Physical activity and its correlates in children and adolescents post‐liver transplant

Abstract

The health benefits of PA are well established for healthy and chronically ill children. This study objectively measures physical fitness and PA levels in children PLT and explores potential correlates and perceived barriers impacting their PA. A total of 23 children (16 females, mean 14.01 ± 2.49 yrs) >1 yr PLT were assessed for peak oxygen consumption (VO2 peak), muscle strength, endurance, and flexibility. MVPA and steps/day were determined with accelerometry. Additionally, SE, perceived fatigue, and barriers and benefits of PA were examined. VO2 peak (mean 33. 2 ± 7.61 mL/kg/min; 77.0 ± 15.6% predicted) and PA (average 6841 ± 2299 steps/day) were below healthy norms. MVPA (31.6 ± 16.1 min/day) was lower than national guidelines. Six participants (30%) attained criterion standards for abdominal strength and one participant (5%) for push-ups. Fatigue and SE were lower than reported levels in healthy children. A commonly perceived barrier to PA was "I am tired." A positive correlation was shown between SE and MVPA (r = 0.57, p = 0.007), SE and fatigue (r = 0.54, p = 0.01), and PELD score and fatigue (r = 0.66, p = 0.007). Children PLT demonstrate below normal levels of PA and aerobic capacity. SE is a modifiable correlate of their PA. Further investigation of the impact of PA correlates can guide the development of future innovative PA intervention strategies in children PLT.

Physical activity experiences in children post–liver transplant: Developing a foundation for rehabilitation interventions

“…Even though previous research suggests that children PLT are less active then healthy norms, this study indicated that children perceive themselves as physically active and took part in unstructured play and a range of organized PA's and sports. Although scores on the PAQ were higher than previously reported PA levels, it is important to note that the PAQ is a self‐report measure that is prone to overestimation of levels of PA due to social bias and the complex cognitive recall required .…”

“…Although scores on the PAQ were higher than previously reported PA levels, it is important to note that the PAQ is a self‐report measure that is prone to overestimation of levels of PA due to social bias and the complex cognitive recall required . The high levels of fatigue reported in this study are consistent with previous quantitative and qualitative findings . Parent proxy report of the fatigue measure was higher than their children.…”

“…Although the results of our quantitative measures demonstrate a degree of correlation with the qualitative data, our small sample size limits their significance. Further investigation into the use of the PAQ and PedsQL MFS to explore the issue of fatigue and PA is merited as results of this study and previous research data indicate that these measures may have good clinical utility to assist in discussing and monitoring PA and fatigue in children PLT.…”

“…Additionally, PA can positively impact motor and social development, mental health, and school functioning, making it an important influence on overall HRQOL . Research shows that children PLT are not as physically active, have reduced cardiorespiratory fitness, and report lower levels of physical function compared to their healthy peers, making it critical to examine this multidimensional health behavior. To the best of our knowledge, this is the first mixed‐methods study focusing on PA experiences.…”

Physical activity and aerobic fitness in children after liver transplantation

“…Fatigue is one of the most common complaints in adult liver transplantation patients . Both parent report and child report showed a higher level of fatigue compared to published healthy norms, and these findings are similar to other children after liver transplantation . Children in our study reported more sleep/rest fatigue compared to their parents, meaning parents underestimate the children's experience of sleep/rest fatigue.…”