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How does a physical activity programme in elementary school affect fracture risk? : A prospective controlled intervention study in Malmo, Sweden

Cöster, Marcus E. LU ; Fritz, Jesper LU ; Nilsson, Jan-Åke LU ; Karlsson, Caroline; Rosengren, Björn E. LU ; Dencker, Magnus LU and Karlsson, Magnus LU (2017) In BMJ Open 7(2).
Abstract

Objectives: Recent evidence from the 7-year followup of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention. Setting: The study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school. Participants: We included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study.... (More)

Objectives: Recent evidence from the 7-year followup of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention. Setting: The study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school. Participants: We included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study. Intervention: We launched an 8-year intervention programme with 40 min of moderate PA per school day, while the controls continued with the Swedish national standard of 60 min of PA per week. Primary outcome measure: We used the regional radiographic archive to register objectively verified fractures and we estimated annual fracture incidences and incidence rate ratios (IRRs). Results: During the first year after initiation of the intervention, the fracture IRR was 1.65 (1.05 to 2.08) (mean 95% CI). For each year of the study, the fracture incidence rate in the control group compared with the intervention group increased by 15.7% (5.6% to 26.8%) (mean 95% CI). After 8 years, the IRR of fractures was 52% lower in the intervention group than in the control group (IRR 0.48 (0.25 to 0.91) (mean 95% CI))]. Conclusions: Introduction of the school-based intervention programme is associated with a higher fracture risk in the intervention group during the first year followed by a gradual reduction, so that during the eighth year, the fracture risk was lower in the intervention group.

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author
organization
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type
Contribution to journal
publication status
published
subject
in
BMJ Open
volume
7
issue
2
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85014047630
  • wos:000397872400025
ISSN
2044-6055
DOI
10.1136/bmjopen-2016-012513
language
English
LU publication?
yes
id
22f1e18a-48c8-420b-91d0-9f395d2d2fd8
date added to LUP
2017-03-22 16:45:18
date last changed
2018-01-07 11:56:40
@article{22f1e18a-48c8-420b-91d0-9f395d2d2fd8,
  abstract     = {<p>Objectives: Recent evidence from the 7-year followup of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention. Setting: The study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school. Participants: We included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study. Intervention: We launched an 8-year intervention programme with 40 min of moderate PA per school day, while the controls continued with the Swedish national standard of 60 min of PA per week. Primary outcome measure: We used the regional radiographic archive to register objectively verified fractures and we estimated annual fracture incidences and incidence rate ratios (IRRs). Results: During the first year after initiation of the intervention, the fracture IRR was 1.65 (1.05 to 2.08) (mean 95% CI). For each year of the study, the fracture incidence rate in the control group compared with the intervention group increased by 15.7% (5.6% to 26.8%) (mean 95% CI). After 8 years, the IRR of fractures was 52% lower in the intervention group than in the control group (IRR 0.48 (0.25 to 0.91) (mean 95% CI))]. Conclusions: Introduction of the school-based intervention programme is associated with a higher fracture risk in the intervention group during the first year followed by a gradual reduction, so that during the eighth year, the fracture risk was lower in the intervention group.</p>},
  articleno    = {e012513},
  author       = {Cöster, Marcus E. and Fritz, Jesper and Nilsson, Jan-Åke and Karlsson, Caroline and Rosengren, Björn E. and Dencker, Magnus and Karlsson, Magnus},
  issn         = {2044-6055},
  language     = {eng},
  month        = {02},
  number       = {2},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {How does a physical activity programme in elementary school affect fracture risk? : A prospective controlled intervention study in Malmo, Sweden},
  url          = {http://dx.doi.org/10.1136/bmjopen-2016-012513},
  volume       = {7},
  year         = {2017},
}