Physical Fitness, Ambulation and Physical Activity in Ambulatory Children and Adolescents with ...

173 Pages·2010·0.78 MB·English

Physical Fitness, Ambulation
and Physical Activity in
Ambulatory Children and
Adolescents with Spina Bifida

Janke F. de Groot
Physical Fitness, Ambulation and Physical Activity in Ambulatory Children
and Adolescents with Spina Bifida
Theses, Utrecht University, 2010
© Janke F. de Groot

ISBN: 9789088912115

Cover design: Proefschriftmaken.nl || Printyourthesis.com
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Published by: Uitgeverij BOXPress, Oisterwijk, The Netherlands
Physical Fitness, Ambulation
and Physical Activity in
Ambulatory Children and
Adolescents with Spina Bifida

Fysieke Fitheid, Loopfunctie en Fysieke Activiteit bij lopende kinderen
en adolescenten met Spina Bifida
(met een samenvatting in het Nederlands)

PROEFSCHRIFT
ter verkrijging van de graad van doctor aan de Universiteit Utrecht op
gezag van de rector magnificus, prof. dr. J.C. Stoof, ingevolge het besluit
van het college voor promoties in het openbaar te verdedigen op vrijdag 17
december 2010 des middags te 4.15 uur.

door

Janke Frederike de Groot
geboren op 24 februari 1971 te Enschede
Promotoren: Prof. dr. P.J.M. Helders
Prof. dr. L. Vanhees

Co-promotoren: Dr. T.Takken
Dr. R.H.J.M. Gooskens

Dit onderzoek en dit proefschrift werden mogelijk gemaakt met financiële steun van
de Hogeschool Utrecht (promotievoucher), het Wetenschappelijke College voor
Fysiotherapie van het Koninklijk Nederlands Genootschap voor Fysiotherapie, het
WKZ onderzoeksfonds, de Stichting BIO Kinderrevalidatie in Arnhem en de
Stichting Steunfonds van de Faculteit Gezondheidszorg van de Hogeschool
Utrecht
Voor mijn oma

en kinderen met Spina Bifida

Contents

Chapter 1: General Introduction 9
Part I. Fitness and energy cost of locomotion in ambulatory
children with SB: two exploratory studies.

Chapter 2: Muscle Strength, Aerobic Capacity and Physical Activity in 19
Independent Ambulating Children with Lumbosacral Spina
Bifida

Chapter 3: Limiting Factors in Peak Oxygen Uptake and the Relation- 37
ship with Functional Ambulation in Ambulating Children
with Spina Bifida

Part II. Development of appropriate exercise testing for
ambulatory children with Spina Bifida

Chapter 4: Reproducibility of Energy Cost of Locomotion in Ambula- 57
tory Children with Spina Bifida

Chapter 5: Treadmill testing in ambulatory children with Spina Bifida: 75
does peak oxygen uptake reflect maximum oxygen uptake?

Chapter 6: Reproducibility of Maximal and Submaximal Exercise 93
Testing in Normal and Community Ambulatory Children
with Spina Bifida: which is best for the evaluation and
application of exercise training?

Part III. Intervention aimed to improve ambulation and physical
fitness in ambulatory children with Spina Bifida

Chapter 7: Randomized controlled study of home-based treadmill 111
training for ambulatory children with Spina Bifida

Chapter 8: General Discussion 133
Summary 151
Samenvatting 157
Dankwoord 163
Curriculum Vitae and List of publications 169

7
8
General Introduction

Chapter 1

J.F. de Groot

9
Physical activity, physical fitness in healthy adults and children.

Many studies have shown the association between levels of physical activity (PA)
and physical fitness (PF) and cardiovascular and overall mortality (1-3). Bouchard
and Shephard (4) have described the relationship between physical activity, physical
fitness and health in their model of health related fitness, with physical activity and
physical fitness and general health being dependent on each other, while at the
same time genetics and environment playing an important role in this interaction (see
Fig. 1).
Heridity
Health relatedfitness
Physicalactivity Health
•morphological
•leisuretime •muscular •wellness
•occupational •motor skills •morbidity
•exercisetherapy •cardiorespiratory •mortality
•metabolic
Environmentalconditions
•lifestylebehaviours
•personalattributes
•physicalenvironment
•socialenvironment

Fig. 1 Model of health-related fitness according to Bouchard and Shephard (4).

Although the presumed relationship between levels of physical activity and fitness
during youth and adolescence and physical activity and fitness in adulthood are not
consistently found in several studies on this topic (5-7), there does seem to be a
relationship between health status in youth and health status in adults. The European
Youth Heart Study found children engaged in physical activities less than one hour a
day at higher risk for cardiovascular risk factors than those who were more active (8).
Other studies have looked at the relationship between body composition and fitness
10