Dorine C. M. Collard

Motor fitness in Dutch youth: Differences over a 26-year period (1980–2006)

This study aimed to compare neuromotor fitness test scores of 9-12-year-old Dutch youth in 2006 with scores of same aged children in 1980. Body height, body weight and performance on neuromotor fitness test items were measured in 2050 Dutch children from 9 to 12 years in 2006 and were compared with data of 2603 same aged Dutch children measured in 1980 with the same neuromotor fitness test battery. Dutch 9-12 year olds in 2006 were significantly taller and heavier than their peers in 1980. Age- and sex-specific performance on almost all neuromotor fitness test items was significantly worse in 2006. Thus, our data suggest that neuromotor fitness of Dutch youth has significantly decreased over the past 26 years.

Physical inactivity is a risk factor for physical activity-related injuries in children

Objectives To describe the risk factors associated with injuries resulting from physical education (PE), leisure time physical activity (leisure time PA) and sports in 9–12-year-old children. Design Prospective cohort study. Setting Primary schools. Participants Nine hundred and ninety-five children aged 9–12 years. Main outcome measures Injuries occurring during either PE class, leisure time PA or sports, and caused the child to at least stop the current activity were recorded prospectively. Individual weekly exposure was estimated from baseline and follow-up questionnaires. Potential risk factors were gender, age, socioeconomic status, ethnicity, habitual level of PA, body mass index and a motor fitness. A multivariate Cox proportional hazard regression model was developed, accounting for clustering within schools. Results Gender, age and level of PA were independent significant risk factors for injury. Different modalities of PA had different injury risk factors. Most importantly, the low levels of habitual PA significantly increased injury risk. Conclusions The children at highest injury risk are the target audience of the contemporary PA promotion efforts. PA promotion should also focus on injury prevention.

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

Background Injuries in children occur most often in physical activity–related activities. A lot of these injuries result in direct and indirect costs. A detailed overview of the economic burden of those injuries in children is lacking. Method A prospective study was conducted with 996 children in Dutch primary schools to describe the economic burden of injuries that occur during organised sports, leisure time and physical education (PE) class activities. Injuries were continuously monitored by PE teachers during the school year 2006–2007. An injury was recorded if it occurred during PE class, leisure time or organised sports activity and caused the child to at least stop the current activity. If an injury was recorded, parents received a cost diary to report the direct and indirect costs of the childs injury. Costs were collected from a societal perspective. Results During one school year, a total of 119 injuries were reported by 104 children. The mean total costs as a result of an injury were €188±317. The mean direct costs as a result of an injury were much higher than the mean indirect costs (€131±213 and €57±159, respectively). The highest costs were found for upper extremity and leisure time injuries. Conclusion Physical activity–related injuries are common in children and result in medical costs. Injuries that lead to the highest costs are those that occur during leisure time activities and upper extremity injuries. Intervention programmes for children to prevent upper extremity injuries and leisure time activity injuries may reduce direct (ie, healthcare) and indirect costs. Trial registration: ISRCTN78846684

Effectiveness of a School-Based Physical Activity Injury Prevention Program A Cluster Randomized Controlled Trial

OBJECTIVE To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. DESIGN Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. SETTING Forty Dutch primary schools. PARTICIPANTS A total of 2210 children (aged 10-12 years). INTERVENTION Schools were randomized to receive either the regular curriculum or an intervention program that targeted physical activity injuries. OUTCOME MEASURES Incidence and severity of physical activity injuries per 1000 hours of physical activity participation. RESULTS A total of 100 injuries in the intervention group and 104 injuries in the control group were registered. Nonresponse at baseline or follow-up was minimal (8.7%). The Cox regression analyses adjusted for clustering showed a small nonsignificant intervention effect on total (HR, 0.81; 95% confidence interval [CI], 0.41-1.59), sports club (0.69; 0.28-1.68), and leisure time injuries (0.75; 0.36-1.55). However, physical activity appeared to be an effect modifier. In those who were less physically active, the intervention had a larger effect. The intervention reduced the total and leisure time injury incidence (HR, 0.47; 95% CI, 0.21-1.06; and 0.43; 0.16-1.14; respectively). Sports club injury incidence was significantly reduced (HR, 0.23; 95% CI, 0.07-0.75). CONCLUSION We found a substantial and relevant reduction in physical activity injuries, especially in children in the low active group, because of the intervention. This school-based injury prevention program is promising, but future large-scale research is needed.

Design of the iPlay study: systematic development of a physical activity injury prevention programme for primary school children.

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

A prospective cohort study on physical activity and sports-related injuries in 10-12-year-old children

Objectives: To describe the incidence and severity of injuries resulting from physical education, sports and leisure time physical activity (PA) in 10–12-year-old children. Design: This was a prospective cohort study conducted in primary schools, with 995 children aged 10–12 years old as participants. Individual weekly exposure was estimated from baseline and follow-up questionnaires. Exposure to physical education (PE) classes was equal in all schools. An injury was recorded if it occurred during either PE class, leisure time PA, or sports, and caused the child to at least stop the current activity. Injuries were reported within 1 week of injury onset. The main outcome measure was injury incidence density. Results: During the school year a total of 119 injuries were reported by 104 children, resulting in an overall injury incidence density (ID) of 0.48 per 1000 h of exposure (95% CI 0.38 to 0.57). Injury ID was lowest for leisure time PA, followed by PE and sports, respectively. Of all injuries, 40% required medical treatment and 14% resulted in 1 or more days of absence from regular school activities. In general for girls a higher injury ID was reported than for boys, mainly caused by a twofold higher risk during leisure time PA. Conclusions: Next to specific areas of preventive interest it was found that in this specific age group, girls require special attention as they seem to be at higher injury risk than boys.

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

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

Acute physical activity and sports injuries in children.

An increase in the physical activity of individuals has many health benefits, but a drawback of an increase in physical activity is the risk of related injuries. To reduce the short- and long-term effects in terms of social and economic consequences, prevention of physical activity injuries is an important challenge. A sequence of prevention model has been proposed that aims to prevent physical activity injuries in different steps. The model includes (i) identification of the problem in terms of incidence and severity of physical activity injuries, (ii) identification of the risk factors and injury mechanisms that play a role in the occurrence of physical activity injuries, (iii) introduction of measures that are likely to reduce the future risk and (or) severity of physical activity injuries, and (iv) evaluation of the effectiveness of the measures by conducting a randomized controlled trial (RCT). This review describes what is currently known about all of the various aspects of the sequence of prevention in children (steps i-iv).