Clinical Outcome Measures for Monitoring Physical Function in Pediatric Obesity: An Integrative Review

Objective: Measuring physical function in children with obesity is important to provide targets for clinical intervention to reduce impairments and increase participation in activities. The objective of this integrative review was to evaluate measurement properties of performance-based measures of physical function in overweight and obese children. Methods: An integrative review of literature published in Cochrane reviews, SPORTDiscus, CINAHL, Plos, Medline and Scopus was conducted. Results: Twenty-eight studies were eligible and represented 66 performance-based measures of physical function. Assessments of repeatability and feasibility were not conducted in the majority of performance measures reported, only 6 minute-timed-walk (6MTW) was examined for test-retest repeatability. Measures of flexibility, strength, aerobic performance, anaerobic performance, coordination and balance demonstrated construct validity and responsiveness, but findings were inconsistent across all performance-based measures. Multi-item tests of physical function demonstrated acceptable construct validity and responsiveness, but internal consistency was not determined.Conclusions: There is moderate evidence 6MTW is suitable for measurement of physical function in children with obesity. But, evidence is low for use of aerobic and anaerobic performance, muscle strength, MABC and BOT2 multi-item performance instruments and, very low for flexibility, co-ordination and balance tests. Based on this review, measurement of physical function utilising 6MTW is recommended.