لخّصلي

In the case of pediatric obesity, it is very important to recognize that the child may not be seeking physical therapy for diagnosis and treatment of obesity; rather, it may exist as a comorbidity of a more physical impairment, such as back or knee pain.For the obese population, ventilation and respiration measures may also need to be examined, to ensure safety with aerobic and strengthening activities within the treatment plan.Knowledge of the potential for weight gain as a side effect of some antipsychotic drugs used in some cases to treat attention deficit hyperactivity disorder or autism, mood stabilizers, antidepressants, and oral steroids such as those used to treat asthma is also important for the pediatric PT, In some cases, parents or educational staff may need education regarding these side effects that may be contributing to changes in the weight status of a child.It is imperative to be comprehensive in the history and physical aspects of the examination to include consideration of the whole body structure and function that may be related to the functional limitations of the presenting diagnosis.A comprehensive review of the musculoskeletal and neuromuscular systems must be performed, because impairments may result in developing joints related to a child's elevated weight status.Because it relates to both primary diagnosis and overall health-related fitness level, it is important to measure muscle performance as well, through manual muscle testing and other measurements outlined earlier.Particular attention must be paid to risk factors, including ethnicity, cultural beliefs, family/caregiver resources, education, social interaction, activities, and support systems.

In the case of pediatric obesity, it is very important to recognize that the child may not be seeking physical therapy for diagnosis and treatment of obesity; rather, it may exist as a comorbidity of a more physical impairment, such as back or knee pain. It is imperative to be comprehensive in the history and physical aspects of the examination to include consideration of the whole body structure and function that may be related to the functional limitations of the presenting diagnosis. Particular attention must be paid to risk factors, including ethnicity, cultural beliefs, family/caregiver resources, education, social interaction, activities, and support systems. General health status questions will lead to information regarding physical functioning, psychological functioning, level of physical fitness, and general health perception. Physical functioning would include perceived mobility issues or sleep patterns or issues. Psychological functioning might look into existing conditions such as depression, anxiety, memory, or social issues related to weight status. It would also be important to assess the family because it might relate to overall home environment and health-related fitness. Intake information about medications currently being used by the child for comorbidities may also offer vital information regarding weight status in the child. Knowledge of the potential for weight gain as a side effect of some antipsychotic drugs used in some cases to treat attention deficit hyperactivity disorder or autism, mood stabilizers, antidepressants, and oral steroids such as those used to treat asthma is also important for the pediatric PT, In some cases, parents or educational staff may need education regarding these side effects that may be contributing to changes in the weight status of a child. Within a systems review, attention should be paid to cardiopulmonary-related measures, as indicated earlier in the discussion of health-related fitness measures. Blood pressure, resting heart rate, and respiratory rate are important factors to monitor when proposing an exercise plan for a child with obesity. Anthropometric measurements must be recorded, including height, weight, and BMI for age determined in children who have weight-related issues, even if not the primary diagnosis. As previously noted, these measures will impact the return to maximal health and wellness in the pediatric client. BMI for age can and should be used as an objective measure for health risk. Discussion with parents regarding the weight status category can open a dialogue to provide education regarding the potential health risks of obesity. A comprehensive review of the musculoskeletal and neuromuscular systems must be performed, because impairments may result in developing joints related to a child’s elevated weight status. Because it relates to both primary diagnosis and overall health-related fitness level, it is important to measure muscle performance as well, through manual muscle testing and other measurements outlined earlier. Weight status can also impact posture and alignment, and must be measured on examination. For the obese population, ventilation and respiration measures may also need to be examined, to ensure safety with aerobic and strengthening activities within the treatment plan. As previously noted, gross motor skills and coordinated movements may also be impacted if a child is obese. The child and family’s motivation for change and expectations for results must be measured as well to determine goal attainment strategies