Child's feet on scale

The science of self-management

Children with special needs may face two to three times the risk of obesity than other children, and it’s a concern that Michele Polfuss wants to alleviate.

“Anytime a child is obese,” Polfuss says, “it takes away from their health promotion, their wellness, their ability to interact with peers as fully.”

Polfuss wants to develop interventions that could help families and health care providers. To do so, she’s working through the UWM College of Nursing’s Self-Management Science Center, or SMSC. Established in 2007, it researches ways to help people better manage their own health and improve their quality of life, even when dealing with chronic conditions.

The SMSC is funded as an Exploratory Center by the National Institute of Nursing Research, part of the National Institutes of Health. Examples of current SMSC projects include seeking ways to help young adults manage their fatigue during chemotherapy and improving the health of low-income African-Americans who have hypertension.

Often, SMSC research is done in collaboration with other UWM departments, as well as other universities and health care institutions, such as the Medical College of Wisconsin, the Clement J. Zablocki VA Medical Center or Children’s Hospital of Wisconsin.

Michele Polfuss measures a child's height
Michelle Polfuss' research through the Self-Management Science Center seeks to alleviate the increased risk of obesity for children with special needs. (UWM Photo/Troye Fox)

Polfuss, an assistant professor of nursing, holds a joint research chair in the nursing of children with UWM and Children’s Hospital. She’s done pilot studies on the energy expenditure and body composition of children with Down syndrome, spina bifida and other conditions.

“Because muscle burns more calories than fat, if you have two children both weighing 120 pounds, the one with more muscle is going to burn more calories with every activity they do,” Polfuss says. This comes into play for children with Down syndrome, who generally have less muscle tone, or children with spina bifida, whose physical limitations may curb activities and decrease their muscle tone.

That was borne out in one of Polfuss’ pilot studies. Children in a control group expended 2,500 calories a day. Children with Down syndrome and children with spina bifida who were ambulatory expended 2,000 calories a day. Those with spina bifida who used wheelchairs were closer to 1,700 a day.

Polfuss’ next steps include repeating the pilot studies with larger groups and starting research on ways to intervene.

“It’s really a passion of mine to help children start in the healthiest frame possible,” Polfuss says, “so they have the best opportunity for the rest of their life.”