Fitness Appraisal in Children with Disabilities: Body Composition
The preferred method for assessing body composition in children with disabilities is with the use of skinfolds. Skinfold measurements have been used with nondisabled children in several fitness assessment tools, including the Prudential FITNESSGRAM and the American Alliance for Health, Physical Education, Recreation, and Dance Health-Related Fitness test.43.44
The skinfold sites that have been recommended for nondisabled children are the triceps and subscapular, or triceps and calf.45 In children who have paralysis in their lower body, it is recommended that the measurements be recorded over functional muscle mass. Thus, the triceps and subscapular skinfolds would be the preferred sites. In children who have use of their lower body, the preferred sites would be the triceps and calf. Although there are skinfold equations that have been developed for use with nondisabled children to compute percent body fat, they have not been validated on children with disabilities. Therefore, it is recommended that the two sites be summed (i.e., triceps and calf) and used as a general measure of adiposity. Since the therapist is primarily concerned with individual performance rather than norm-referenced standards, pre/post measures can be compared for each individual.
A more general but easier way to assess body composition is using Body Mass Index (BMI). BMI is equal to weight in kilograms (1 kg = 2.2 lbs.) divided by height2 in meters (1 m = 39.39 inches). Although some experts would argue that a fairer way to assess body composition would be to compare children with the same level of functional muscle mass, the table can be used as a general index of adiposity. In children who are able to ambulate and have similar levels of body mass compared to nondisabled children, the values reported in this table should be applicable to this group.