PENGARUH AKTIVITAS FISIK

TERHADAP PERKEMBANGAN
ANAK
Dr. Izzuddin Fathoni, Sp.K.O
Growth, maturation and development
⚫ Growth is a dominant biological activity during the first
two decades of life.
⚫ It starts at conception and continues until the late teens or
even the early twenties for a number of individuals.
⚫ Growth refers to the increase in size of the body as a
whole or the size attained by the specific parts of the body.
⚫ The changes in size are outcomes of:
(a) an increase in cell number or hyperplasia;
(b) an increase in cell size or cell hypertrophy; and
(c) an increase in intercellular material, or accretion.

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GROWTH
Body dimensions
and proportions

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⚫Maturation refers to the process of becoming fully
mature
🡪 Adulthood
🡪 The progress towards the mature biological state.
🡪 Most often:
🡪 sexual maturation (reaching functional reproductive
capability),
🡪 morphological maturation (the adolescent growth curve),
🡪 dental maturation and skeletal maturation (a fully ossified
adult skeleton or dentition).
🡪 Under the control of hormonal and biochemical axes
and their interactions.

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⚫Development is a broader concept, encompassing
growth, maturation, learning, and experience
(training). It relates to becoming competent in a
variety of tasks.
⮚ cognitive development,
⮚ motor development and
⮚ emotional development
⚫Motor development is the process by which the
child acquires movement patterns and skills.
⮚ It is characterized by continuous modification based
upon neuromuscular maturation, growth and
maturation of the body, residual effects of prior
experience and new motor experiences per se.

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⚫ Postnatal motor development:
🡪 is characterized by a shift from primitive reflex mechanisms towards
postural reflexes and definite motor actions.
🡪the acquisition of independent walking and competence in a variety
of manipulative tasks and fundamental motor skills (running,
skipping, throwing, catching, jumping, climbing and hopping).

⚫ From school age onwards:

🡪 the focus shifts towards the development of physical performance
capacities/physical fitness or motor fitness.
🡪 Motor fitness:
🡪 cardiorespiratory endurance,
🡪 anaerobic power,
🡪 muscular strength and power,
🡪 local muscular endurance (sometimes called functional strength),
🡪 speed,
🡪 flexibility and
🡪 balance.

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Postnatal growth may be divided into four phases:
• infancy (from birth to 2 years),
• early childhood (pre-school),
• middle childhood (to adolescence) and
• adolescence (from 8–18 years for girls and 10–22 years for boys).

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 Child development theories
⚫The biological theories 🡨 genetic inheritance, the
maturation of systems
⚫The learning theories: only reflexes are inherited and
that all subsequent behaviour changes are learnt🡨
the environment, the process within that of learning.

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 PHYSICAL ACTIVITY
⚫ MOVEMENT of LARGE MUSCLE groups
resulting in increased energy expenditure.
⚫ Children’s activity is usually intermittent, NOT
SUSTAINED.
⚫ Child and adolescent physical activity consists
of active play, sports, exercise, organized
activities (eg. ballet, callistenics) walking and
cycling for transport.

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 The importance of physical activity in the
growth and development of children
⚫Early in life, particularly in infancy and early
childhood, physical activity has an important role in
the physical, psychosocial and mental development
of the child.
⚫Self-initiated informal play 🡪the opportunity for the
young child to experience a wide range of physical
activities 🡪to provide the greatest chance of
developing the set of motor skills needed for
participation in later lifestyle and/or sports activities.

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 physical play
⚫Physical play🡪 has an immediate development
function for physical, cognitive and social skills.
⚫3 phases of physical activity:
❖ The first is a stage of ‘rhythmic stereotype’ which
peaks in infancy. Children at this stage strive to
improve control of specific and gross motor
movement patterns. This activity peaks at six
months, and children can spend up to 40 per cent
of their time🡪 The onset of this is controlled by
neuromuscular maturation.

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❖The second stage, exercise play, can be seen in the
preschool child🡪develop their strength and endurance.
⮚ Gross motor development declines to the age of five years
and only accounts for 20 percent of their physical activity.
Preschool children run, flee, wrestle, chase, jump, push
and pull, lift and climb.

⮚ Muscle strength,central nervous function and metabolic

capacity improve skills ability and economy of movement.
Exercise will have the effect of increasing muscle fibre
differentiation and cerebellar synaptogenesis 🡪The
eventual outcome will be to demonstrate fine motor
control.

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❖The third stage, rough and tumble play, is seen most
clearly in mid-childhood🡪the development of dominance
function and fighting skills.
⮚ From the age of six to ten years, exercise play declines
to 13 per cent of the child’s activity.
⮚ At nine to ten years, running, walking fast, games and
sports, and cycling are enjoyed.
⮚ Males indulge in wrestling, grappling, kicking and tumbling,
can be seen in 4 percent of four year olds, 7–8 per cent of
six to ten year olds, 10 percent of seven to eleven year
olds, 4 per cent of eleven to thirteen year olds and 2 per
cent of boys at fourteen.

⚫ Children of this age are testing their strength against

their peers and trying out social dominance by physical
means.

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The health’s benefit of
physical activity for
young people:
• the prevention of
overweight and obesity;
• improvement in skeletal
health;
• enhancement of heart and
lung function; and
• better psychological health

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 the prevention of overweight and
obesity
⚫The dramatic increases in the prevalence of
childhood overweight and obesity🡪 the role of
physical activity in weight management??
⚫A useful starting point is to be aware of ‘critical periods’
during the growing years, times when the risk of onset,
complications or persistence of overweight and obesity
is increased:
⚫ infancy, early childhood and adolescence🡪times of rapid
growth and development and transition.

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Regular physical activity and normal
motor development
⚫The early years of life should be the time of motor
learning foundation and the subsequent
development of progressively more complex skills.
⚫more physically active have the opportunity to further
refine their motor skills
⚫movement provides the ideal opportunity for
youngsters to explore the environment and their
physical capabilities

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⚫Differences in the individual patterns of growth and
development are largely responsible for the
variability in timing of motor milestones🡪specific
characteristics (self-esteem, self-confidence and
competence).
⚫Activity experiences also provide children with
sensory information through visual, tactile and
auditory mechanisms, as well as from vestibular and
kinaesthetic receptors.
⚫young children engage in movement activities🡪
‘learning to move’ and ‘learning through movement’.

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WHO Motor Development Milestone

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THE EFFECTS of EXERCISE on
GROWTH
⚫Peningkatan ‘size’ (ukuran) tubuh
⚫Dibahas: Lean Body Mass (massa tubuh tanpa lemak)
⚫Ada 3 jenis:
1. Statural or incremental growth: pertumbuhan alami
dan bertahap, mulai dari konsepsi - setelah pubertas.
2. Hypertrophic growth: pembesaran bagian tubuh
karena kebutuhan fungsional
3. Reparative growth: kemampuan perbaikan dan
pemeliharaan tubuh. Dipengaruhi oleh kerja GH dan
Growth Factors pada tingkat jaringan .
⚫ Aktifitas fisik mempengaruhi 3 jenis pertumbuhan tadi dengan 3 cara:
1. Kontraksi otot menghasilkan stress mekanik (mechanical stresses)
pada sistem muskulo skeletal🡪 jaringan terlibat, akan mengalami
regangan🡪hypertrophic. Berperan penting pada pemeliharaan
sistem muskulo skeletal sejak awal incremental growth.
2. Exercise meningkatkan kebutuhan metabolisme energi (metabolic
energy demands), melibatkan peran neuroendokrin dalam
penyediaan dan pemakaian sumber energi dengan segera🡪anabolic
actions🡪mempengaruhi pertumbuhan struktur tubuh secara
keseluruhan dan organ yang terlibat dalam proses penyediaan
oksigen maupun pemanfaatan oksidatif lemak. Berperan terutama
pada pengaturan komposisi tubuh.
3. Mayoritas aktifitas fisik melibatkan rangsang mekanik dan
metabolik🡪 statural and hypertrophic growth
⚫Pengaruh langsung aktivitas fisik bergantung pada
beberapa faktor:
⚫Jenis aktifitas fisik🡪predominan rangsang mekanik
atau predominan rangsang metabolik
⚫Intensitas dan volume aktivitas fisik🡪 meningkatkan
atau mengurangi pertumbuhan. Masih belum diketahui
bagaimana rentang dose-response nya.
⚫Pertumbuhan endogen
⚫Pemilihan waktu aktifitas fisik, nutrisi, dan sistem
hormonal
EXERCISE AND FETAL GROWTH
⚫3 aspek pembahasan:
1. Efek pemakaian energi, bumil yang melakukan
aktivitas fisik pada pertumbuhan janin ? Ibu pekerja
fisik yang berat?🡪 BBLR
2. Efek latihan fisik pada kebutuhan oksigen janin?
Mempengaruhi pertumbuhan plasenta
3. Pengaruh kehamilan pada sekresi GH?
EXERCISE AND GROWTH DURING
CHILDHOOD
⚫ Exercise merangsang atau menghambat petumbuhan?
⚫ Incremental growth dipengaruhi hormon anabolik dan nutrisi
⚫ Exercise membutuhkan energi dan itu mengurangi ketersediaan energi
untuk pertumbuhan
⚫ Exercise merangsang sekresi GH
⚫ Mechanical stress selama exercise menghasilhan hypertrophic growth
⚫ Beban mekanik pada persendian, dapat merusak lempeng pertumbuhan
tulang (epiphyseal plate).
⚫ Pada gymnastic dan balet, banyak ditemukan keterlambatan
kematangan tulang dan keterlambatan pubertas. Ini terkait dengan
intensitas latihan dan kecukupan nutrisi.
⚫ Perlu memperhatikan faktor hormonal maupun energi yang
dikeluarkan (energi expenditure), energi yang diasup, dan energi
yang disimpan.
EXERCISE AND PUBERTAL GROWTH
SPURT
⚫Remaja pria yang aktif pada masa pra pubertas,
diketahui memiliki lingkar/diameter lebih besar pada
lengan atas dan betis, dibanding yang tidak aktif.
Begitu juga dengan tinggi badan.
Exercise and Regulation of Adult Body
Compostition
⚫Meningkatnya gaya hidup sedentary🡪
hypokinetic🡪penimbunan lemak🡪obesitas🡪penyakit
metabolik/tidak menular
⚫Endurance exercise🡪 sensitivitas insulin ↑, GH
↑🡪anabolik ↑ dan lipolytic ↑🡪mengurangi
penimbunan lemak.
TERIMAKASIH

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