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van der Wurff I, Kirschner M, Golsteijn R, de Jonge M, Berendsen B, Singh A, Savelberg H, de Groot R. School-based physical activity interventions: which intervention characteristics are associated with participation and retention? A meta-analysis. Prev Med 2024; 182:107925. [PMID: 38437923 DOI: 10.1016/j.ypmed.2024.107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Many school-based intervention studies are conducted to increase students' physical activity (PA). Recruitment and retention problems potentially impact the robustness of RCT findings. We conducted a meta-analysis to summarize recruitment and retention rates in long-term secondary school-based PA intervention studies and examined associated participant and intervention characteristics. METHODS Web of Science, Pubmed, Medline, and PsychInfo were searched until March 20th 2023. We included studies on secondary school-based PA interventions ≥12 weeks, aimed at typically developing adolescents. We abstracted number of schools and students invited, randomized, and participating at follow-up to calculate pooled recruitment and retention rates; participant and intervention characteristics were abstracted to execute subgroup or meta-regression analyses. RESULTS Recruitment rates were 51% for invited schools and 80% for invited students, the retention for schools was almost 100% and for students 91%. Interventions with fixed and flexible components, executed in Asia and South America, and from later publication years had higher student recruitment rates. Students' retention rates were lower for interventions which had flexible components, were theory/model-based, used an accelerometer, had a longer intervention duration, and included more females. CONCLUSION Recruitment and retention rates in school-based PA interventions are high. Some participant and intervention characteristics influence these rates: flexibility of the intervention, theory/model-based intervention, accelerometer use, intervention duration, continent, and number of females. Researchers should consider these characteristics in intervention development to achieve optimal balance between intervention effectiveness, recruitment, and retention.
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Affiliation(s)
- I van der Wurff
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands.
| | - M Kirschner
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - R Golsteijn
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - M de Jonge
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands
| | - B Berendsen
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands
| | - A Singh
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands; Human Movement. School and Sport, Applied University of Windesheim, Zwolle, the Netherlands
| | - H Savelberg
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands; SHE, School of Health Professions Education, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - R de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
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Agostinete RR, Werneck AO, Narciso PH, Ubago-Guisado E, Coelho-E-Silva MJ, Bielemann RM, Gobbo LA, Lynch BT, Fernandes RA, Vlachopoulos D. Resistance training presents beneficial effects on bone development of adolescents engaged in swimming but not in impact sports: ABCD Growth Study. BMC Pediatr 2024; 24:247. [PMID: 38594697 PMCID: PMC11003018 DOI: 10.1186/s12887-024-04634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 02/09/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months. METHODS This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD. RESULTS After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and - 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p < 0.05) and whole body less head (WBLH) aBMD (0.039 [0.024 to 0.054] g/cm2 in swimming + RT vs. 0.017 [0.007 to 0.027] g/cm2 swimming-only; p < 0.05). CONCLUSION Despite the significant gain in aBMD in all groups and body sites after 12-months, except for the spine site of swimmers, the results indicate that participation in RT seems to improve aBMD accrual in swimmers at the upper limbs and WBLH.
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Affiliation(s)
- Ricardo R Agostinete
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, Brazil
| | - Pedro H Narciso
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Esther Ubago-Guisado
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - Renata M Bielemann
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Alberto Gobbo
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Bruna Turi Lynch
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - Romulo Araújo Fernandes
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Public Health and Sport Sciences, University of Exeter, Exeter, UK.
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Zurc J, Laaksonen C. Effectiveness of Health Promotion Interventions in Primary Schools-A Mixed Methods Literature Review. Healthcare (Basel) 2023; 11:1817. [PMID: 37444651 DOI: 10.3390/healthcare11131817] [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: 03/05/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
School-based health promotion interventions (HPIs) are commonly used in schools, but scientific evidence about the structures of effective interventions is lacking. Therefore, we conducted a mixed methods systematic literature review to recognize the HPI structures related to their effectiveness. Based on the inclusion criteria, 49 articles were selected for the literature review. The articles, published in 2011-2022, described 46 different school-based interventions conducted in 20 different countries. The average duration of the interventions was 12 months, and they were implemented mostly with an RCT study design (61.2%) and by targeting children (69.4%). Three main groups of interventions were identified and explained: (1) extensive and long-term interventions; (2) school policy-changing interventions; and (3) highly effective interventions. Effective school-based HPIs included multiple target groups, multiple providers with external experts, and an efficient duration and timing of follow-ups. The implications for educational research and school practice are presented. Evidence on the effectiveness of health-related interventions is still lacking and needs to be addressed in further studies.
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Affiliation(s)
- Joca Zurc
- Department of Pedagogy, Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia
| | - Camilla Laaksonen
- Faculty of Health and Well-Being, Turku University of Applied Sciences, 20520 Turku, Finland
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Adolescent Bone Advantages 3 Years After Resistance Training Trial. Pediatr Exerc Sci 2022; 35:61-69. [PMID: 36150707 DOI: 10.1123/pes.2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/30/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE We assessed maintenance of skeletal advantages 3 years after completion of a 2-year, school-based, controlled exercise trial in adolescent girls. METHOD Middle-school girls participated in a resistance training program embedded in physical education classes. Effort groups (low-effort group [LO] and high-effort group [HI]) were identified; the control group (CON) participated in standard physical education at a separate school. Baseline and follow-up (FU) assessments at 6, 18, and 54 (FU3) months included densitometry, anthropometry, and questionnaires assessing physical maturity and nonintervention organized physical activity. Linear mixed effects models were fit to evaluate bone outcomes across all FU time points for CON versus LO/HI. RESULTS Sixty-eight girls (23 CON/25 HI/20 LO) were 11.6 (0.3) years at baseline. Bone parameters did not differ at baseline, except femoral neck bone mineral density (LO < HI/CON, P < .05). Forty-seven participants provided FU3 assessment: 17 CON/16 HI/14 LO. After adjusting for height, gynecologic age, baseline bone, and organized physical activity, bone gains across all time points were greater for HI versus CON for legs bone mineral content, femoral neck bone mineral content/bone mineral density, and third lumbar vertebra bone mineral content/bone mineral density (P ≤ .05). At FU3, bone values were greater for HI versus CON at subhead, legs, femoral neck, and third lumbar vertebra (P < .03). CONCLUSION Adolescent girls who exerted high effort in a school-based resistance training program demonstrated significant skeletal benefits 3 years after program completion.
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Mello JB, Pedretti A, García-Hermoso A, Martins CML, Gaya AR, Duncan MJ, Gaya ACA. Exercise in school Physical Education increase bone mineral content and density: Systematic review and meta-analysis. Eur J Sport Sci 2021; 22:1618-1629. [PMID: 34328066 DOI: 10.1080/17461391.2021.1960426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTThis systematic review and meta-analysis aimed to evaluate the effectiveness of interventions through Physical Education (PE) exercises on bone mineral content (BMC) and density (BMD) of children and adolescents. The research was conducted using the online electronic databases PubMed, Science Direct, Web of Science and Scopus (March 2021). The analysis was restricted to school-based studies that examined the effect of PE interventions on BMC and BMD in schoolchildren (<18 years old). Standardised mean differences (SMD) with 95% confidence interval (CI) and random-effects models were calculated. The heterogeneity and inconsistency of the studies were estimated using Cochran's Q-statistic and I2, respectively. Twenty-two studies with 2,556 participants were selected. PE interventions were associated with a significant increase in BMC (SMD = 1.348; 95% CI, 1.053-1.643) and BMD (SMD = 0.640; 95% CI, 0.417-0.862). Femoral neck subgroup analysis indicate an increase in BMC for boys (SMD = 1.527; 95% CI, 0.990-2.065) and girls (SMD = 1.27; 95% CI, 0.782-1.767), and in BMD for boys (SMD = 0.518; 95% CI, 0.064-0.972) and girls (SMD = 0.817; 95% CI, 0.349-1.284). Finally, increases are reported in the lumbar spine BMC for boys (SMD = 1.860; 95% CI, 1.018-2.700) and girls (SMD = 1.275; 95% CI, 0.782-1.767). This meta-analysis provides insights into the effectiveness of interventions aimed at including physical exercise in PE on bone mass, suggesting that increasing the proportion of curriculum time allocated to PE may improve students' BMD and BMC, especially in the femoral neck and lumbar spine.
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Affiliation(s)
- Júlio B Mello
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Publica de Navarra, Pamplona, Spain.,Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | | | - Anelise R Gaya
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Guillem CM, Loaiza-Betancur AF, Rebullido TR, Faigenbaum AD, Chulvi-Medrano I. The Effects of Resistance Training on Blood Pressure in Preadolescents and Adolescents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217900. [PMID: 33126545 PMCID: PMC7663568 DOI: 10.3390/ijerph17217900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022]
Abstract
The aim was to systematically review and meta-analyze the current evidence for the effects of resistance training (RT) on blood pressure (BP) as the main outcome and body mass index (BMI) in children and adolescents. Two authors systematically searched the PubMed, SPORTDiscus, Web of Science Core Collection and EMBASE electronic databases. Inclusion criteria were: (1) children and adolescents (aged 8 to 18 years); (2) intervention studies including RT and (3) outcome measures of BP and BMI. The selected studies were analyzed using the Cochrane Risk-of-Bias Tool. Eight articles met inclusion criteria totaling 571 participants. The mean age ranged from 9.3 to 15.9 years and the mean BMI of 29.34 (7.24) kg/m2). Meta-analysis indicated that RT reduced BMI significantly (mean difference (MD): −0.43 kg/m2 (95% CI: −0.82, −0.03), P = 0.03; I2 = 5%) and a non-significant decrease in systolic BP (SBP) (MD: −1.09 mmHg (95% CI: −3.24, 1.07), P = 0.32; I2 = 67%) and diastolic BP (DBP) (MD: −0.93 mmHg (95% CI: −2.05, 0.19), P = 0.10; I2 = 37%). Limited evidence suggests that RT has no adverse effects on BP and may positively affect BP in youths. More high-quality studies are needed to clarify the association between RT and BP in light of body composition changes throughout childhood and adolescence.
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Affiliation(s)
- Carles Miguel Guillem
- Department of Physical and Sports Education, Faculty of Physical Activity and Sport Sciences, University of Valencia, 46010 Valencia, Spain;
| | | | | | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Iván Chulvi-Medrano
- UIRFIDE (Sport Performance and Physical Fitness Research Group), Department of Physical and Sports Education, Faculty of Physical Activity and Sports Sciences, University of Valencia, 46010 Valencia, Spain
- Correspondence:
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7
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Stricker PR, Faigenbaum AD, McCambridge TM. Resistance Training for Children and Adolescents. Pediatrics 2020; 145:peds.2020-1011. [PMID: 32457216 DOI: 10.1542/peds.2020-1011] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Resistance training is becoming more important as an integral part of comprehensive sport training regimens, school physical education classes, and after-school fitness programs. The increasing number of youth who are involved in sport activities, coupled with the health problems of inactivity and being overweight, have resulted in increased interest in resistance training. Secular declines in measures of muscular fitness in modern-day youth highlight the need for participation in youth resistance training for nonathletes as well as athletes. Parents often ask pediatricians to offer advice regarding the safety, benefits, and implementation of an effective resistance-training program. This report is a revision of the 2008 American Academy of Pediatrics policy statement and reviews current information and research on the benefits and risks of resistance training for children and adolescents.
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Affiliation(s)
- Paul R Stricker
- Department of Orthopedics, Pediatric & Adolescent Sports Medicine, Scripps Clinic, San Diego, California;
| | - Avery D Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey; and
| | - Teri M McCambridge
- Department of Orthopedics, University of Maryland, College Park, Maryland
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Tan JL, Siafarikas A, Rantalainen T, Hart NH, McIntyre F, Hands B, Chivers P. Impact of a multimodal exercise program on tibial bone health in adolescents with Development Coordination Disorder: an examination of feasibility and potential efficacy. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:445-471. [PMID: 33265073 PMCID: PMC7716678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Developmental coordination disorder (DCD) compromises bone health purportedly due to lower levels of physical activity. The potential of an exercise intervention to improve bone health parameters in adolescents with DCD has not previously been studied. This study thus aimed to determine the impact of a multimodal exercise intervention on bone health in this population at-risk of secondary osteoporosis. METHODS Twenty-eight adolescents (17 male, 11 female) aged between 12-17 years (Mage=14.1) with DCD participated in a twice weekly, 13-week generalised multimodal exercise intervention. Peripheral quantitative computed tomography scans of the tibia (4% and 66%) were performed over a six month period. Generalised estimating equations were used to examine the impact of fitness measures on bone parameters over time. RESULTS An overall improvement trend was observed for bone health, with significant increases at the 66% tibial site for bone mass (4.12% increase, dcohen=0.23, p=0.010) and cortical area (5.42% increase, η2 =12.09, p=0.014). Lower body fitness measures were significantly associated with improvements in bone health parameters, tempered by the degree of motor impairment. CONCLUSION A multimodal exercise intervention may be effective in improving bone health of adolescents with DCD. Given the impact of motor impairments, gains may be greater over an extended period of study.
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Affiliation(s)
- Jocelyn L. Tan
- School of Health Sciences, University of Notre Dame Australia,Western Australian Bone Research Collaboration,Corresponding author: Jocelyn Tan, School of Health Sciences, University of Notre Dame Australia, 33 Phillimore Street, Fremantle, WA, Australia E-mail:
| | - Aris Siafarikas
- Western Australian Bone Research Collaboration,Department of Endocrinology and Diabetes, Perth Children’s Hospital,Exercise Medicine Research Institute, Edith Cowan University,Institute for Health Research, University of Notre Dame Australia,Medical School, Division of Paediatrics, University of Western Australia,Telethon Kids Institute for Child Health Research
| | - Timo Rantalainen
- Western Australian Bone Research Collaboration,Exercise Medicine Research Institute, Edith Cowan University,Institute for Health Research, University of Notre Dame Australia,School of Medical and Health Science, Edith Cowan University,Gerontology Research Center, University of Jyväskylä
| | - Nicolas H. Hart
- Western Australian Bone Research Collaboration,Exercise Medicine Research Institute, Edith Cowan University,Institute for Health Research, University of Notre Dame Australia,School of Medical and Health Science, Edith Cowan University
| | - Fleur McIntyre
- School of Health Sciences, University of Notre Dame Australia
| | - Beth Hands
- School of Health Sciences, University of Notre Dame Australia,Western Australian Bone Research Collaboration,Institute for Health Research, University of Notre Dame Australia
| | - Paola Chivers
- Western Australian Bone Research Collaboration,Exercise Medicine Research Institute, Edith Cowan University,Institute for Health Research, University of Notre Dame Australia,School of Medical and Health Science, Edith Cowan University
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Min SK, Oh T, Kim SH, Cho J, Chung HY, Park DH, Kim CS. Position Statement: Exercise Guidelines to Increase Peak Bone Mass in Adolescents. J Bone Metab 2019; 26:225-239. [PMID: 31832388 PMCID: PMC6901695 DOI: 10.11005/jbm.2019.26.4.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research. Methods Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified. Results An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep·set−1 1-2 set·region−1 and 3 days·week−1 using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps·min−1, 10 min·day−1 and 2 days·week−1. Conclusions Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.
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Affiliation(s)
- Seok-Ki Min
- Department of Sport Science, Korea Institute of Sport Science, Seoul, Korea
| | - Taewoong Oh
- Department of Sport Leisure, College of Sport Sciences, Yongin University, Yongin, Korea
| | - Sang Hyun Kim
- Department of Sports Science, College of Natural Science, Chonbuk National University, Jeonju, Korea
| | - Jinkyung Cho
- College of Sport Science, Sungkyunkwan University, Suwon, Korea
| | - Ho Yeon Chung
- Department of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dong-Ho Park
- Department of Kinesiology, Inha University, Incheon, Korea
| | - Chang-Sun Kim
- Department of Physical Education, Dongduck Women's University, Seoul, Korea
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Dowthwaite JN, Weiss DM, Thein-Nissenbaum J, Scerpella TA. A 2-yr, School-Based Resistance Exercise Pilot Program Increases Bone Accrual in Adolescent Girls. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2019; 4:74-83. [PMID: 31673627 PMCID: PMC6822173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE The current analysis evaluates cumulative benefits after year two (Y2) of a school-based resistance training intervention. METHODS Adolescent girls were enrolled and measured at the beginning of 6th grade (baseline, BL) and again at 1st follow-up (FU1: Y1 end) and 2nd follow-up (FU2: Y2 end). School gym classes met alternate school days. Site 1 had standard gym classes (CON). Site 2 gym classes included 8-12 minutes of resistance training (INT); INT girls were categorized based on observed participation effort and time (LO, HI). Measurements included: 1) height and weight; 2) questionnaires to assess extracurricular exercise and diet (calcium, vitamin D); 3) dual-energy X-ray absorptiometry (DXA, Lunar Prodigy). Whole body less head (SUB) scans yielded bone mineral content (BMC) and body composition. Lumbar spine (L1-L4) and femoral neck (FN) scans yielded BMC and areal bone mineral density (BMD); radius scans yielded ultradistal and 1/3 BMD. ANCOVA compared group means for percent gains from BL to FU2, accounting for biological maturity, BL height, height change, inter-scan interval, organized activity, calcium and vitamin D. RESULTS In 62 girls (21 CON, 41 INT), intention to treat analyses detected INT vs. CON advantages for L1-L4 BMC and BMD (4.1%, 5.6%: p<0.05). HI effort participants (n=19) demonstrated advantages for BMC and BMD at L1-L4 and FN (5.7% to 8.2%, p<0.01) vs. CON. CONCLUSIONS Over two school years, this resistance intervention yielded lumbar spine advantages; enthusiastic participation (HI) yielded lumbar spine and femoral neck advantages. Further work is warranted to evaluate benefit persistence after intervention cessation.
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Affiliation(s)
- Jodi N. Dowthwaite
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, N.Y
| | - Deena M. Weiss
- University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, WI
| | | | - Tamara A. Scerpella
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, N.Y
- Department of Orthopedics and Rehabilitation, UWSMPH, Madison, WI
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Dowthwaite JN, Winzenrieth R, Binkley N, Krueger D, Scerpella TA. A focused evaluation of lumbar spine trabecular bone score in the first year post-menarche. Arch Osteoporos 2017; 12:90. [PMID: 29046970 DOI: 10.1007/s11657-017-0388-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/10/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Trabecular bone score, an index of lumbar spine trabecular texture, has not been explored fully in adolescent girls. Our cross-sectional analysis supported the hypothesis that "adult normal" trabecular bone score has been achieved by the end of the first year post-menarche, providing a potential screening tool, independent from bone density. INTRODUCTION Trabecular bone score (TBS) evaluates lumbar spine (LS) trabecular texture from DXA images. Limited evidence suggests low TBS in pre-pubertal girls. TBS has not been assessed in the context of the key peri-menarcheal bone accrual phase. Thus, we evaluated (1) whether "normal" adult TBS (≥ 1.35) is reached in the first year post-menarche and (2) the role of maturational timing (menarcheal age) and status (gynecological age) in TBS variation. METHODS For 44 healthy girls aged 11 to 13 years, whole body and LS DXA scans were obtained within 1 year post-menarche. As TBS is optimized for adults and can be affected by body thickness, custom software provided unadjusted "rawTBS" and adjusted for tissue thickness "corrTBS" (TBS iNsight, Medimaps, France). Correlations evaluated menarcheal age and gynecological age as factors in LS bone mineral content (BMC), areal bone mineral density (BMD), and TBS. RESULTS Lowest observed TBS exceeded 1.35 (rawTBS = 1.362; corrTBS = 1.352). Menarcheal age correlated negatively with rawTBS (r = - 0.34, p = 0.02), with a similar trend for corrTBS (r = - 0.29, p < 0.06). Gynecological age did not correlate with TBS but was positively correlated with LSBMD (r = + 0.37, p = 0.01). Correlations with body composition variables differed between rawTBS and corrTBS. CONCLUSIONS In this healthy cohort, "normal" adult TBS is present by 1 year post-menarche, 2 years before projected LS peak bone mass. Thus, TBS may be a useful bone architectural screen during the first post-menarcheal year, enabling intervention to improve structure prior to "peak bone mass". Longitudinal studies are needed to elucidate TBS development and intervention response.
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Affiliation(s)
- Jodi N Dowthwaite
- Department of Orthopedic Surgery, SUNY Upstate Medical University, 750 E. Adams St, Syracuse, NY, 13210, USA.
| | | | - N Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin-Madison, Madison, WI, USA
| | - D Krueger
- Osteoporosis Clinical Research Program, University of Wisconsin-Madison, Madison, WI, USA
| | - T A Scerpella
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
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Zwolski C, Quatman-Yates C, Paterno MV. Resistance Training in Youth: Laying the Foundation for Injury Prevention and Physical Literacy. Sports Health 2017; 9:436-443. [PMID: 28447880 PMCID: PMC5582694 DOI: 10.1177/1941738117704153] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Context: The rising incidence of physical activity– and sports-related injuries has prompted the present-day investigation of resistance training as a potential means of injury prevention and physical literacy development among youth. Evidence Acquisition: Relevant studies on the topics of athlete development, physical literacy, resistance training, and injury prevention in children and adolescents were reviewed (PubMed and Sports Discus, 1982-2016). Recommendations from consensus guidelines and position statements applicable to resistance training and injury prevention in youth, in addition to young athlete development, were reviewed. Additionally, hand searches, expert requests, article reference lists, and gray literature were utilized and reviewed for pertinent content. Study Design: Clinical review. Level of Evidence: Level 4. Results: Youth throughout the physical activity spectrum are at risk for physical activity– and sports-related injury. Of highest priority are early specializers, physically inactive youth, and young girls, owing to increased injury rates. Resistance training among these at-risk populations has been shown to reduce injury risk by up to 68% and improve sports performance and health measures, in addition to accelerating the development of physical literacy. Recent recommendations, position statements, and national initiatives advocate for the incorporation of resistance training with qualified instruction among these groups. Conclusion: Resistance training in addition to free play and other structured physical activity training can serve as a protective means against injury and a positive catalyst for the development of physical literacy to offset the impact of diminishing physical activity and early sport specialization in today’s youth.
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Affiliation(s)
- Christin Zwolski
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Catherine Quatman-Yates
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mark V Paterno
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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