Physiology

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OBJECTIVESChildren are not just smaller

versions of adults.

1. GROWTH AND MATURATION2. PHYSIOLOGICAL DIFFERENCES3. NUTRITIONAL CONSIDERATIONS4. PSYCHOLOGICAL CONSIDERATIONS5.THE IMMATURE MUSCULOSKELETAL SYSTEM

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OBJECTIVES

6. ACUTE SPORTING INJURIES7. OVERUSE INJURIES8. CHRONIC CHILDHOOD ILLNESS9. ACUTE ILLNESS AND SPORTS PARTICIPATION10.PRE-PARTICIPATION HEALTH EVALUATION11. INJURY PREVENTION

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GROWTH AND MATURATION

1) VARIABILITY IN THE PHYSICAL GROWTH OF 6 YEARS2) PEAK HEIGHT VELOCITY ( PHV )3) 12 YEAR OLD: SIGNIFICANT DIFFERENT HEIGHT,

MUSCULAR STRENGTH, CARDIOVASCULAR FITNESS LEVELS

4) NO REASON TO SEGREGATE SEXES UP TO 14 YEARS OLD

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PHYSIOLOGICAL DIFFERENCES

1. Aerobic Capacity in Children • VO2max (L/min) peaks around age 17 to 21 in males,

then decreases linearly with age.• VO2max (L/min) has been shown to peak around age

12 to 15 in females– Decrease after age 15 may be due to females tending to

reduce physical activity

• Absolute VO2max (L/min) is lower in children than adults at similar training levels.

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Aerobic Capacity in Children

• When VO2max is expressed relative to body weight, there is little difference in aerobic capacity between adults and children, thus, additional muscle mass increases maximal oxygen consumption.

• Relative to body weight, running economy is lower in children compared to adults.

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Changes in VO2max With Age

Absolute (e.g. L/min)Relative to body weight (e.g. ml/kg/min)

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PHYSIOLOGICAL DIFFERENCES

2) ANAEROBIC POWER:- SIGNIFICANT LOWER IN CHILDREN( SHORT TERM POWER OUTPUT )- IMPROVING WITH GROWTH- IN GIRLS LITTLE CHANGE AFTER 12 YEARS OLD- CHILDREN: LESS USE OF GLYCOGEN, LESS ABLE TO REDUCE PH

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Optimal Anaerobic Power Output

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Aerobic and Anaerobic Capacities as a % of Adult Levels

Adult level

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PHYSIOLOGICAL DIFFERENCES

3) CARDIOVASCULAR SYSTEM:- CHILDREN: HIGHER MAXIMAL HEART RATE- LOWER STROKE VOLUME- LOWER SYSTOLIC BLOOD PRESSURE- BETTER PERIFERAL BLOOD FLOW ADJUSTMENT TO SPORT

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HR and SV as a Function of O2 Uptake

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PHYSIOLOGICAL DIFFERENCES

4) RESPIRATORY SYSTEM:- CHILDREN: SHALLOW BREATHING PATTERN RESULTING IN LOWER ABSORPTION OF OXYGEN FROM INSPIRATION- HIGHER RESPIRATORY FREQUENCY RESULTING IN GREATER OXYGEN COST IN RESPIRATION

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PHYSIOLOGICAL DIFFERENCES

5) EXERCISE IN HOT AND COLD ENVIRONMENTS:CHILDREN VUNERABLE: RATIO OF SURFACE AREA TO VOLUME 30-40% HIGHER THAN ADULTS RESULTING IN FASTER INCREASE OR LOOSING BODY HEAT SWEATING MECHANISM IS FULLY OPERATIVE AFTER ADOLESCENT GROWTH SPURT - DEHYDRATION

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Beginning TrainingSensitive Periods.

• Max strength : 12-14(f) 14-16(m)• explosive strength : 10-12(f) 12-14(m)• Strength Endurance : 12-14(f) 14-16(m)• Aerobic Endurance : 8-10 (f & m)

Anaerobic Endurance : 12-14(f) 14-16(m)• Speed of Reaction : 8-10 (f & m)• Maximal Speed : 10-12(f) 12-14(m)• Coordination : 5-8 (f & m)

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NUTRITIONAL CONSIDERATIONS

1) ADOLESCENT GROWTH SPURT2) IRREGULAR EATING HABITS (SNACKS, MISSING

LUNCH ETC )3) CALCIUM, FOLIC ACID, ZINC, IRON,VITAMINS

A,B6,C4) DIETARY MANIPULATION, EATING DISORDERS

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PSYCHOLOGICAL CONSIDERATIONS

1) CHILDHOOD PLAY IMPORTANT FOR SPORT: ( FIRST 7 YEARS OF LIFE)- BALANCE AND CO-ORDINATION- PROPREOCEPTION ( POSITION SENSE )

2) REWARDS OF PHYSICAL ACTIVITYSELF ESTEEM AND ADMIRATION

3) SPORTS VERSUS PLAY ( AFTER 6 YEARS OLD ) GROUP GAMES, RULES OF GAMES, GOAL GAMESPREPARATION AND FEELINGS OF GAME SPORTS

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THE IMMATURE MUSCULOSKELETAL SYSTEM

• 1) PRESENCE OF GROWTH CARTILAGE IN SKELETON• A) ARTICULAR SURFACES• B) EPIPHYSEAL PLATES, APOPHYSEAL INSERTIONS• 2) EFFECTS OF EXERCISE:• INTENSIVE PROGRAMMES LEAD TO BONY DEFORMATION• HEAVY PHYSICAL TRAINING LEADS TO LONGER PREPUBERTAL

STATE IN GIRLS• SPECIAL INTENSIVE TRAINING LEADS TO STRENGTH

IMBALANCE: SHOULDER

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THE IMMATURE MUSCULOSKELETAL SYSTEM

• 3) FACTORS ASSOCIATED WITH INCIDENCE OF SPORT INJURIES

• EPIDEMIOLOGY: 3 INJURIES PER 100 CHILDREN PER YEAR

• 0.69 SERIOUS INJURIES PER YEAR• PEAK FOR BOYS: 14 YEARS OLD• GIRLS: 15 YEARS OLD

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THE IMMATURE MUSCULOSKELETAL SYSTEM

• INCOMPLETE RECOVERY FROM INJURY: 30%• FOUL OR ILLEGAL PLAY: 13%• OVERUSE INJURIES: 50%• - COMPETITION 35% OF INJURIES• - RUGBY LEAGUE 32%,SOCCER, RUGBY UNION 11%,

MARTIAL ARTS, HORSE RIDING 2% SAFEST• SPRAIN ANKLE 45%. 30% MEDICAL ATTENTION, 11%

HOSPITALIZED, 12% LONG TERM DYSFUNCTION

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ACUTE SPORTING INJURIES

• 1) HEAD AND NECK : VERY RARE BELOW 11 YRS• 1-5% OF ALL SPORT INJURIES SERIOUS CNS DAMAGE• 2) DIAPHYSEAL FRACTURES• 3) GROWTH PLATE INJURY: SALTER-HARRIS

CLASSIFICATION• 4) AVULSION FRACTURE OF ACL• 5) AVULSION FRACTURE MUSCLE GROUPS• 6) SUFE: 30% SUDDENLY, 70% GRADUAL

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OVERUSE INJURIES

• 1) OSTEOCHONDROSES• 2) STRESS FRACTURES: SUDDEN INCREASE IN

TRAINING INTENSITY• X-RAYS OR BONE SCANS• NAVICULAR, PARS-INTERARTICULARIS, FEMORAL

NECK• 3) MALALIGNMENT SYNDROMES:• TARSAL COALITIONS ( PERONEI TENDINITIS )

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OVERUSE INJURIES

• 1) OSTEOCHONDROSES:• “ SELF-LIMITED,IDIOPATHIC, DEVELOPEMENTAL

DISORDERS OF PRIMARY OR SECONDARY OSSIFICATION CENTRES”

• - TRACTION OSTEOCHONDRITIS (APOPHYSITIS ): OSGOOD-SCHLATTERS, SINDING-LARSEN-JOHANSSON, SEVERS

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OVERUSE INJURIES

• 1) OSTEOCHONDROSES:• - ARTICULAR SUBCHONDRAL ( CRUSHING )• PERTHES DISEASE (FEMORAL HEAD)• KIEBOCKS DISEASE ( LUNATE )• KOHLERS DISEASE ( NAVICULAR )• FREIBERGS DISEASE ( 2ND METAT.)• ARTICULAR CHONDRAL (SPLITTING)• OSTEOCHONDRITIS DISSECANS ( FEMUR,CAPITELUM,TALAR)• PHYSEAL: SCHEURMANNS (THORACIC SPINE )• BLOUNTS ( TIBIA )

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CHRONIC CHILDHOOD ILLNESS

• 1) ASTHMA: EXERCISE INDUCED BRONCHSPASM ( EIB)

• EXERCISE INDUCED ASTHMA ( EIA )• 2) DIABETES: INCREASED FATIGUE,

ABNORMAL THIRST, FREQ.URINARY,WEIGHT LOSS

• 3) EPILEPSY ( PETIT MAL, TEMPORAL LOBE, GRAND MAL )

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CHRONIC CHILDHOOD ILLNESS

• 4) CYSTIC FIBROSIS ( GENERAL EXOCRCINE GLAND DYSFUNCTION )

• CHRONIC RECURRENT SINUS AND RESPIRATORY TRACT INFECTIONS

• DIGESTIVE TRACT DISORDERS AND MALNUTRITION

• SWIMMING OF PARTICULAR BENEFIT IN BRONCHOSPASM HYGIENE

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CHRONIC CHILDHOOD ILLNESS

• 5) HYPERTENSION:• (?) CAUSES, PRIMARY OR SECONDARY• SPORTS BENEFICIAL FOR PRIMARY

HYPERTENSION• AVOIDANCE IN PRIMARY ISOMETRIC

ACTIVITIES: WEIGHT LIFTING, WRESTLING, ICE-SKATING

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CHRONIC CHILDHOOD ILLNESS

• 6) HEART DISEASE: CONGENITAL HEART DISEASE IN 5/1000 SCHOOL AGED CHILDREN. RHEUMATIC HEART DISEASE 1/1000, VALVULAR DAMAGE

• CARDIOMYOPATHY, MYOPATHY, HEREDITARY SYNDROME 0.8/1000

• RHYTHM SIGNIFICANT DISORDER 0.7/1000• CONGENITAL CORONARY ANOMALIES 2/100.000

CHILDREN

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CHRONIC CHILDHOOD ILLNESS

• 6) HEART DISEASE• - CARDIAC CONDITIONS ASSOCIATED COMMONLY

WITH SUDDEN DEATH IN SPORT ACTIVITIES• AORTIC STENOSIS, TETRALOGY OF FALLOT,

HYPERTROPHIC CARDIOMYOPATHY, PULMONARY HYPERTENSION, MYOCARDITIS

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CHRONIC CHILDHOOD ILLNESS

• - CARDIAC CONDITIONS ASSOCIATED WITH SUDDEN DEATH IN YOUNG ATHLETES:

• HYPERTROPHIC CARDIOMYOPATHY, ABERRANT LEFT CORONARY ARTERY, AORTIC DISSECTION ( MARFANS SYNDROME ) CORONARY ARTERY DISEASE

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ACUTE ILLNESS AND SPORT PARTICIPATION

• 1) INFECTIONS MONONUCLEOSIS • ( GLANDULAR FEVER )• - SELF-LIMITED ACUTE VIRAL ILLNESS• - 90% INFECTED BY 30 YEAR OLDS• - PEAK IS 15-25 YEARS OLD• - EPSTEIN-BARR VIRUS (EBV)• - DIAGNOSIS FROM POSITIVE HETEROPHILE

ANTIBODY TEST (MONOSPOT)

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ACUTE ILLNESS AND SPORT PARTICIPATION

• - ENLARGED SPLEEN 40-60%, RUPTURE 0.1 –0.2%

• - 4 WEEKS ABSENCE, SYMPTOMS CAN LAST UP TO 6 MONTHS

• 2) OTHER ACUTE ILLNESSES: HAEM.STREPTOCOCCUS, MYCOPLASMA PNEUMONIA, SIMPLE HERPES, TINEA PEDIS

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PRE-PARTICIPATION HEALTH EVALUATION

• HISTORY TAKING, PHYSICAL EXAMINATION, INVESTIGATIONS, ANTHROPOMETRIC MEASUREMENT

• - CONDITIONS REQUIRING FURTHER EVALUATION AND POSSIBLE DISQUALIFICATION FROM SPORT:

• 1) UNRESOLVED ORGANIC HEART DISEASE• 2) SUSTAINED HYPERTENSION WITH EXERCISE

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PRE-PARTICIPATION HEALTH EVALUATION

• 3) LOSS OF CONCIOUSNESS WITH EXERCISE• 4) SERIOUS CNS TRAUMA OR SURGERY• 5) HISTORY OF RECURRENT CNS SYMPTOMS

( SEIZURE ETC )• 6) PERSISTENT HEAT INTOLERANCE• 7) INTRACTABLE ORTHOPAEDIC PROBLEMS

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PRE-PARTICIPATION HEALTH EVALUATION

• 8) SINGLE ORGAN• 9) HAEMORRHAGIC DISSORDERS• 10) CHRONIC INFECTIONS• 11) CHRONIC DEBILITATING ILLNESS• 12) ENLARGED ABDOMINAL VISCERA• 13) OBVIOUS PHYSICAL IMMATURITY

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INJURY PREVENTION

• 1) FACTORS CONTRIBUTING TO SPORT INJURIES• - LACK OF COACHING EDUCATION• - INADEQUATE PREPARTICIPATION PHYSICAL EXAMS• - HAZARDOUS PLAYING FIELDS• - CONDITIONING AND TRAINING ERRORS• - EQUIPMENT – LACK, IMPROPER, POORLY FITTED

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INJURY PREVENTION

• - PLAYING WHILE INJURED OR OVERTIRED• - GROUPING TEAMS BY AGE NOT SIZE• - POOR NUTRITION• - RULES AND OFFICIALS• - IMPROPER TECHNIQUE• - INADEQUATE SUPERVISION• - PSYCHOLOGICAL STRESS• - WEATHER CONDITIONS

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INJURY PREVENTION

• PREVENTION STRATEGIES:• - GENERAL FITNESS – TRAINING• - RANGE OF SPORT ACTIVITIES• - TRAINING WELL BEFORE SEASON • - ALLOW CHILDREN TO CONTROL INTENSITY OF

ACTIVITIES• - MODIFY RULES OF ADULT GAMES• - LESS EMPHASIS ON WINNING

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INJURY PREVENTION

• - OPPONENTS TO BE MATCHED IN AGE, HEIGHT, WEIGHT, MATURITY

• - STRICT SUPERVISION• - NO MORE THAN A 10% INCREASE PER WEEK

IN TRAINING• - WARM-UP AND COOL-DOWN TIME• - PRE-PARTICIPATION EXAMS.