Authors (including presenting author) :
See WSQ (1), Chau SK(1), Chiu A (2), Leung E (3), Ip B (4), Poon WKG (1), Lee SL (1)
Affiliation :
(1) Paediatrics & Adolescent Medicine, Queen Mary Hospital
(2) Physiotherapy, Duchess of Kent Children's Hospital
(3) Dietetics, Queen Mary Hospital
(4) Clinical Psychology, Duchess of Kent Children's Hospital
Introduction :
Obesity is a complex disease and there are various associated co-morbidities such as diabetes mellitus, hypertension, dyslipidaemia, sleep apnoea, precocious puberty, polycystic ovarian syndrome, etc, resulting in a major healthcare burden. Obesity has become a global epidemic. Not only does it affect adults but it is of increasing impact in children and adolescent. During the covid-19 pandemic, the incidence of obesity further increased. Schools, sport centers, swimming pools etc facilities were closed. In order to help the obese adolescents, we developed a multidisciplinary hybrid mode of summer weight reduction programme involving physiotherapists, dietitians and clinical psychologists. It is based in Duchess of Kent Children's Hospital (DKCH) with tele-medicine component so that patients could also have supervised physical activities at home.
Objectives :
To increase the amount of physical activities in obese adolescents in order to achieve weight reducton and decrease complication of obesity.
Methodology :
Patients age 13-18 years old were recruited in obesity clinic a month before summer holiday. A first outpatient clinic would be arranged in DKCH for baseline assessment: body weight, height, BMI HR , SaO2, body composition analysis, basal metabolic rate, body fat ratio, screening for exercise precautions and clinical psychologists would perform psychoeducation on healthy eating habits, clarifications on myths, introduction to mindful eating and assess patients using 1. Beck Youth Inventory (measuring depression, anxiety, self-concept etc). 2. CBCL (filled by parents) 3. SUDS (Subjective Unit of Distress Scale). 4. Adult Eating Behaviour Questionnaire (we have obtained authorization from author to use the validated Chinese version). Other than that a quality of life assessment (on line), a PedsQL version 4 Teen Report and a PedsQL version 4 Parent Report would be carried out.
After the initial enrollment, an actigraph weight would be given to them to monitor their physical activities. Weight reduction equipment would also be on-loan to patient to facilitate their exercise. Patients were required to physically attend OPD in week 3, week 6 +/- week 8 to make sure correct physical exercise and use of equipment. Tele-medical video conference would be carried out in week 2, 4, 5 +/- 7 to monitor patients physical exercise at home.
The body weight, height, BMI, body composition analysis, basal metabolic rate, body fat ratio and intake from history would be assessed. A quality of life assessment (on line), a PedsQL version 4 Teen Report and a PedsQL version 4 Parent Report would also be carried out after the programme.
Result & Outcome :
Five patients were recruited initially. However 3 defaulted. The other 2 patients completed 8 weeks of training. Patient 1 has a weight reduction of 1.3% (114.4kg to 112.9kg), BMI reduction of 2.8% (BMI 37.4 to 36.4), a body fat composition reduction of 6.6% , an increase in skeletal muscle mass of 0.7%. and an increase in basal metabolic rate from 2023 to 2054. He was also more motivated and engaged in dietary changes. Paitent 2 body weight has a slight rise of 0.9% (from 91.1kg to 91.9kg) but his BMI was reduced from 32.3 to 31.8 (1.5%). His body fat composition was also reduced for 14% (from 41.4% to 35.6%) and his skeletal muscle mass was reduced for 11%. His basal metabolic rate was increased from 1522 to 1648.
In conclusion, the multidisciplinary hybrid mode of summer weight reduction programme provides a platform for home-based exercise session via telemedicine for obese adolescent.
