Join us for our 1st Annual CHKD Dance Medicine Update

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Dr. Joel Brenner Interviewed about Long-Term Effects of Concussion

BrennerJoelDr. Joel Brenner, director of CHKD Sports Concussion Program, was recently interviewed on NewsChannel 3 about the long-term effects of concussions in kids.

“With a developing brain, sometimes it does take longer for younger kids to get better after a concussion.  We know about 75 percent of kids, high school kids and younger take about 3 weeks to get better, but that means 25 percent are still having problems 3 or 4 weeks later,” Brenner said.

Check out the interview here: A Dangerous Game: Kids and Concussions

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Young Athletes and Evaluating the Use of Electrocardiograms

By: Tori Faulkner, MS, CES

SCDAlthough rare, sudden cardiac death (SCD) is the most common cause of death in athletes. SCD is defined as an abrupt, unexpected death due to a cardiovascular cause. It is generally recognized as death that occurs within one hour from the onset of cardiovascular symptoms. However, in young people, it can occur within minutes from the onset of symptoms and sports participation has been associated with an increased risk of SCD. A preventive measure may be to use electrocardiograms.

What causes SCD?

In most cases of SCD a cardiac abnormality is at fault, like atypical arrhythmias. Sometimes, a genetic disorder is to blame, most common being hypertrophic cardiomyopathy or coronary artery anomalies. All SCD episodes have different origins but share similar pathways. Heart signals become chaotic causing an abnormal electrical rhythm and the heart beats out of control, known as ventricular fibrillation.

Can it be prevented?

Signs preceding the events may include fatigue, fainting, dizziness, chest pain, shortness of breath, weakness, or palpitations, but often occur without warning. Therefore, cardiovascular screenings for conditions that lead to an increased risk of SCD have focused on the pre-participation evaluation of athletes. In the U.S., current recommendations focus on personal and family history. Sill this may not show any red flags. An electrocardiogram (ECG) is a simple test that looks at the electrical activity of the heart by placing 12 electrical leads on the chest and torso.

ECG leadsWho should be screened for risk factors?

Recently an intense debate has been occurring over the effectiveness of ECG screening for athletes. For the last 25 years in Italy all athletes have undergone ECG screenings, with data indicating fewer deaths during athletic events. This reduction of SCD events is also related to disqualification of more young people whose ECG’s showed heart abnormalities. The current U.S. recommendations are against ECG screenings due to the large number of athletes that would require them. Cost of an ECG, its interpretation, in addition to further testing due to frequent false-positives, have resulted in an unfavorable cost-benefit ratio.

 What can be done now?

Although rare in the young population, SCD can happen, and is important find those at risk. Some important considerations and actions that can be taken right now include:

  • Recognizing the warning signs and symptoms of SCD
  • Using standardized pre-participation evaluation forms and processes
  • Ensuring those with known or suspected cardiac disorders are referred to a pediatric cardiac center for a comprehensive evaluation
  • Support educational programs for effective bystander CPR and AED use
  • Participation in school emergency response programs

References:

Campbell, R., Berger, S., Ackerman, M.  Pediatric Sudden Cardiac Arrest. American Academy of Pediatrics. 2012; 0144

Khan, B. Sudden Cardiac Arrest in Kids: What and Why? Sudden Cardiac Arrest Foundation. 2015.

Liberthson, R. Sudden Death from Cardiac Causes in Young Children and Adults. N Engl J M. 1996; 334:1039-1044

Link M., Estates III, M. Sudden Cardiac Death in the Athlete Bridging the Gaps Between Evidence, Policy and Practice. American Heart Association. 2012; 125:2511-2516

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Kids and Screen Time: How Much is Too Much?

Teens and Screens
Today’s tweens and teens are spending more time than ever with some kind of technology at their fingertips. It’s hard to avoid. Texting, researching, social media, video games and the like are the new way of life for this generation, and the technology that we think will give them an edge up in school or keep them connected to their peers may be causing them more harm than good. And it’s not just the older kids who are locked into a screen – toddlers and even infants are spending increased time in front of a screen, and while the negative effects of screen time aren’t yet apparent for them now, the consequences will show as they get older.

Some statistics aren’t all that surprising: on average, 8-18 year olds spend 7 hours of screen time media per day1, and 29% of babies under the age of 1 are watching TV for 90 minutes.2 Research has linked increased screen time to some facts that may be surprising however. Here are some facts:

  • Time with screens is a significant risk factor for childhood obesity regardless of socioeconomic status.3
  • For each hour of television viewing per day, children consume an additional 167 calories.4
  • Bedroom TVs are associated with increased risk of obesity in children of all ages.5
  • Children who play active video games such as the Wii do not show an increase of physical activity.6
  • Screen time is linked to sleep disturbance in 6 to 12 year olds7, and irregular sleep patterns in children under three.8
  • For babies and preschool children, screen time is negatively correlated with time spent interacting with parents – time essential for learning.9
  • Older children and adolescents show increased psychological difficulties including hyperactivity, emotional and conduct problems, and difficulty with peers.10
  • Adolescents who spend 3 or more hours daily on a screen are at a high risk for poor homework completion, negative attitudes towards school, poor grades, and long-term academic failure.11
  • Increased screen time in sixth graders has been linked to blunted emotion recognition such as reading facial cues and nonverbal body language. 12

Baby with iPadBaby with iPad 2Some of these facts are downright scary, and that is nowhere near an exhaustive list of the negative implications of screen time. One of the findings that is of particular salience is the blunting of emotion recognition. Instead of forming meaningful connections with peers via face-to-face conversations, kids are hiding behind technology, texting their friends from the refuge of their bedroom. And not only is technology encouraging isolation, but it’s encouraging sedentary isolation leading to obesity, decreased attention spans, and poor school performance.

For most of us, completely eliminating screen time from our lives is impossible as computers are essential for work, and more and more kids are sent home with online homework, so the big question is: how do we find the balance? One strategy may be to sit down as a family and decide how much time to spend with screen media every day, and then stick to that rule. Other ways may be to replace some of the screen time with an activity such as playing outside, joining a sport, going for a family walk, taking up a new active hobby, or finding a family gym. By reducing daily screen time the whole family will enjoy improved health, improved grades, improved behavior, and an improved quality of life!

References

  1. Rideout, V. J., Foehr, U. G., & Roberts, D. F. (2010). Generation M2: Media in the Lives of 8- to 18-Year-Olds. Menlo Park, CA: Kaiser Family Foundation, 2.
  2. Rideout, V. (2011). Zero to eight: Children’s media use in America. San Francisco, CA: Commonsense Media. Further analysis of original data published by Commonsense Media was conducted on October 4, 2012 by Melissa Saphir and Vicky Rideout at the request of this publication.
  3. Wijga A. H., Scholtens S., Bemelmans W. J., et al. (2010). Diet, screen time, physical activity, and childhood overweight in the general population and in high risk subgroups: prospective analyses in the PIAMA birth cohort. Journal of Obesity 2010, Article ID 423296, 9.
  4. Weicha, J. L., Peterson, K. E., Ludwig, D. S., et al. (2006). When children eat what they watch: Impact of television viewing on dietary intake in youth. Archives of Pediatric and Adolescent Medicine, 60, 436-442.
  5. Adachi-Mejia, A. M., Longacre, M. R., Gibson. J. J., Beach, M. L., et al. (2007). Children with a TV in their bedroom at higher risk for being overweight. International Journal of Obesity, 31(4), 644-651.
  6. Baranowski, T., Abdelsamad, D., Baranowski, J., et al. (2012). Impact of an active video game on healthy children’s physical activity. Pediatrics, e636-e642.
  7. Barlett, N.D., Gentile, D.A., Barlett, C.P., Eisenmann, J.C., et al. (2012). Sleep as a mediator of screen time effects on children’s health outcomes. Journal of Children and Media, 6(1), 37-50.
  8. Thompson, D. A., & Christakis, D. (2005). The association between television viewing and irregular sleep schedules among children less than 3 years of age. Pediatrics, 116(10), 851-856.
  9. Vandewater, E. A., Bickham, D. S., & Lee, J. H. (2006). Time well spent? Relating television use to children’s free-time activities. Pediatrics, 117(2), 181-191.
  10. Page, A. S., Cooper, A. R., Griew, P., & Jago, R. (2010). Children’s screen viewing is related to psychological difficulties irrespective of physical activity. Pediatrics, 126(5), 1011-1017.
  11. Johnson, J., Brook, J., Cohen, P., & Kasen, S. (2007). Extensive television viewing and the development of attention and learning difficulties during adolescence. Archives of Pediatric and Adolescent Medicine, 161(5), 480-486.
  12. Uhls, Y., Michikyan, M., Morris, J., Garcia, D., Small, G., Zgourou, E., and Greenfield, P. (2014). Five days at outdoor education camp without screens improves preteen skills with nonverbal emotion cues. Computers in Human Behavior, 39, 387-392.
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Pilates Program for Athletes starting Jan 18!

Pilates Program January

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