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Physical Activity Assessment and Counseling in Pediatric Clinical Settings

February 28, 2020 by Felipe Lobelo, M.D., Ph.D., FAHA

Over the last decades overall youth physical activity levels have decreased. Coupled with rising rates of obesity, increases in the incidence of type 2 diabetes mellitus, and declines in estimated life expectancy, the role of physical activity on child and later adult health remains an important component of preventive care and disease treatment. Despite the importance of adequate physical activity on child health and development, clinicians are in many cases unfamiliar or unlikely to routinely implement activity-related care.

Strong evidence supports the role physical activity plays for cardiovascular health, musculoskeletal health, mental and behavioral health, and physical, social, and cognitive development in children and youth. The recently released Clinical Report by the American Academy of Pediatrics is intended to offer guidance to physicians and providers rendering physical activity-related care for children and adolescents. The report replaces the APP policy statement on “Active Healthy Living: Prevention of Childhood Obesity through Increased Physical Activity” published in 2006, and extends its scope to overall primordial, primary and secondary prevention.

This report includes a systematic literature review on the validity, reliability and feasibility for integrating physical activity assessment tools in pediatric clinical settings for evaluating compliance with the 2018 Federal Physical activity Guidelines. Additionally, the statement summarizes the most recent age-appropriate recommendations for increased physical activity, supporting physical literacy and gross motor skills development during the pediatric life stages.

Along complementary policy documents such as the U.S Preventive Services Taskforce, the National Youth Sports Strategy, the National Physical Activity Report Card, and the Prescription for Activity Taskforce, this report aligns with the Exercise is Medicine Initiative mission and objectives. Specifically, the focus for this document is on strategies to help overcome barriers for integration of physical activity assessment and promotion into routine care and incorporating physical activity assessment and prescription in medical school and residency curricula.

Physical activity promotion in the health care setting constitutes an important component of the overall National Physical Activity Plan. In conjunction with a similar statement for adult populations, this report reinforces the critical role clinicians play in screening for inadequate physical activity and recommend resources for counseling, prescription and referral to community-based physical activity resources.

Felipe Lobelo, M.D., Ph.D., FAHA, is an ACSM member, serves on the Exercise is Medicine® Pediatric Committee, directs the EIM Global Research & Collaboration Center and is lead author on this AAP paper.

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