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Lykkegaard CR, Wedderkopp N, Wehberg S, Holden S, Andersen HS, Waldorff FB, Søndergaard J. Does children's healthcare seeking change after participation in a musculoskeletal study? A register-based study. BMC PRIMARY CARE 2023; 24:271. [PMID: 38093260 PMCID: PMC10717731 DOI: 10.1186/s12875-023-02233-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Participating in research studies often involves interactions with healthcare professionals, potentially influencing the participant's future help-seeking behaviour. We investigated whether participating in the Childhood Health Activity and Motor Performance School Study - Denmark (CHAMPS) (2008-2014), which involved telephone consultations and clinical assessments by healthcare professionals with participants experiencing musculoskeletal complaints, changed frequency of contacts with primary public healthcare services among participants over the subsequent five-years-period, compared to non-participating children. METHODS Using Danish health register data from 1998 to 2020, we compared CHAMPS participant's and two control group's contacts with private physiotherapists, chiropractors (outside hospitals), and general practitioners: a random 10% sample of children from Denmark (National Controls), and a secondary local control group (Local Controls) during three periods: Before (1998-31.10.2008), during (01.11.2008-20.06.2014), and after (21.06.2014-31.12.2019) the CHAMPS-study. Separate multivariable Poisson regression models were used to assess the differences between groups for the outcome variables: contacts with physiotherapists, chiropractors, and general practitioners, and overall contacts. RESULTS Compared to National Controls, the CHAMPS-Group had fewer physiotherapy contacts before the study with an estimated mean of 0.01 vs 0.02 per person-year, and after (0.13 vs 0.18 per person-year), corresponding to a crude incidence rate ratio (IRR) of 0.69 (95% confidence intervals (CI): 0.58-0.83) after the study period. However, they had more chiropractor contacts before (0.05 vs 0.03), and after (0.21 vs 0.09) the study, with a crude IRR of 2.29 (95% CI: 1.93-2.71) after the study period. General practice contacts were equal for the CHAMPS-group compared to national controls (5.84 vs 5.84) before the study but reduced during and after (3.21 vs 3.71), with a crude IRR of 0.86 (95% CI: 0.83-0.90) after the study. Comparable patterns of contacts changes from before to after the study were observed between the CHAMPS-group and the Local Controls except for physiotherapy which was equal between the two groups after the study. CONCLUSION Our findings suggest that research studies involving systematic engagement with participants experiencing musculoskeletal complaints can influence subsequent healthcare-seeking behaviour. Future research should address the influence of health literacy, health education, and healthcare provider recommendations on healthcare decisions during such research studies.
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Affiliation(s)
- Charlotte Raadkjaer Lykkegaard
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, DK-5230, Odense, Denmark.
| | - Niels Wedderkopp
- Center for Research in Childhood Health, Department of Regional Health Research, University of Southern Denmark, DK-5230, Odense, Denmark
| | - Sonja Wehberg
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, DK-5230, Odense, Denmark
| | - Sinead Holden
- Centre for General Practice at Aalborg University, Aalborg University, 9220, Aalborg East, Denmark
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg East, Denmark
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Helene Stoettrup Andersen
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, DK-5230, Odense, Denmark
| | - Frans Boch Waldorff
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, DK-5230, Odense, Denmark
- Section of General Practice and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, 1353, Copenhagen, Denmark
| | - Jens Søndergaard
- The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, DK-5230, Odense, Denmark
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Wong C, Bjerge CY, Jurca A, Petersen MM, Boedtker S, Balslev-Clausen A, Harsted S. Protocol Article: A Cross-Sectional Evaluation of Children's Feet and Lower Extremities. Methods Protoc 2023; 6:115. [PMID: 38133135 PMCID: PMC10745981 DOI: 10.3390/mps6060115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The health of children's lower extremities and feet is a focus area for caregivers and healthcare professionals such as doctors, school nurses, and podiatrists. Our study aims to investigate the general health status of Danish children's lower extremities and feet to identify anthropometric parameters that might be preconditions for pain and evaluate for foot diseases and whether they are associated with pain intensity and location, three-dimensional foot dimensions and foot pressure mapping, shoe dimensions, types and intensity of sports activity, quality of life, and foot health. The aim is that we will be able to identify parameters pre-dispositioning for pain, thus providing recommendations for sports activities in relation to the anthropometric conditions of a child as a potential preventive measure for pain. This analysis will be stratified by socioeconomic status on a group level, and this perspective will be able to provide preventative recommendations to prevent pain. METHODS This study is a cross-sectional examination of a thousand children in the first, fifth, and ninth grades in randomized selected Danish primary schools. We will perform a clinical examination of the lower extremities and feet for misalignments, deformities, and diseases as well as rotational status and range of motion. Moreover, we will evaluate their pain levels, sports activities, three-dimensional foot dimensions, plantar pressure, footwear, and patient-related outcome measures (PROMs) for foot health and quality of life. RESULTS We aim to provide an anthropometrical overview of the lower extremities and feet in children. The obtained basic understanding of healthy normal material in children will be analyzed for its relationships with pain level, sports activities, and socioeconomic status on a group level. This could potentially provide us with an understanding of the factors that impact lower extremity and foot diseases in children. In conclusion, examining children's lower extremities and feet in Danish primary schools is a step toward identifying areas of improvement in self-care and shoe fitting, mapping podiatry-related needs of care in children's feet, and providing parental recommendations for preventive actions on shoe fitting and the choice and intensity of sports activity concerning pain. CONCLUSIONS The tenet of this study is a long-term follow-up to evaluate the long-term socioeconomic course on a group level, foot status, and sports activity, using patient-related outcome measures evaluating quality of life and other lifestyle factors such as emotional functioning, social functioning and interaction, and school functioning. Potentially, this will improve children's quality of life and prevent future diseases.
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Affiliation(s)
- Christian Wong
- Department of Orthopedic Surgery, Copenhagen University Hospital, 2650 Hvidovre, Denmark (A.B.-C.)
- Department of Orthopedic Surgery, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark;
| | | | - Ales Jurca
- Volumental AB, 118 72 Stockholm, Sweden;
- Jozef Stefan International Postgraduate School, 1000 Ljubljana, Slovenia
| | - Michael Mørk Petersen
- Department of Orthopedic Surgery, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Soren Boedtker
- Department of Orthopedic Surgery, Copenhagen University Hospital, 2650 Hvidovre, Denmark (A.B.-C.)
| | - Andreas Balslev-Clausen
- Department of Orthopedic Surgery, Copenhagen University Hospital, 2650 Hvidovre, Denmark (A.B.-C.)
| | - Steen Harsted
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
- Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, 5500 Middelfart, Denmark
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Lykkegaard CR, Wehberg S, Waldorff FB, Søndergaard J, Holden S. Adaptation of a Danish online version of the Oxford Physical Activity Questionnaire (OPAQ) for secondary school students—a pilot study. Pilot Feasibility Stud 2022; 8:153. [PMID: 35879808 PMCID: PMC9309605 DOI: 10.1186/s40814-022-01108-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 07/02/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To adapt and partly validate a Danish online version of the patient-reported outcome measure (PROM) Oxford Physical Activity Questionnaire (“OPAQ”) and evaluate mobile phones and tablets as data capturing tool to identify potential problems and deficiencies in the PROM prior to implementation in the full study. Methods The OPAQ was translated into Danish by a formalised forward-backward translation procedure. Face validity was examined by interviewing 12 school students aged 10–15, recruited from two Danish public schools. After modifications, the online version of the Danish OPAQ was pilot tested in a convenience sample of seven school students for 1 week. Simultaneous objective accelerometer data were captured during the registration period. Results No major challenges were identified when translating OPAQ. Based on the interviews, the Danish version of OPAQ was perceived to be easy to understand in general, and the questions were relevant for tracking activities during the week. Five of the 12 participants had difficulties with understanding the introductory question: “what is your cultural background” in the original OPAQ. The interviews revealed that the participants recalling 7 days forgot to record some of the physical activity they had done during the week, indicating issues with the weekly recall method. After transforming to the online version, this was reported to be easy and quick to fill in (taking 1–3 min per day), and participants reported the daily design was helpful to remember activities. There was good correspondence between the online version and objective actigraphs with a tendency to underreport. Six participants reported 10–60 min less moderate to vigorous physical activity compared to the actigraphs, while one participant reported 3 min more. Conclusion Participants found the online OPAQ quick and easy to complete during a 1-week period. Completing daily rather than weekly may help limit issues with recall. Overall, there was good agreement between the objective actigraphs and the OPAQ, though the OPAQ tended to slightly underreport moderate to vigorous physical activity. The Danish online version of OPAQ may be useful for capturing school students’ physical activity when objective measures are not feasible. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01108-x.
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Siersbaek GM, Have M, Wedderkopp N. The Effect of Leisure Time Sport on Executive Functions in Danish 1st Grade Children. CHILDREN 2022; 9:children9101458. [PMID: 36291397 PMCID: PMC9601112 DOI: 10.3390/children9101458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022]
Abstract
Physical inactivity can influence children’s executive functions with severe impact on wellbeing and academic learning. The objective is to study the effect of leisure time sport on executive functions in Danish 1st grade children, and secondary to explore if socio-economy is a confounder for associations between leisure time sport and executive functions. This study is a sub-study nested within a cluster-randomized controlled trial with two arms (ClinicalTrials.gov, NCT02488460). 505 children from twelve schools, mean age 7.2 ± 0.3 years participated. Outcomes for executive function were “Modified Eriksen Flanker/Reverse Flanker Task” and “Behavior Rating Inventory of Executive Function” (BRIEF-P). Parents used SMS-tracking to register their children’s leisure time sport. Multivariate analyzes was performed using mixed linear regression, with adjustment for highest parental education, sex, municipality, and school-type. We found that leisure time sport seems to significantly improve working memory (WM) with nearly 20%, and furthermore it seems to be a significant predictor of ‘Initiate’ (the ability to begin an activity, to generate ideas, responses or problem-solving strategies). Socio-economy was not found to be a confounder. This study lends support to the hypothesis that leisure time sport is related to working memory capacity in children.
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Affiliation(s)
| | - Mona Have
- Danish School of Education, Campus Emdrup, 2400 Copenhagen, Denmark
| | - Niels Wedderkopp
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence: ; Tel.: +45-63-48-42-96
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Nielsen RO, Shrier I, Casals M, Nettel-Aguirre A, Møller M, Bolling C, Bittencourt NFN, Clarsen B, Wedderkopp N, Soligard T, Timpka T, Emery C, Bahr R, Jacobsson J, Whiteley R, Dahlstrom O, van Dyk N, Pluim BM, Stamatakis E, Palacios-Derflingher L, Fagerland MW, Khan KM, Ardern CL, Verhagen E. Statement on methods in sport injury research from the 1st METHODS MATTER Meeting, Copenhagen, 2019. Br J Sports Med 2020; 54:941. [PMID: 32371524 PMCID: PMC7392492 DOI: 10.1136/bjsports-2019-101323] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 01/08/2023]
Abstract
High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.
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Affiliation(s)
- Rasmus Oestergaard Nielsen
- Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark .,Research Unit for General Practice, Aarhus, Denmark
| | - Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Marti Casals
- Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain.,Medical Department, Futbol Club Barcelona, Barça Innovation Hub, Barcelona, Spain
| | | | - Merete Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Caroline Bolling
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Natália Franco Netto Bittencourt
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Sports Physical Therapy Department, Minas Tenis Clube, Belo Horizonte, Brazil.,Physical Therapy, Centro Universitário UniBH, Belo Horizonte, Brazil
| | - Benjamin Clarsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
| | - Niels Wedderkopp
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,The Orthopedic department, Hospital of Southwestern Jutland, Esbjerg, Denmark
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Toomas Timpka
- Health and Society, Linköping University, Linköping, Sweden
| | - Carolyn Emery
- Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
| | - Jenny Jacobsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Rod Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Orjan Dahlstrom
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Babette M Pluim
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Section Sports Medicine, Faculty of Health Science, University of Pretoria, Pretoria, South Africa.,Medical Department, Royal Netherlands Lawn Tennis Association, Amstelveen, The Netherlands
| | - Emmanuel Stamatakis
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,University College London, London, UK
| | - Luz Palacios-Derflingher
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Morten Wang Fagerland
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
| | - Karim M Khan
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada.,British Journal of Sports Medicine, London, United Kingdom
| | - Clare L Ardern
- Division of Physiotherapy, Linköping University, Linköping, Sweden.,Division of Physiotherapy, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Statement on Methods in Sport Injury Research From the First METHODS MATTER Meeting, Copenhagen, 2019. J Orthop Sports Phys Ther 2020; 50:226-233. [PMID: 32354314 DOI: 10.2519/jospt.2020.9876] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting. Meeting participants agreed that the definition of sport injury depends on the research question and context. It was considered essential to be explicit about the goal of the research effort and to use frameworks to illustrate the assumptions that underpin measurement and the analytical strategy. Complex systems were discussed to illustrate how potential risk factors can interact in a nonlinear way. This approach is often a useful alternative to identifying single risk factors. Investigating changes in exposure status over time is important when analyzing sport injury etiology, and analyzing recurrent injury, subsequent injury, or injury exacerbation remains challenging. The choice of statistical model should consider the research question, injury measure (eg, prevalence, incidence), type and granularity of injury data (categorical or continuous), and study design. Multidisciplinary collaboration will be a cornerstone for future high-quality sport injury research. Working outside professional silos in a diverse, multidisciplinary team benefits the research process, from the formulation of research questions and designs to the statistical analyses and dissemination of study results in implementation contexts. This article has been copublished in the British Journal of Sports Medicine and the Journal of Orthopaedic & Sports Physical Therapy. J Orthop Sports Phys Ther 2020;50(5):226-233. doi:10.2519/jospt.2020.9876.
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Learmonth YC, Hebert JJ, Fairchild TJ, Møller NC, Klakk H, Wedderkopp N. Physical education and leisure-time sport reduce overweight and obesity: a number needed to treat analysis. Int J Obes (Lond) 2019; 43:2076-2084. [PMID: 30622314 DOI: 10.1038/s41366-018-0300-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/31/2018] [Accepted: 11/30/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND School-based physical education (PE) and organised leisure-time sports participation (LTSP) represent important physical activity opportunities for children. We examined the preventive effect of increased PE as well as LTSP on overweight and obesity (OW/OB) in school children. METHODS Longitudinal data from children attending 10 primary schools in the Danish municipality of Svendborg, comprising 6 intensive PE (270 min/week) and 4 control (90 min/week) schools were assessed. Age- and sex-specific cut-offs for body mass index (BMI) determined OW/OB status. Associations between OW/OB status and school type (intensive PE or control) or LTSP were investigated using mixed, multilevel logistic regression models. Significant parameter estimates were converted into number needed to treat statistics (NNT). RESULTS In total, 1009 children (53.3% female; mean age 8.4 ± 1.4 years) were included in the analysis, with 892 children (52% female) being normal weight (NW) at baseline. Eighteen (NNT = 17.1; 95% CI [11.0, 226.1]) children attending an intensive PE school for 2 years, resulted in one fewer case of OW/OB compared with attendance at a normal PE school. For NW children, prevention of one case of OW/OB requires 36 (NNT = 35.8; 95% CI [25.1, 596.3]) children to participate in intensive PE for 2 years in comparison with normal PE. LTSP over 2 years may prevent OW/OB if 15 children participate in one LTSP session/week, 9 in two LTSP sessions/week and 8 in three LTSP sessions/week; for normal weight children, 25 children had to participate in one LTSP session/week, 16 in two LTSP sessions/week and 14 in three LTSP sessions/week. CONCLUSION We provide the first NNT estimates of school-based PE and LTSP to prevent the onset of OW/OB. PE, and separately, LTSP seem to have both a protective and a treatment effect against OW/OB in children.
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Affiliation(s)
- Yvonne C Learmonth
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, 6150, Australia.
| | - Jeffrey J Hebert
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, 6150, Australia.,Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Timothy J Fairchild
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, 6150, Australia
| | - Niels Christian Møller
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Heidi Klakk
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,University College Lillebælt, Odense, Denmark
| | - Niels Wedderkopp
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada.,Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Orthopedic Department, Hospital of Southern Jutland, Esbjerg, Denmark
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