Malte Nejst Larsen

Structural and functional cardiac adaptations to a 10-week school-based football intervention for 9-10-year-old children.

The present study investigated the cardiac effects of a 10‐week football training intervention for school children aged 9–10 years using comprehensive transthoracic echocardiography as a part of a larger ongoing study. A total of 97 pupils from four school classes were cluster‐randomized into a control group that maintained their usual activities (CON; two classes, n = 51, 21 boys and 30 girls) and a football training group that performed an additional 3 × 40 min of small‐sided football training per week (FT; two classes, n = 46, 23 boys and 23 girls). No baseline differences were observed in age, body composition, or echocardiographic variables between FT and CON. After the 10‐week intervention, left ventricular posterior wall diameter was increased in FT compared with CON [0.4 ± 0.7 vs −0.1 ± 0.6 (± SD) mm; P < 0.01] as was the interventricular septum thickness (0.2 ± 0.7 vs −0.2 ± 0.8 mm; P < 0.001). Global isovolumetric relaxation time increased more in FT than in CON (3.8 ± 10.4 vs −0.9 ± 6.6 ms, P < 0.05) while the change in ventricular systolic ejection fraction tended to be higher (1.4 ± 8.0 vs −1.1 ± 5.5%; P = 0.08). No changes were observed in resting heart rate or blood pressure. In conclusion, a short‐term, school‐based intervention comprising small‐sided football sessions resulted in significant structural and functional cardiac adaptations in pre‐adolescent children.

The human myotendinous junction: An ultrastructural and 3D analysis study

The myotendinous junction (MTJ) is a specialized structure in the musculotendinous system, where force is transmitted from muscle to tendon. Animal models have shown that the MTJ takes form of tendon finger‐like processes merging with muscle tissue. The human MTJ is largely unknown and has never been described in three dimensions (3D). The aim of this study was to describe the ultrastructure of the human MTJ and render 3D reconstructions. Fourteen subjects (age 25 ± 3 years) with isolated injury of the anterior cruciate ligament (ACL), scheduled for reconstruction with a semitendinosus/gracilis graft were included. Semitendinosus and gracilis tendons were stripped as grafts for the ACL reconstruction. The MTJ was isolated from the grafts and prepared for transmission electron microscopy (TEM) and focused ion beam/scanning electron microscopy. It was possible to isolate recognizable MTJ tissue from all 14 patients. TEM images displayed similarities to observations in animals: Sarcolemmal evaginations observed as finger‐like processes from the tendon and endomysium surrounding the muscle fibers, with myofilaments extending from the final Z‐line of the muscle fiber merging with the tendon tissue. The 3D reconstruction revealed that tendon made ridge‐like protrusions, which interdigitiated with groove‐like indentations in the muscle cell.

Effect of game format on heart rate, activity profile, and player involvement in elite and recreational youth players

The purpose of this study was to evaluate activity profile, aerobic load, and player involvement in two game formats of recreational and elite youth football for two age groups. A total of 152 youth players participated, with 45 U10 players playing 5v5 and 8v8 games, and 41 U13 players playing 8v8 and 11v11 (20 min) games. Activity profile, heart rate (HR), and technical actions were measured during all games using 10 Hz GPS, video filming, and HR monitors. For U10, no difference was found in total distance covered (1754 ± 237 vs 1771 ± 314 m, P = 0.650, d = 0.06), whereas mean HR (174 ± 10 vs 168 ± 12 bpm, P = 0.001, d = 0.59) and number of technical actions (65.1 ± 24.0 vs 36.9 ± 20.4, P <  0.001, d = 1.27) were higher in 5v5 than in 8v8. For U13, lower total distance covered (1821 ± 325 vs 2038 ± 328 m, P < 0.001, d = 0.66) and higher number of technical actions (36.2 ± 14.9 vs 26.9 ± 14.1, P < 0.001, d = 0.64) were observed in 8v8 than in 11v11, with no difference in mean HR (170 ± 10 vs 171 ± 10 bpm, P = 0.679, d = 0.10). In conclusion, HR is high in youth football matches irrespective of the level of play and the game format. Playing with fewer players on smaller pitches results in minor changes to the physical loading but elevates the technical involvement of youth players both at elite level and recreational level.

Motor skills and exercise capacity are associated with objective measures of cognitive functions and academic performance in preadolescent children

Objective To investigate associations between motor skills, exercise capacity and cognitive functions, and evaluate how they correlate to academic performance in mathematics and reading comprehension using standardised, objective tests. Methods This cross-sectional study included 423 Danish children (age: 9.29±0.35 years, 209 girls). Fine and gross motor skills were evaluated in a visuomotor accuracy-tracking task, and a whole-body coordination task, respectively. Exercise capacity was estimated from the Yo-Yo intermittent recovery level 1 childrens test (YYIR1C). Selected tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to assess different domains of cognitive functions, including sustained attention, spatial working memory, episodic and semantic memory, and processing speed. Linear mixed-effects models were used to investigate associations between these measures and the relationship with standard tests of academic performance in mathematics and reading comprehension. Results Both fine and gross motor skills were associated with better performance in all five tested cognitive domains (all P<0.001), whereas exercise capacity was only associated with better sustained attention (P<0.046) and spatial working memory (P<0.038). Fine and gross motor skills (all P<0.001), exercise capacity and cognitive functions such as working memory, episodic memory, sustained attention and processing speed were all associated with better performance in mathematics and reading comprehension. Conclusions The data demonstrate that fine and gross motor skills are positively correlated with several aspects of cognitive functions and with academic performance in both mathematics and reading comprehension. Moreover, exercise capacity was associated with academic performance and performance in some cognitive domains. Future interventions should investigate associations between changes in motor skills, exercise capacity, cognitive functions, and academic performance to elucidate the causality of these associations.

Positive effects on bone mineralisation and muscular fitness after 10 months of intense school-based physical training for children aged 8–10 years: the FIT FIRST randomised controlled trial

Objectives We investigated whether musculoskeletal fitness of school children aged 8–10 years was affected by frequent intense PE sessions. Design and participants 295 Danish school children aged 8–10 years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes). Intervention SSG or CST was performed 3×40 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness. Results Analysis of baseline-to-10 months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8 mg/cm2, 95% CI 3 to 13; CST vs CON: 7 mg/cm2, 95% CI 2 to 13, p<0.05) and leg BMC (SSG vs CON: 11 g, 95% CI 4 to 18; CST vs CON: 11 g, 95% CI 3 to 18, p<0.05). SSG had higher change scores in leg aBMD compared with CON and CST (SSG vs CON: 19 mg/cm2, 95% CI 11 to 39, p<0.05; SSG vs CST: 12 mg/cm2, 95% CI 3 to 21, p<0.05), and CST had higher change scores in whole-body BMC compared with CON (CST vs CON: 25 g, 95% CI 10 to 39, p<0.05). Both training types resulted in higher change scores in postural balance (SSG vs CON: 2.4 fewer falls/min, 95% CI 0.3 to 4.5, CST vs CON: 3.6 fewer falls/min, 95% CI 1.3 to 5.9, p<0.05) and jump length (SSG vs CON: 10%, 95% CI 5 to 16%; CST vs CON: 9%, 95% CI 3 to 15%, p<0.05). No between-group differences were observed for sprint performance or LBM (p>0.05). Conclusions In conclusion, 3×40 min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8–10 years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children. Trial registration number NCT02000492, post results.

‘FIFA 11 for Health’ for Europe. 1: effect on health knowledge and well-being of 10- to 12-year-old Danish school children

Aim To modify the ‘FIFA 11 for Health’ programme to the European situation, and to assess its effects on health knowledge and well-being in Danish school children. Method A two-cohort study with seven intervention and two control schools. Of the 546 Danish children (boys 269; girls 277) of mean age 11.1 (±0.4) years from five city and four country-side schools, 402 undertook the ‘FIFA 11 for Health’ programme and 144 acted as controls. As part of each schools PE curriculum, seven intervention schools received a 45 min Play Football period (football skills and 3 vs 3 games) and a 45 min Play Fair period (health issues and football drills) on a weekly-basis for 11 weeks. Control participants continued with their regular school PE activities. Participants completed preintervention and postintervention health knowledge and well-being questionnaires. Results Overall, health knowledge increase was significantly (p<0.05) greater for the intervention group (11.9%) than the control group (2.6%). Significant (p<0.05) between-group differences were obtained for 8 of 10 health topics (6.1–20.2%) related to physical activity, nutrition, hygiene and well-being. The social dimension of the well-being questionnaire was significantly (p<0.05) improved in the intervention group compared to the control group, but there were no significant between-group effects for the physical, emotional and school dimensions. Positive reporting about the programme was given by 72.4% of the children and only 4.8% reported negatively. Conclusions The ‘FIFA 11 for Health’ programme modified for Europe demonstrated positive effects on childrens health knowledge and social dimension of well-being, thereby providing evidence that the football-based health education programme can be used effectively within a European schools curriculum to increase physical activity, well-being and health knowledge.

Long‐term progressive motor skill training enhances corticospinal excitability for the ipsilateral hemisphere and motor performance of the untrained hand

It is well established that unilateral motor practice can lead to increased performance in the opposite non‐trained hand. Here, we test the hypothesis that progressively increasing task difficulty during long‐term skill training with the dominant right hand increase performance and corticomotor excitability of the left non‐trained hand. Subjects practiced a visuomotor tracking task engaging right digit V for 6 weeks with either progressively increasing task difficulty (PT) or no progression (NPT). Corticospinal excitability (CSE) was evaluated from the resting motor threshold (rMT) and recruitment curve parameters following application of transcranial magnetic stimulation (TMS) to the ipsilateral primary motor cortex (iM1) hotspot of the left abductor digiti minimi muscle (ADM). PT led to significant improvements in left‐hand motor performance immediately after 6 weeks of training (63 ± 18%, P < 0.001) and 8 days later (76 ± 14%, P < 0.001). In addition, PT led to better task performance compared to NPT (19 ± 15%, P = 0.024 and 27 ± 15%, P = 0.016). Following the initial training session, CSE increased across all subjects. After 6 weeks of training and 8 days later, only PT was accompanied by increased CSE demonstrated by a left and upwards shift in the recruitment curves, e.g. indicated by increased MEPmax (P = 0.012). Eight days after training similar effects were observed, but 14 months later motor performance and CSE were similar between groups. We suggest that progressively adjusting demands for timing and accuracy to individual proficiency promotes motor skill learning and drives the iM1‐CSE resulting in enhanced performance of the non‐trained hand. The results underline the importance of increasing task difficulty progressively and individually in skill learning and rehabilitation training.

The importance of cohesion and enjoyment for the fitness improvement of 8–10-year-old children participating in a team and individual sport school-based physical activity intervention

Abstract This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure enjoyment and cohesion. The Yo-Yo IR1C test determined fitness improvements. Results showed that enjoyment and cohesion (social) measured at the beginning of the intervention significantly predict fitness improvements achieved after 10 months. No differing developmental effects over time could be found in the intervention groups with regard to cohesion and enjoyment when comparing them to the control group. However, enjoyment and cohesion (social) significantly decreased in the groups that performed individual sports. Team sports seem to be more advantageous for the development of enjoyment and cohesion, which are both factors that positively impact the health outcomes of the intervention.

Fitness Effects of 10-Month Frequent Low-Volume Ball Game Training or Interval Running for 8–10-Year-Old School Children

We investigated the exercise intensity and fitness effects of frequent school-based low-volume high-intensity training for 10 months in 8–10-year-old children. 239 Danish 3rd-grade school children from four schools were cluster-randomised into a control group (CON, n = 116) or two training groups performing either 5 × 12 min/wk small-sided football plus other ball games (SSG, n = 62) or interval running (IR, n = 61). Whole-body DXA scans, flamingo balance, standing long-jump, 20 m sprint, and Yo-Yo IR1 childrens tests (YYIR1C) were performed before and after the intervention. Mean running velocity was higher (p < 0.05) in SSG than in IR (0.88 ± 0.14 versus 0.63 ± 0.20 m/s), while more time (p < 0.05) was spent in the highest player load zone (>2; 5.6 ± 3.4 versus 3.7 ± 3.4%) and highest HR zone (>90% HRmax; 12.4 ± 8.9 versus 8.4 ± 8.0%) in IR compared to SSG. After 10 months, no significant between-group differences were observed for YYIR1C performance and HR after 2 min of YYIR1C (HRsubmax), but median-split analyses showed that HRsubmax was reduced (p < 0.05) in both training groups compared to CON for those with the lowest aerobic fitness (SSG versus CON: 3.2%  HRmax [95% CI: 0.8–5.5]; IR versus CON: 2.6%  HRmax [95% CI: 1.1–5.2]). After 10 months, IR had improved (p < 0.05) 20 m sprint performance (IR versus CON: 154 ms [95% CI: 61–241]). No between-group differences (p > 0.05) were observed for whole-body or leg aBMD, lean mass, postural balance, or jump length. In conclusion, frequent low-volume ball games and interval running can be conducted over a full school year with high intensity rate but has limited positive fitness effects in 8–10-year-old children.

FIFA 11 for Health for Europe in the Faroe Islands: Effects on health markers and physical fitness in 10- to 12-year-old schoolchildren

We evaluated effects of the school‐based intervention “FIFA 11 for Health” for Europe on health and fitness profile in 10‐ to 12‐year‐old Faroese schoolchildren. 392 fifth‐grade children were randomized into a control group (CG: n = 100, 11.1 ± 0.3 years, 149.0 ± 6.7 cm, 42.4 ± 10.2 kg) and an intervention group (IG: n = 292, 11.1 ± 0.3 years, 150.6 ± 6.9 cm, 44.2 ± 9.4 kg). IG underwent an 11‐week intervention in which 2 weekly sessions of 45 minutes were included in the school curriculum focusing on health aspects, football skills, and 3v3 small‐sided games. CG continued with their regular activities. Body composition, blood pressure, and resting heart rate, as well as Yo‐Yo intermittent recovery children’s test (YYIR1C) performance, horizontal jumping ability and postural balance were assessed pre and post intervention. Systolic blood pressure decreased more (−2.8 ± 9.9 vs 2.9 ± 8.4 mm Hg, P < .05) in IG than in CG. Lean body mass (1.0 ± 1.7 vs 0.7 ± 1.6 kg), postural balance (0.3 ± 3.9 vs −1.2 ± 5.9 seconds) and horizontal jump performance (5 ± 9 vs ‐5 ± 10 cm) increased more (P < .05) in IG than in CG. YYIR1C performance improved in CG (17%, 625 ± 423 to 730 ± 565 m) and IG (18%, 689 ± 412 vs 813 ± 391 m), but without between‐group differences. A within‐group decrease from 23.1 ± 8.4 to 22.5 ± 8.3% (P < .05) was observed in body fat percentage in IG only. In conclusion, the “FIFA 11 for Health” for Europe program had beneficial effects on SBP, body composition, jump performance and postural balance in 10‐ to 12‐year‐old Faroese schoolchildren, supporting the notion that school‐based football interventions can facilitate health of children in a small‐scale society and serve as an early step in the prevention of non‐communicable diseases.