Study on Sports, Extracurricular Activities, Electronic Device Usage Factors Associated with CFS in Taiwanese Preschoolers 2023 Huang and Duan

Abstract

Under the impact of the pandemic, electronic device usage has become the primary tool for learning. Due to social distancing restrictions, many sports facilities have been forced to close, resulting in changes in daily activities for preschool children. This research aimed to investigate the sports, extracurricular activities, and electronic device usage factors associated with chronic fatigue syndrome among Taiwanese preschoolers.

Five-year-old preschoolers were randomly selected using a stratified multi-stage random cluster sampling method. The parents of the preschoolers completed the questionnaires, which contained items related to the symptoms of fatigue, extracurricular activities, and electronic device usage of their preschoolers. A total of 1536 valid questionnaires were returned. The data were then analyzed using descriptive statistics and the chi-square test.

The following results were obtained: (1) the preschoolers who exercised at least three times per week, engaged in sweating exercise for at least 30 min at a time, had a continuous rhythmic exercise habit, and participated in a variety of exercise types experienced a lower degree of fatigue; (2) the preschoolers who engaged in extracurricular activities every day exhibited a higher degree of fatigue; (3) the preschoolers who watched television or used smartphones to pass the time due to boredom, watched television or used smartphones on holidays, played video games or surfed the Internet due to boredom, and played video games or surfed the Internet on holidays displayed a higher degree of fatigue.

This research verified that regular exercise with various sports, extreme extracurricular activities, and laissez-faire electronic device usage are factors associated with fatigue syndrome in preschoolers. It is suggested to develop children’s regular exercise habits, avoid excessive extracurricular activities, and guide their electronic device usage.

Open access, https://www.mdpi.com/2227-9067/10/8/1278

 

"According to the diagnostic criteria for CFS in children initially published by the International Association for Chronic Fatigue Syndrome in 2005 and republished in 2006, the seven primary symptoms are fatigue, sleep dysfunction, pain (e.g., headaches and muscle and abdominal pain), and neurocognitive, autonomic, neuroendocrine, and immune manifestations [12]. In addition to the aforementioned symptoms, CFS in children is also associated with numerous psychological and behavioral problems, such as mood disturbance, cognitive dysfunction, memory problems, and concentration problems [13,14,15]. Moreover, Richards [16] stated that, despite the similarity of the presentation of CFS in children and adults, the diagnosis of CFS varies between the two groups; the physical and psychological symptoms and symptom combinations vary among children and are easily misdiagnosed by pediatricians as manifestations of aleinophobia or emotional disorders. The literature has indicated that the determination and prediction of CFS in children are challenging. Accordingly, understanding the causes and improving the timely prediction of CFS in children, as well as treating and preventing such symptoms, are topics that warrant in-depth investigation.

Solomon-Moore et al. [17] pointed out 25 years ago that children and young people with CFS were assumed to be relatively physically inactive. Although there is no evidence supporting their claim, it is not defined in all cases. Light activity was associated with better physical functioning and lower fatigue than inactivity. Japanese scholars have suggested that fatigue in young children is significantly associated with staying up late, irregular outdoor sports, dietary habits, skipping breakfast, late-night snacks, excessive extracurricular activities, and prolonged exposure to electronic devices [18,19,20,21]."

 

"Assessment Scale for Symptoms of Fatigue in Children

In order to meet the needs of Taiwanese studies and to analyze the research results with international studies, the Chinese version of the assessment scale for CFS in children with the same content was not developed. Instead, this study adopted the assessment scale for CFS in children with similar cultural backgrounds by Japanese scholars Hattori et al. [18]. For this study, the CFS of children was measured based on three dimensions: sleepy and inactive/blunted responses/lacking energy, difficulty concentrating, and localized pain, totaling ten items. Each of the ten items was rated on a five-point Likert scale, with scores of 1, 2, 3, 4, and 5 indicating “never”, “rarely”, “sometimes”, “very often”, and “always”, respectively. The total score ranged from 10 to 50; higher scores indicated that the children exhibited a higher degree of fatigue, whereas lower scores indicated that the children exhibited a lower degree of fatigue. The parents provided answers based on their observations of their children. The scale’s internal consistency and reliability are good, and it is appropriate for assessing the symptoms of fatigue in young children."

 

"This study found that young children who engaged in a variety of appropriate sports, such as exercising at least three times a week, sweating for at least 30 min each time, having a regular exercise habit, and engaging in a variety of sports, were low in fatigue symptoms. In addition, additional sports, such as going on outdoor excursions during holidays, playing outdoors after school, participating in sports clubs and sports teams, and often taking the initiative to ask family members or classmates to play sports with them, were not significantly different.

This finding is consistent with Kyok and Ikeda’s [19] study of Japanese children. They emphasized that children who had regular outdoor activities had lower fatigue. Bakker et al. [31] assessed 91 patients aged 8 to 18 who completed questionnaires about sleep, somatic symptoms, physical activity, and fatigue. They concluded that poor sleep quality, a physically inactive lifestyle, and specific somatic complaints were important predictive factors. Farmer et al. [32] observed a gradual upward trend in chronic fatigue syndrome (CFS) prevalence in children and adolescents; its prevalence in those over 11 years is equivalent to that in adults. Additionally, according to information on the Harvard Health Publishing website, frequent complaints made by children about being fatigued and the presence of CFS prevent children from enjoying activities and are indicators of health problems [33]. Thus, CFS must not be regarded as affecting adults exclusively. Lee et al. [34] explored the relationship between preschool children’s sleep, exercise abilities, and daily life functions. The results of their study showed that exercise ability had significant effects on daily life functions. Thus, there is a correlation between the appropriateness and diversity of daily activities for children and the manifestation of fatigue symptoms, and developing regular exercise habits in children is an important topic for young children’s health.

Therefore, it is recommended that parents develop regular exercise habits themselves and encourage children to engage in various types of appropriate activities."

 

They don't have a damn clue what CFS is. They looked at a box that said "fatigue" and looked no further.

I don't even get how this happens not just at all, but routinely, in what is supposed to be a serious profession. It's basically the professional version of doing a report on "youth in Asia", instead of euthanasia. Which is doubly fitting here, way more than usual.

It's also, yet again, purely correlational and could just as well work the other way around. For people who use statistics so heavily, they really don't understand some of the most basic aspects of how to use them properly.

 

There are so many doctors who think CFS is vague fatigue symptoms associated with not being disciplined enough in life. Not necessarily psychosomatic, just related to lifestyle. Like someone who gets obese by eating junk food.

The thing is, in medicine doctors are not taught the scientific method, they are just told how X and Y illnesses work and they take it at face value. There is no education surrounding CFS so it becomes a self fulfilling prophecy of a vague fatigue disorder. If at least it had a different name, this wouldn't happen.

 

It seems like the term CFS has come to mean something completely different in Taiwan, as we've seen a lot of these studies. I guess there isn't really a great solution other than just ignoring any study related to CFS from Taiwan.