Sphygmomanometer

RTP criteria have been defined^{26 (link)} and include symmetrical hip flexion/internal rotation range of motion and
pain-free squeeze test in 45° and 0° of hip flexion,^{9 (link)} pubic stress test,¹⁸ and linear and multidirectional running.^{26 (link)} The squeeze tests were recorded using a sphygmomanometer (Welch Allyn),
preinflated to 20 mm Hg, with a maximum value and a value at first onset of pain
recorded.^{9 (link),18} Self-reported disability and function were assessed using
the HAGOS (0-100, with 100 indicating nil problems),^{49 (link)} and the level of sporting activity was assessed with the Marx activity scale^{22 (link)} (0-16, with higher scores indicating increased frequency of high-demand
sporting activity).

The primary outcome of the study will be cardiorespiratory fitness ( $\dot{V}$ O₂ peak: mL/kg/min) measured by a maximal cardiopulmonary-exercise test (CPET) on an ergocycle (Ergoline 800S, Bitz, Germany). The protocol will be individualised and will include a 3 min warm up at 20 W, followed by an increase in workload from 10 to 20 W/min (depending on the participant’s fitness level) until exhaustion, while maintaining cadence >60 rpm. Electrocardiogram (Marquette, case 12, St. Louis, MI, USA) and oxygen saturation will be continuously monitored, whereas the rating of perceived exertion (Borg Scale, 6–20) and manual blood pressure (sphygmomanometer: Welch Allyn Inc., Skaneateles Falls, NY, USA) will be measured every 2 min during the test. Participants will be encouraged during the test. Minute ventilation ( $\dot{V}$ E: L/min), oxygen uptake ( $\dot{V}$ O₂: mL/min) and carbon dioxide production ( $\dot{V}$ CO₂: mL/min) will be continuously measured at rest as well as during exercise and recovery using a metabolic system (Cosmed Quark, Rome, Italy). Gas exchange will be collected on a breath-by-breath basis and expressed with a 15 s time averaging for analysis. The highest $\dot{V}$ O₂ value during the exercise period will be considered as the $\dot{V}$ O₂ peak.

A brief survey was conducted on sociodemographic characteristics and family history for data collection. The survey was designed by a pediatric physician and a nutritionist. Anthropometric measurements were taken in the presence of the parents and/or child´s guardian, and American Union criteria were used. Weight was measured using a scale and SECA^® stadiometer while barefoot and wearing light clothing, and abdominal circumference was measured with an inextensible tape measure. Waist circumference was measured at the lower edge of the last rib and the upper edge of the iliac crest; the standard error for weight was less than 0.02 kg, and that for circumference was less than 0.01 cm, as indicated by the American Diabetes Association. Body mass index (BMI) was calculated for nutritional status using the Z-score with its respective cutoff points according to the WHO [12 (link)]. Trained personnel measured blood pressure with a sphygmomanometer (Welch Allyn, Ciudad de Mexico, Mexico) and stethoscope (3M^TMLittmann, Ciudad de Mexico, Mexico).

Baseline data consisting of a full medical history were collected in 1998 and 2001. Patients were considered to have macrovascular complications when they had a previous history of angina pectoris, myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, stroke, or transient ischaemic attack. Physical and laboratory assessment data, such as blood pressure, body mass index, lipid profile, creatinine levels, HbA1c and urinary albumin-creatinine ratio, were collected annually. Blood pressure was measured twice with a Welch Allyn Sphygmomanometer in supine position after at least five minutes of rest. The mean blood pressure of two recordings was calculated for each visit.