Optimising motor adaptation in childhood obesity

Childhood obesity is a major public health concern. According to the World Health Organization, more than 22 million children worldwide are classified as overweight (WHO, 2009). In Australia, the most recent data available show that 4.5% of boys and 5.5% of girls ages 2–18 years old are obese (Magarey & Daniels, 2001). Cutoffs for body mass index, weight in kilograms divided by height in metres squared, ‡ 30 kg/m2 for obesity are universally accepted for adults. International cutoffs for obesity designed for children (Cole, Bellizzi, Flegal & Dietz, 2000) use age, gender and body mass index to define obesity (e.g. the cutoff for a 2-year-old boy is 20.09 kg/m2, whereas the cutoff for a 171⁄2-year-old girl is 29.84 kg/m2). Current research on the role of occupational therapy in addressing childhood obesity has focussed on weight loss, weight gain prevention, or increases in physical activity by restructuring environments and routines (Ziviani, Desha, Poulsen & Whiteford, 2010). However, weight loss is not immediate. Examining how to maintain children’s safety during weight loss is important. Obesity affects children’s ability to maintain safety (Bazelmans et al., 2004) while performing their occupations. Impairments in motor adaptation, altering actions to cope with continuously changing environments, result in increased safety risks for children who are obese. They also influence occupational performance, ‘the ability to perceive, desire, recall, plan and carry out roles, routines, tasks, and subtasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of