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Clinical outcome measures for monitoring physical function in pediatric obesity: An integrative review
Ryan Mahaffey1, Stewart C Morrison2, David Stephensen3
1School of Health, Sport and Bioscience, University of East London, London, UK.
Insights
The 6-minute timed walk (6MTW) is recommended for measuring physical function in children with obesity. Other tests for flexibility, strength, and coordination show limited evidence of reliability and validity.
Area of Science:
- Pediatric physical function assessment
- Obesity in children
- Measurement properties of performance-based tests
Background:
- Assessing physical function in obese children is crucial for targeted interventions.
- Performance-based measures are key to evaluating impairments and activity participation.
Purpose of the Study:
- To conduct an integrative review of measurement properties of performance-based physical function tests in children with overweight and obesity.
- To evaluate the validity, reliability, and responsiveness of these measures.
Main Methods:
- An integrative literature review was performed across multiple databases (Cochrane Reviews, SPORTDiscus, CINAHL, PLoS, Medline, Scopus).
- Twenty-eight studies encompassing 66 performance-based measures were analyzed.
Main Results:
- The 6-minute timed walk (6MTW) demonstrated test-retest repeatability.
- Measures of flexibility, strength, aerobic/anaerobic performance, coordination, and balance showed construct validity and responsiveness, but with inconsistent findings.
- Multi-item tests had acceptable construct validity and responsiveness, but internal consistency was not consistently determined.
Conclusions:
- Moderate evidence supports the 6-minute timed walk (6MTW) for measuring physical function in children with obesity.
- Low to very low evidence exists for other measures including aerobic/anaerobic performance, strength, flexibility, coordination, and balance tests.
- The 6-minute timed walk (6MTW) is recommended for physical function assessment in this population.
Objective:
Measuring physical function in children with obesity is important to provide targets for clinical intervention to reduce impairments and increase participation in activities. The objective of this integrative review was to evaluate measurement properties of performance-based measures of physical function in children with overweight and obesity.
Design And Methods:
An integrative review of literature published in Cochrane Reviews, SPORTDiscus, CINAHL, PLoS, Medline, and Scopus was conducted.
Results:
Twenty-eight studies were eligible and represented 66 performance-based measures of physical function. Assessments of repeatability and feasibility were not conducted in the majority of performance measures reported; only 6-min-timed walk (6MTW) was examined for test-retest repeatability. Measures of flexibility, strength, aerobic performance, anaerobic performance, coordination, and balance demonstrated construct validity and responsiveness; however, findings were inconsistent across all performance-based measures. Multi-item tests of physical function demonstrated acceptable construct validity and responsiveness; however, internal consistency was not determined.
Conclusions:
There is moderate evidence that 6MTW is suitable for the measurement of physical function in children with obesity. However, evidence is low for the use of aerobic and anaerobic performance, muscle strength, Movement Assessment Battery for Children, and Bruininks-Oseretsky Test of Motor Proficiency multi-item performance instruments and very low for flexibility, coordination, and balance tests. Based on this review, measurement of physical function using 6MTW is recommended.
