No abstract

The children at highest injury risk are the target audience of the contemporary PA promotion efforts. PA promotion should also focus on injury prevention.

Objectives: To describe the incidence and severity of injuries resulting from physical education, sports and leisure time physical activity (PA) in 10-12-year-old children.Design: This was a prospective cohort study conducted in primary schools, with 995 children aged 10-12 years old as participants. Individual weekly exposure was estimated from baseline and follow-up questionnaires. Exposure to physical education (PE) classes was equal in all schools. An injury was recorded if it occurred during either PE class, leisure time PA, or sports, and caused the child to at least stop the current activity. Injuries were reported within 1 week of injury onset. The main outcome measure was injury incidence density. Results: During the school year a total of 119 injuries were reported by 104 children, resulting in an overall injury incidence density (ID) of 0.48 per 1000 h of exposure (95% CI 0.38 to 0.57). Injury ID was lowest for leisure time PA, followed by PE and sports, respectively. Of all injuries, 40% required medical treatment and 14% resulted in 1 or more days of absence from regular school activities. In general for girls a higher injury ID was reported than for boys, mainly caused by a twofold higher risk during leisure time PA. Conclusions: Next to specific areas of preventive interest it was found that in this specific age group, girls require special attention as they seem to be at higher injury risk than boys.The numerous health benefits of regular physical activity (PA) in children are well described in the literature. 2With the subsequent focus on a physically active lifestyle, an increasing number of sports and physical activity injuries can be expected.3 4 These injuries lead to high direct and indirect costs.5 More importantly, children may lose their enthusiasm for PA and sports through negative associations with injuries.6 Consequently, the successful prevention of sports and PA injuries in youth has great potential health gain. 7 In the short term, the absolute number of injuries will fall and, in the longer term, the risk of injury recurrences and prolonged periods of impairment will be prevented. Prevention may also promote a physically active lifestyle from childhood into adulthood.An important purpose of injury epidemiology is to supply knowledge on injuries that occur frequently and have serious consequences, and to describe their aetiology in order to provide a basis for preventive measures.8 A recent review on the risk of sports injuries in children revealed that epidemiological data on this topic is scarce. 9 Moreover, it was concluded that there is a high need for more insight into injuries during unorganised activities and for younger age groups.In particular, the combination of unorganised activities in younger age groups requires attention. An active child is growing, learning and developing its skills. During this process the younger child ''evolves'' from a participant in joyful PA to a participant in sports.7 Therefore, the purpose of this prospective cohort study was to des...

BackgroundTo investigate the effects of a school-based physical activity-related injury prevention program, called 'iPlay', on risk behavior and neuromotor fitness.MethodsIn this cluster randomized controlled trial 40 primary schools throughout the Netherlands were randomly assigned in an intervention (n = 20) or control group (n = 20). The study includes 2,210 children aged 10-12 years.The iPlay-intervention takes one school year and consists of a teacher manual, informative newsletters and posters, a website, and simple exercises to be carried out during physical education classes.Outcomes measures were self-reported injury preventing behavior, self-reported behavioral determinants (knowledge, attitude, social-influence, self-efficacy, and intention), and neuromotor fitness.ResultsThe iPlay-program was not able to significantly improve injury-preventing behavior. The program did significantly improve knowledge and attitude, two determinants of behavior. The effect of the intervention-program on behavior appeared to be significantly mediated by knowledge and attitude. Improved scores on attitude, social norm, self-efficacy and intention were significantly related to changes in injury preventing behavior. Furthermore, iPlay resulted in small non-significant improvements in neuromotor fitness in favor of the intervention group.ConclusionThis cluster randomized controlled trial showed that the iPlay-program did significantly improved behavioral determinants. However, this effect on knowledge and attitude was not strong enough to improve injury preventing behavior. Furthermore, the results confirm the hypothetical model that injury preventing behavior is determined by intention, attitude, social norm and self-efficacy.Trial numberISRCTN78846684

ISRCTN78846684.

To study the effects of a school-based injury prevention program on physical activity injury incidence and severity.

Children with a low level of neuromotor fitness are less skilled to participate in sports activities. Moreover, lower levels of neuromotor fitness are related to adiposity, lower cardiovascular health, and poor self-esteem in children. The aim of this paper was to determine neuromotor fitness in 10-12-year-old Dutch children over a 10-year period. Test scores measured in 2015/2017 (N = 533 in 2015, N = 941 in 2017) were compared with scores of same-aged children measured in 2006 (N = 1986). Neuromotor fitness was assessed using the MOPER fitness test battery, including speed and agility, strength, flexibility, and coordination and upper-limb speed. Data were analyzed using multilevel linear regression models and tobit regression analyses in case of skewed distributions with an excess of zeros. Analyses were stratified by age and gender, and adjusted for level of urbanization. Children in 2015/2017 performed significantly worse on speed and agility (β = 0.8 to 1.1 s), significantly better on coordination/upper-limb speed (β = −1.0 to −0.6 s), and-except for 12-year-old girls-significantly worse on flexibility vs. children in 2006 (β = −3.4 to −1.8 cm). Additionally, upper-body strength was significantly worse among 10-year olds (β = −3.2 to −2.5 s) while leg strength was significantly worse among 11-year-olds in 2015/2017 vs. 2006 (β = −1.8 to −1.7 cm). Trunk strength was worse among 11-and 12-year old boys (β = 1.1 to 1.2 s). In line with a previously observed downward trend in neuromotor fitness among children (1980-2006), we found worse scores on speed and agility, and flexibility in 2015/2017 vs. 2006, stressing the need for interventions aimed at improving neuromotor fitness in order to promote physical activity and future health.

An increase in the physical activity of individuals has many health benefits, but a drawback of an increase in physical activity is the risk of related injuries. To reduce the short- and long-term effects in terms of social and economic consequences, prevention of physical activity injuries is an important challenge. A sequence of prevention model has been proposed that aims to prevent physical activity injuries in different steps. The model includes (i) identification of the problem in terms of incidence and severity of physical activity injuries, (ii) identification of the risk factors and injury mechanisms that play a role in the occurrence of physical activity injuries, (iii) introduction of measures that are likely to reduce the future risk and (or) severity of physical activity injuries, and (iv) evaluation of the effectiveness of the measures by conducting a randomized controlled trial (RCT). This review describes what is currently known about all of the various aspects of the sequence of prevention in children (steps i-iv).