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Motor competence in overweight and obese children

Eva D'Hondt (UGent)
(2011)
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Abstract
Background: In the past decades, the prevalence as well as the degree of overweight and obesity in children has been rapidly increasing across the world. This is of particular concern due to the corresponding complications for psychosocial and physical health. Nowadays, research into the constraints imposed by excess body weight and fatness on children’s functional capacity is gaining increased attention. Within the existing literature, however, the focus is primarily on components contributing to the level of physical fitness. By contrast, the lower motor competence of overweight and obese children relative to normal-weight peers has not yet been thoroughly investigated. Motor competence refers to the performance as well as the underlying quality of movement when executing various motor tasks. Since an adequate level of motor skill is considered to be a prerequisite for everyday activities and an essential aspect underlying children’s engagement in physical activities, the scarcity of information on the motor (in)competence associated with childhood overweight and obesity contrasts with the potential importance of this factor in both development and treatment of the current epidemic. Research: The overall objective of the present doctoral thesis was twofold. The first aim was to further map the movement-related difficulties in the overweight and obese childhood population across the continuum from gross to fine motor skills. The second aim was to gain greater insight into the specific nature of these difficulties. More specifically, the hypothesis of a decreased perceptual-motor function was examined. These aims were pursued by means of cross-sectional studies conducted both in field- and laboratory-based settings with a focus on motor skill performance (i.e., the product or outcome of a motor action) and movement execution and control (i.e., the process through which that particular outcome is obtained), respectively. The first study investigated the relationship between children’s weight status (i.e., normal-weight, overweight or obese) and their performance on both gross and fine motor tasks. Level of motor skill was evaluated using the Movement Assessment Battery for Children (MABC), which consists of age-specific test items organized in clusters for balance, ball skills, and manual dexterity. It was shown that childhood obesity is associated with poorer overall motor skill performance. This finding was not solely restricted to tasks requiring whole body movement, but also tended to exist in tasks where only a limited part of body mass was involved in the action. The subsequent two studies separately examined gross and fine motor skill performance with a common focus on the age-related impact of excess body weight or fatness on children’s motor coordination. In chapter two, BMI-related differences in gross motor coordination were explored by means of the Körperkoordinationstest für Kinder (KTK). Childhood overweight and - to a greater extent - obesity were found to result in poorer KTK performances, with the most apparent differences on test items relying on physical properties in addition to dynamic body coordination. Using a modified peg placing task in chapter three, it was demonstrated that being overweight or obese was also detrimental for fine motor skill coordination. Besides, results of both studies pointed to more pronounced BMI-related differences as children grow older. The reported deficiency in both gross and fine motor skill among overweight and particularly obese children appeared to decline relative to the performance of normal-weight peers across developmental time. With regard to the KTK, this finding was substantiated by a growing proportion of overweight and obese children that could be identified as being motor impaired according to the age- and gender-specific standards of the test battery. Based on our findings in the field, it could be critically questioned to what extent the mechanical problem of moving excess mass exclusively accounts for the reported lower motor competence associated with childhood overweight and obesity. Hence, two laboratory-based studies were conducted to test the alternative hypothesis of perceptual-motor difficulties as a probable complementary underlying mechanism. In chapter four, the relative contribution of visual (i.e., eyes open or closed) and somatosensory information (i.e., normal or reduced plantar sensation) to postural balance control was explored during quiet bilateral stance in overweight children versus normal-weight peers using computerized posturography. No significantly different centre of pressure (COP) responses to the more challenging conditions were established between groups. Overweight children were not found to be less capable to compensate for the loss of normal sensory inputs in maintaining postural stability. The last study, in chapter five, provided details on the impact of visual deprivation on obese and normal-weight children’s gait control when walking over ground at self-selected speeds. The removal of vision resulted in a number of identical changes in spatiotemporal and kinematic gait characteristics in both groups of children. However, a different response in temporal phasing (i.e., a significantly greater percentage of the gait cycle spent in the stance phase due to a more pronounced increase in relative double support time) suggested an increased reliance on online visual information and a reduced capacity to reweight remaining sensory cues among obese children in order to produce their usual walking pattern. Conclusions: The research presented in this thesis aimed to refine the picture of the motor (in)competence in overweight and obese children and to enhance the current understanding of its underlying mechanism(s). It can be concluded that overweight and obese children are less motor competent as compared to normal-weight peers. More specifically, excess body weight and fatness were found to impose significant constraints on both gross and fine motor skill performance. In the absence of targeted initiatives addressing this problem, the reported deficiencies even appeared to be increasing with age. Finally, preliminary evidence could be provided for difficulties in the perception and/or integration of (altered) sensory information needed to plan and control movement among obese children. A decreased perceptual-motor function might thus underlie their lower motor competence. In the end, future wide-ranging research is required because a more comprehensive view on the implications of being overweight or obese on children’s motor function can significantly contribute to prevention and treatment programs.

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Citation

Please use this url to cite or link to this publication:

Chicago
D’Hondt, Eva. 2011. “Motor Competence in Overweight and Obese Children”. Ghent, Belgium: Ghent University. Faculty of Medicine and Health Sciences.
APA
D’Hondt, E. (2011). Motor competence in overweight and obese children. Ghent University. Faculty of Medicine and Health Sciences, Ghent, Belgium.
Vancouver
1.
D’Hondt E. Motor competence in overweight and obese children. [Ghent, Belgium]: Ghent University. Faculty of Medicine and Health Sciences; 2011.
MLA
D’Hondt, Eva. “Motor Competence in Overweight and Obese Children.” 2011 : n. pag. Print.
@phdthesis{1256355,
  abstract     = {Background: In the past decades, the prevalence as well as the degree of overweight and obesity in children has been rapidly increasing across the world. This is of particular concern due to the corresponding complications for psychosocial and physical health. Nowadays, research into the constraints imposed by excess body weight and fatness on children{\textquoteright}s functional capacity is gaining increased attention. Within the existing literature, however, the focus is primarily on components contributing to the level of physical fitness. By contrast, the lower motor competence of overweight and obese children relative to normal-weight peers has not yet been thoroughly investigated. Motor competence refers to the performance as well as the underlying quality of movement when executing various motor tasks. Since an adequate level of motor skill is considered to be a prerequisite for everyday activities and an essential aspect underlying children{\textquoteright}s engagement in physical activities, the scarcity of information on the motor (in)competence associated with childhood overweight and obesity contrasts with the potential importance of this factor in both development and treatment of the current epidemic.
Research: The overall objective of the present doctoral thesis was twofold. The first aim was to further map the movement-related difficulties in the overweight and obese childhood population across the continuum from gross to fine motor skills. The second aim was to gain greater insight into the specific nature of these difficulties. More specifically, the hypothesis of a decreased perceptual-motor function was examined. These aims were pursued by means of cross-sectional studies conducted both in field- and laboratory-based settings with a focus on motor skill performance (i.e., the product or outcome of a motor action) and movement execution and control (i.e., the process through which that particular outcome is obtained), respectively.
The first study investigated the relationship between children{\textquoteright}s weight status (i.e., normal-weight, overweight or obese) and their performance on both gross and fine motor tasks. Level of motor skill was evaluated using the Movement Assessment Battery for Children (MABC), which consists of age-specific test items organized in clusters for balance, ball skills, and manual dexterity. It was shown that childhood obesity is associated with poorer overall motor skill performance. This finding was not solely restricted to tasks requiring whole body movement, but also tended to exist in tasks where only a limited part of body mass was involved in the action.
The subsequent two studies separately examined gross and fine motor skill performance with a common focus on the age-related impact of excess body weight or fatness on children{\textquoteright}s motor coordination. In chapter two, BMI-related differences in gross motor coordination were explored by means of the K{\"o}rperkoordinationstest f{\"u}r Kinder (KTK). Childhood overweight and - to a greater extent - obesity were found to result in poorer KTK performances, with the most apparent differences on test items relying on physical properties in addition to dynamic body coordination. Using a modified peg placing task in chapter three, it was demonstrated that being overweight or obese was also detrimental for fine motor skill coordination. Besides, results of both studies pointed to more pronounced BMI-related differences as children grow older. The reported deficiency in both gross and fine motor skill among overweight and particularly obese children appeared to decline relative to the performance of normal-weight peers across developmental time. With regard to the KTK, this finding was substantiated by a growing proportion of overweight and obese children that could be identified as being motor impaired according to the age- and gender-specific standards of the test battery.
Based on our findings in the field, it could be critically questioned to what extent the mechanical problem of moving excess mass exclusively accounts for the reported lower motor competence associated with childhood overweight and obesity. Hence, two laboratory-based studies were conducted to test the alternative hypothesis of perceptual-motor difficulties as a probable complementary underlying mechanism. In chapter four, the relative contribution of visual (i.e., eyes open or closed) and somatosensory information (i.e., normal or reduced plantar sensation) to postural balance control was explored during quiet bilateral stance in overweight children versus normal-weight peers using computerized posturography. No significantly different centre of pressure (COP) responses to the more challenging conditions were established between groups. Overweight children were not found to be less capable to compensate for the loss of normal sensory inputs in maintaining postural stability. The last study, in chapter five, provided details on the impact of visual deprivation on obese and normal-weight children{\textquoteright}s gait control when walking over ground at self-selected speeds. The removal of vision resulted in a number of identical changes in spatiotemporal and kinematic gait characteristics in both groups of children. However, a different response in temporal phasing (i.e., a significantly greater percentage of the gait cycle spent in the stance phase due to a more pronounced increase in relative double support time) suggested an increased reliance on online visual information and a reduced capacity to reweight remaining sensory cues among obese children in order to produce their usual walking pattern.
Conclusions: The research presented in this thesis aimed to refine the picture of the motor (in)competence in overweight and obese children and to enhance the current understanding of its underlying mechanism(s). It can be concluded that overweight and obese children are less motor competent as compared to normal-weight peers. More specifically, excess body weight and fatness were found to impose significant constraints on both gross and fine motor skill performance. In the absence of targeted initiatives addressing this problem, the reported deficiencies even appeared to be increasing with age. Finally, preliminary evidence could be provided for difficulties in the perception and/or integration of (altered) sensory information needed to plan and control movement among obese children. A decreased perceptual-motor function might thus underlie their lower motor competence. In the end, future wide-ranging research is required because a more comprehensive view on the implications of being overweight or obese on children{\textquoteright}s motor function can significantly contribute to prevention and treatment programs.},
  author       = {D'Hondt, Eva},
  isbn         = {9789490695644},
  language     = {eng},
  pages        = {V, 203},
  publisher    = {Ghent University. Faculty of Medicine and Health Sciences},
  school       = {Ghent University},
  title        = {Motor competence in overweight and obese children},
  year         = {2011},
}