The Evolution of an Exercise Prescription Clinic for the Treatment of Pediatric Obesity

  • Miss Astrid De Souza, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr Kristin Houghton, Division of Rheumatology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr Mary Hinchliffe, Shapedown Program, Centre for Healthy Weights, British Columbia Children's Hospital, Canada
  • Dr Shubhayan Sanatani, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr Walter Duncan, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr Derek Human, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr George Sandor, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada
  • Dr James Potts, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and The University of British Columbia, Canada

    • BACKGROUND: Obese children are less active than their non-obese peers. The establishment of an exercise prescription clinic may provide families with the support they need to change their child’s exercise habits. PURPOSE: To describe the evolution of and results for our exercise prescription clinic. METHODS: An initial cardiopulmonary exercise test (CPX) was performed to determine absolute and relative VO2peak. A clinical exercise physiologist performed a baseline assessment of the child’s current exercise regimen, habitual activity and screen time, and constructed a daily activity timeline. Perceived barriers to exercise and goals were also reviewed. Exercise prescription was child-specific and incorporated a periodized model. Children were asked to record their daily physical activity for 1 month to allow for modifications to the initial exercise prescription. Families were to return to the clinic on a monthly basis for continuous monitoring of the child’s activity levels. Program length was a minimum of 6 months, with a repeat CPX performed afterwards. RESULTS: Fifty-three children were seen between January 2007 and February 2008. Twenty-eight patients (53%) were seen at 6 month follow-up, while twenty-two patients (42%) discontinued contact. Three patients did not need to be followed further. At follow-up, there was a significant increase in absolute and relative VO2peak (p<0.001 and p<0.002, respectively), despite no change in weight (p=0.086). Peak HR and treadmill time increased significantly from baseline (p<0.006 and p<0.001, respectively) suggesting an increased ability to tolerate exercise. CONCLUSION: Individualized exercise prescription is an important component of family-based behavioral programs directed at reducing pediatric obesity.