Correction: Characterising lower-body musculoskeletal morphology and whole-body composition of elite female and male Australian Football players

The Benefits to Bone Health in Children and Pre-School Children with Additional Exercise Interventions: A Systematic Review and Meta-Analysis

OBJECTIVE

Determine if exercise interventions, beyond what is already provided to children and preschool children, improve bone health and reduce fracture incidence.

DESIGN

Systematic review and meta-analysis reported using the PRISMA guidelines. Certainty of evidence was assessed using GRADE recommendations.

DATA SOURCES

Five electronic databases were searched for records: PUBMED; CINAHL; CENTRAL; SPORTDiscus; Web of Science.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised, quasi-randomised and non-randomised controlled trials (including cluster-randomised) assessing the impact of additional exercise interventions (e.g., increased physical education classes or specific jumping programs) on bone health in children (6-12 years) and pre-school children (2-5 years) without dietary intervention.

RESULTS

Thirty-one records representing 16 distinct clinical trials were included. Dual-energy X-ray Absorptiometry (DXA) and/or peripheral Quantitative Computed Tomography (pQCT) were used to quantify bone health. Increased femoral neck bone mineral content in children with additional exercise interventions (n = 790, SMD = 0.55, 95% CI = 0.01 to 1.09) was reported, however this was not significant following sensitivity analysis. Other DXA and pQCT measures, as well as fracture incidence, did not appear to significantly differ over time between intervention and control groups. No studies reported adverse events. Studies failed to report all domains within the TIDieR checklist. All studies were at high risk of bias using the Cochrane RoB Tool 2.0. The certainty of the evidence was very low.

CONCLUSIONS

The addition of exercise interventions, beyond what is provided to children, does not appear to improve DXA and pQCT measures of bone health. The effect of additional exercise interventions on bone health in pre-school children is largely unknown. Future trials should ensure adherence is clearly reported and controlled for within analysis as well as including reports of adverse events (e.g., apophysitis) that occur due to increased exercise interventions.

Pre-season body composition has minimal influence on in-season match availability, and match performance in female Australian Football League (AFLW) players

This study examined the relationship between pre-season body composition, in-season match performance, and match availability in female players competing in the Australian Football League Women's (AFLW) competition. With the outlawing of body composition assessments as part of pre-draft player evaluations in the AFLW, this study seeks to examine whether this is justified. Twenty-two (n = 22) players had body composition assessed with dual-energy x-ray absorptiometry at the beginning of the 2021 AFLW pre-season (whole-body and regional fat mass and lean soft-tissue mass [LSTM]). In-season match availability and match performance data (Coaches Score [CS], Champion Data Player Rank, average disposals, disposal and kicking efficiency) were collected throughout the 2021 competition. Pearson correlations were performed to assess if associations existed between body composition and in-season match performance and availability. A median split was performed to divide players into higher and lower performing groups for match performance variables. Two-sample independent t-tests were then used to assess differences between groups. No body composition characteristics could differentiate between in-season match availability groups (100% availability vs. <100% availability) or higher and lower performing groups for all match performance variables. Total leg LSTM asymmetry shared a moderate negative association with CS. Body composition may not be important for determining in-season match availability and performance in female AFLW players. Thus, the repercussions following the removal of pre-draft body composition assessments across the league may not be as significant as is currently perceived. Other physiological, biomechanical, or performance qualities are more variable and may mask the effect of body composition in these players. AFLW practitioners should prioritize the development of other important attributes, such as aerobic fitness, muscular strength and power, and technical skill.