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Beaulieu E, Beno S. Healthy childhood development through outdoor risky play: Navigating the balance with injury prevention. Paediatr Child Health 2024; 29:255-269. [PMID: 39045477 PMCID: PMC11261819 DOI: 10.1093/pch/pxae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/18/2023] [Indexed: 07/25/2024] Open
Abstract
Free play is essential for children's development and for their physical, mental, and social health. Opportunities to engage in outdoor free play-and risky play in particular-have declined significantly in recent years, in part because safety measures have sought to prevent all play-related injuries rather than focusing on serious and fatal injuries. Risky play is defined by thrilling and exciting forms of free play that involve uncertainty of outcome and a possibility of physical injury. Proponents of risky play differentiate "risk" from "hazard" and seek to reframe perceived risk as an opportunity for situational evaluation and personal development. This statement weighs the burden of play-related injuries alongside the evidence in favour of risky play, including its benefits, risks, and nuances, which can vary depending on a child's developmental stage, ability, and social and medical context. Approaches are offered to promote open, constructive discussions with families and organizations. Paediatricians are encouraged to think of outdoor risky play as one way to help prevent and manage common health problems such as obesity, anxiety, and behavioural issues.
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Affiliation(s)
| | - Suzanne Beno
- Canadian Paediatric Society, Injury Prevention Committee
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Beaulieu E, Beno S. Le développement sain de l'enfant par le jeu risqué extérieur : un équilibre à trouver avec la prévention des blessures. Paediatr Child Health 2024; 29:255-269. [PMID: 39045472 PMCID: PMC11261840 DOI: 10.1093/pch/pxae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/18/2023] [Indexed: 07/25/2024] Open
Abstract
Le jeu libre est essentiel pour le développement de l'enfant, de même que pour sa santé physique, mentale et sociale. Les occasions de se livrer au jeu libre extérieur, et au jeu risqué en particulier, ont considérablement diminué ces dernières années, en partie parce que les mesures de sécurité ont visé à prévenir toutes les blessures liées aux jeux plutôt que seulement les blessures graves et fatales. Le jeu risqué désigne des formes passionnantes et stimulantes de jeu libre dont l'issue est incertaine et qui comportent une possibilité de blessure physique. Les promoteurs du jeu risqué distinguent le « risque » du « danger » et aspirent à recadrer la perception du risque pour qu'il devienne une occasion d'évaluer une situation et de favoriser le développement personnel. Dans le présent document de principes, les auteures soupèsent le fardeau des blessures liées au jeu par rapport aux données probantes en appui au jeu risqué, notamment les avantages, les risques et les nuances, qui peuvent varier en fonction de l'étape de développement de l'enfant, de ses aptitudes et du contexte social et médical. Elles proposent des approches pour promouvoir des échanges ouverts et constructifs avec les familles et les organisations. Les pédiatres sont invités à percevoir le jeu risqué extérieur comme un moyen de contribuer à prévenir et à gérer des problèmes de santé courants tels que l'obésité, l'anxiété et les problèmes de comportement.
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Affiliation(s)
- Emilie Beaulieu
- Société canadienne de pédiatrie, comité de la prévention des blessures, Ottawa (Ontario) Canada
| | - Suzanne Beno
- Société canadienne de pédiatrie, comité de la prévention des blessures, Ottawa (Ontario) Canada
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Xu L, Chen S, Gao D, Fang Y, Li L. The associated factors for physical activity-related injuries among first-year university students in southern China from a biopsychosocial perspective. Front Public Health 2024; 12:1369583. [PMID: 38628852 PMCID: PMC11018952 DOI: 10.3389/fpubh.2024.1369583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/08/2024] [Indexed: 04/19/2024] Open
Abstract
Background Understanding the diverse factors influencing physical activity-related injuries is crucial for developing effective interventions that enable individuals to participate in physical activity (PA) while minimizing injury risk. Currently, research evidence on the multiple factors associated with PA-related injuries is inadequate. This study aimed to examine the associations between PA-related injuries and various biological, psychological, and social factors among first-year university students in China. Methods We recruited first-year university students from Shantou University in Guangdong Province, China, to participate in our study. Data collection employed a structured self-administered questionnaire, gathering information on PA-related injuries, as well as relevant biological, psychological, and social factors. Binary logistic regression, using a stepwise modeling approach, was employed for the data analysis. Results Among 1,051 first-year university students, 28.16% reported having experienced PA-related injuries in the past year. Most of the injuries reported were minor, with the knee or lower leg being the most frequently injured part of the body. Improper posture, environmental conditions, and excessive physical load were the leading causes of PA-related injuries. Multiple logistic regression analysis revealed that female students (OR = 0.67, 95% CI: 0.47-0.94, p = 0.022) had reduced odds of PA-related injuries. Conversely, high neuroticism (OR = 1.61, 95% CI: 1.07-2.41, p = 0.022), being a member of a sports team (OR = 2.09, 95% CI: 1.34-3.27, p < 0.001), PA on the wet ground (OR = 1.73, 95% CI: 1.18-2.54, p = 0.005) increased the odds of PA-related injuries. Conclusion Our findings underscore the intricate interplay of various factors contributing to PA-related injuries. Identifying high-risk individuals based on physiological and psychological characteristics, coupled with targeted interventions addressing modifiable risk factors, is crucial for effective prevention.
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Affiliation(s)
- Lingyu Xu
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Shangmin Chen
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Dongna Gao
- School of Public Health, Shantou University, Shantou, China
| | - Ying Fang
- Mental Health Center, Shantou University, Shantou, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Oliver BE, Nesbit RJ, McCloy R, Harvey K, Dodd HF. Adventurous play for a healthy childhood: Facilitators and barriers identified by parents in Britain. Soc Sci Med 2023; 323:115828. [PMID: 36931037 DOI: 10.1016/j.socscimed.2023.115828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/22/2022] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
RATIONALE Adventurous play, where children take age-appropriate risks involving uncertainty, fear, and thrill, is positively associated with children's physical health, mental health, and development. There is growing concern that children's access to and engagement with adventurous play opportunities are declining in Westernised countries, which may have negative implications for children's health. OBJECTIVE The current study aimed to ascertain the facilitators of and barriers to children's adventurous play most identified by parents in Britain and to determine whether these differ across socio-demographic and geographic groups. METHODS This study analysed the responses of a nationally representative sample of 1919 parents who took part in the British Children's Play Survey. Two open-ended questions asked parents to identify what they perceive to be the facilitators of and barriers to their child's adventurous play. A quantitative coding scheme, developed using the qualitative framework identified by Oliver et al. (2022), was applied to parents' responses. RESULTS A diversity in the most identified facilitators and barriers was found, including concerns about the risk of injury from adventurous play and the safety of society, positive attitudes about the benefits of adventurous play, as well as factors related to child attributes. In general, these were consistently identified across different socio-demographic and geographic groups, although some differences were found in barriers. CONCLUSIONS The findings of this research support the identification of key targets for those working with parents to improve children's adventurous play opportunities and ultimately their physical and mental health. Future research should seek to design and tailor interventions by asking parents about the support they would value.
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Affiliation(s)
- Brooke E Oliver
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Rachel J Nesbit
- Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, United Kingdom
| | - Rachel McCloy
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom
| | - Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, United Kingdom; Children and Young People's Mental Health (ChYMe), College of Medicine and Health, University of Exeter, United Kingdom.
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Sankova MV, Nikolenko VN, Oganesyan MV, Vovkogon AD, Gadzhiakhmedova AN, Zharikova TS, Zharikov YO. Identifying sex-specific injury predictors as a key factor in maintaining optimal physical activity levels. World J Orthop 2023; 14:146-154. [PMID: 36998385 PMCID: PMC10044326 DOI: 10.5312/wjo.v14.i3.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/11/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Optimal physical activity is known to reduce cardiovascular, respiratory and endocrine system diseases and, as a consequence, improve quality of life. An important risk factor for reinjuries during normal exercise is the initial connective tissue pathology. The variety of clinical dysplastic manifestations significantly complicate the timely diagnosis of this comorbidity.
AIM To establish pathognomonic sex-specific dysplasia phenotypes that indicate a particular sensitivity to physical exertion.
METHODS The study involved 117 participants with recurrent musculoskeletal injuries that occurred during normal exercise. There were 67 women (57.26%) and 50 men (42.74%), which made it possible to compare the presence of the identified signs between sexes. A validated questionnaire was used to screen their connective tissue status.
RESULTS Ranking the most commonly revealed dysplasia signs depending on their clinical significance made it possible to establish pathognomonic sex-specific phenotypes that indicated a particular susceptibility to injuries. Individualized programs of optimal physical activity are necessary for men with chest deformities, flat-valgus feet, dolichostenomelia, arachnodactylia, hemorrhoids, abdominal muscle diastasis and recurrent hernias. In women, special sensitivity to physical exertion was associated with a combination of signs such as asthenic body, joint hypermobility, overly soft auricles, thin hyperelastic skin, atrophic striae, telangiectasias and varicose veins. Of particular importance were universal signs such as gothic palate, scoliosis, kyphosis, leg deformities, temporomandibular joint crunching, and moderate to high myopia.
CONCLUSION Participants’ connective tissue condition should be considered when designing optimal physical activity programs. Identifying the established sex-specific dysplasia phenotypes will allow timely optimization of training loads, thus reducing the risk of injury.
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Affiliation(s)
- Maria V Sankova
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
| | - Vladimir N Nikolenko
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow 119991, Russia
| | - Marine V Oganesyan
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow 119991, Russia
| | - Andjela D Vovkogon
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
- European Osteopathic Clinical Center of the Moscow Branch of the “Medical Academy of Osteopathic Education”, Saint Petersburg 199106, Russia
| | - Aida N Gadzhiakhmedova
- Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
| | - Tatyana S Zharikova
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow 119991, Russia
| | - Yury O Zharikov
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 125009, Russia
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Eager D, Zhou S, Barker R, Catchpoole J, Sharwood LN. A Public Health Review into Two Decades of Domestic Trampoline Injuries in Children within Queensland, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1742. [PMID: 36767107 PMCID: PMC9914378 DOI: 10.3390/ijerph20031742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Trampolining as an activity brings enjoyment and many health benefits, but at the same time it carries an injury risk. Most domestic trampoline users are children who are developing in skill, cognition, risk perception, physical strength and resilience to injury. Several common patterns of child trampoline injuries have been identified and countermeasures outlined in standards have been taken to reduce higher risk injury mechanisms, such as entrapment and falls from the trampoline through design, product and point of sale labelling. In Australia, the first national trampoline standard was published in 2003 which introduced improvements in trampoline design and requirements for labelling and padding. This work investigated the potential impact of these and subsequent changes based on almost two decades of emergency department trampoline injury data collected in Queensland, Australia. These data describe the changing representative proportion and pattern of trampoline injuries in Queensland over time by age, mechanism, gender, severity and nature of injury of injured persons up to the age of 14 years. The interrelationships between different injury characteristics were also analysed to propose the main factors influencing injury occurrence and severity. These findings seem to indicate that safety evolution in the form of enclosure nets, frame impact attenuation and entrapment protection have likely improved domestic trampoline safety. Other factors, such as adult supervision, minimum age and avoidance of multiple users, could further reduce injury but are harder to influence in the domestic setting.
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Affiliation(s)
- David Eager
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
| | - Shilei Zhou
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
| | - Ruth Barker
- Queensland Injury Surveillance Unit, Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston 4029, Australia
| | - Jesani Catchpoole
- Queensland Injury Surveillance Unit, Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston 4029, Australia
| | - Lisa N. Sharwood
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney 2032, Australia
- Translational Health Collective, Kolling Institute, Clinical School Northern, University of Sydney, Sydney 2006, Australia
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Elareibi I, Fakron S, Gaber A, Lambert M, El Tantawi M, Arheiam A. Awareness of sports-related dental emergencies and prevention practices among Libyan contact sports coaches: A cross-sectional study. Health Sci Rep 2023; 6:e977. [PMID: 36479391 PMCID: PMC9718920 DOI: 10.1002/hsr2.977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/28/2022] [Accepted: 11/18/2022] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND AND AIMS Despite the high incidence rate of dental trauma and its possible devastating physical and psychological consequences on children, little is known about sport-related dental trauma and its prevention and management among Libyan sports coaches. The present study aimed to assess the knowledge and attitude of Benghazi contact sports coaches regarding sport-related dental trauma and its prevention and management. METHODS A cross-sectional study design was used. Two hundred and thirty-one contact sports coaches were recruited from different public and private youth sports centers across Benghazi. The data were collected using a self-administered questionnaire translated into Arabic and piloted to evaluate its validity and clarity. In addition, Mann-Whitney U, Kruskal-Wallis, and χ 2 tests were used to check associations between the variables. RESULTS A total of 151 contact sports coaches returned a completed questionnaire; the majority of coaches (74%) have seen orofacial injuries during their coaching career, whereas less than half of them (47%) personally experienced these injuries. Only one participant said he would preserve the tooth in milk, and four indicated that they would replant it. Most coaches (89.4%) knew what a mouthguard is, but 53.6% would recommend its use, and these were more likely to have previously used mouthguards (p ≤ 0.001). About 41.1% received previous training on TDIs-related emergencies. Higher knowledge scores were observed among coaches who previously received training (p = 0.023). CONCLUSION The findings of this study indicate low awareness of how to manage and prevent orofacial injuries among Libyan contact sports coaches, even though they commonly encounter these injuries and believe in mouthguards' effectiveness. Previous training on managing emergencies and experience appeared to influence the coaches' knowledge. Training coaches on preventing TDIs and their early management in sports fields should be an implemented policy and a prerequisite to obtaining a training license.
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Affiliation(s)
- Iman Elareibi
- Department of Paediatric Dentistry, Faculty of DentistryUniversity of BenghaziBenghaziLibya
| | - Sarah Fakron
- Department of Paediatric Dentistry, Faculty of DentistryUniversity of BenghaziBenghaziLibya
| | - Amal Gaber
- Department of Dental Public Health and Preventive Dentistry, Faculty of DentistryUniversity of BenghaziBenghaziLibya
| | - Martijn Lambert
- Dental Public Health, ELOHA (Equal Lifelong Oral Health for All) Research Group, Oral Health SciencesGhent UniversityGhentBelgium
| | - Maha El Tantawi
- Department of Paediatric Dentistry and Dental Public Health, Faculty of DentistryAlexandria UniversityAlexandriaEgypt
| | - Arheiam Arheiam
- Department of Dental Public Health and Preventive Dentistry, Faculty of DentistryUniversity of BenghaziBenghaziLibya
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Wang C, Stokes T, Vargas JT, Steele R, Wedderkopp N, Shrier I. Predicting Injury Risk Over Changes in Physical Activity in Children Using the Acute:Chronic Workload Ratio. Am J Epidemiol 2022; 191:665-673. [PMID: 34849538 DOI: 10.1093/aje/kwab280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Limited research exists on the relationship between changes in physical activity levels and injury in children. In this study, we investigated the prognostic relationship between changes in activity, measured by the acute:chronic workload ratio (ACWR), and injury in children. We used data from the Childhood Health, Activity, and Motor Performance School Study Denmark (2008-2014), a prospective cohort study of 1,660 children aged 6-17 years. We modeled the relationship between the uncoupled 5-week ACWR and injury, defined as patient-reported musculoskeletal pain, using generalized additive mixed models. These methods accounted for repeated measures, and they improved model fit and precision compared with previous studies that used logistic models. The prognostic model predicted an injury risk of approximately 3% between decreases in activity level of up to 60% and increases of up to 30%. Predicted risk was lower when activity decreased by more than 60% (minimum of 0.5% with no recreational activity). Predicted risk was higher when activity increased by more than 30% (4.5% with a 3-fold increase in activity). Girls were at significantly higher risk of injury than boys. We observed similar patterns but lower absolute risks when we restricted the outcome to clinician-diagnosed injury. Predicted increases in injury risk with increasing activity were much lower than those of previous studies carried out in adults.
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Perceived Barriers and Facilitators of Adventurous Play in Schools: A Qualitative Systematic Review. CHILDREN-BASEL 2021; 8:children8080681. [PMID: 34438572 PMCID: PMC8392663 DOI: 10.3390/children8080681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/28/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023]
Abstract
Adventurous play, defined as exciting, thrilling play where children are able to take age-appropriate risks, has been associated with a wide range of positive outcomes. Despite this, it remains unclear what factors might aid or hinder schools in offering adventurous play opportunities. The purpose of this systematic review is to synthesise findings from qualitative studies on the perceived barriers and facilitators of adventurous play in schools. A total of nine studies were included in the final synthesis. The review used two synthesis strategies: a meta-aggregative synthesis and narrative synthesis. Findings were similar across the two syntheses, highlighting that key barriers and facilitators were: adults’ perceptions of children; adults’ attitudes and beliefs about adventurous play and concerns pertaining to health and safety, and concerns about legislation. Based on the findings of the review, recommendations for policy and practice are provided to support adventurous play in schools.
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Heath MR, Janosky JJ, Pegno A, Schachne JM, Fabricant PD. Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes. Am J Sports Med 2021; 49:1904-1911. [PMID: 33914649 DOI: 10.1177/03635465211008562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. PURPOSE To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. STUDY DESIGN Cross-sectional study with prospectively collected data. METHODS Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. RESULTS Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level (r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score (R2 = 0.242; B = 3.0; P < .001). CONCLUSION This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. CLINICAL RELEVANCE All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.
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Affiliation(s)
| | | | - Angelo Pegno
- Hospital for Special Surgery, New York, New York, USA
| | - Jonathan M Schachne
- Hospital for Special Surgery, New York, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Lin CI, Houtenbos S, Lu YH, Mayer F, Wippert PM. The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review. J Foot Ankle Res 2021; 14:41. [PMID: 34049565 PMCID: PMC8161930 DOI: 10.1186/s13047-021-00480-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations. Methods An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method. Results After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias. Conclusions The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.
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Affiliation(s)
- Chiao-I Lin
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany. .,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.
| | - Sanne Houtenbos
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Yu-Hsien Lu
- JC School of Public Health and Primary Care Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | - Frank Mayer
- University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Pia-Maria Wippert
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
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12
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Dodd HF, Lester KJ. Adventurous Play as a Mechanism for Reducing Risk for Childhood Anxiety: A Conceptual Model. Clin Child Fam Psychol Rev 2021; 24:164-181. [PMID: 33464448 PMCID: PMC7880968 DOI: 10.1007/s10567-020-00338-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 01/05/2023]
Abstract
In this conceptual article, we draw upon the literature regarding cognitive and behavioural factors that underpin childhood anxiety to outline how a range of these risk markers might be targeted through adventurous play. When children play in an adventurous way, climbing trees, riding their bikes fast downhill and jumping from rocks, they experience feelings of fear and excitement, thrill and adrenaline. We propose that the positive, thrilling and playful emotions associated with this type of child-led play facilitate exposure to fear-provoking situations and, in doing so, provide opportunities for children to learn about physiological arousal, uncertainty and coping. We hypothesise that these learning opportunities will, over time, reduce children's risk for elevated anxiety by increasing children's expectations and ability to cope with anxiety, decreasing intolerance of uncertainty and preventing catastrophic misinterpretations of physiological arousal. If our conceptual model is correct, then ensuring that children have the physical and psychological space required to play in an adventurous way may help to decrease their risk for elevated or clinical anxiety.
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Affiliation(s)
- Helen F Dodd
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights, Reading, RG6 6AL, UK.
| | - Kathryn J Lester
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK
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13
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Smith J, Chhina H, Sidhu P, Brussoni M, Pike I, Cooper A. Paediatric elbow fractures and public play spaces: adherence to standards for children's playground equipment and surfacing. BMJ Paediatr Open 2021; 5:e001125. [PMID: 34786490 PMCID: PMC8587356 DOI: 10.1136/bmjpo-2021-001125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/05/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Supracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and surgical intervention. The aim of this study was to examine SCHF occurring at public play spaces-particularly to determine whether or not the playground equipment implicated in injurious falls aligned with Canadian playground safety standards. METHODS Cases of children who attended the provincial paediatric orthopaedic clinic following SCHF at a public playground between April 2017 and October 2019 were included in the study. A research assistant visited each playground to measure the play structure type and dimensions, height of the equipment at the point from which the child fell and the type and depth of the surface material, and compare measurements to the 2016 safety standards. Child demographics and injury classification were also noted. Descriptive statistics were calculated and a scatterplot of fall height and surface depth was generated. RESULTS Forty-three sites, representing 47 SCHF cases (18 female, 29 male), were included in the final analysis. Fourteen children sustained type 1 fracture, 23 had type 2 fracture and the remaining 10 had type 3 fracture. Five children with type 2 fracture and all 10 children with type 3 fracture required surgery. The majority of sites had engineered wood fibre surfacing, with surfacing at 35 sites being less than 300 mm deep. Twenty-six play structures were upper body equipment (ie, monkey bars or similar), seven were track rides, five were rotating structures and the rest comprised a variety of classified and unclassified structures. Twenty-seven children fell from a height exceeding 2 m. CONCLUSIONS The majority of SCHF cases occurred at playgrounds with insufficient surface depth and/or non-compliant equipment. Upper body equipment, track rides and rotating play structures were of particular concern, as the children fell from heights exceeding the recommended standard, likely reflecting the degradation and compaction of the surfacing material over time.
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Affiliation(s)
- Jennifer Smith
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Harpreet Chhina
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Pardeep Sidhu
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Mariana Brussoni
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada.,Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Anthony Cooper
- Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Orthopaedics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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14
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Gauß G, Beller R, Boos J, Däggelmann J, Stalf H, Wiskemann J, Götte M. Adverse Events During Supervised Exercise Interventions in Pediatric Oncology-A Nationwide Survey. Front Pediatr 2021; 9:682496. [PMID: 34490156 PMCID: PMC8417361 DOI: 10.3389/fped.2021.682496] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives: Exercise interventions during and after treatment for pediatric cancer are associated with beneficial physical, psychological, and social effects. However, valid data about adverse events (AEs) of such interventions have rarely been evaluated. This retrospective study evaluates AEs that occurred during supervised oncological exercise programs for pediatric cancer patients and survivors. Methods: This Germany-wide study used a self-administered online survey focusing on general program characteristics and AEs retrospectively for 2019. The questionnaire included (a) basic data on the offered exercise program, (b) AEs with consequences (Grade 2-5) that occurred in 2019 during an exercise intervention, (c) number of Grade 1 AEs, (d) safety procedures as part of the exercise programs, and (e) possibility to give feedback and describe experience with AEs in free text. Results: Out of 26 eligible exercise programs, response rate of program leaders was 92.3% (n = 24). Representatives working for Universities (n = 6), rehabilitation clinics (n = 3), acute cancer clinics (n = 12), and activity camps (n = 3) participated. In total, 35,110 exercise interventions with varying duration were recorded for 2019. Six AEs with consequences (Grade 2-3) occurred during exercise interventions after cancer treatment resulting in an incidence of 17 per 100,000 exercise interventions (0.017%). No life-threatening consequences or death were reported and no serious AE occurred during acute cancer treatment. Grade 1 AE occurred with a frequency of 983, corresponding to an incidence of 2,800 per 100,000 interventions (2.8%). Most frequent Grade 1 AE were muscle soreness, circulatory problems, and abdominal pain. The most frequent preventive safety procedures at the institutions were regular breaks, consultations with the medical treatment team, and material selection with low injury potential. Conclusions: Supervised exercise interventions for pediatric cancer patients and survivors seem to be safe and AEs with consequences comparatively rare when compared to general childhood population data. Occurrence of grade 1 AEs was common, however, causality was probably not evident between AEs and the exercise intervention. Future research should standardize assessment of AEs in clinical practice and research, and prospectively register and evaluate AEs that occur in the context of exercise interventions in pediatric cancer patients and survivors.
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Affiliation(s)
- Gabriele Gauß
- Department of Pediatric Hematology and Oncology, Pediatrics III, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Ronja Beller
- Department of Pediatric Hematology and Oncology, Pediatrics III, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Joachim Boos
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Münster, Germany
| | - Julia Däggelmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiology and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Hannah Stalf
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Joachim Wiskemann
- Working Group Exercise Oncology Division of Medical Oncology, University Clinic Heidelberg and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Miriam Götte
- Department of Pediatric Hematology and Oncology, Pediatrics III, West German Cancer Center, University Hospital Essen, Essen, Germany
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15
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Chen P, Wang D, Shen H, Yu L, Gao Q, Mao L, Jiang F, Luo Y, Xie M, Zhang Y, Feng L, Gao F, Wang Y, Liu Y, Luo C, Nassis GP, Krustrup P, Ainsworth BE, Harmer PA, Li F. Physical activity and health in Chinese children and adolescents: expert consensus statement (2020). Br J Sports Med 2020; 54:1321-1331. [PMID: 32471813 PMCID: PMC7606574 DOI: 10.1136/bjsports-2020-102261] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2020] [Indexed: 12/28/2022]
Abstract
China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation's youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China's more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6-17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.
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Affiliation(s)
- Peijie Chen
- Shanghai University of Sport, Shanghai, China
| | - Dengfeng Wang
- Department of Physical, Health and Arts Education, Ministry of Education of People's Republic of China, Beijing, China
| | | | - Lijuan Yu
- Shanghai Municipal People's Government, Shanghai, China
| | - Qian Gao
- School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Lijuan Mao
- Shanghai Municipal Education Commission, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaojia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, Guangdong, China
| | - Minhao Xie
- Institute of Sports Medicine, General Administration of Sport of China, Beijing, China
| | - Yong Zhang
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin, China
| | - Lianshi Feng
- China Institute of Sport Science, Beijing, China
| | - Feng Gao
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Liu
- Shanghai University of Sport, Shanghai, China
| | - Chunyan Luo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - George P Nassis
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Faculty of Health Sciences, Odense, Denmark
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai, China
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Faculty of Health Sciences, Odense, Denmark
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai, China
| | - Barbara E Ainsworth
- Shanghai University of Sport, Shanghai, China
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Peter A Harmer
- Department of Exercise and Health Science, Willamette University, Salem, Oregon, USA
| | - Fuzhong Li
- Oregon Research Institute, Eugene, Oregon, USA
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16
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Bauer MEE, Brussoni M, Giles AR. Categorizing mothers' and fathers' conceptualizations of children's serious play-related injuries: "You won't grow a finger back". Child Care Health Dev 2020; 46:530-536. [PMID: 32037597 DOI: 10.1111/cch.12761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/29/2020] [Accepted: 02/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is inconsistency across child development and care literature in operationalizing serious play-related injury and also a lack of understanding of how mothers and fathers conceptualize serious play-related injury. The current study explores parents' perspectives of their 2- to 7-year-old children's serious play-related injuries in urban and rural areas of British Columbia and Québec, Canada, and provides an urban/rural and gender analysis of the results. METHODS We conducted semistructured interviews with 41 mothers and 63 fathers from 57 families, a total of 104 participants, in urban and rural locations in British Columbia and Québec, Canada. We used a social constructionist approach to the research and reflexive thematic analysis to construct themes from participant responses and to inform the consequent categorizations of serious play-related injury. RESULTS The results indicate four categories of parents' conceptualizations of serious play-related injury: (a) injury requiring medical intervention, (b) injury resulting in head trauma, (c) injury resulting in debilitation, and (d) broken bones. CONCLUSIONS Child development and care advocates can use these categories to strengthen their communications with parents and to improve understanding of parents' conceptualizations of children's serious play-related injury.
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Affiliation(s)
- Michelle E E Bauer
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Mariana Brussoni
- Department of Pediatrics, School of Population & Public Health, University of British Columbia; British Columbia Children's Hospital Research Institute; British Columbia Injury Research & Prevention Unit, Vancouver, British Columbia, Canada
| | - Audrey R Giles
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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17
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Versloot O, Timmer MA, de Kleijn P, Schuuring M, van Koppenhagen CF, van der Net J, Fischer K. Sports participation and sports injuries in Dutch boys with haemophilia. Scand J Med Sci Sports 2020; 30:1256-1264. [PMID: 32246553 PMCID: PMC7317861 DOI: 10.1111/sms.13666] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/26/2020] [Accepted: 03/24/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Sports participation in children with hemophilia is generally considered to be associated with increased injury risk, which is generally considered highest in severe hemophilia. AIM To assess sports participation according to age and severity in children with hemophilia and its association with sports injuries. METHODS In a retrospective single-center study, sports participation, injuries, and bleeding data from three consecutive annual clinic visits were collected for young patients with hemophilia (PWH, aged 6-18). Sports in categories 2.5 and 3 of 3 according to the National Hemophilia Foundation classification were considered high-risk. Groups were compared using chi-square testing. RESULTS 105 PWH (median age: 13(IQR 10-14); 53% severe; bleeding rate: 1/y) were identified; three were unable to perform sports and were excluded. The majority of PWH (77%) played sports weekly, of which 80% high-risk sports. Sports participation (median 3.0x/wk), and the proportion of injured PWH was similar in severe (42%) and non-severe (33%) PWH. Sports injuries were rare (65% no injuries in 3 years, median 0/y (IQR 0-1)). Annually, PWH did not report more injuries (15%) than age-matched boys (28%). Sports injuries were not associated with frequency and type of sports. DISCUSSION This retrospective study showed high sports participation (including high-risk sports) and low injury rates. Sports participation was similar across severities and injury rates were not higher than among the general population. Injuries were not associated with frequency or type of sports. A prospective study with objective assessment of sports participation and injuries is warranted to confirm these findings and avoid recall bias.
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Affiliation(s)
- Olav Versloot
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel A Timmer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Piet de Kleijn
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marleen Schuuring
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | | | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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18
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Lankhorst K, de Groot J, Takken T, Backx F. Sports participation related to injuries and illnesses among ambulatory youth with chronic diseases: results of the health in adapted youth sports study. BMC Sports Sci Med Rehabil 2020; 11:36. [PMID: 31890227 PMCID: PMC6915977 DOI: 10.1186/s13102-019-0145-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022]
Abstract
Background Although sports participation leads to important health enhancement for youth with chronic diseases or physical disabilities (CDPD), it may pose an increased risk for injury or illness. This study investigated the incidence, type, severity and risks to (sports-related) injuries and illnesses among ambulatory youth with CDPD. Methods Over a 12-month period, every 2 weeks, the characteristics of injuries and illnesses were registered by an online questionnaire and phone-based interview. Physical activity level was measured with the Activ8 during 1 week. Complete data was available of 103 youngsters with CDPD (61 boys, 42 girls), with a mean age of 14.4 (SD = 2.7) years. The personal characteristics, the injury and illness rates per 1000 h of PA were investigated per group of organized sports participation per week (0, 1 or ≥ 2 times p/wk). Results Almost half of the youngsters sustained one or more injuries (46%) or illnesses (42%) during 1 year. The injury rate per 1000 h of PA between 0, 1 and ≥ 2 times per week of sports participation was 0.84, 1.88, 133 respectively and the illness rate were 1.87, 1.88 and 1.18 respectively. Differences between the rates were not statically significant. Most reported health problems had no subsequent restriction (49%) or other minor consequences (21%) in school, physical education or sports participation. Most reported health problems were contusions (41%) at the lower extremity (74%) and flu plus fever (58%). Conclusions Participation in sports ≥2 times per week does not pose a significant increased risk in the incidence of injury or illness per 1000 h of PA in youth with CDPD compared to their peers who participate less frequent (once weekly) and compared to non-sports participants. Athletes who participate in sports at least twice weekly get injured mostly during their sporting activities, while peers who do participate in sports once a week or not at all, get injured during less intense physical activities during physical eduction lessons, ADL or non-organized sports and play in leisure time. The social impact of injuries or illnesses was limited.
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Affiliation(s)
- Kristel Lankhorst
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke de Groot
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.,4Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, the Netherlands
| | - Tim Takken
- 3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank Backx
- 2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
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Griffiths LJ, Cortina-Borja M, Tingay K, Bandyopadhyay A, Akbari A, DeStavola BL, Bedford H, Lyons RA, Dezateux C. Are active children and young people at increased risk of injuries resulting in hospital admission or accident and emergency department attendance? Analysis of linked cohort and electronic hospital records in Wales and Scotland. PLoS One 2019; 14:e0213435. [PMID: 30969971 PMCID: PMC6457613 DOI: 10.1371/journal.pone.0213435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 02/21/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Children and young people (CYP) are encouraged to increase time spent being physically active, especially in moderate and vigorous intensity pursuits. However, there is limited evidence on the prospective association of activity levels with injuries resulting in use of hospital services. We examined the relationship between objectively-measured physical activity (PA) and subsequent injuries resulting in hospital admissions or accident and emergency department (A&E) attendances, using linked electronic hospital records (EHR) from a nationally representative prospective cohort of CYP in Wales and Scotland. METHODS We analysed accelerometer-based estimates of moderate to vigorous (MVPA) and vigorous PA (VPA) from 1,585 (777 [46%] boys) seven-year-old Millennium Cohort Study members, living in Wales or Scotland, whose parents consented to linkage of cohort records to EHRs up until their 14th birthday. Negative binomial regression models adjusted by potential individual, household and area-level confounders, were fitted to estimate associations between average daily minutes of MVPA, and VPA (in 10-minute increments), and number of injury-related hospital admissions and/or A&E attendances from age nine to 14 years. RESULTS CYP spent a median of 59.5 and 18.1 minutes in MVPA and VPA/day respectively, with boys significantly more active than girls; 47.3% of children experienced at least one injury-related admission or A&E attendance during the study period. Rates of injury-related hospital admission and/or A&E attendance were positively associated with MVPA and VPA in boys but not in girls: respective adjusted incidence rate ratios (95% CI) for boys: 1.09 (1.01, 1.17) and 1.16 (1.00, 1.34), and for girls: 0.94 (0.86, 1.03) and 0.85 (0.69, 1.04). CONCLUSION Boys but not girls who engage in more intense PA at age seven years are at higher risk of injury-related hospital admission or A&E attendance when aged nine to 14 years than their less active peers. This may reflect gender differences in the type and associated risks of activities undertaken. EHRs can make a useful contribution to injury surveillance and prevention if routinely augmented with information on context and setting of the injuries sustained. Injury prevention initiatives should not discourage engagement in PA and outdoor play given their over-riding health and social benefits.
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Affiliation(s)
- Lucy J. Griffiths
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Karen Tingay
- Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, United Kingdom
| | - Amrita Bandyopadhyay
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
| | - Ashley Akbari
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- Administrative Data Research Centre Wales, Swansea University Medical School, Swansea, United Kingdom
| | - Bianca L. DeStavola
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Helen Bedford
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ronan A. Lyons
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, United Kingdom
- National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, United Kingdom
| | - Carol Dezateux
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Health Data Research UK London, Queen Mary University London, London, United Kingdom
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20
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Andersen MH, Ottesen L, Thing LF. The social and psychological health outcomes of team sport participation in adults: An integrative review of research. Scand J Public Health 2018; 47:832-850. [DOI: 10.1177/1403494818791405] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this article was to review the international scientific research literature about the social and psychological health outcomes associated with participation in team sport and to synthesise the key issues about team sport as a health-promoting activity. Methods: The methodological framework guiding the review process is the integrative research review. A search of 10 key electronic databases was conducted to identify both quantitative and qualitative studies addressing the social and/or psychological health outcomes from participation in a team sport. A total of 6,097 publications were identified and 17 studies met the inclusion criteria. Results: A wide range of different positive social, psychological, and psychosocial health outcomes associated with team sport participation were identified in the studies, with emotional social support, sense of belonging, higher self-esteem, social network, and social interaction being the most frequently reported health benefits. In addition, three key issues influencing the psychological and social health outcomes of team sport participation as a health-promoting activity were identified: (1) team sport versus individual sport, (2) competitive versus non-competitive structure, and (3) commitment and continuation. Conclusions: There is consistent evidence that participation in a team sport is associated with improved social and psychological health independent of the type of team sport, age, somatic, or mental health problems. The findings indicate that team sport could be more efficient in promoting health and ensuring exercise participation and continuation than individual sport. However, when utilising team sports for health purposes, precautions must be taken with regard to their inherent competitive nature.
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Affiliation(s)
- Marie Høstrup Andersen
- The Children’s Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen N, Denmark
| | - Laila Ottesen
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen N, Denmark
| | - Lone Friis Thing
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen N, Denmark
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Abstract
BACKGROUND Weight-training sports, including weightlifting, powerlifting, bodybuilding, strongman, Highland Games, and CrossFit, are weight-training sports that have separate divisions for males and females of a variety of ages, competitive standards, and bodyweight classes. These sports may be considered dangerous because of the heavy loads commonly used in training and competition. OBJECTIVES Our objective was to systematically review the injury epidemiology of these weight-training sports, and, where possible, gain some insight into whether this may be affected by age, sex, competitive standard, and bodyweight class. METHODS We performed an electronic search using PubMed, SPORTDiscus, CINAHL, and Embase for injury epidemiology studies involving competitive athletes in these weight-training sports. Eligible studies included peer-reviewed journal articles only, with no limit placed on date or language of publication. We assessed the risk of bias in all studies using an adaption of the musculoskeletal injury review method. RESULTS Only five of the 20 eligible studies had a risk of bias score ≥75 %, meaning the risk of bias in these five studies was considered low. While 14 of the studies had sample sizes >100 participants, only four studies utilized a prospective design. Bodybuilding had the lowest injury rates (0.12-0.7 injuries per lifter per year; 0.24-1 injury per 1000 h), with strongman (4.5-6.1 injuries per 1000 h) and Highland Games (7.5 injuries per 1000 h) reporting the highest rates. The shoulder, lower back, knee, elbow, and wrist/hand were generally the most commonly injured anatomical locations; strains, tendinitis, and sprains were the most common injury type. Very few significant differences in any of the injury outcomes were observed as a function of age, sex, competitive standard, or bodyweight class. CONCLUSION While the majority of the research we reviewed utilized retrospective designs, the weight-training sports appear to have relatively low rates of injury compared with common team sports. Future weight-training sport injury epidemiology research needs to be improved, particularly in terms of the use of prospective designs, diagnosis of injury, and changes in risk exposure.
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Affiliation(s)
- Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia. .,Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand. .,Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
| | - Paul W Winwood
- Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.,Department of Sport and Recreation, School of Applied Science, Bay of Plenty Polytechnic, Tauranga, New Zealand
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Martins A, Monjardino T, Nogueira L, Canhão H, Lucas R. Do bone mineral content and density determine fracture in children? A possible threshold for physical activity. Pediatr Res 2017; 82:396-404. [PMID: 28467405 DOI: 10.1038/pr.2017.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/15/2017] [Indexed: 11/09/2022]
Abstract
BackgroundRelations between bone parameters, physical exertion, and childhood fractures are complex. We aimed to estimate the associations between fracture history and bone mineral content (BMC) and areal bone mineral density (aBMD) at 7 years of age, by levels of physical activity, as a proxy for trauma frequency.MethodsWe used data collected from 2,261 children of the Generation XXI birth cohort, assembled in 2005/6 in Porto, Portugal. At the age of 7 years (2012/4), fracture history, time spent per week in active play, and sports practice were reported by parents. Subtotal and lumbar spine (LS) BMC and aBMD were measured using whole-body dual-energy X-ray absorptiometry.ResultsBoys and girls in the highest categories of time spent in sports practice or active play generally had higher BMC and aBMD. Among girls, BMC and aBMD were protective of fracture only in the highest quarter of active play (>660 min/week)-odds ratios (OR; 95% confidence interval (95% CI)) for subtotal BMC=0.27 (0.11-0.67), subtotal aBMD=0.18 (0.06-0.49), and LS aBMD=0.41 (0.22-0.75). For boys in the highest quarter of sports practice (>240 min/week), subtotal and LS BMC were protective of fracture-OR=0.39 (0.16-0.98) and 0.51 (0.27-0.96), respectively.ConclusionIn prepubertal children, BMC and aBMD predicted fracture history only in the highest levels of physical activity.
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Affiliation(s)
- Ana Martins
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa Monjardino
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Luísa Nogueira
- Department of Radiology, School of Health Technology of Porto/Polytechnic Institute of Porto (ESTSP/IPP), Porto, Portugal
| | - Helena Canhão
- EpiDoC, CEDOC, Nova Medical School, NOVA University, Lisbon, Portugal
| | - Raquel Lucas
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Räisänen AM, Parkkari J, Karhola L, Rimpelä A. Adolescent physical activity-related injuries in sports club, school sports and other leisure time physical activities. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1260786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Anu M. Räisänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland
| | - Lotta Karhola
- School of Medicine, University of Tampere, Tampere, Finland
| | - Arja Rimpelä
- School of Health Sciences and PERLA–Tampere Centre for Childhood, Youth and Family Research, University of Tampere, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
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Schneeberg A, Ishikawa T, Kruse S, Zallen E, Mitton C, Bettinger JA, Brussoni M. A longitudinal study on quality of life after injury in children. Health Qual Life Outcomes 2016; 14:120. [PMID: 27561258 PMCID: PMC5000468 DOI: 10.1186/s12955-016-0523-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 08/18/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In high income countries, injuries account for 40 % of all child deaths, representing the leading cause of child mortality and a major source of morbidity. The need for studies across age groups, and use of health related quality of life measures that assess functional limitations in multiple health domains, with sampling at specific post-injury time points has been identified. The objective of this study was to describe the impact of childhood injury and recovery on health related quality of life (HRQoL) for the 12 months after injury. METHODS In this prospective cohort study parents of children 0-16 years old attending British Columbia Children's Hospital for an injury were surveyed over 12 months post-injury. Surveys assessed HRQoL at four points: baseline (pre-injury), one month, four to six months and 12 months post injury. Generalized estimating equation models identified factors associated with changes in HRQoL over time. RESULTS A total of 256 baseline surveys were completed. Response rates for follow-ups at one, four and twelve months were 74 % (186), 67 % (169) and 64 % (161), respectively. The mean age of participants was 7.9 years and 30 % were admitted to the hospital. At baseline, a retrospective measure of pre-injury health, the mean HRQoL score was 90.7. Mean HRQoL ratings at one, four and 12 months post injury were 77.8, 90.3 and 91.3, respectively. Both being older and being hospitalized were associated with a steeper slope to recovery. CONCLUSIONS Although injuries are prevalent, the long term impacts of most childhood injuries are limited. Regardless of injury severity, most injured children recuperated quickly, and had regained total baseline status by four month post-injury. However, although hospitalization did not appear to impact long term psychosocial recovery, at four and 12 months post injury a greater proportion of hospitalized children continued to have depressed physical HRQoL scores. Both older and hospitalized children reported greater impact to HRQoL at one month post injury, and both had a steeper slope to recovery and were on par with their peers by four month.
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Affiliation(s)
- Amy Schneeberg
- School of Population & Public Health, University of British Columbia, Vancouver, BC Canada
- British Columbia Injury Research & Prevention Unit, F508 – 4480 Oak Street, Vancouver, BC V6H 3 V4 Canada
- British Columbia Children’s Hospital, Vancouver, BC Canada
| | - Takuro Ishikawa
- British Columbia Injury Research & Prevention Unit, F508 – 4480 Oak Street, Vancouver, BC V6H 3 V4 Canada
- British Columbia Children’s Hospital, Vancouver, BC Canada
| | - Sami Kruse
- British Columbia Children’s Hospital, Vancouver, BC Canada
| | - Erica Zallen
- British Columbia Children’s Hospital, Vancouver, BC Canada
| | - Craig Mitton
- School of Population & Public Health, University of British Columbia, Vancouver, BC Canada
| | - Julie A. Bettinger
- British Columbia Children’s Hospital, Vancouver, BC Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
- Vaccine Evaluation Center, BC Children’s Hospital, Vancouver, Canada
| | - Mariana Brussoni
- School of Population & Public Health, University of British Columbia, Vancouver, BC Canada
- British Columbia Injury Research & Prevention Unit, F508 – 4480 Oak Street, Vancouver, BC V6H 3 V4 Canada
- British Columbia Children’s Hospital, Vancouver, BC Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
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25
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Houston MN, Hoch MC, Hoch JM. Health-Related Quality of Life in Athletes: A Systematic Review With Meta-Analysis. J Athl Train 2016; 51:442-53. [PMID: 27258942 DOI: 10.4085/1062-6050-51.7.03] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized. OBJECTIVE To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury? DATA SOURCES We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. STUDY SELECTION Studies were included if they used generic instruments to compare HRQOL outcomes between athletes and nonathletes and between uninjured and injured athletes. Studies were excluded if they did not use a generic instrument, pertained to instrument development, or included retired athletes or athletes with a chronic disease. DATA EXTRACTION We assessed study quality using the modified Downs and Black Index Tool. Bias-corrected Hedges g effect sizes and 95% confidence intervals (CIs) were calculated. The Strength of Recommendation Taxonomy (SORT) was used to determine the overall strength of the recommendation. A random-effects meta-analysis was performed for all studies using the composite or total score. DATA SYNTHESIS Eight studies with modified Downs and Black scores ranging from 70.6% to 88.4% were included. For question 1, the overall random-effects meta-analysis was weak (effect size = 0.27, 95% confidence interval = 0.14, 0.40; P < .001). For question 2, the overall random-effects meta-analysis was moderate (effect size = 0.68, 95% confidence interval = 0.42, 0.95; P < .001). CONCLUSIONS Grade A evidence indicates that athletes reported better HRQOL than nonathletes and that uninjured athletes reported better HRQOL than injured athletes. However, the overall effect for question 1 was weak, suggesting that the differences between athletes and nonathletes may not be clinically meaningful. Clinicians should monitor HRQOL after injury to ensure that all dimensions of health are appropriately treated.
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Rosendahl K, Strouse PJ. Sports injury of the pediatric musculoskeletal system. Radiol Med 2016; 121:431-41. [DOI: 10.1007/s11547-015-0615-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
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What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6423-54. [PMID: 26062038 PMCID: PMC4483710 DOI: 10.3390/ijerph120606423] [Citation(s) in RCA: 214] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/29/2015] [Accepted: 04/08/2015] [Indexed: 12/02/2022]
Abstract
Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.
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Tremblay MS, Gray C, Babcock S, Barnes J, Costas Bradstreet C, Carr D, Chabot G, Choquette L, Chorney D, Collyer C, Herrington S, Janson K, Janssen I, Larouche R, Pickett W, Power M, Sandseter EBH, Simon B, Brussoni M. Position Statement on Active Outdoor Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6475-505. [PMID: 26062040 PMCID: PMC4483712 DOI: 10.3390/ijerph120606475] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/22/2015] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.
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Affiliation(s)
- Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
- School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, Ontario, K1N 1A2, Canada
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-613-737-7600; Fax: +1-613-738-4800
| | - Casey Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | - Shawna Babcock
- KidActive, 559A, Burtron Lane, Combermere, Ontario, K0J 1L0, Canada; E-Mail:
| | - Joel Barnes
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | | | - Dawn Carr
- Canadian Parks Council, 455 Hunter Street West, Peterborough, Ontario, K9H 2M7, Canada; E-Mail:
| | - Guylaine Chabot
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Laval University, 2725 Chemin Ste-Foy, Québec City, Québec, G1V 4G5, Canada; E-Mail:
| | - Louise Choquette
- Best Start Resource Centre—Health Nexus, 180 Dundas Street West, Toronto, Ontario, M5G 1Z8, Canada; E-Mail:
| | - David Chorney
- PHE Canada, 301-2197 Riverside Drive, Ottawa, Ontario, K1H 7X3, Canada; E-Mail:
| | - Cam Collyer
- Evergreen, 550 Bayview Avenue, Toronto, Ontario, M4W 3X8, Canada; E-Mail:
| | - Susan Herrington
- School of Architecture and Landscape Architecture, University of British Columbia, 379-2357 Main Mall, Vancouver, British Columbia, B6T 1Z4, Canada; E-Mail:
| | - Katherine Janson
- ParticipACTION, 77 Bloor Street West, Toronto, Ontario, M5S 1M2, Canada; E-Mails: (C.C.B.); (K.J.)
| | - Ian Janssen
- Department of Public Health Sciences, School of Kinesiology and Health Studies, Queen’s University, 99 University Avenue, Kingston, Ontario, K7L 2P5, Canada; E-Mail:
| | - Richard Larouche
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | - William Pickett
- Department of Public Health Sciences, Carruthers Hall, Queen’s University, Kingston, Ontario, K7L 2P5, Canada; E-Mail:
| | - Marlene Power
- Forest School Canada, Child and Nature Alliance of Canada, 411 Corkstown Road, Ottawa, Ontario, K2K 2Y1, Canada; E-Mail:
| | - Ellen Beate Hansen Sandseter
- Department of Physical Education and Health, College of Early Childhood Education, Queen Maud University, Thrond Nergaardsvei 7, NO-7044 Trondheim, Norway; E-Mail:
| | - Brenda Simon
- PLAYbynature, 226 Albany Avenue, Toronto, Ontario, M5R 3C6, Canada; E-Mail:
| | - Mariana Brussoni
- British Columbia Injury Research & Prevention Unit, Department of Pediatrics, School of Population & Public Health, Child & Family Research Institute, British Columbia Children’s Hospital, University of British Columbia, , F511-4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada; E-Mail:
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