1. Children Exercise Physiology
by
Moch.Yunus
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2. (EXERCISE PHYSIOLOGY)
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The study of the human body during exercise
Offers ability to study the body out of homeostasis

3. Exercise Physiology
Stimulus Response
Acut exercise Response
Chronic Exercise Adaptation
HOMEOSTASIS
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4. Moch.Yunus / Exercise Physiology 4
• Homeostasis,, is the property of a
system in which variables are
regulated so that internal conditions
remain stable and relatively constant.
Examples of homeostasis include the regulation
of temperature and the balance between
acidity and alkalinity (pH). It is a process that
maintains the stability of the human body's
internal environment in response to changes in
external conditions

5. Children and Adolescents
Exercise Physiology
?????
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6. OBJECTIVES
Children are not just smaller
versions of adults.
1. GROWTH AND MATURATION
2. PHYSIOLOGICAL DIFFERENCES
3. NUTRITIONAL CONSIDERATIONS
4. PSYCHOLOGICAL CONSIDERATIONS
5.THE IMMATURE MUSCULOSKELETAL SYSTEM
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7. OBJECTIVES
6. ACUTE SPORTING INJURIES
7. OVERUSE INJURIES
8. CHRONIC CHILDHOOD ILLNESS
9. ACUTE ILLNESS AND SPORTS PARTICIPATION
10.PRE-PARTICIPATION HEALTH EVALUATION
11. INJURY PREVENTION
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8. GROWTH AND MATURATION
1) VARIABILITY IN THE PHYSICAL GROWTH OF 6 YEARS
2) PEAK HEIGHT VELOCITY ( PHV )
3) 12 YEAR OLD: SIGNIFICANT DIFFERENT HEIGHT,
MUSCULAR STRENGTH, CARDIOVASCULAR FITNESS
LEVELS
4) NO REASON TO SEGREGATE SEXES UP TO 14 YEARS
OLD
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9. PHYSIOLOGICAL DIFFERENCES
1. Aerobic Capacity in Children
• VO2max (L/min) peaks around age 17 to 21 in
males, then decreases linearly with age.
• VO2max (L/min) has been shown to peak around
age 12 to 15 in females
– Decrease after age 15 may be due to females tending
to reduce physical activity
• Absolute VO2max (L/min) is lower in children
than adults at similar training levels.
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10. Aerobic Capacity in Children
• When VO2max is expressed relative to body
weight, there is little difference in aerobic
capacity between adults and children, thus,
additional muscle mass increases maximal
oxygen consumption.
• Relative to body weight, running economy is
lower in children compared to adults.
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11. Changes in VO2max With Age
Absolute (e.g. L/min)
Relative to body weight
(e.g. ml/kg/min)
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12. PHYSIOLOGICAL DIFFERENCES
2) ANAEROBIC POWER:
- SIGNIFICANT LOWER IN CHILDREN
( SHORT TERM POWER OUTPUT )
- IMPROVING WITH GROWTH
- IN GIRLS LITTLE CHANGE AFTER 12 YEARS OLD
- CHILDREN: LESS USE OF GLYCOGEN, LESS ABLE TO
REDUCE PH
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13. Optimal Anaerobic Power Output
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14. Aerobic and Anaerobic Capacities as a
% of Adult Levels
Adult level
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15. PHYSIOLOGICAL DIFFERENCES
3) CARDIOVASCULAR SYSTEM:
- CHILDREN: HIGHER MAXIMAL HEART RATE
- LOWER STROKE VOLUME
- LOWER SYSTOLIC BLOOD PRESSURE
- BETTER PERIFERAL BLOOD FLOW
ADJUSTMENT TO SPORT
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16. HR and SV as a Function of O2
Uptake
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17. PHYSIOLOGICAL DIFFERENCES
4) RESPIRATORY SYSTEM:
- CHILDREN: SHALLOW BREATHING PATTERN
RESULTING IN LOWER ABSORPTION OF
OXYGEN FROM INSPIRATION
- HIGHER RESPIRATORY FREQUENCY
RESULTING IN GREATER OXYGEN COST IN
RESPIRATION
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18. PHYSIOLOGICAL DIFFERENCES
5) EXERCISE IN HOT AND COLD ENVIRONMENTS:
CHILDREN VUNERABLE: RATIO OF SURFACE AREA TO
VOLUME 30-40% HIGHER THAN ADULTS RESULTING
IN FASTER INCREASE OR LOOSING BODY HEAT
SWEATING MECHANISM IS FULLY OPERATIVE AFTER
ADOLESCENT GROWTH SPURT - DEHYDRATION
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19. 19
Beginning Training
Sensitive Periods.
• Max strength : 12-14(f) 14-16(m)
• explosive strength : 10-12(f) 12-14(m)
• Strength Endurance : 12-14(f) 14-16(m)
• Aerobic Endurance : 8-10 (f & m)
Anaerobic Endurance : 12-14(f) 14-16(m)
• Speed of Reaction : 8-10 (f & m)
• Maximal Speed : 10-12(f) 12-14(m)
• Coordination : 5-8 (f & m)
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21. NUTRITIONAL CONSIDERATIONS
1) ADOLESCENT GROWTH SPURT
2) IRREGULAR EATING HABITS (SNACKS,
MISSING LUNCH ETC )
3) CALCIUM, FOLIC ACID, ZINC, IRON,VITAMINS
A,B6,C
4) DIETARY MANIPULATION, EATING DISORDERS
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22. PSYCHOLOGICAL CONSIDERATIONS
1) CHILDHOOD PLAY IMPORTANT FOR SPORT: ( FIRST 7
YEARS OF LIFE)
- BALANCE AND CO-ORDINATION
- PROPREOCEPTION ( POSITION SENSE )
2) REWARDS OF PHYSICAL ACTIVITY
SELF ESTEEM AND ADMIRATION
3) SPORTS VERSUS PLAY ( AFTER 6 YEARS OLD ) GROUP
GAMES, RULES OF GAMES, GOAL GAMES
PREPARATION AND FEELINGS OF GAME SPORTS
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23. THE IMMATURE MUSCULOSKELETAL
SYSTEM
• 1) PRESENCE OF GROWTH CARTILAGE IN SKELETON
• A) ARTICULAR SURFACES
• B) EPIPHYSEAL PLATES, APOPHYSEAL INSERTIONS
• 2) EFFECTS OF EXERCISE:
• INTENSIVE PROGRAMMES LEAD TO BONY DEFORMATION
• HEAVY PHYSICAL TRAINING LEADS TO LONGER PREPUBERTAL
STATE IN GIRLS
• SPECIAL INTENSIVE TRAINING LEADS TO STRENGTH
IMBALANCE: SHOULDER
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24. THE IMMATURE MUSCULOSKELETAL
SYSTEM
• 3) FACTORS ASSOCIATED WITH INCIDENCE OF
SPORT INJURIES
• EPIDEMIOLOGY: 3 INJURIES PER 100 CHILDREN
PER YEAR
• 0.69 SERIOUS INJURIES PER YEAR
• PEAK FOR BOYS: 14 YEARS OLD
• GIRLS: 15 YEARS OLD
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25. THE IMMATURE MUSCULOSKELETAL
SYSTEM
• INCOMPLETE RECOVERY FROM INJURY: 30%
• FOUL OR ILLEGAL PLAY: 13%
• OVERUSE INJURIES: 50%
• - COMPETITION 35% OF INJURIES
• - RUGBY LEAGUE 32%,SOCCER, RUGBY UNION 11%,
MARTIAL ARTS, HORSE RIDING 2% SAFEST
• SPRAIN ANKLE 45%. 30% MEDICAL ATTENTION, 11%
HOSPITALIZED, 12% LONG TERM DYSFUNCTION
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26. ACUTE SPORTING INJURIES
• 1) HEAD AND NECK : VERY RARE BELOW 11 YRS
• 1-5% OF ALL SPORT INJURIES SERIOUS CNS DAMAGE
• 2) DIAPHYSEAL FRACTURES
• 3) GROWTH PLATE INJURY: SALTER-HARRIS
CLASSIFICATION
• 4) AVULSION FRACTURE OF ACL
• 5) AVULSION FRACTURE MUSCLE GROUPS
• 6) SUFE: 30% SUDDENLY, 70% GRADUAL
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27. OVERUSE INJURIES
• 1) OSTEOCHONDROSES
• 2) STRESS FRACTURES: SUDDEN INCREASE IN
TRAINING INTENSITY
• X-RAYS OR BONE SCANS
• NAVICULAR, PARS-INTERARTICULARIS, FEMORAL
NECK
• 3) MALALIGNMENT SYNDROMES:
• TARSAL COALITIONS ( PERONEI TENDINITIS )
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28. OVERUSE INJURIES
• 1) OSTEOCHONDROSES:
• “ SELF-LIMITED,IDIOPATHIC, DEVELOPEMENTAL
DISORDERS OF PRIMARY OR SECONDARY
OSSIFICATION CENTRES”
• - TRACTION OSTEOCHONDRITIS (APOPHYSITIS ):
OSGOOD-SCHLATTERS, SINDING-LARSEN-
JOHANSSON, SEVERS
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29. OVERUSE INJURIES
• 1) OSTEOCHONDROSES:
• - ARTICULAR SUBCHONDRAL ( CRUSHING )
• PERTHES DISEASE (FEMORAL HEAD)
• KIEBOCKS DISEASE ( LUNATE )
• KOHLERS DISEASE ( NAVICULAR )
• FREIBERGS DISEASE ( 2ND METAT.)
• ARTICULAR CHONDRAL (SPLITTING)
• OSTEOCHONDRITIS DISSECANS (
FEMUR,CAPITELUM,TALAR)
• PHYSEAL: SCHEURMANNS (THORACIC SPINE )
• BLOUNTS ( TIBIA )
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30. CHRONIC CHILDHOOD ILLNESS
• 1) ASTHMA: EXERCISE INDUCED
BRONCHSPASM ( EIB)
• EXERCISE INDUCED ASTHMA ( EIA )
• 2) DIABETES: INCREASED FATIGUE,
ABNORMAL THIRST, FREQ.URINARY,WEIGHT
LOSS
• 3) EPILEPSY ( PETIT MAL, TEMPORAL LOBE,
GRAND MAL )
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31. CHRONIC CHILDHOOD ILLNESS
• 4) CYSTIC FIBROSIS ( GENERAL EXOCRCINE
GLAND DYSFUNCTION )
• CHRONIC RECURRENT SINUS AND
RESPIRATORY TRACT INFECTIONS
• DIGESTIVE TRACT DISORDERS AND
MALNUTRITION
• SWIMMING OF PARTICULAR BENEFIT IN
BRONCHOSPASM HYGIENE
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32. CHRONIC CHILDHOOD ILLNESS
• 5) HYPERTENSION:
• (?) CAUSES, PRIMARY OR SECONDARY
• SPORTS BENEFICIAL FOR PRIMARY
HYPERTENSION
• AVOIDANCE IN PRIMARY ISOMETRIC
ACTIVITIES: WEIGHT LIFTING, WRESTLING,
ICE-SKATING
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33. CHRONIC CHILDHOOD ILLNESS
• 6) HEART DISEASE: CONGENITAL HEART DISEASE IN
5/1000 SCHOOL AGED CHILDREN. RHEUMATIC
HEART DISEASE 1/1000, VALVULAR DAMAGE
• CARDIOMYOPATHY, MYOPATHY, HEREDITARY
SYNDROME 0.8/1000
• RHYTHM SIGNIFICANT DISORDER 0.7/1000
• CONGENITAL CORONARY ANOMALIES 2/100.000
CHILDREN
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34. CHRONIC CHILDHOOD ILLNESS
• 6) HEART DISEASE
• - CARDIAC CONDITIONS ASSOCIATED COMMONLY
WITH SUDDEN DEATH IN SPORT ACTIVITIES
• AORTIC STENOSIS, TETRALOGY OF FALLOT,
HYPERTROPHIC CARDIOMYOPATHY, PULMONARY
HYPERTENSION, MYOCARDITIS
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35. CHRONIC CHILDHOOD ILLNESS
• - CARDIAC CONDITIONS ASSOCIATED WITH
SUDDEN DEATH IN YOUNG ATHLETES:
• HYPERTROPHIC CARDIOMYOPATHY,
ABERRANT LEFT CORONARY ARTERY, AORTIC
DISSECTION ( MARFANS SYNDROME )
CORONARY ARTERY DISEASE
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36. ACUTE ILLNESS AND SPORT
PARTICIPATION
• 1) INFECTIONS MONONUCLEOSIS
• ( GLANDULAR FEVER )
• - SELF-LIMITED ACUTE VIRAL ILLNESS
• - 90% INFECTED BY 30 YEAR OLDS
• - PEAK IS 15-25 YEARS OLD
• - EPSTEIN-BARR VIRUS (EBV)
• - DIAGNOSIS FROM POSITIVE HETEROPHILE
ANTIBODY TEST (MONOSPOT)
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37. ACUTE ILLNESS AND SPORT
PARTICIPATION
• - ENLARGED SPLEEN 40-60%, RUPTURE 0.1 –
0.2%
• - 4 WEEKS ABSENCE, SYMPTOMS CAN LAST UP
TO 6 MONTHS
• 2) OTHER ACUTE ILLNESSES:
HAEM.STREPTOCOCCUS, MYCOPLASMA
PNEUMONIA, SIMPLE HERPES, TINEA PEDIS
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38. PRE-PARTICIPATION HEALTH
EVALUATION
• HISTORY TAKING, PHYSICAL EXAMINATION,
INVESTIGATIONS, ANTHROPOMETRIC
MEASUREMENT
• - CONDITIONS REQUIRING FURTHER EVALUATION
AND POSSIBLE DISQUALIFICATION FROM SPORT:
• 1) UNRESOLVED ORGANIC HEART DISEASE
• 2) SUSTAINED HYPERTENSION WITH EXERCISE
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39. PRE-PARTICIPATION HEALTH
EVALUATION
• 3) LOSS OF CONCIOUSNESS WITH EXERCISE
• 4) SERIOUS CNS TRAUMA OR SURGERY
• 5) HISTORY OF RECURRENT CNS SYMPTOMS (
SEIZURE ETC )
• 6) PERSISTENT HEAT INTOLERANCE
• 7) INTRACTABLE ORTHOPAEDIC PROBLEMS
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40. PRE-PARTICIPATION HEALTH
EVALUATION
• 8) SINGLE ORGAN
• 9) HAEMORRHAGIC DISSORDERS
• 10) CHRONIC INFECTIONS
• 11) CHRONIC DEBILITATING ILLNESS
• 12) ENLARGED ABDOMINAL VISCERA
• 13) OBVIOUS PHYSICAL IMMATURITY
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41. INJURY PREVENTION
• 1) FACTORS CONTRIBUTING TO SPORT INJURIES
• - LACK OF COACHING EDUCATION
• - INADEQUATE PREPARTICIPATION PHYSICAL EXAMS
• - HAZARDOUS PLAYING FIELDS
• - CONDITIONING AND TRAINING ERRORS
• - EQUIPMENT – LACK, IMPROPER, POORLY FITTED
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42. INJURY PREVENTION
• - PLAYING WHILE INJURED OR OVERTIRED
• - GROUPING TEAMS BY AGE NOT SIZE
• - POOR NUTRITION
• - RULES AND OFFICIALS
• - IMPROPER TECHNIQUE
• - INADEQUATE SUPERVISION
• - PSYCHOLOGICAL STRESS
• - WEATHER CONDITIONS
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43. INJURY PREVENTION
• PREVENTION STRATEGIES:
• - GENERAL FITNESS – TRAINING
• - RANGE OF SPORT ACTIVITIES
• - TRAINING WELL BEFORE SEASON
• - ALLOW CHILDREN TO CONTROL INTENSITY OF
ACTIVITIES
• - MODIFY RULES OF ADULT GAMES
• - LESS EMPHASIS ON WINNING
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44. INJURY PREVENTION
• - OPPONENTS TO BE MATCHED IN AGE,
HEIGHT, WEIGHT, MATURITY
• - STRICT SUPERVISION
• - NO MORE THAN A 10% INCREASE PER WEEK
IN TRAINING
• - WARM-UP AND COOL-DOWN TIME
• - PRE-PARTICIPATION EXAMS.
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