Study: Doctors should treat physical activity as a 'vital sign' of children's overall health

A new study from Nationwide Children’s Hospital researchers shows that just 5 percent of youth get the federally recommended amount of exercise – 60 minutes per day. As such, doctors should ask parents how much activity their children get, discuss what’s enough or too much and, when necessary, write “prescriptions” for activity.

Gary George III has a hard time slowing down, even when his mom tells him to.

The 10-year-old Ashland boy plays soccer, football, basketball and baseball. He plays laser tag and other activities with his family. And he’s also active during school recess.

But this past summer, he injured a growth plate in his right shoulder, likely in part due to overuse. Several weeks and several rounds of physical therapy later, Gary thinks he’s back to normal.

His mom, Carly George, has tried to help Gary avoid overdoing activities, cutting back his year-round soccer schedule and encouraging him to attend family and school events and just have some down time.

“It is very hard for me to limit him,” she said. “I have to remind him that, as his parent, I’m the one who has to put those parameters in place.”

A new study by Nationwide Children’s researchers indicates that about 55 percent of youngsters get far less exercise than Gary. And others get too much.

The research, presented last month at an American Academy of Pediatrics conference in Orlando, Florida, showed that only about 5 percent of children seen at outpatient pediatric sports medicine clinics received the federally recommended amount of physical activity — at least one hour every day.

Another 50 percent were less active and another 5 percent participated in no physical activity. The remaining 40 percent were either getting too much exercise overall, or too much on certain days and too little on others.

Researchers said the numbers indicate a need to screen for physical activity like a vital sign, akin to height or weight. They say physicians should ask families how many minutes of activity youngsters get, discuss what’s enough or too much and, when necessary, write “prescriptions” for activity, ideally in specific programs.

“A lot of physicians talk about physical activity, but making a patient give them a number and then talking about a number, I think is where that next step should be,” said Julie Young, a research assistant in Nationwide Children’s pediatric sports medicine division who performed the study with Dr. Amy Valasek.

Valasek, who works in sports medicine at Nationwide Children’s, has used physical-activity screening for about three years and said parents are responsive.

“Exercise is medicine” initiatives for adults need to be implemented at the pediatric level, she said. She pointed to an Ohio State University Wexner Medical Center program through which adults are screened for activity levels by primary-care physicians then, when necessary, sent to an eight-week program that helps people who are sedentary, injured or apprehensive learn how to be active.

Programs for children should be fun — not exercise as punishment, Young said. Those who are active as youths tend to continue being active as adults.

“We want kids being active and moving so they can learn motor-skill development, so they can gain confidence, they can have less depression and anxiety, have better cognitive performance,” she said. “All these factors can be related to physical activity.”

Too much activity, however, can lead to detrimental injury, said Valasek, who also is an assistant pediatrics professor at Ohio State’s College of Medicine. Some of her patients report as many as 20 to 25 hours of activity per week, a concern because chronic injury and pain will inevitably lead children to stop being active. 

The study reviewed patient charts to determine the self-reported activity level of 7,822 children ages 5 to 18 from March 2015 to March 2018.

Gary’s mom said her children’s pediatricians ask how much television they watch, but not about physical activity levels.

Gary’s shoulder was treated at Nationwide Children’s, where George was told that the injury was likely due to a combination of overuse, his mechanics and because of the intensity with which he throws. He stayed active throughout treatment, but was told not to throw.

Sports are his passion, she said, but there also is increased outside pressure for him to be so active.

“There’s a lot of pushing: If you’re going to be involved in things, be involved in everything at all times,” she said. “We really push back against that.”

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