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Published in: European Journal of Applied Physiology 4/2016

01-04-2016 | Original Article

A 5-year exercise program in children improves muscle strength without affecting fracture risk

Authors: Jesper Fritz, Marcus E. Cöster, Susanna Stenevi-Lundgren, Jan-Åke Nilsson, Magnus Dencker, Björn E. Rosengren, Magnus K. Karlsson

Published in: European Journal of Applied Physiology | Issue 4/2016

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Abstract

Purpose

High level of physical activity (PA) is associated with great muscle strength and high fracture risk. This prospective controlled population-based study evaluated how a pediatric PA intervention program influenced muscle strength and fracture risk.

Methods

We carried out a school-based exercise intervention program with 200 min of PA per week for 5 years in 335 girls and 408 boys aged 6–9 years at study start. An age-matched control cohort including 756 girls and 782 boys continued with 60 min of PA per week. We registered fractures during the study period and calculated rate ratio. In a sub-sample, including 74 girls and 107 boys in the intervention and 51 girls and 54 boys in the control group, we measured knee flexion and extension strength by a computerized dynamometer and leg composition by dual energy X-ray absorptiometry. Group comparisons were adjusted for differences in age, baseline value for the measured parameter and changes in height.

Results

Children in the intervention group had a rate ratio to sustain a fracture of 1.03 (0.78, 1.36) (mean and 95 % confidence interval) (p = 0.79). The annual gain in flexion peak torque muscle strength was greater in both girls (at 60°/s) [1.1 Nm (0.5, 1.8), p < 0.01] and boys (at 180°/s) [0.7 Nm (0.1, 1.2), p < 0.05] in the intervention than in the control group, while leg composition was similar.

Conclusion

Increased PA during a 5-year period, starting in the pre-pubertal period, improves the gain in muscle strength without affecting the fracture risk.
Literature
go back to reference Ara I, Vicente-Rodriguez G, Jimenez-Ramirez J, Dorado C, Serrano-Sanchez JA, Calbet JA (2004) Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys. Int J Obes Relat Metab Disord J Int Assoc Stud Obes 28:1585–1593. doi:10.1038/sj.ijo.0802754 CrossRef Ara I, Vicente-Rodriguez G, Jimenez-Ramirez J, Dorado C, Serrano-Sanchez JA, Calbet JA (2004) Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys. Int J Obes Relat Metab Disord J Int Assoc Stud Obes 28:1585–1593. doi:10.​1038/​sj.​ijo.​0802754 CrossRef
go back to reference Ara I, Vicente-Rodriguez G, Perez-Gomez J, Jimenez-Ramirez J, Serrano-Sanchez JA, Dorado C, Calbet JA (2006) Influence of extracurricular sport activities on body composition and physical fitness in boys: a 3-year longitudinal study. Int J Obes 30:1062–1071. doi:10.1038/sj.ijo.0803303 CrossRef Ara I, Vicente-Rodriguez G, Perez-Gomez J, Jimenez-Ramirez J, Serrano-Sanchez JA, Dorado C, Calbet JA (2006) Influence of extracurricular sport activities on body composition and physical fitness in boys: a 3-year longitudinal study. Int J Obes 30:1062–1071. doi:10.​1038/​sj.​ijo.​0803303 CrossRef
go back to reference Clark EM, Ness AR, Tobias JH (2008) Vigorous physical activity increases fracture risk in children irrespective of bone mass: a prospective study of the independent risk factors for fractures in healthy children. J Bone Miner Res 23:1012–1022. doi:10.1359/jbmr.080303 CrossRefPubMedPubMedCentral Clark EM, Ness AR, Tobias JH (2008) Vigorous physical activity increases fracture risk in children irrespective of bone mass: a prospective study of the independent risk factors for fractures in healthy children. J Bone Miner Res 23:1012–1022. doi:10.​1359/​jbmr.​080303 CrossRefPubMedPubMedCentral
go back to reference De Ste Croix M, Deighan M, Armstrong N (2003) Assessment and interpretation of isokinetic muscle strength during growth and maturation. Sports Med 33:727–743CrossRefPubMed De Ste Croix M, Deighan M, Armstrong N (2003) Assessment and interpretation of isokinetic muscle strength during growth and maturation. Sports Med 33:727–743CrossRefPubMed
go back to reference Duke PM, Litt IF, Gross RT (1980) Adolescents’ self-assessment of sexual maturation. Pediatrics 66:918–920PubMed Duke PM, Litt IF, Gross RT (1980) Adolescents’ self-assessment of sexual maturation. Pediatrics 66:918–920PubMed
go back to reference Faigenbaum AD, Westcott WL, Loud RL, Long C (1999) The effects of different resistance training protocols on muscular strength and endurance development in children. Pediatrics 104:e5CrossRefPubMed Faigenbaum AD, Westcott WL, Loud RL, Long C (1999) The effects of different resistance training protocols on muscular strength and endurance development in children. Pediatrics 104:e5CrossRefPubMed
go back to reference Goran MI, Gower BA, Nagy TR, Johnson RK (1998) Developmental changes in energy expenditure and physical activity in children: evidence for a decline in physical activity in girls before puberty. Pediatrics 101:887–891CrossRefPubMed Goran MI, Gower BA, Nagy TR, Johnson RK (1998) Developmental changes in energy expenditure and physical activity in children: evidence for a decline in physical activity in girls before puberty. Pediatrics 101:887–891CrossRefPubMed
go back to reference Jonsson B, Gardsell P, Johnell O, Redlund-Johnell I, Sernbo I (1994) Remembering fractures: fracture registration and proband recall in southern Sweden. J Epidemiol Community Health 48:489–490CrossRefPubMedPubMedCentral Jonsson B, Gardsell P, Johnell O, Redlund-Johnell I, Sernbo I (1994) Remembering fractures: fracture registration and proband recall in southern Sweden. J Epidemiol Community Health 48:489–490CrossRefPubMedPubMedCentral
go back to reference Kannus P et al (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31CrossRefPubMed Kannus P et al (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31CrossRefPubMed
go back to reference Landin LA (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 202:1–109CrossRefPubMed Landin LA (1983) Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 202:1–109CrossRefPubMed
go back to reference Linden C, Ahlborg HG, Besjakov J, Gardsell P, Karlsson MK (2006) A school curriculum-based exercise program increases bone mineral accrual and bone size in prepubertal girls: 2-year data from the pediatric osteoporosis prevention (POP) study. J Bone Miner Res 21:829–835. doi:10.1359/jbmr.060304 CrossRefPubMed Linden C, Ahlborg HG, Besjakov J, Gardsell P, Karlsson MK (2006) A school curriculum-based exercise program increases bone mineral accrual and bone size in prepubertal girls: 2-year data from the pediatric osteoporosis prevention (POP) study. J Bone Miner Res 21:829–835. doi:10.​1359/​jbmr.​060304 CrossRefPubMed
go back to reference MacKelvie KJ, Khan KM, Petit MA, Janssen PA, McKay HA (2003) A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. Pediatrics 112:e447CrossRefPubMed MacKelvie KJ, Khan KM, Petit MA, Janssen PA, McKay HA (2003) A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. Pediatrics 112:e447CrossRefPubMed
go back to reference Nagano A, Komura T (2003) Longer moment arm results in smaller joint moment development, power and work outputs in fast motions. J Biomech 36:1675–1681CrossRefPubMed Nagano A, Komura T (2003) Longer moment arm results in smaller joint moment development, power and work outputs in fast motions. J Biomech 36:1675–1681CrossRefPubMed
go back to reference Ramsay JA, Blimkie CJ, Smith K, Garner S, MacDougall JD, Sale DG (1990) Strength training effects in prepubescent boys. Med Sci Sports Exerc 22:605–614CrossRefPubMed Ramsay JA, Blimkie CJ, Smith K, Garner S, MacDougall JD, Sale DG (1990) Strength training effects in prepubescent boys. Med Sci Sports Exerc 22:605–614CrossRefPubMed
go back to reference Valdimarsson O, Linden C, Johnell O, Gardsell P, Karlsson MK (2006) Daily physical education in the school curriculum in prepubertal girls during 1 year is followed by an increase in bone mineral accrual and bone width–data from the prospective controlled Malmo pediatric osteoporosis prevention study. Calcif Tissue Int 78:65–71. doi:10.1007/s00223-005-0096-6 CrossRefPubMed Valdimarsson O, Linden C, Johnell O, Gardsell P, Karlsson MK (2006) Daily physical education in the school curriculum in prepubertal girls during 1 year is followed by an increase in bone mineral accrual and bone width–data from the prospective controlled Malmo pediatric osteoporosis prevention study. Calcif Tissue Int 78:65–71. doi:10.​1007/​s00223-005-0096-6 CrossRefPubMed
go back to reference Weltman A et al (1986) The effects of hydraulic resistance strength training in pre-pubertal males. Med Sci Sports Exerc 18:629–638CrossRefPubMed Weltman A et al (1986) The effects of hydraulic resistance strength training in pre-pubertal males. Med Sci Sports Exerc 18:629–638CrossRefPubMed
Metadata
Title
A 5-year exercise program in children improves muscle strength without affecting fracture risk
Authors
Jesper Fritz
Marcus E. Cöster
Susanna Stenevi-Lundgren
Jan-Åke Nilsson
Magnus Dencker
Björn E. Rosengren
Magnus K. Karlsson
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Applied Physiology / Issue 4/2016
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-015-3310-x

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