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THEORETICAL SUBSTANTIATION OF APPROACHES TO THE EVALUATION OF INDICATORS OF PHYSICAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS


(Kuchma V.R., Skoblina N.A.)
An analysis of the information content of methods for assessing indicators of the physical development of children and adolescents at the population and individual levels allows us to give preference to methods that use regional regression scales.
Estimation by regional modified scales of regression of body weight by body length and a comprehensive scheme have much in common:
- indicators of physical development are evaluated taking into account their relationship
- indicators of physical development are estimated taking into account age and gender
- biological development is evaluated
- standards of physical development take into account regional and other factors
- as a result of applying the methodology, a comprehensive conclusion is given, including information on further medical care for a particular child.
Significant differences in methods are:
- use of a different set of indicators of physical development
- the regression scales are modified in the first case (the range of normal fluctuations in body weight from M - 1SR to + 25r, in order to simplify the data on the circumference of the chest are excluded from the tables) in the second
- a conclusion on physical development is given in various terminology
- techniques vary in degree of complexity and complexity,
- the methodology for using regional modified regression scales was tested according to WHO requirements (specificity, sensitivity and reproducibility, timing of the examination were assessed, the feasibility of performance by paramedical personnel was evaluated) and has high diagnostic information content with economical expenditure of material and labor resources.
The advantages of each of the methods for assessing indicators of the physical development of children and adolescents require further analysis.
In addition, it is of interest to search for the “ideal” methodology for assessing indicators of the physical development of children and adolescents. For this, a factor analysis was used, which allows on the one hand to reduce the number of indicators, on the other hand, to determine the structure of the relationship between the indicators. The main idea of ​​the analysis is that correlated indicators are combined into one factor, which is called the main component. The purpose of component analysis is to find the correlation coefficients of the initial indicators and the main components. These coefficients are called factor loadings of indicators on the main components. According to the values ​​of the loads, one can interpret the meaning of the main components, i.e. determine the initial correlated indicators described by them. Loads were allocated according to the normalized varimax method. To determine the number of main components used the "Scree of scree".
The results of factor analysis were obtained using various methods for assessing indicators of physical development for socially different populations of children and adolescents 6 and 15 years old (tab. 6.1, 6.2).
In a population of boys and girls of 6 years, the methodology for assessing indicators of physical development can be described by three main components:
1st main component describes the assessment of biological development
2nd component describes the assessment of body mass index
The 3rd component describes the assessment of the indicator of body length.
For boys and girls, the main components are the same. Based on the values ​​of factor loads of indicators on the main components, it can be concluded that biological development is best assessed using an integrated scheme. Body weight is well estimated using a comprehensive scheme, intergroup grading tables, and body mass index. Factor analysis shows that the use of Z-Score scores is focused only on body weight scores. Body length is best estimated using regionally modified regression scales.
Table 6.1 Factor loads of indicators on the main components when using various methods for assessing indicators of physical development in a population of children 6 years old
Statistic
Indicators
Boys 6 years old Girls 6 years old
1st
home
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
1st
home
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
According to regional modified scales of regression of body weight along the length of the body
Growth rate 0.24 -0.05 -0.77 0.30 0.19 -0.83
Physical development assessment 0.08 0.58 0.57 0.39 0.53 0.26
Biological development assessment 0.65 0.12 -0.09 0.70 -0.14 0.17
According to the integrated scheme
Morpho score
functional
state
0.001 0.78 0.05 0.14 0.77 -0.11
Biological development assessment 0.85 0.04 -0.08 0.84 0.01 0.02
By intergroup grading tables
Body Length Estimation 0.63 0.23 0.47 0.68 0.25 -0.22
Body weight estimation by body length 0.19 0.87 0.08 -0.07 0.75 0.05
An enlarged scheme for estimating body length and weight 0.39 0.36 0.67 0.55 0.55 0.06
Z-score ratings
Z-score ratings 0.28 0.74 0,07 0.32 0.72-0.18
Calculation of body mass index
BMI 0.11 0,03 -0.01 -0.07 0.39 -0.04
BMI score 0.13 0.82 0.09 0,03 0.76 -0.13
By centile tables
Body Length Estimation -0.01 -0.01 0.69 0.37 -0.04 0.51
Body weight 0.02 0.75 -0.11 0.09 0.12 0.66



Table 6.2 Factor loads of indicators on the main components when using various methods for assessing indicators of physical development in a population of 15-year-olds bgcolor = white> -0.06
Statistic
Indicators
Boys 15 years old Girls 15 years old
1st
glan
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
1st
home
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
According to regional modified scales of regression of body weight along the length of the body
Growth rate 0.08 -0.94 -0.08 0.37 0.82 0.12
Physical development assessment 0.12 0.37 0.80 -0.001 0.34 -0.87
Biological development assessment 0.89 0.01 0.31 0.81 0.21 0.21
According to the integrated scheme
Morpho score
functional
state
0.23 -0.29 0.76 0.16 0.11 0.91
Biological development assessment 0.93 -0.02 0.19 0.84 0.01 0.02
Z-score ratings
Z-score ratings 0.23 0.32 0.76 0.25 -0.53
Calculation of body mass index
BMI 0.13 -0.64 -0.07 -0.16 -0.18 -0.09
BMI score 0.28 -0.04 0.71 -0.13 -0.16 0.79
By centile tables
Body Length Estimation 0.52 0.67 0.20 0.41 -0.57 -0.09
Body weight 0.39 0.34 0.51 0.19 -0.22 0.31




For boys and girls, the main components are the same. Based on the values ​​of factor loads of indicators on the main components, it can be concluded that biological development is best assessed using an integrated scheme. Body weight is well estimated using a comprehensive scheme, intergroup grading tables, and body mass index. Factor analysis shows that the use of Z-Score scores is focused only on body weight scores. Body length is best estimated using regionally modified regression scales.
In the population of boys and girls of 15 years old, the methodology for assessing indicators of physical development can also be described by three main components:
1st main component describes the assessment of biological development
The 2nd component describes the assessment of the body length indicator
The 3rd component describes the assessment of body mass index.
For boys and girls, the main components are the same. Fundamentally, the main components do not differ, although their order has changed, which can be explained by a change in the significance of indicators of physical development with age.
Based on the values ​​of the factor loadings of the indicators on the main components, it can be concluded that biological development is well assessed using regional modified regression scales and an integrated scheme. Body length is still best estimated using regionally modified regression scales. Body mass is well estimated using regionally modified regression scales, an integrated circuit, and body mass index.
The results of factor analysis suggest that the “ideal” methodology for assessing the indicators of the physical development of children and adolescents should contain three main components: an assessment of biological development, an assessment of body weight, and an assessment of body length. To confirm this assumption, a factor analysis was performed on a numerically representative population of 11-year-old adolescents, since this age group is also sensitive (tab. 6.3).
In a population of 11 years old boys and girls, the methodology for assessing indicators of physical development can also be described by three main components:
1st main component describes body weight estimation
The 2nd component describes the assessment of the indicator of biological development
The 3rd component describes the assessment of the indicator of body length.
For boys and girls, the main components are the same. Fundamentally, the main components do not differ, although their order has changed, which can be explained by a change in the significance of indicators of physical development with age.
Based on the values ​​of the factor loadings of the indicators on the main components, it can be concluded that body weight is well estimated using regional modified regression scales, an integrated scheme, intergroup assessment tables and body mass index. Biological development is equally well evaluated using regionally modified regression scales and an integrated scheme. Body length is still best estimated using regionally modified regression scales.
Since previous analysis results indicate the absence of gender differences and similar main components in the three age sensitive groups, a factor analysis was performed on the population of all examined children and adolescents 6-17 years old (Table 6.4).
The methodology for assessing the indicators of the physical development of children and adolescents is also described by three main components:
Table 6.3
Factor loads of indicators on the main components when using various methods of assessing indicators of physical development in a population of 11-year-olds
Statistic
Indicators
Boys 11 years old Girls 11 years old
1st
home
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
1st
home
compo
nenta
2nd
home
compo
nenta
3rd
home
compo
nenta
According to regional modified scales of regression of body weight along the length of the body
Growth rate 0.15 0.11 0.89 0.04 0.34 0.85
Physical development assessment 0.72 0.13 0.42 0.87 0.01 -0.02
Biological development assessment -0.04 0.96 0.005 -0.13 0.97 0.02
According to the integrated scheme
Morpho score
functional
state
0.91 0.01 0.28 0.73 -0.15 0.23
Biological development assessment -0.10 0.92 0.02 -0.13 0.96 0.05
By intergroup grading tables
Body Length Estimation 0.11 0.35 0.70 0.60 0.30 0,03
Body weight estimation by body length 0.83 -0.08 0.39 0.74 -0.12 0.02



bgcolor = white> 0.43
An enlarged scheme for estimating body length and weight 0.42 -0.08 0.73 0.65 -0.04 -0.02
Z-score ratings
Z-score ratings 0.72 0.47 0.34 0.77 0.001 0.02
Calculation of body mass index
BMI 0.82 -0.04 0.32 -0.14 0.48
BMI score 0.63 -0.07 0.52 0.68 0.15 -0.40
By centile tables
Body Length Estimation -0.06 -0.11 0.53 0.14 0.12 0.88
Body weight -0.20 -0.15 0.79 0.28 0.09 -0.79


Table 6.4
Factor loads of indicators on the main components when using various methods of assessing indicators of physical development in the population of children and adolescents 6-17 years old
Statistic
Indicators
Boys and girls 6-17 years old
1st main component 2nd main component 3rd main component
According to regional modified scales of regression of body weight along the length of the body
Growth rate 0.02 0.88 0.70
Physical development assessment 0.86 0.04 0,07
Biological development assessment 0.48 0.73 0.44
According to the integrated scheme
Morpho score
functional state
0.89 0.09 0.001
Biological development assessment -0.004 0.74 0.23
By intergroup grading tables
Body Length Estimation 0.06 -0.27 0.12
Body weight estimation by body length 0.89 0,07 0.05
An enlarged scheme for estimating body length and weight 0.58 -0.28 0,07
Z-score ratings



Z-score ratings 0.75 0.09-0.09
Calculation of body mass index
BMI 0.39 0.36 0.09
BMI score 0.91 0.02 0.02
By centile tables
Body Length Estimation 0.19 -0.20 -0.37
Body weight 0.67 -0.19 -0.13



1st main component describes body weight estimation
The 2nd component describes the assessment of the indicator of biological development
The 3rd component describes the assessment of the indicator of body length.
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THEORETICAL SUBSTANTIATION OF APPROACHES TO THE EVALUATION OF INDICATORS OF PHYSICAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS

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    In the last decade of the XX and at the beginning of the XXI century, a number of works were published devoted to the physical development of children and adolescents and its relationship with environmental factors and living conditions (Bogomolova E.S., 1994, Mikhailova S.A., 1995, Sukhanova N. N., 1996, Svinarev M.Yu., 2002, Ivannikov A.I., Sitnikova V.P. et al., 2007, Belyakova N.A., 2006 and others). Using different assessment techniques
  3. PHYSICAL AND NERVO-MENTAL DEVELOPMENT OF THE CHILD. COMPREHENSIVE ASSESSMENT OF THE HEALTH OF CHILDREN. ASSESSMENT OF THE FUNCTIONAL CONDITION OF THE CARDIOVASCULAR SYSTEM IN CHILDREN AND ADOLESCENTS
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  4. Informativeness of methods for assessing indicators of physical development of children and adolescents at the individual level
    (Kuchma V.R., Skoblina N.A., Pinelis V.G., Karganov M.Yu.) Literature data indicate the relationship of physical development and the health status of children and adolescents: moreover, different authors question "what is primary?" It is decided differently. V.N. Kardashenko, E.P. Stromskaya et al. (1982, 1985) note that the relationship between the characteristics of physical development and the state of health remains insufficient
  5. Physical development. Methods for determining and assessing the physical development of children
    Physical development is understood as a combination of morphological and functional signs of the body: height, weight, chest circumference, lung capacity, muscle strength of the hands, etc. Physical development is directly related to the state of the cardiovascular, respiratory, digestive, musculoskeletal, and other systems . In turn, stability depends on the level of physical development.
  6. EVALUATION OF ANTHROPOMETRIC INDICATORS AND PHYSICAL DEVELOPMENT OF A CHILD
    Methods by which physical development is studied include • anthropometry; • examination and description of the signs of physique and appearance (somatoscopy); • function research: dynamometry with the help of special dynamometer devices; • study of physical performance using a step test or bicycle ergometry; • physical indicators (vital lung capacity, ECG data,
  7. METHODS FOR STUDYING THE PHYSICAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS
    (Baranov A.A., Kuchma V.R.) There are two methods for collecting anthropometric material. 1. The individualizing method - examination of a specific child once or in the dynamics of several years, followed by an assessment of its biological level of development and the harmony of the morphological and functional state using the appropriate evaluation tables. 2. The generalizing method - one-stage
  8. PHYSICAL DEVELOPMENT OF SOCIALLY DIFFERENT POPULATIONS OF CHILDREN AND ADOLESCENTS
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  9. Physical development of socially different populations of children and adolescents living in various territories of Russia in the first decade of the 21st century
    In the previous paragraph, the hygienic characteristics of the studied populations of children and adolescents were given and their social differences were shown. Since physical development is considered as an indicator of the sanitary-epidemiological well-being of the population, it can be assumed that it will have differences in these populations. For the description and analysis of indicators of physical development were selected
  10. Baranov A.A., Kuchma V.R., Skoblina N.A. Physical development of children and adolescents at the turn of the millennium, 2008

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