An 11-week school-based "health education through football" programme improves musculoskeletal variables in 10-12-yr-old Danish school children

Purpose

To investigate the effects of the "11 for Health" programme on musculoskeletal fitness.

Methods

A total of 108 Danish children aged 10-12 years participated in the study, with 61 children in the intervention group (IG, 25 girls and 36 boys) and 47 children in the control group (CG, 21 girls and 26 boys). Measurements were conducted before and after an 11-week intervention consisting of twice-weekly 45-min football training sessions for IG or continuation of normal Physical Education program for CG. Whole-body dual X-ray absorptiometry was conducted for evaluation of leg and total bone mineral density as well as bone, muscle and fat mass. Standing Long Jump and Stork balance tests were employed to assess musculoskeletal fitness and postural balance.

Results

During the 11-week study period, leg bone mineral density as well as leg lean body mass increased more (p < 0.05) in the intervention group (IG) compared to the control group (CG) (0.021 ± 0.019 vs 0.014 ± 0.018 g/cm² and 0.51 ± 0.46 vs 0.32 ± 0.35 kg, respectively). Moreover, body fat percentage decreased more in IG than in CG (-0.6 ± 0.1 vs 0.1 ± 0.1 %-points, p < 0.05). No significant between-group differences were found in bone mineral content. Stork balance test performance increased more in IG than in CG (0.5 ± 2.6 vs -1.5 ± 4.4 s, p < 0.05), whereas no between-group differences were found in jump performance.

Conclusions

The school-based football programme, 11 for Health, with twice-weekly 45-min training sessions over 11 weeks improves various, but not all evaluated parameters related to musculoskeletal fitness in 10-12-yr-old Danish school children.

Implementation facilitation of the "11 for Health in Denmark": A case study in a Danish 5th grade class

The “11 for Health in Denmark” concept aims to enhance 10–12‐year‐old schoolchildren's physical activity levels and health knowledge through an 11‐week football intervention and has been shown to induce positive effects in numerous areas. However, little is known about the implementation facilitation of this concept in schools. This case study therefore aims to gain a deeper understanding of the implementation facilitation of “11 for Health” in a Danish 5^th grade class comprising 22 schoolchildren (12 boys and 10 girls, M_age 11.86±) and one teacher. Data were derived from multiple school situations using photographs and videos, observations, and informal interviews. Five themes were identified: (1) environmental and organizational factors impacting on the implementation; (2) familiarization with the concept for the teacher and schoolchildren; (3) previous clique formation; (4) the central role of the teacher; and (5) the importance of how praise partners are allocated. We found high adherence to the “11 for Health” concept, in which the teacher played a key role by applying an autonomy‐supportive style of teaching and using the praise partner concept in a suitable manner. A clique of football‐playing boys was a resource, as their praising of classmates encouraged adherence. However, familiarization with the “11 for Health” concept was a challenge and the clique's competitive nature occasionally built barriers to other schoolchildren without football experience, potentially leading to a more controlled form of motivation. Based on the results, we encourage teachers to apply autonomy‐supportive teaching when applying the “11 for Health” concept.

One year of Football Fitness improves L1-L4 BMD, postural balance, and muscle strength in women treated for breast cancer

PURPOSE

To examine efficacy of 12 months Football Fitness offered twice per week on bone mineral density (BMD), bone turnover markers (BTM), postural balance, muscle strength, and body composition in women treated for early-stage breast cancer (BC).

METHODS

Women treated for early-stage BC were randomized to Football Fitness (FFG, n = 46) or control (CON, n = 22) in a 2:1 ratio for 12 months, with assessments performed at baseline, 6 months and 12 months. Outcomes were total body-, lumbar spine- and proximal femur BMD, total body lean and fat mass, leg muscle strength, postural balance, and plasma amino-terminal propeptide of type 1 procollagen (P1NP), osteocalcin, and C-terminal telopeptide of type 1 collagen (CTX). Intention-to-treat (ITT) analyses and per-protocol analyses (≥50% attendance in FFG) were performed using linear mixed models.

RESULTS

Participants in FFG completing the 12-month intervention (n = 33) attended 0.8 (SD = 0.4) sessions per week. Intention to treat analysis of mean changes over 12 months showed significant differences (p<.05) in L1-L4 BMD (0.029 g/cm2 , 95%CI: 0.001 to 0.057), leg press strength (7.2 kg, 95%CI: 0.1 to 14.3), and postural balance (-4.3 n need of support, 95%CI: -8.0 to -0.7) favoring FFG compared to CON. In the per-protocol analyses, L1-L4 and trochanter major BMD were improved (p = .012 and .030, respectively) in FFG compared with CON. No differences were observed between groups in BTMs in the ITT or per protocol analyses.

CONCLUSION

One year of Football Fitness training may improve L1-L4 BMD, leg muscle strength, and postural balance in women treated for early-stage breast cancer.

Exercise intensity and cardiovascular health outcomes after 12 months of football fitness training in women treated for stage I-III breast cancer: Results from the football fitness After Breast Cancer (ABC) randomized controlled trial

PURPOSE

To examine the exercise intensity and impact of 12 months of twice-weekly recreational football training on cardiorespiratory fitness (CRF), blood pressure (BP), resting heart rate (HR_rest), body fat mass, blood lipids, inflammation, and health-related quality of life in women treated for early-stage breast cancer (BC).

METHODS

Sixty-eight women who had received surgery for stage I-III BC and completed adjuvant chemo- and/or radiation therapy within 5 years were randomized in a 2:1 ratio to a Football Fitness group (FFG, n = 46) or a control group (CON, n = 22). Football Fitness sessions comprised a warm-up, drills and 3-4 × 7 min of small-sided games (SSG). Assessments were performed at baseline, 6 months and 12 months. Outcomes were peak oxygen uptake (VO₂peak), blood pressure (BP), HR_rest, total body fat mass, and circulating plasma lipids and hs-CRP, and the 36-Item Short Form Health Survey (SF36). Intention-to-treat (ITT) analyses were performed using linear mixed models. Data are means with SD or 95% confidence intervals.

RESULTS

Adherence to training in participants completing the 12-months follow-up (n = 33) was 47.1% (22.7), and HR during SSG was ≥80% of HR_max for 69.8% (26.5) of total playing time. At baseline, VO₂peak was 28.5 (6.4) and 25.6 (5.9) ml O₂/kg/min in FFG and CON, respectively, and no significant changes were observed at 6- or 12 months follow-up. Systolic BP (SBP) was 117.1 (16.4) and 116.9 (14.8) mmHg, and diastolic BP (DBP) was 72.0 (11.2) and 72.4 (8.5) mmHg in FFG and CON, respectively, at baseline, and a 9.4 mmHg decrease in SBP in CON at 12 months resulted in a between-group difference at 12 months of 8.7 mmHg (p = .012). Blood lipids and hs-CRP were within the normal range at baseline, and there were no differences in changes between groups over the 12 months. Similarly, no differences between groups were observed in HR_rest and body fat mass at 6- and12-months follow-up. A between-group difference in mean changes of 23.5 (0.95-46.11) points in the role-physical domain of the SF36 survey favored FFG at 6 months.

CONCLUSION

Football Fitness training is an intense exercise form for women treated for breast cancer, and self-perceived health-related limitations on daily activities were improved after 6 months. However, 1 year of Football Fitness training comprising 1 weekly training session on average did not improve CRF, BP, blood lipids, fat mass, or HR_rest.

TRIAL REGISTRATION NUMBER

The trial was registered at ClinicalTrials.gov with identifier NCT03284567.