Organized sports for children and preadolescents

Mens sana in corpore sano: the effects of sport on children’s learning in Italy

This study analyses the impact of sports participation on both cognitive and non-cognitive skills using micro data from Italian fifth grade pupils’ test scores. The performance of students is investigated by estimating different frequencies of sports practice. Using sports facilities as an instrument for sports participation, we find that its effect on school performance is positive, but only for an intermediate level of training. Sports drills have a negative effect, especially on females, when the extremes come into play: both inactivity and full-week action. On the contrary, daily sports practice seems to be effective on non-cognitive skills, revealing positive contributions to some personality traits that represent a major component of human capital.

Sport activities for children and adolescents: the Position of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians 2023-Part 1. Pre-participation physical evaluation in young athletes

The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.

Microbial bowel infections-induced biochemical and biological abnormalities and their effects on young Egyptian swimmers

Swimmers' personal hygiene affects the spread of microbes in pools. The present study aimed to determine the incidence of microbial infections among young Egyptian swimmers and its impact on swimmers' scores. From January 2020 to June 2021, 528 public club swimmers were examined cross-sectionally. Swimmers were divided into two groups according to their star tests and their scores in the competition (group 1 with a high score and group 2 with a low score). Stool samples, biochemical and biological parameters were assessed. Microbial infections were 54% for intestinal parasitosis and 2.8% for Helicobacter pylori. The rate of intestinal parasitosis was higher among Gp2 as compared to Gp1. The results also revealed higher prevalence of Cryptosporidium spp., Giardia lamblia, Entameba histolytica, and Cyclospora among Gp2 than Gp1. Swimming frequency, and duration influenced the infectious status that induced anemia, abnormal blood pressure, and heart rate. Infected swimmers with cryptosporidiosis had higher alanine transaminase levels, white blood cells, and differential cells but lower aspartate transaminase levels. Giardiasis showed higher reduction in the biochemical markers including ferritin, lactoferrin, iron, and transferrin among Gp 2, compared to Gp 1 and thus affected the swimmers' scores. Thus, raising swimmers' hygiene awareness and targeting health education is obliged.

The impact of coordination-based movement education model on balance development of 5-year-old children

With this study, it was aimed to examine the effect of coordination-based movement education model on the development of balance in 5-year-old children. The research was designed with a control group pre-test post-test design, which is one of the quasi-experimental research models. The research group consists of a total of 42 (n = 20 experimental n = 22 control) 5-year-old children formed by using the convenient sampling method, which is one of the purposeful sampling methods. Each participant's age, body weight, body length and lower extremity limb lengths were measured. As a data collection tool and used the three-part Y Balance Test (YBT) platform, which was previously stated to have high reliability (ICC = 0.85-0.93). Reach distances of the participants were measured in three directions, anterior posteromedial and posterolateral. YBT scores were determined by calculating the average and normalized values for lower extremity limb length for each reach direction of the obtained scores, and composite YBT scores were determined by taking the averages of anterior, posteromedial and posterolateral reach distance scores. In order to determine whether the collected data are suitable for normal distribution, Levene test was applied first and it was determined that p > 0.05 for all parameters as a result of the test. Independent sample T-test from parametric tests was used to determine the differences between groups. Paired-group T-test was used to determine within-group differences. According to the results of the research, it was found that the balance motor capacity levels between the experimental and control groups did not differ significantly compared to the pre-test, but there was a significant difference in all reach directions scores in favor of the post-test and experimental group compared to the control group and the pre-test. When the results of the right and left lower extremity ANT, PM, PL and Composite reach distances were examined according to gender, although there was no statistically significant difference, when the averages were considered, it was seen that all parameters were in favor of girls (p > 0.05). As a result, it was concluded that coordination-based movement education model had a positive effect on the balance motor capacities of 5-year-old children.

Self-perception of physical appearance of adolescents and associated factors in Addis Ababa, Ethiopia

INTRODUCTION

Establishing a positive body image is a critical factor for adolescents' physical and mental health, as it determines self-confidence, and sustainable individual growth and development throughout their lives. This reality needs to be supported by evidences generated locally. However, there is a lack of information in this regard in the study setting. Thus, the aim of this study was to assess the self-perception of one's physical appearance and its associated factors among adolescents in Addis Ababa, Ethiopia.

METHODS AND MATERIALS

A community-based, cross-sectional study design was used to conduct the study. At the end of the multistage sampling procedure, a systematic random sampling technique was employed to select 308 study participants from selected districts. The questionnaire was adapted from previous studies as it was appropriate for local context. The data collectors were trained before the data collection and supervised during the data collection period, and the questionnaire was pretested. Bivariate logistic regression was used to identify candidate variables, and then variables with p<0.2 were taken to multiple logistic regressions to identify independent associated factors. Statistical significance was considered at P <0.05 with adjusted odds ratios calculated at 95% CIs.

RESULT

A total of 283 adolescents were participated in the study, with a response rate of 91.9%. The overall good self-perception of one's physical appearance was 48.4% [95% CI = 43.8, 54.1]. Having a BMI between 18.5 kg/m2-24.9 kg/m2 (AOR = 2.56; 95% CI: 1.45, 4.54), presence of enough sport fields in the school (AOR = 1.89; 95% CI: 1.09, 3.29), having daily access to internet services (AOR = 1.69; 95% CI: 1.07, 2.94), following Ethiopian movies/cinemas (AOR = 2.46; 95% CI: 1.46, 4.15), and regularly following western movies/cinemas (AOR = 2.0; 95% CI: 1.11, 3.59) were significantly associated with a good self-perception of one's physical appearance.

CONCLUSION

According to this study, only 48.4% of respondents reported a good self-perception of their physical appearance. Adolescents and their family need to work to bring normal body mass index, which in turn will increase good self-perceptions of their physical appearance. Schools and the local administrations need to increase availability and access to enough sport fields for students to strengthen their physical fitness, which increases their good self-perception of their physical appearance.

Youth Judokas Competing in Higher Age Groups Leads to a Short-Term Success

Coaches of youth judo athletes might be under the influence of some extraordinary elite judo athletes that have won elite competitions at a relatively young age and might put youth athletes under pressure to gain as much fighting experience as fast as possible. The present study aims to present a 5-year competition structure, volume and age competition categories (ACC) range in which youth judokas competed with 10-year dropout status. Data from 46 judokas were collected (M = 24; F = 22) for four categorisation classes (National-NC; Perspective-PC; International-IC; World class-WC). Competitive structure, volume, performance and number of ACC were collected from 2009 to 2013 for all age groups from scores and standings records of the National Federation. Youth judokas competed in 8 (±2) competitions per year and also competed in 3 (±1) ACC. Abroad competitions affect the fighting experience and competitive success (CS). CS showed positive correlations with the number of ACC in the year 2009 (p = 0.01), 2010 (p = 0.01) and 2011 (p = 0.04). The final observed years’ CS 2012 (p = 0.009) and 2013 (p = 0.002) showed a negative association with the number of ACC. CS in the final observed year 2013 showed a positive association (p = 0.012) with the dropout status in 2018 and a negative one with the number of abroad competitions in 2013 (p = 0.029). In total, 52% dropout was noted in 10 years. This ‘’playing-up’’ approach was shown to be successful in creating youth medalists. However, just in the short term, if implemented for too long, it starts to affect competition success negatively and increases youth athletes’ dropout. Therefore, coaches should include more competitions abroad in competitors’ primary age group, while training sessions could be done with higher age groups which would allow for gathering additional experience in a more controlled environment in their yearly periodisation.

Should Adolescents Run Marathons?: Youth Marathon Training Injury Epidemiology and Risk Factors

OBJECTIVE

Youth participation in distance running has increased, yet little data exist about the injury patterns and safety of such activity. This study seeks to determine the types and rates of injuries seen in an adolescent marathon training program.

DESIGN

Observational prospective cohort study.

SETTING

Community-based adolescent marathon training program.

PARTICIPANTS

The study enrolled 1927 students from 50 high schools (HS) and 34 middle schools (MS) participating in the 2017 to 2018 Students Run Los Angeles marathon training program.

ASSESSMENT OF RISK FACTORS

Weekly injury reports completed by running coaches. Data elements included participant demographics, weekly training distance, injury type, injury acuity, and missed training time.

MAIN OUTCOME MEASURES

Epidemiology of self-reported injury in adolescent runners.

RESULTS

A total of 583 injuries occurred in 18% of runners during the training program. High schools runners were more likely to be injured than MS runners (20.8% vs 14.2%, P < 0.001). Seventy-two percent of injuries were acute with a mean missed training time of 4.8 days (SD 4.8). The most frequent site of injury was the knee (33%). Overall, runners with injuries ran a significantly greater distance per week than uninjured runners (14.6 mi vs 12.0 mi, P < 0.001). Ninety-nine percent of marathon participants completed the race.

CONCLUSIONS

During a 28-week marathon training program, 18% of adolescent participants reported an injury. More injuries occurred in HS students, were acute, and involved the knee. This study represents one of the largest descriptions of injury prevalence in adolescent distance running and highlights a lower injury rate than adults during marathon training.

Youth Athlete Development Models: A Narrative Review

CONTEXT

Physical activity has shown to be beneficial for the overall physical and mental health of youth. There has been an increasing focus on youth sports moving from a recreational activity to becoming a launching pad for participation at elite levels. Several models of athlete development have emerged to guide specialized and nonspecialized athletes at an age-appropriate level, taking into consideration their physical and mental development. The purpose of this review is to summarize the current evidence and theoretical models regarding youth athlete development and discuss broader initiatives for sports participation and future directions for the field.

EVIDENCE ACQUISITION

An electronic databases search, including PubMed, Google Scholar, ScienceDirect, National Institutes of Health, UpToDate, and Springer was conducted. Articles from 1993 to 2021 were included. The search terms long term athlete development, LTAD model, youth physical development, youth athlete development, sports specialization, and pediatric athlete, among others, were used.

STUDY DESIGN

Narrative review.

LEVEL OF EVIDENCE

Levels 4 and 5.

RESULTS

Several models of youth athlete development are discussed in this article. More recent models have built on previous models to incorporate more age- and development-specific recommendations; however, no singular model could be identified as the gold standard for youth athlete development, especially given the lack of empirical data to support these models.

CONCLUSION

Youth athlete development currently consists of several theoretical models, each with their own strengths and weaknesses, that can guide the training of young athletes to maximize their performance. Those involved in this process-physicians, athletic trainers, coaches, physical educators, and parents-should understand these various models and trial their various features to see what works best for their individual athlete with consideration given to factors such as their stage of development. Ultimately, more empirical data are required to definitively state which is the optimal approach.

Social Competence and Peer Social Acceptance: Evaluating Effects of an Educational Intervention in Adolescents

This study aims to evaluate the impact of an educational intervention on social competence and social acceptance among adolescents. The participants were 106 adolescents aged 12–15 years (M = 13.41 years; SD = 0.81 years). Participants were randomly assigned to the control group (n = 44) and an experimental group (n = 69). In the experimental group, an intervention based on the Sport Education Model (SEM) was applied. While in the control group, an intervention based on the Traditional Model of Direct Instruction (TM-DI) was carried out. An experimental design with repeated pretest and posttest measurements was developed. The Adolescent Multidimensional Social Competence Questionnaire (AMSC-Q) was used to assess social competence. The Guess Who (GW4) questionnaire was used to assess social acceptance (SA) among peers. The preliminary results showed that the intervention based on the SEM (experimental group) promoted more significant improvements in some indicators of social competence and social acceptance among peers than those obtained with the TM-DI (control group). The results confirm a similar impact of the intervention between boys and girls. These preliminary results suggest the potential of the Sport Education Model with adolescents.

Longitudinal Trends in Sport Participation and Retention of Women and Girls

Measurement and analysis of sport participation data is vital to understand trends, and therefore to make informed decisions relating to sport policy and strategies to get more people active through sport. This study identified patterns of club sport participation, retention and drop-out of women and girls over a 7 year period in a popular team sport in Australia. The study included registered women and girls of all ages (4–96 years at baseline) in an almost exclusively female sport, with a particular focus on the ages 4–14 years where most participation occurs. All commencing participants in the base year (2010) were tracked over the 7 year period. Participants were classified in two ways: the total number of years they played and their overall pattern of participation. Differences between age groups were analyzed using Kruskall Wallis and Mann Whitney tests. Registration records of 29,225 participants were analyzed in the study. Overall, there were considerable differences in the years participating in the sport. Almost one third (30%) of commencing 4–9 year olds played continuously for the 7 years. This proportion diminished through ages at commencement from 10 to 19, reaching a low point of 4% for ages 15–19, then rebounded slightly, reaching 7% for ages 30+. The proportion who dropped out during the 7 year period and did not return varied with age in the converse manner, as did the proportion of single-year players. The optimal age of entry to sport for retention in participation was 6–9 years. Consideration needs to be given to the age appropriateness of sports programs for very young participants. Strategies specifically relating to retention of girls and young women during adolescence should be developed.

The Public Health Consequences of Sport Specialization

Sport specialization was thought to affect a relatively small number of elite athletes, but it is now a common practice in youth sport culture. Recent research in the field of sport specialization has led to a better understanding of the influence this issue is having on youth (ie, younger than 19 years of age) today. This review focuses on sport specialization from a public health perspective to elucidate the effect that this practice is having within the United States. The specific goals of this review are to describe (1) the prevalence of sport specialization and the factors that may affect the decision to specialize, (2) the costs of youth sport-related injuries in the context of sport specialization, (3) the financial costs that sport specialization has for families, and (4) how sport specialization may be affecting physical literacy.

Organized Sports for Children, Preadolescents, and Adolescents

Interest and participation in organized sports for children, preadolescents, and adolescents continue to grow. Because of increased participation, and younger entry age, in organized sports, appropriate practice, game schedules, and content become more important, taking into account athlete developmental stage and skills. Parental support for organized sports in general, with focus on development and fun instead of winning, has emerged as a key factor in the athlete's enjoyment of sports. Schools and community sports organizations who support multiple levels of sport (eg, recreational, competitive, elite) can include more youth who want to play sports and combat sport dropout. This report reviews the benefits and risks of organized sports as well as the roles of schools, community organizations, parents, and coaches in organized sports. It is designed to complement the American Academy of Pediatrics clinical reports "Physical Activity Assessment and Counseling in Pediatric Clinical Settings" and "Sports Specialization and Intensive Training in Young Athletes" by reviewing relevant literature on healthy organized sports for youth and providing guidance on organized sport readiness and entry. The report also provides guidance for pediatricians on counseling parents and advocating for healthy organized sports participation.

Effect of COL5A1, GDF5, and PPARA Genes on a Movement Screen and Neuromuscular Performance in Adolescent Team Sport Athletes

Stastny, P, Lehnert, M, De Ste Croix, M, Petr, M, Svoboda, Z, Maixnerova, E, Varekova, R, Botek, M, Petrek, M, Lenka, K, and Cięszczyk, P. Effect of COL5A1, GDF5, and PPARA genes on a movement screen and neuromuscular performance in adolescent team sport athletes. J Strength Cond Res 33(8): 2057-2065, 2019-The risk of injury increases with adolescents' chronological age and may be related to limited muscle function neuromuscular, genetic, and biomechanical factors. The purpose of this study was to determine whether COL5A1, PPARA, and GDF5 genes are associated with muscle functions and stretch-shortening cycle performance in adolescent athletes. One hundred forty-six youth players (14.4 ± 0.2 years) from various team sports (basketball n = 54, soccer n = 50, handball n = 32) underwent a manual test for muscle function, maturity estimation, functional bend test (FBT), passive straight leg raise (SLR) test, leg stiffness test, test of reactive strength index (RSI), and gene sampling for COL5A1, PPARA, and GDF5. The χ test did not show any differences in allele or genotype frequency between participants before and after peak height velocity. Multivariate analysis of variance showed that COL5A1 rs12722 CT heterozygotes had worse score in FBT (p < 0.001), worse score in SLR (p = 0.003), and lower maturity offset (p = 0.029, only in females) than TT homozygotes. Male GDF5 rs143383 GG homozygotes showed better score in SLR than AA and AG genotypes (p = 0.003), and AA and AG genotypes in both sex had greater RSI than GG homozygotes (p = 0.016). The PPARA rs4253778 CC homozygotes had greater RSI than GG and GC genotypes (p = 0.004). The CT genotype in COL5A1 rs12722 is possible predictor of functional movement disruption in the posterior hip muscle chain, causing shortening in FBT and SLR, which includes hamstrings function. CT genotype in COL5A1 rs12722 should be involved in programs targeting hamstring and posterior hip muscle chain.

Organized Sports and Physical Activities as Sole Influencers of Fitness: The Homeschool Population

Homeschool children may rely solely on organized sports and physical activities to achieve recommended levels of physical activity and fitness. The purpose of this study was to investigate differences in fitness levels between homeschool children who did, and did not, participate in organized sports or physical activities, and then examine relationships between hours per week in sports or physical activities and cardiorespiratory fitness as measured by portions of the FitnessGram^® test battery. Organized sports/physical activity participation information was gathered on 100 children ages 10-17 years who completed tests of upper, abdominal, and cardiorespiratory fitness. The current investigation revealed that participation alone was not associated with higher levels of physical fitness as assessed by the 90° push-up test or curl-up test nor was time in participation related to cardiorespiratory fitness as assessed by the Progressive Aerobic Capacity Endurance Run (PACER). These activities alone may be insufficient for meeting physical activity recommendations and improving physical fitness. Therefore, children and adolescents educated at home may need additional opportunities to participate in unstructured daily physical activity.

Urban Adolescents' Physical Activity Experience, Physical Activity Levels, and Use of Screen-Based Media during Leisure Time: A Structural Model

There is limited understanding of the relationship between physical activity and use of screen-based media, two important behaviors associated with adolescents’ health outcomes. To understand this relationship, researchers may need to consider not only physical activity level but also physical activity experience (i.e., affective experience obtained from doing physical activity). Using a sample predominantly consisting of African and Latino American urban adolescents, this study examined the interrelationships between physical activity experience, physical activity level, and use of screen-based media during leisure time. Data collected using self-report, paper and pencil surveys was analyzed using structural equation modeling. Results showed that physical activity experience was positively associated with physical activity level and had a direct negative relationship with use of non-active video games for males and a direct negative relationship with use of computer/Internet for both genders, after controlling for physical activity level. Physical activity level did not have a direct relationship with use of non-active video games or computer/Internet. However, physical activity level had a direct negative association with use of TV/movies. This study suggests that physical activity experience may play an important role in promoting physical activity and thwarting use of screen-based media among adolescents.

Sports and Genitourinary Traumas

Introduction

Statistical data referring to sports-related traumas of the urinary tract are quite scarce; nevertheless, it is possible to draw general data on the relationship between sports and urological traumas.

Methods

Literature review of peer-reviewed articles published by May 2009.

Results

Urological traumas account for about 10% of all traumas, and about 13% of them is sports-related. Genitourinary traumas are among the most common cause of abdominal injuries in sports. Blunt injuries are more common than penetrating ones and renal injuries are by far the most common, followed by testicular injuries; ureters, bladder and penis injuries are much more infrequent. Considering chronic microtraumas, injuries of bulbar urethra are also common in sports that involve riding. Overall, the incidence of genitourinary trauma due to sports is low. Renal traumas in sports injuries usually consist of grade 1–11 lesions and usually do not require surgical treatment. Cycling is the sporting activity most commonly associated with genitourinary injuries, followed by winter sports, horse riding and contact/collision sports. Literature data suggest that significant injuries are rare also in athletes with only one testicle or kidney. General preventive measures against sport-related injuries, along with the use of protective cups for male external genitalia, are generally sufficient to reduce the incidence of urogenital trauma.

Conclusions

Overall, studies show that urogenital injuries are uncommon in team and individual sports, and that most of them are low-grade injuries. Participation in sports that involve the potential for contact or collision needs to be carefully assessed in the athletes with only one testicle or kidney, even though urogenital injuries should not preclude sports participation to an appropriately informed and counseled patient. Further research is needed to acquire more knowledge on genitourinary injuries according to age, sports type and technical skill.

Seasonal Changes in Functional Fitness and Neurocognitive Assessments in Youth Ice-Hockey Players

Avery, M, Wattie, N, Holmes, M, and Dogra, S. Seasonal changes in functional fitness and neurocognitive assessments in youth ice-hockey players. J Strength Cond Res 32(11): 3143-3152, 2018-Deficits in balance and strength combined with differing rates of sensory and motor neural development may increase risk of sports-related injury in youth. This study evaluated changes in functional fitness and concussion status over the course of a competitive season in youth ice-hockey players, and examined the relationship between these variables and injury occurrence. Thirty-six participants (8.9 ± 1.1 years) completed preseason and postseason assessments including anthropometric measurements, the functional movement screen (FMS), Lower Quarter Y-Balance Test (YBT-LQ), and a computerized neurocognitive assessment (ImPACT). Paired-samples t-tests were used to compare preseason and postseason data. Independent samples t-tests were used to compare FMS, YBT-LQ, and ImPACT scores between injured and uninjured participants at baseline. The mean composite score of the FMS was not statistically different between preseason (15.1 ± 1.8) and postseason (15.6 ± 2.3, p < 0.16). The YBT-LQ composite score showed a decrease in reach distance scores between preseason (86.10 ± 6.00) and postseason (83.20 ± 5.40, p < 0.001). Neurocognitive assessment scores improved in both the injured and uninjured participants. There were no significant relationships between FMS scores, YBT-LQ, and injury incidence. Results from our study provide insight into changes in functional fitness levels and neurocognitive scores over the course of a season in youth ice-hockey players. These findings provide insight into expected changes over the course of a season and provide context for injury risk monitoring by coaches.

Effects of the Healthy Start randomized intervention trial on physical activity among normal weight preschool children predisposed to overweight and obesity

BACKGROUND

There is limited evidence to support the effectiveness of primary interventions aiming to prevent excess weight gain among young children. Evaluating behavioral changes, such as physical activity (PA), may add to future development of efficient interventions. The objective was to evaluate the effect on PA outcomes of the 15 month Healthy Start intervention that focused on changing diet, PA, sleep and stress management among normal weight but obesity-prone preschool children. Children were defined as obesity-prone if they had a birth weight > 4,000 g, mothers with a pre-pregnancy body mass index of > 28 kg/m2, or mothers with ≤ 10 years of schooling.

METHOD

From a baseline study population of 635 normal weight 2-6 year old preschool children from the greater Copenhagen area, parents of 307 children had given information on PA at both the baseline and follow-up examinations. PA was obtained from a 7 days recording in the Children's Physical Activity Questionnaire. Time used for sport activities were combined with outdoor playing time to achieve a proxy of total PA level of moderate to vigorous intensity.

RESULTS

Linear regression analyses revealed that at follow-up the intervention group spent more time on sports and outdoor activities combined per week than the control group (ITT analyses: intervention: 400 min/week; 95% confidence interval (CI): 341, 459 versus control: 321 min/week; 95% CI: 277, 366; p = 0.02), although no significant intervention effects were seen for each of the subcategories, e.g. sports participation, outdoor activities, screen time, or commuting frequency.

CONCLUSION

Our results suggest that the overall time spent on sports and outdoor activities combined was increased at follow-up among normal weight obesity-prone children, as a result of the Healthy Start intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01583335.

Infectious Diseases Associated With Organized Sports and Outbreak Control

Participation in organized sports has a variety of health benefits but also has the potential to expose the athlete to a variety of infectious diseases, some of which may produce outbreaks. Major risk factors for infection include skin-to-skin contact with athletes who have active skin infections, environmental exposures and physical trauma, and sharing of equipment and contact with contaminated fomites. Close contact that is intrinsic to team sports and psychosocial factors associated with adolescence are additional risks. Minimizing risk requires leadership by the organized sports community (including the athlete's primary care provider) and depends on outlining key hygiene behaviors, recognition, diagnosis, and treatment of common sports-related infections, and the implementation of preventive interventions.

Dose-response relationship between sports activity and musculoskeletal pain in adolescents

Supplemental Digital Content is Available in the Text.

A school-based cohort study showed that time spent in sports activity had a linear association with musculoskeletal pain prevalence and risk among Japanese adolescents.

Physical activity has multiple health benefits but may also increase the risk of developing musculoskeletal pain (MSP). However, the relationship between physical activity and MSP has not been well characterized. This study examined the dose–response relationship between sports activity and MSP among adolescents. Two school-based serial surveys were conducted 1 year apart in adolescents aged 12 to 18 years in Unnan, Japan. Self-administered questionnaires were completed by 2403 students. Associations between time spent in organized sports activity and MSP were analyzed cross-sectionally (n = 2403) and longitudinally (n = 374, students free of pain and in seventh or 10th grade at baseline) with repeated-measures Poisson regression and restricted cubic splines, with adjustment for potential confounders. The prevalence of overall pain, defined as having pain recently at least several times a week in at least one part of the body, was 27.4%. In the cross-sectional analysis, sports activity was significantly associated with pain prevalence. Each additional 1 h/wk of sports activity was associated with a 3% higher probability of having pain (prevalence ratio = 1.03, 95% confidence interval = 1.02-1.04). Similar trends were found across causes (traumatic and nontraumatic pain) and anatomic locations (upper limbs, lower back, and lower limbs). In longitudinal analysis, the risk ratio for developing pain at 1-year follow-up per 1 h/wk increase in baseline sports activity was 1.03 (95% confidence interval = 1.02-1.05). Spline models indicated a linear association (P < 0.001) but not a nonlinear association (P ≥ 0.45). The more the adolescents played sports, the more likely they were to have and develop pain.

Epidemiology of High School Sports-Related Injuries Resulting in Medical Disqualification: 2005-2006 Through 2013-2014 Academic Years

BACKGROUND

Although rare, season- or career-ending injuries in young athletes are concerning because they can result in time lost from sport participation and school, social costs, and economic costs of medical care.

PURPOSE

To describe rates and patterns of medically disqualifying (MDQ) injuries among United States high school athletes overall and by sport, sex, type of athletic activity, and mechanism.

STUDY DESIGN

Descriptive epidemiological study.

METHODS

Sports-related injury data on high school athletes were collected during the 2005-2006 through 2013-2014 academic years from a large national sample of United States high schools via High School Reporting Information Online (RIO). MDQ injuries were defined as season- or career-ending injuries.

RESULTS

From 2005-2006 through 2013-2014, High School RIO captured 59,862 total injuries including 3599 MDQ injuries (6.0% of all injuries). Most MDQ injuries (60.4%) occurred in competition. Football had the highest injury rate (26.5 per 100,000 athlete-exposures), followed by gymnastics (18.6) and wrestling (17.9). MDQ injury rates were higher among girls in the sex-comparable sports of basketball (rate ratio [RR], 1.6; 95% CI, 1.3-2.0), cross-country (RR, 2.6; 95% CI, 1.0-7.5), soccer (RR, 1.6; 95% CI, 1.3-1.9), and track and field (RR, 2.6; 95% CI, 1.7-4.0). Player-player contact (48.2%) was the most common MDQ injury mechanism. The most commonly injured body site was the knee (33.7%). The most common MDQ injury diagnosis was sprains/strains (35.9%); the most common specific MDQ injury was knee sprains/strains (25.4%), with the anterior cruciate ligament being the most commonly injured knee structure. Among boys, fracture was the most common diagnosis in 3 sports, and sprain/strain was the most common in 6 sports. Among girls, sprain/strain was the most common diagnosis in 9 sports, and fracture was the most common only in softball.

CONCLUSION

MDQ injuries vary by sport, sex, and type of athletic activity and occur most frequently as a result of player-player contact. These findings should prompt additional research into the development, implementation, and evaluation of targeted injury prevention efforts.

Anticipatory Guidance for Long-Distance Running in Young Athletes

More young children are participating in endurance running events such as full and half marathons, and the safety of these events for children has been heavily debated. There is a paucity of evidence on either side of the debate. However, overuse injuries, stress fractures, as well as the potential for psychologic burnout are legitimate concerns. Parents who are seeking advice from pediatricians about child participation in these endurance events should be made aware of these risks. Young children may participate in endurance running events under close supervision from health professionals, coaches, and parents, with full medical evaluation before initiation of training, throughout training, as well as 6 to 12 months post-race. Special attention should be made to the psychologic well-being of the child, with the participation in running being child-driven, not parent- or coach-driven, and emphasis on enjoyment and fitness, not competition.

Prioritizing school intramural and interscholastic programs based on observed physical activity

PURPOSE

To examine which school sports engage children in more physical activity.

DESIGN

Observational, cross-sectional study examining differences between intramural (IM) and interscholastic (IS) sports.

SETTING

Athletic facilities at two schools with IM sports and two schools with IS sports in Wake County, North Carolina.

SUBJECTS

Middle-school children (N = 6735).

MEASURES

Percentage of children observed in sedentary, moderate, and vigorous activity assessed by the System for Observation Play and Leisure Among Youth (SOPLAY). Energy expenditure and physical activity intensity were also estimated by using MET values.

ANALYSIS

T-tests; generalized linear model using cumulative logit link function.

RESULTS

IM sports had higher MET values than IS sports (t = -3.69, p < .001), and IM sports ranked in four of the top five sports in terms of average MET values. Regression models found a significant interaction between school sport delivery model and gender, with boys significantly less physically active in IS programs than boys in IM programs (B = -.447, p < .001) but more physically active (B = .359, p <.001) than girls in IM sports.

CONCLUSION

Regardless of sport type, IM sports generated more physical activity than IS sports among boys but not girls. Soccer, basketball, and track, regardless of school delivery approach, provide the highest physical activity levels. Results suggest that school administrators consider reassessing their programs to more efficiently use diminishing resources to increase students' physical activity levels.

Canadian Society for Exercise Physiology position stand: Benefit and risk for promoting childhood physical activity

Current guidelines recommend children accumulate 60 min of daily physical activity; however, highly publicized sudden-death events among young athletes raise questions regarding activity safety. An expert group convened (June 2012) to consider the safety of promoting increased physical activity for children, and recommended the publication of an evidence-based statement of current knowledge regarding the benefits and risks of physical activity for children. Recommendations for encouraging physical activity while maximizing the opportunity to identify children who have been prescribed a physical activity restriction include (1) professionals and (or) researchers that encourage children to change the type of physical activity or to increase the frequency, intensity, or duration of their activity should inquire whether a child has primary healthcare provider-prescribed activity limitations before the child’s activity participation changes; (2) physical activity researchers should prioritize the development of evidence regarding the benefits and risks of childhood physical activity and inactivity, particularly data on the risks of sedentary lifestyles and physical activity-associated injury risks that accounts for the amount of activity performed, and the effectiveness of current risk-management strategies and screening approaches; (3) professionals and researchers should prioritize the dissemination of information regarding the benefits of physical activity and the risks of sedentary behaviour in children; and (4) parents and professionals should encourage all children to accumulate at least 60 min of physical activity daily. The recommendations are established as a minimum acceptable standard that is applicable to all physical activity opportunities organized for children, whether those opportunities occur in a community, school, or research setting.

Characteristics of extracurricular physical activity and cognitive performance in adolescents. The AVENA study

The aim of this report was to examine the associations between some characteristics (i.e., structure and number) of extracurricular physical activity (EPA) and cognitive performance in adolescents. A total of 1662 adolescents (880 girls; 13.0-18.5 years) from 5 Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) were included in this study. Structure (organised and non-organised) and number of EPAs, and participation at vigorous intensity during EPA were self-reported. Cognitive performance (verbal, numeric and reasoning abilities, and an overall score) was measured with the "SRA-Test of Educational Ability". Results showed that vigorous EPA was positively associated with all cognitive variables. Adolescents who practiced an organised EPA had higher scores in 3 of the 4 cognitive variables than those who practiced a non-organised EPA (all P < 0.05). Likewise, the group who participated in more than one EPA had higher cognitive performance in all variables than the group who participated in only one EPA (all P < 0.05). Regardless of potential confounder variables, including vigorous EPA, both structure and number of EPAs were each other independently associated with cognitive performance. Therefore, structure and number of EPAs may positively influence cognitive performance in adolescents. Participating in multiple, organised EPA may have benefits for cognitive performance.

Sport participation and alcohol and illicit drug use in adolescents and young adults: a systematic review of longitudinal studies

Sport participation can play an important and positive role in the health and development of children and youth. One area that has recently been receiving greater attention is the role that sport participation might play in preventing drug and alcohol use among youth. The current study is a systematic review of 17 longitudinal studies examining the relationship between sport participation and alcohol and drug use among adolescents. Results indicated that sport participation is associated with alcohol use, with 82% of the included studies (14/17) showing a significant positive relationship. Sport participation, however, appears to be related to reduced illicit drug use, especially use of non-cannabis related drugs. Eighty percent of the studies found sport participation associated with decreased illicit drug use, while 50% of the studies found negative association between sport participation and marijuana use. Further investigation revealed that participation in sports reduced the risk of overall illicit drug use, but particularly during high school; suggesting that this may be a critical period to reduce or prevent the use of drugs through sport. Future research must better understand what conditions are necessary for sport participation to have beneficial outcomes in terms of preventing alcohol and/or illicit drug use. This has been absent in the extent literature and will be central to intervention efforts in this area.

Clinical use of objective measures of physical activity

With measurement of physical activity becoming more common in clinical practice, it is imperative that healthcare professionals become more knowledgeable about the different methods available to objectively measure physical activity behaviour. Objective measures do not rely on information provided by the patient, but instead measure and record the biomechanical or physiological consequences of performing physical activity, often in real time. As such, objective measures are not subject to the reporting bias or recall problems associated with self-report methods. The purpose of this article was to provide an overview of the different methods used to objectively measure physical activity in clinical practice. The review was delimited to heart rate monitoring, accelerometers and pedometers since their small size, low participant burden and relatively low cost make these objective measures appropriate for use in clinical practice settings. For each measure, strengths and weakness were discussed; and whenever possible, literature-based examples of implementation were provided.

Reducing sports heat illness risk

After reading this article, readers should 1. Appreciate that exertional heatstroke is the leading cause of preventable death in youth sports.2. Know the importance of progressive acclimatization to minimize the risk of exertional heat illness in youth sports.3. Be able to identify other contributing risk factors and effective ways to improve exercise-heat tolerance and reduce exertional heat illness risk in youth sports.4. Be prepared to educate others on their roles and responsibilities in improving safety and well-being of youth participating in outdoor sports in the heat.

Girls' physical activity levels during organized sports in Australia

PURPOSE

The primary aim of this study was to objectively examine the physical activity (PA) levels of girls during organized sports (OS) and to compare the levels between games and practices for the same participants. The secondary aims of this study were to document lesson context and coach behavior during practices and games.

METHODS

Participants were 94 girls recruited from 10 teams in three OS (netball, basketball, and soccer) from the western suburbs of Sydney. Each participant wore an ActiGraph GT3X monitor for the duration of one practice and one game. The System for Observing Fitness Instruction Time was concurrently used to document lesson context and coach behavior.

RESULTS

Girls spent a significantly higher percentage of time in moderate-to-vigorous PA (MVPA) during practices compared with games (33.8% vs 30.6%; t = 2.94, P < 0.05). Girls spent approximately 20 min·h(-1) in MVPA during practices and approximately 18 min·h(-1) in MVPA during games. An average of 2957 and 2702 steps per hour were accumulated during practices and games, respectively. However, girls spent roughly two-thirds of their OS time in light PA or sedentary. On the basis of the System for Observing Fitness Instruction Time findings, coaches spent a large proportion of practice time in management (15.0%) and knowledge delivery (18.5%). An average of 13.0 and 15.8 occurrences per hour were observed during games and practices where coaches promoted PA.

CONCLUSIONS

For every hour of game play or practice time, girls accumulated approximately one third of the recommended 60 min of MVPA time and approximately one quarter of the 12,000 steps that girls are recommended to accumulate daily. For this population, OS seems to make a substantial contribution to the recommended amounts of MVPA and steps for participating girls. OS alone, however, does not provide amounts of PA sufficient to meet daily recommendations for adolescent girls.

Direct and indirect associations between the family physical activity environment and sports participation among 10-12 year-old European children: testing the EnRG framework in the ENERGY project

Background

Sport participation makes an important contribution to children’s overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children’s sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10–12 year-old children’s sports participation.

Methods

Children aged 10–12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses.

Results

Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment.

Conclusions

Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children’s sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children’s sport participation are warranted.

Identification of facilitators and barriers to physical activity in children and adolescents with cerebral palsy

OBJECTIVE

To explore facilitators and barriers to participation in physical activity and sport in youth with cerebral palsy (CP).

STUDY DESIGN

This was a qualitative study involving in-depth focus group interviews with 33 ambulatory youth with CP and their parents. The interviews were conducted until informational redundancy was achieved.

RESULTS

Youth with CP and their parents reported personal and environmental facilitators and barriers to participation in physical activity. Seven major themes related to personal and environmental factors were identified.

CONCLUSIONS

This study suggests that various personal and environmental factors play a key role in determining the extent to which youth with CP participate in physical activity. The facilitators and barriers identified provide important theoretical insights into how and why youth with CP and their parents might change their physical activity behavior.

Getting kids active by participating in sport and doing it more often: focusing on what matters

BACKGROUND

Reduced time dedicated to physical education and free play in recent decades emphasizes the need to promote opportunities for sport participation in adolescents in order to increase physical activity levels. The purpose of this study was to examine the association of sociodemographic and biological characteristics, behavioural patterns, and school-related and sport-specific variables with time spent participating in sport.

METHODS

A total of 1837 secondary school students (age: 14.6 ± 1.2 years; 50.9 % boys) from 19 of 23 schools in the Otago Region (New Zealand) completed an online sport survey and Youth Physical Activity Questionnaire in 2009. Using multilevel modeling, we examined the association of individual-, school- and sport-related variables on sport participation and the amount of time spent in sports.

RESULTS

Higher rates of sport participation were associated with lower neighbourhood deprivation scores (OR (95%CI): 0.75 (0.49-1.14), 0.57 (0.38-0.86), 0.48 (0.28-0.81)), higher quintiles of physical activity (2.89 (2.10-3.96), 2.81 (1.68-4.70), 3.54 (2.24-5.57), 3.97 (1.99-7.95)), highest quintiles of screen time (1.58 (0.94-2.65), 1.99 (1.42-2.80), 2.17 (1.43-3.30), 1.88 (1.37-2.57)) and boys only school status (2.21 (1.57-3.10)). Greater amount of time spent in sports was associated with male gender (0.56 (0.43-0.74), lower neighbourhood deprivation scores (0.72 (0.59-0.93), 0.78 (0.58-1.04), 0.62 (0.39-1.00)), higher quintiles of physical activity (3.18 (2.29-4.41), 4.25 (2.91-6.20), 8.33 (5.58-12.44), 6.58 (4.07-10.64)), highest quintile of screen time (1.83 (1.31-2.56), greater availability of sports outside school (1.68 (1.22-2.32)), better sport management (2.57 (1.63-4.07)) and provision of sport courts at school (0.57 (0.40-0.81)). Conversely, obesity was associated with less time spent participating in sport (0.50 (0.31-0.80)).

CONCLUSION

Results support the use of sport participation as an effective strategy to increase physical activity levels and identify target groups and areas for interventions, program design and policy development. Interventions should focus on improving accessibility to sport programs for all adolescents, providing adequate sport grounds at school, and promoting good sport management practices. Programs and policies encouraging sport participation should address in particular the needs of adolescents living in deprived neighborhoods, those attending coeducational and girls-only schools, and those who are obese.

School sport policy and school-based physical activity environments and their association with observed physical activity in middle school children

Empirical research on the effects of school sport policies on children's physical activity is limited. This study examined sport policies (intramural vs. varsity), physical settings within schools, and supervision in relation to physical activity using the System for Observing Play and Leisure in Youth (SOPLAY). Data were collected on physical activity levels of children in four middle schools. Regression analyses assessed the main effects of sport policy, type of physical activity setting, and supervision as well as interactions. Regression models were stratified by gender. Children in intramural schools were more likely to use indoor spaces and be boys. Regression models indicated that varsity sport programs were associated with lower physical activity levels among boys but not girls. Significant associations between type of physical activity settings and physical activity levels were observed only for boys. Adult supervision was not associated with children's physical activity levels. Finally, descriptive results showed athletic facilities were under-utilized in all schools.

Youth sports in the heat: recovery and scheduling considerations for tournament play

One of the biggest challenges facing numerous young athletes is attempting to perform safely and effectively in the heat. An even greater performance challenge and risk for incurring exertional heat injury is encountered when a young athlete has to compete multiple times on the same day, with only a short rest period between rounds of play, during a hot-weather tournament. Within the scope of the rules, tournament directors frequently provide athletes with only the minimum allowable time between same-day matches or games. Notably, prior same-day exercise has been shown to increase cardiovascular and thermal strain and perception of effort in subsequent activity bouts, and the extent of earlier exercise-heat exposure can affect performance and competition outcome. Incurred water and other nutrient deficits are often too great to offset during short recovery periods between competition bouts, and the athletes are sometimes 'forced' to compete again not sufficiently replenished. Providing longer rest periods between matches and games can significantly improve athlete safety and performance, by enhancing recovery and minimizing the 'carryover' effects from previous competition-related physical activity and heat exposure that can negatively affect performance and safety. Governing bodies of youth sports need to address this issue and provide more specific, appropriate and evidence-based guidelines for minimum rest periods between same-day contests for all levels of tournament play in the heat. Youth athletes are capable of tolerating the heat and performing reasonably well and safely in a range of hot environments if they prepare well, manage hydration sufficiently, and are provided the opportunity to recover adequately between contests.

Effect of the 3-point line change on the game dynamics in girls' minibasketball

We examined the game dynamics in minibasketball when comparing two different forms of the 3-point line. During the first competition, participants used a 3-point line delimited by the free-throw lane, and 1,642 ball possessions were recorded. During the second competition, participants played with a 3-point line delimited by a rectangular area, and 1,669 ball possessions were recorded. Results from the Mann-Whitney U Test show that when playing with a 3-point line delimited by the free-throw lane, higher average values were achieved in terms of points scored, number of players taking part in the ball possessions, number of passes, and one-on-one situations.

Dehydration and Thermal Strain in Junior Tennis

Playing tennis effectively and safely in the heat can be particularly challenging in junior tennis, especially during organized tournament competition when young players have to compete in demanding environmental conditions several times on the same day. With sweat rates ranging from 0.5 L to more than 2.0 L per hour, a young player can readily incur significant total body water and sodium deficits during a very long match or when participating in multiple matches on the same day over several days in a row. On-court thermal strain can be quite high, as tournament-level tennis can elicit appreciable metabolic heat production and storage, even during doubles; this can be exacerbated by poor hydration as well as carryover effects from previous same-day competition and heat exposure. Appropriate and effective safety and performance guidelines for young tennis players training and competing in the heat should focus on readily modifiable risk factors such as hydration management and scheduling of play versus any purported inherent thermoregulatory disadvantages in this specific age group.

Socio-economic inequalities in physical activity practice among Italian children and adolescents: a cross-sectional study

Aim

The aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES).

Subjects and methods

Data were derived from the Italian National Health Interview Survey carried out in 2004–2005, which examined a large random sample of the Italian population using both an interviewer-administered and a self-compiled questionnaire. This study was based on a sample of 15,216 individuals aged 6–17 years. The practice of physical activity was measured on the basis of questions regarding frequency and intensity of activity during leisure time over the past 12 months. Parents’ educational and occupational level, as well as family’s availability of material resource, were used as indicators of SES. Multivariable logistic regression analyses were performed to estimate the contribution of each SES indicator to the practice of physical activity, adjusting for potential confounding factors. The results of the regression models are expressed as odds ratio (OR) with 95% confidence intervals (95% CI).

Results

About 64% of children and adolescents in the sample declared that they participated in moderate or vigorous physical activity at least once a week. After adjustment for gender, age, parental attitudes towards physical activity and geographical area, the practice of physical activity increased with higher parental educational and occupational level and greater availability of material resources. Children and adolescents whose parents held a middle or high educational title were 80% more likely to practice moderate or vigorous physical activity than subjects whose parents had a lower level of education (OR = 1.80, 95% CI: 1.40–2.33), while subjects with unemployed parents had an odds of practicing moderate or vigorous physical activity 0.43 times that of those children whose parents belonged to the top job occupation category (administrative/professionals). Socio-economic differences were about the same when the practice of vigorous physical activity only was considered instead of that of moderate or vigorous physical activity.

Conclusion

Interventions that promote the practice of physical activity, and especially those aimed at the wider physical and social environment, are strongly needed to contrast socio-economic differences in physical activity among children and adolescents.

Does participation in organized sports predict future physical activity for adolescents from diverse economic backgrounds?

PURPOSE

To examine cross-sectional and longitudinal associations between socioeconomic status (SES), gender, sports participation and moderate-to-vigorous physical activity (MVPA) in adolescents.

METHODS

Project EAT (Eating Among Teens), a population-based longitudinal study followed a socioeconomically and ethnically diverse sample of 1709 adolescents in 1998-1999 (Time 1) and 2003-2004 (Time 2). Mixed model regression analyses were used to examine longitudinal trends in MVPA as a function of SES and previous sports involvement.

RESULTS

For both genders, participation in organized sports and weekly hours of MVPA were positively associated with SES. On average, MVPA decreased between high school and young adulthood for both genders. Adolescents who participated in sports during high school showed a steeper decline in weekly hours of MVPA than their non-sports-participating counterparts. SES had a significant moderating effect on the change in MVPA over time for boys who participated in organized sports, with low SES boys showing a steeper decline in MVPA between time periods than higher SES boys. Although on average, a statistically significant difference in MVPA between previous sports participants and nonparticipants remained at Time 2, for all SES groups and both genders, the gap between hours of MVPA was either overcome or significantly narrowed by young adulthood.

CONCLUSIONS

Increased dependence on organized sports for MVPA may be insufficient to meet the needs of youth following high school, especially for low SES youth. Designing physical activity promotions that reach and address the unique needs of lower SES youth and families is a public health priority.