Physical Activity-related Injuries Research Articles

Economic burden of physical activity–related injuries in Dutch children aged 10–12

BackgroundInjuries in children occur most often in physical activity–related activities. A lot of these injuries result in direct and indirect costs. A detailed overview of the economic burden of those...

Magnitude and economic burden of sports and physical activity-related injuries in dutch 10–12 year old children

BackgroundThe several health benefits of regular physical activity (PA) in children are well known. Participation in PA, however, also increases the risk of adverse effects, such as injuries. However, reliable...

Process evaluation of a school based physical activity related injury prevention programme using the RE-AIM framework

BackgroundIn general, only information regarding the effectiveness of an intervention programme is ever published. However, in recent years evaluating the translatability and feasibility of an intervention programme has become more important. Therefore, this paper presents the results of the evaluation of the iPlay programme aimed at preventing physical activity related injuries in primary school children.MethodsThe iPlay programme targeted injuries gained through physical activity, and consisted of a teacher's manual, informative newsletters and posters, a website, and set exercises to be carried out during physical education (PE) classes. In order to evaluate the iPlay programme for translatability and feasibility, teachers, children and parents who participated in the iPlay programme filled out a questionnaireThe objective of this study is to describe the results of the process-evaluation of the iPlay programme based on the five dimensions of the RE-AIM framework.ResultsThe results showed that the participation rate of the children was 100% (reach). Nine percent of the schools who were invited to take part were willing to participate in the study (adoption rate). Teachers stated that they implemented the different elements of the programme partly as intended (implementation). The percentage of children and parents who followed the programme was less than expected. In addition, 52% of the teachers indicated that the current iPlay programme could become standard practice in their teaching routine (maintenance).ConclusionThe iPlay programme is a first start in the prevention of physical activity related injuries in children, but further improvements need to be made to the programme on the basis of this process evaluation.Trial registrationISRCTN78846684; http://www.controlled-trials.com

Physical Activity and Injuries During Pregnancy

Although physical activity can provide health benefits to pregnant women, population-based research on the circumstances surrounding injuries from physical activity during pregnancy is lacking. Physical activity and subsequent injuries among a cohort of 1469 pregnant women in North Carolina were examined prospectively from the third phase of the Pregnancy, Infection, and Nutrition Study between 2001 and 2005. Chi-square analyses were used to compare distributions of maternal characteristics among women who sustained injuries from physical activity and women who reported no injuries during pregnancy. Injury incidence rates were calculated. Few pregnant women (N = 34) reported a physical activity-related injury during pregnancy. The rates of physical activity-related and exercise-related injuries during pregnancy were 3.2 per 1000 physical activity hours and 4.1 per 1000 exercise hours, respectively. The most common types of injuries were bruises or scrapes (55%). Among all injuries, 33% resulted from exercise and 67% resulted from nonexercise physical activities. Sixty-four percent of all injuries were due to falls. The incidence of injury from physical activity was low during pregnancy. Women should continue to be encouraged to maintain involvement in physical activity during pregnancy, while being aware of the potential for injury, particularly falls, from these activities.

Effectiveness of a school-based physical activity-related injury prevention program on risk behavior and neuromotor fitness a cluster randomized controlled trial.

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

Design of the iPlay Study

Health benefits of physical activity in children are well known. However, a drawback is the risk of physical activity-related injuries. Children are at particular risk for these injuries, because of a high level of exposure. Because of the high prevalence of physical activity injuries and the negative short- and long-term consequences, prevention of these injuries in children is important. This article describes how we systematically developed a school-based physical activity injury prevention programme using the intervention mapping (IM) protocol. IM describes a process for developing theory- and evidence-based health promotion programmes. The development can be described in six steps: (i) perform a needs assessment; (ii) identify programme and performance objectives; (iii) select methods and strategies; (iv) develop programme; (v) adopt and implement; and (vi) evaluate. First, the results of the needs assessment showed the injury problem in children and the different risk factors for physical activity injuries. Based on the results of the needs assessment the main focus of the injury prevention programme was described. Second, the overall programme objective of the injury prevention programme was defined as reducing the incidence of lower extremity physical activity injuries. Third, theoretical methods and practical strategies were selected to accomplish a decrease in injury incidence. The theoretical methods used were active learning, providing cues and scenario-based risk information, and active processing of information. The practical strategy of the injury prevention programme was an 8-month course about injury prevention to be used in physical education classes in primary schools. Fourth, programme materials that were used in the injury prevention programme were developed, including newsletters for children and parents, posters, exercises to improve motor fitness, and an information website. Fifth, an implementation plan was designed in order to ensure that the prevention programme would be implemented, adopted and sustained over time. Finally, an evaluation plan was designed. The injury prevention programme is being evaluated in a cluster randomized controlled trial with more than 2200 children from 40 primary schools throughout the Netherlands. The IM process is a useful process for developing an injury prevention programme. Based on the steps of the IM we developed an 8-month injury prevention programme to be used in physical education classes of primary schools.

Effects Of A School-based Injury Prevention Program On Acute Physical Activity Injury Incidence And Severity.

The health benefits of regular physical activity in children are widely known. Participation in physical activity, however, also leads to unwanted side effects such as acute physical activity related injuries. Although most injuries in children are not life threatening, they may coincide with direct pain, short-term disability, school absence and long-term consequences, all leading to high direct and indirect costs. PURPOSE: To investigate the effectiveness of a school-based injury prevention program (iPlay) on acute physical activity injury incidence and severity in Dutch children aged 10-12 years. METHOD: The iPlay-study is a cluster randomised controlled trial including 2,210 children from 40 primary schools. The 20 intervention schools received the iPlay-program during one school year whereas the control schools followed the regular curriculum. The iPlay-program targeted acute physical activity injuries and consisted of newsletters, posters, a website, and simple exercises to be carried out during physical education (PE) classes. Primary outcome measures were acute physical activity injury incidence and severity continuously monitored by the PE teacher. Group comparisons were made using the Cox proportional hazard regression analyses. RESULTS: Results showed that the overall physical activity injury incidence per 1,000 hours of physical activity participation was significantly reduced in the intervention group (Hazard Ratio (HR) = 0.68, 95%CI:0.49-0.95). Specifically, during organized sports activities injury incidence was strongly reduced (HR = 0.55, 95%CI:0.31-0.98). Furthermore, in girls injury incidence during leisure time physical activities was considerably reduced (HR = 0.38, 95%CI:0.18-0.82). In boys in the intervention group, the severity of the overall physical activity injuries was significantly lower (OR = 0.12, 95%CI:0.02-0.72). CONCLUSION: This study revealed that a school-based intervention-program was effective in reducing acute physical activity injury incidence in children aged 10-12 years. The program also decreased the severity of the physical activity injuries in boys.

Safety of Strength Training in Premenopausal Women: Musculoskeletal Injuries from a Two-Year Randomized Trial

The health benefits of strength training must be weighed against risks, including injuries. A prior study observed 4.2 injuries that limited usual activities for a day per 1000 strength training sessions among men and women. The analysis herein explores the incidence rates of musculoskeletal injuries from strength training in women. Randomized controlled trial. SETTING; Free-living community. A total of 163 injury-free, overweight, sedentary, premenopausal women aged 25 to 44 years. Two years of strength training (n = 81) or standard care (n = 82). The intervention followed published guidelines (U.S. Department of Health and Human Services) with hypothesized injury prevention strategies. An injury survey was administered at years 1 and 2. Injury was defined as physical activity or strength training associated injuries that limited daily activities for 1 week or more. Denominators for rate calculation were accelerometer-measured physical activity and strength training attendance (strength training only). The between-group probability of injuries was assessed using generalized estimating equations. Injury incidence rates were higher in strength training compared with standard care. In strength training, the injury rates were 3.6 per 1000 strength training sessions (95% confidence interval: 2.5-4.8 per 1000) for physical activity-related injuries, and 2.6 per 1000 (95% confidence interval: 1.5-3.6 per 1000) for strength training-related injuries. Injury rates varied by definition and denominator. Strength training had lower injury rates than previously reported, providing preliminary support for the prevention strategies. The finding of strength training injuries underscores the need for balancing the benefits against the potential risks of this exercise modality.

Ronald Napier Robertson Grant

<h3>Objectives</h3> This study aimed to investigate the epidemiological characteristics and preliminarily explore possible risk factors of physical activity-related injury (PARI) occurrences among Chinese university students via a multicentre mixed survey....

Physical Activity-Related Injury and Body Mass Index Among US High School Students

Few studies have focused on the relationship between physical activity-related (PA) injury and overweight among youth. We analyzed data from the 2001 and 2003 Youth Risk Behavior Surveys (n = 28,815). Logistic regression was used to examine the independent effects of BMI and frequency of participation in vigorous activity, moderate activity, strengthening exercises, physical education (PE) classes, and team sports on the likelihood of PA injury. Approximately 14% of females and 19% of males reported seeing a doctor or nurse during the previous 30 d for an injury that happened while exercising or playing sports. PA injury was associated with participation in team sports, strengthening exercises, and (among females) vigorous physical activity. Controlling for type and frequency of physical activity, injury was not associated with being overweight (BMI >or= 95th percentile). Moderate physical activity and school PE classes may provide relatively low-risk alternatives for overweight youth who need to increase their physical activity.

Influence of Multiple Risk Behaviors on Physical Activity–Related Injuries in Adolescents

The study objectives were to (1) examine the relationship between physical activity and physical activity injuries in youth, (2) determine whether this relationship is modified by the engagement in multiple risk behaviors, and (3) determine whether this relationship is modified by the setting of the injury (school versus outside of school). We examined associations between physical activity and multiple risk behaviors with physical activity injuries occurring at and outside of school. The study population consisted of a representative sample of 5559 Canadian youth in grades 6 through 10 who participated in the 2001/2002 Health Behavior in School-Aged Children Survey. The exposure and outcome measures were determined from a classroom-based survey. Irrespective of grade, there were strong gradient relations between physical activity participation and related injuries outside of school. Conversely, there were modest relations between physical activity participation and related injuries at school. In students in grades 6 to 8, there was no relation between multiple risk behaviors and physical activity injuries at school and a curvilinear relation between multiple risk behaviors and physical activity injuries outside of school. The opposite pattern of relationships between multiple risk behaviors and injuries was observed in students in grades 9 to 10. Irrespective of grade and setting of injury, there was no significant interaction between physical activity and multiple risk behaviors on injury risk. The results were consistent by severity of injury and for structured/organized and unstructured/informal forms of physical activity. The environment moderated the relation between physical activity and related injuries in that strong risk gradients only existed outside of the school setting. Unexpectedly, there were no consistent gradients between the engagement in multiple risk behaviors and physical activity injuries or any interaction effect between physical activity exposure and multiple risk behaviors. These findings suggest that optimizing the environment would be a preferred strategy for preventing physical activity injuries compared with selectively targeting youth who engage in multiple risk behaviors.

Quantifying the Association Between Physical Activity and Injury in Primary School–Aged Children

Regular physical activity is strongly advocated in children, with recommendations suggesting up to several hours of daily participation. However, an unintended consequence of physical activity is exposure to the risk of injury. To date, these risks have not been quantified in primary school-aged children despite injury being a leading cause for hospitalization and death in this population. Our goal was to quantify the risk of injury associated with childhood physical activity both in and out of the school setting and calculate injury rates per exposure time for organized and non-organized activity outside of school. The Childhood Injury Prevention Study prospectively followed a cohort of randomly selected Australian primary school-and preschool-aged children (4 to 12 years). Over 12 months, each injury that required first aid attention was registered with the study. Exposure to physical activity outside school hours was measured by using a parent-completed 7-day diary. The age and gender distribution of injury rates per 10 000 hours of exposure were calculated for all activity and for organized and non-organized activity occurring outside school hours. In addition, child-based injury rates were calculated for physical activity-related injuries both in and out of the school setting. Complete diary and injury data were available for 744 children. There were 504 injuries recorded over the study period, 396 (88.6%) of which were directly related to physical activity. Thirty-four percent of physical activity-related injuries required professional medical treatment. Analysis of injuries occurring outside of school revealed an overall injury rate of 5.7 injuries per 10000 hours of exposure to physical activity and a medically treated injury rate of 1.7 per 10000 hours. Injury rates per hours of exposure to physical activity were low in this cohort of primary school-aged children, with <2 injuries requiring medical treatment occurring for every 10000 hours of activity participation outside of school.

Physical Activity-Related Injuries in Walkers and Runners

University of Cape Town, Newlands, South Africa Associate Editor: Mark Tarnopolsky, MD, PhD Editorial Associate: Ann Lotter

Physical activity-related injuries in walkers and runners in the aerobics center longitudinal study.

To examine the association between physical activity-related injuries and participation in walking versus running. Nested case-control study. Cooper Clinic Preventive Medicine Center, Dallas. Texas. 5,327 men and women undergoing exams between 1987 and 1995 and completing follow-up health history questionnaires in 1990 or 1995. Participants were classified as those reporting regular participation in walking or jogging/running at baseline. Those reporting both or neither activity were excluded from the study (n = 1404). Cases (698 men, 169 women) were those reporting physical activity-related injuries requiring physician visits in the previous year on the follow-up questionnaire. Controls (2,358 men, 698 women) were randomly selected from the remaining population. Logistic regression was used to examine the risk of injury in walkers versus runners and risk of injury by exercise dose while considering age, body mass index, previous injury, and strength training. There was a significantly lower risk of injury for walkers compared with runners in young (<45 years old) (odds ratio [OR] = 0.75, 95% confidence interval [CI] = 0.58-0.97) and older (> or = 45 years) men (OR = 0.64, 95% CI = 0.49-0.82), and a nonsignificantly lower risk among young (OR = 0.73, 95% CI = 0.39-1.37) and older women (OR = 0.72, 95% CI = 0.38-1.35). There was no effect of greater amounts of walking on injuries for either gender; however, there was a higher injury risk associated with running 15-30 min/day (OR = 1.36, 95% CI = 1.07-1.73) and 30+ min/day (OR = 1.52, 95% CI = 1.14-2.04) compared with <15 min/day among men, but not among women. This low risk of musculoskeletal injury suggests that participation in walking can be safely recommended as a way to improve health and fitness.