Impact of an Effort Rehabilitation Program for Overweight/Obese Children/Teens on Quality of Life and Wellbeing (PRESEVAL)

Impact of an Effort Rehabilitation Program for Overweight/Obese Children/Teens on Quality of Life and Wellbeing

Impact of an Effort Rehabilitation Program for Overweight or Obese Children and Teens on Quality of Life and Wellbeing: A French Monocentric Prospective Study

Obese and overweight children or teens can join the Prevention and Care of Pediatric Obesity and Pediatric Diabetes Organization of Mulhouse. Those patients who are no longer able to exercize because of their physical condition start an effort rehabilitation program at the Organization. The study will evaluate the impact of this rehabilitation program on quality of life and appetency to physical activity for these children and teens.

Because of a National Obesity Plan (2010-2013) initiated by the French government in charge of health, the Pediatric Obesity and Pediatric Diabetes Organization of Mulhouse was created in 2011. This Organization is in charge of children or teens with: severe or growing obesity associated with respiratory, osteo-articular metabolic complications comorbidities worsened by obesity The Organization and the Physical Medicine and Rehabilitation department of the Mulhouse Hospital have worked together to create an effort rehabilitation program for obese or overweight children. The program, aiming movement rehabilitation, is based on reinforcement and endurance activities in a playful atmosphere and in an important motivational dimension. A medical examination is performed before the first session to confirm the patient's ability to follow an effort rehabilitation program. Each session is supervised by a teacher of adapted physical activity.

An effort rehabilitation program designed for obese and overweight children or teens : 13 weekly sessions of 1hour30 then 1 session 2 months, 6 months and 12 months later. This program is part of the routine practice of the Pediatric Obesity and Pediatric Diabetes Organization of Mulhouse. Child Health Questionnaire (CHQ) of quality of life are completed by parents and children on the 1st and the 13th session, then 3 more times : 2, 6 and 12 months after the 13th session. Eurofit tests of Physical Fitness performed on the 1st and the 13th session, then 3 more times : 2, 6 and 12 months after the 13th session.

Eurofit tests are a physical skills assessment. For the study, tests performed on the 1st and the 13th session of the program, then 3 more times : 2 months, 6 months and 12 months after the 13th weekly session.

The CHQ is a questionnaire about quality of life. The CHQ children form (CHQ-CF87) and the CHQ parent form (CHQ-PF50) are completed each time the Eurofit tests are performed : at the 1st and 13th weekly session then 2 months, 6 months and 12 months later.

Part of the routine practice of the Pediatric Obesity and Pediatric Diabetes Organization of Mulhouse, the program consists in 13 sessions of 1hour30 of adapted physical activity. The physical activity in this program use cycles of games where rules are adapted to the overweight or obese children. The activities are performed in a playful atmosphere, for example using creative games like tchoukball or peteca, with each session aiming a specific objective each time.

Appetency to physical activity assessed with the evolution of the amount of time spent weekly in a physical activity

Inclusion Criteria: BMI > 97 percentile at least one of the following symptoms : respiratory functional signs orthopedic complications sleep apnea cardiovascular complications metabolic syndrome Exclusion Criteria: lack of motivation uncontrolled psychological issue ambulatory care more appropriate to treat the same issues any related psychiatric pathology likely to worsen with weight loss patient or family not committed to therapeutics program psychological inability to deal with separation behavior disorders making collective activity impossible

Fulton JE, Garg M, Galuska DA, Rattay KT, Caspersen CJ. Public health and clinical recommendations for physical activity and physical fitness: special focus on overweight youth. Sports Med. 2004;34(9):581-99. doi: 10.2165/00007256-200434090-00003.

Bar-or O. Médecine du Sport chez l'enfant. Principes physiologiques et applications cliniques. Paris : Masson ; 1987

Publication from Department of Movement and Sports Sciences, Ghent University, BELGIUM about physical activity for babies and toddlers

http://www.has-sante.fr/portail/upload/docs/application/pdf/2012-09/overweight_and_obesity_in_children_and_adolescents_-_quick_reference_guide.pdf

English version of the National Health Authority (French acronym : HAS) listing recommendations for overweight or obese children