The rate of perceived exertion during exercise in children with overweight or obesity.

The prevalence of childhood obesity and overweight is high and increases.
Physical activity is important in preventing and treating obesity and in
reducing cardiovascular risk factors. Participation in physical activity by
children has also an important role in reducing obesity in adulthood. To
enhance physical activity it is important to know which factors influence this
behaviour. Cognitive and emotional aspects play a part. The rate of perceived
exertion during exercise is higher in obese children, but the Health Related
Quality of Life (HRQoL) is lower in these children. It is unknown if this HRQoL
is associated with the rate of perceived exertion and with physical fitness and
the rate of physical activity in daily life. This is important because
cognitive therapy has an increasing role in lifestyle-intervention programs,
this therapy could focus on emotional and cognitive aspects to increase the
HRQoL.
Our hypothesis is that a lower HRQoL is associated with a higher rate of
perceived exertion during exercise.

The primary objective of this study is to determine the association between
HRQoL and the rate of perceived exertion in children with overweight or
obesity.
The secondary goals are 1) investigation of the association between physical
activity, physical fitness and HRQoL and perceived exertion during exercise; 2)
to determine the difference between the HRQoL of the child reported by the
parent and reported by the child itself; and 3) to evaluate if the present
intervention program increases the HRQoL and if this involves a better rate of
perceived exertion during exercise.

This study is an observational cohort study. Children (and their parents) who
will start this fall with the obesity and overweight treatment program "de
Dikke vrienden Club' in hospital 'Gelderse Vallei' in Ede will be asked for
participation. There will be two measurement periods. One at the start of the
program and one after the intensive part of the treatment (3 months). Both
measures include three parts: a questionnaire (for both parent and child),
accelerometry and an exercise test (during this test the rate of perceived
exertion will be measured also).

The child and its parents are asked to participate in extra measurements for
this study. These measurements are of a minimal burden.
The participants will be asked to wear an accelerometer during four days. The
parents and children will be asked to fill in a questionnaire about the HRQoL
of the child, this will take 20 minutes. The children will be asked to
participate in an exercisetest, this will take ~ 45 minuten. During this test
the heartrate and the oxygensaturation will be measured. The oxygen consumption
will be measured by a facemask. These measurements won't hurt. After the
exercisetest the child can experience tiredness.
These measurements are going to take place two times. Before the start of the
present treatment and after the intensive part of this treatment (3 months).
These measurements will be linked to an already planned visit to the hospital.
The risks for the participants are minimal, these children are physically
capabel to exercise. On exhaustion they have the possibility to stop. The
incidence of sudden death among Minnesota high school athletes was estimated to
be 1 case/200,000 population per year. There is no documentation of sudden
death among athletes who are overweight or obese. In fact, routine exercise has
been well-documented to be beneficial for these conditions. To lower the risks
there will be exclusion of children with a higher risk on sudden death based on
there medical history or family history.