There is no need to avoid resistance training (weight lifting) until physeal closure

Reporting of Adverse Events in Muscle Strengthening Interventions in Youth: A Systematic Review

Clear definition, identification, and reporting of adverse event (AE) monitoring during training interventions are essential for decision making regarding the safety of training and testing in youths.

PURPOSE

To document the extent to which AEs, resulting from intervention studies targeting muscle strengthening training (MST) in youth, are reported by researchers.

METHODS

Electronic databases (CINAHL, PubMed, SPORTDiscus, and Web of Science) were searched for English peer-reviewed articles published before April 2018. Inclusion criteria were: (1) average age <16 years, (2) use of MST, (3) statement(s) linked to the presence/absence of AEs, and (4) randomized controlled trials or quasi-experimental designs. Risk of reporting bias for AEs followed recommendations by the Cochrane Collaboration group.

RESULTS

One hundred and ninety-one full-text articles were screened. One hundred and thirty met all MST criteria, out of which only 44 (33.8%; n = 1278, age = 12.1 [1.1] y) included a statement as to the presence/absence of adverse events. The 86 other studies (66.2%) included no such statement. Of the reporting 44 studies, 18 (40.1%) indicated one or more adverse events. Of the 93 reported adverse events, 55 (59.1%) were linked to training or testing.

CONCLUSIONS

Most MST studies in youth do not report presence/absence of adverse events, and when reported, adverse events are not well defined.

Safety and Feasibility of 1-Repetition Maximum (1-RM) Testing in Children and Adolescents With Bilateral Spastic Cerebral Palsy

PURPOSE

The purpose of this study was to standardize 1-repetition maximum (1-RM) testing procedures and evaluate the safety and feasibility of these procedures in youth with cerebral palsy (CP).

METHODS

Youth with CP completed 1-RM testing on a leg press.

RESULTS

Mean absolute, adjusted, and normalized 1-RM loads were 262.4 ± 161.3 lb, 127.0 ± 80.2 lb, and 1.28 ± 0.51, respectively, and 67% were able to successfully lift the same or heavier load after a single failure. Cessation of testing after 1 failed attempt resulted in a 19.0% underestimation of the 1-RM.

CONCLUSIONS

1-RM testing in youth with CP is safe and feasible. Multiple attempts at a failed load should be provided to prevent underestimation in strength. The 1-RM test provides a more accurate strength assessment, which will improve the dosing for resistance training in youth with CP.

Incidence and temporal changes in lumbar degeneration and low back pain in child and adolescent weightlifters: A prospective 5-year cohort study

This study was conducted to investigate the incidence of lumbar degeneration findings and low back pain (LBP) in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires over a 5-year period. Moreover, we aimed to reveal the temporal changes in the lumbar vertebrae caused by long-term weightlifting training during the growth period. Twelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys, including data on practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up. Lumbar disc degeneration was detected in all the participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting. This 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. High frequency weightlifting training over a long period during the growth period may increase the risk of developing current and future LBP.

Incidence rates and characteristics of abnormal lumbar findings and low back pain in child and adolescent weightlifter: A prospective three-year cohort study

Purpose

The purpose of this three-year cohort study was to assess the incidence rates and characteristics of abnormal lumbar findings and low back pain (LBP) in child and adolescent weightlifting athletes using magnetic resonance imaging (MRI) and medical questionnaires. This study evaluated subclinical sports injuries, which in turn may help prevent competition-specific injuries and improve performance levels.

Materials and methods

Between 2014 and 2016, twelve participants who had been competing in weightlifting events for at least 2 years were enrolled in this study. The mean age of the participants at the start of this study was 11.4 ± 2.0 years, and there were 6 boys and 6 girls. Annual medical questionnaire surveys and lumbar examinations using MRI were performed during the 3-year follow-up. The incidence rates and variations of LBP and abnormal MRI findings were evaluated.

Results

At the start of this study, there were no positive findings of LBP, and abnormal lumbar findings on MRI were observed in only 2 participants. At the 2-year follow-up, 1 participant had LBP, and 8 of 12 participants had abnormal lumbar findings. In the final year, only 3 participants had LBP; however, abnormal lumbar findings were observed on MRI in 11 participants. Among these, lumbar spondylolysis was observed in 4 participants, lumbar disc protrusion or extrusion in 2 participants, and lumbar disc degeneration in 9 participants.

Conclusion

This prospective 3-year cohort study of 12 child and adolescent weightlifters revealed abnormal lumbar findings in 11 participants at a high rate on MRI examination. Children and adolescents undergoing resistance training at the competition level could potentially have irreversible changes in the lumbar vertebra without symptoms.

Resistance training for children and adolescents

As more children and adolescents are becoming involved in exercise and school or community based athletics, attention is turned towards proper training and conditioning to optimize performance, stimulate athletic development and ensure safety while tolerating long-term competition. Resistance training (RT) refers to the methodology of ensuring such optimal performance and safety. This is a common component of sports and physical fitness in schools and organized athletic programs around the country. RT is a physical conditioning program that involves various training techniques (e.g., machine based, free weight, plyometric, complex and functional training) and progressively increasing resistive loads to achieve desired muscle endurance, strength, power or a combination of the above. Proper RT programs have a plethora of associated benefits including increased strength, lower rates of sports-related injury, increased bone strength index (BSI), decreased risk of fracture and improved self-esteem and interest in fitness. There are risks involved with improper or poor training programs. Proper training programs involve knowledgeable trainers, effective supervision and tailored weight training.