patient advocacy

Survival of the Fitness: Exercise with Kids Indoors

More than 80% of the world's adolescent population is insufficiently physically active, according to the World Health Organization (W.H.O.). With obesity rates on the rise, it’s more important than ever to present every option for kids to get physically active, no matter where they are. When it’s safer, more convenient, or more seasonable to stay indoors, how can kids get the appropriate amount of physical activity? Here we’ll cover the latest AAP recommendations for staying fit, physical education options, non-sports options for keeping active, and appropriate options for kids with disabilities.

The Latest in Pediatric Fitness

Obesity rates as high as 15% are a strong matter of concern for pediatricians and parents, and yet physical activity is crucial not only in ending the epidemic of obesity in children, but for their overall physical, cognitive, emotional, and social development and lifelong health.

A March 2020 clinical report in Pediatrics notes that assessment and counseling are critical for children and teens to achieve the recommended level of physical activity every day. The report also states that pediatricians have important roles in advocating for screening tools and payor coverage for assessments, encouraging and promoting physical activity and literacy, providing guidance in meeting goals to families, advocating for physical activity opportunities for kids in schools, hospitals, and communities, and finally setting a positive example with their own physical activity. This is a lot for anyone to feel responsible for, and this post is here to help break it down.

In June 2020, a Pediatrics report reviewed the benefits of resistance training in kids and teens. According to the report, “It is now accepted that children and adolescents can increase strength with low injury rates if resistance training is well supervised with an emphasis on correct technique.” The report defines strength- and resistance-training, positive outcomes, bodyweight as well as weight training options, and the importance of advocating strength-training in physical education. It also encourages proper medical screening before a resistance- or strength-training program is undertaken, whether for athletes or non-athletes.

Pediatrics revisited the topic of obesity in a metadata report on the effectiveness of motivational interviewing (MI). In this context, MI was used with parents with the intent of positively changing the lifestyles of their childrens’ physical activity. The metadata found that there were significant changes after this method was used, both in body weight and in other positive changes.

Indoor Physical Activity for Kids

Whether due to rain, heat, safety, access to the outdoors, or simple convenience, it makes sense that children need outlets for physical activity indoors to maintain the recommended amount of 1 hour of physical activity a day. From the type of exercise that suits kids best and options for every child’s unique circumstances, there are many ways to help families keep kids active inside.

Physicians and parents know that physical activity is important for kids’ health, but does jumping on a trampoline offer equal benefits as performing a handstand or pushups? The answer is yes, but for different reasons. While the AAP, U.S. Department of Health and Human Services, and the W.H.O. recommend both anaerobic and aerobic forms of exercise for children, muscle and bone-strengthening exercises play an important role in health, and the current guidelines recommend at least 3 days of this type of exercise per week, while 1 hour a day total exercise is recommended for kids older than 5, according to the 2018 recommendations by the Department of Health & Human Services.

Anaerobic Exercise

Strength-building exercises can be helpful for families with limited space or access to indoor-friendly exercise equipment such as treadmills, stationary bikes, or trampolines, which may be inappropriate for kids to use depending on their age, height, and ability. In fact, whether at home or at a trampoline park, trampolines carry significant risk of injury for kids and the AAP actively discourages their use

Remember that strength-training is not exclusive to weight lifting, and both body weight and light free weight exercises are helpful for kids. Free weights are safe after about age 7 -- kids can begin by learning correct forms under supervision while exercising all muscle groups and progressing slowly.

Aerobic Exercise

Aerobic exercises are a little more limited indoors, but there are plenty of ways to keep kids moving. Here are some:

  • Dancing
  • Active toys like hoola-hoops and jump ropes
  • Yoga (Yoga also builds strength and improves flexibility and balance)
  • Climbing stairs
  • Workout videos (appropriate for age, interest, and skill level)

Aerobic or “cardio” exercises are often flexible and adaptable for kids of many ages, abilities, and skill levels. Parents can incorporate exercise into kids’ daily lives indoors and out with strategies such as choosing stairs over elevators, taking family walks, and even cleaning. A successful strategy for young children is making exercise play by, for example, racing to a destination in the house together or engaging in a friendly strength competition.

Exercise is for Everyone

For some kids, exercise is an inherent joy, and they find little trouble finding time for it. For others, physical activity might come at an emotional or physical cost. By handling obstacles early, physicians and parents can guide kids to form healthy, positive relationships with daily activities that fit their needs and interests. Pediatricians can also work in collaboration with sports medicine specialists and physical therapists to create an appropriate program.

Exercise with a Disability

For families with kids or caregivers with certain disabilities, outdoor physical activities can be unsafe or simply inconvenient to access. Before beginning a program or signing up for an activity, a child’s caregivers and pediatrician should sign off to ensure it is safe and appropriate. The CDC recommends this Youtube playlist designed for adults and children with various skill levels and disability considerations.

After Illness, Injury, or an Eating Disorder

Recovery is an important, individual process, and a patient’s activity needs may change over time. Appropriate exercise for patients recovering from an illness or injury will often depend on their physician’s recommendations, the nature of the illness or injury, and the patient’s comfort level. 

Meanwhile, patients recovering from an eating disorder should lean on the support of their pediatrician and a behavioral health specialist to maintain a balance between a healthy diet and building routines that support their psychological as well as physical recovery process. To learn more about the role of exercise in eating disorder recovery, you can visit resources by the AAP.

Other Considerations

Sometimes physical fitness requires some creativity and an open mind. Maybe an activity is inappropriate for a child because it’s not appropriate for their age or fitness level, maybe there isn’t space inside, or maybe sports just aren’t their “thing.” The great thing about indoor exercise is that there are many options to try. 

Variety and fun are important for kids still discovering their preferred way to move, as well as a child’s personality and interests. Social kids might find success with a buddy, independent movers might enjoy a family dance performance or a private yoga session, and kids bored of being inside might enjoy creating obstacle courses with objects in their home. Parents and physicians can together find the right activities for each child’s physical activity to flourish, even if for now, it has to be indoors. 

Feeling cooped up inside? It’s healthy for pediatricians to get outside the office, not just for exercise but to get to know their colleagues’ unique approaches to problems, expand their skills, and meet new people with fresh ideas. Whether you’re planning an online conference or in-person meeting, learn how to improve your pediatric business by getting outside the practice with our webinar, hosted by PCC’s Chip Hart.

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Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.