Influence of physical activity intensity and maturation in injury profile on youth

Introduction: Despite the growth in participation of younger generations in physical activity (PA), significant lack of knowledge exists regarding sports injuries [1 Stracciolini A, Casciano R, Levey Friedman H, et al. Pediatric sports injuries: an age comparison of children versus adolescents. Am J Sports Med. 2013;41(8):1922–1929. doi:10.1177/0363546513490644[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. The increased sports involvement from an early age through the years of growth raises serious concerns [1 Stracciolini A, Casciano R, Levey Friedman H, et al. Pediatric sports injuries: an age comparison of children versus adolescents. Am J Sports Med. 2013;41(8):1922–1929. doi:10.1177/0363546513490644[Crossref], [PubMed], [Web of Science ®] , [Google Scholar],2 Myer GD, Jayanthi N, DiFiori JP, et al. Sports Specialization, Part II: Alternative Solutions to Early Sport Specialization in Youth Athletes. Sports Health. 2015;8(1):65–73. doi:10.1177/1941738115614811[Crossref], [PubMed] , [Google Scholar]]. Therés a general trend toward specialization, intensive training and competition. These factors combined with a growing body can predispose the young child to sports injuries [1 Stracciolini A, Casciano R, Levey Friedman H, et al. Pediatric sports injuries: an age comparison of children versus adolescents. Am J Sports Med. 2013;41(8):1922–1929. doi:10.1177/0363546513490644[Crossref], [PubMed], [Web of Science ®] , [Google Scholar],3 Jayanthi NA, LaBella CR, Fischer D, et al. Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes: A Clinical Case-Control Study. Am J Sports Med. 2015;43(4):794–801. doi:10.1177/0363546514567298[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. So our aim was to identify the importance of PA intensity and maturity as predictors of injury in youth.Materials and methods: Information about injury was assessed via a questionnaire (LESADO), PA intensity via accelerometry and maturity via TW III bone age and maturity offset. To perform this evaluation 121 participants aged between 10 and 18 years attending four schools were selected. Logistic regressions analyses were used to determine significant predictors of injury occurrence, injury rate, body area injury location and injury type. All subjects’ guardians gave their written informed consent. The research protocol was in accordance with the Helsinki Declaration and was approved by the Ethics Committee of the Faculty of Human Kinetics.Results: There were not found significant results for injury occurrence, injury rate and body area injury location. Only injury type presented significant results. Time spent in moderate PA (χ2(2) = 6.701, p = .035) and bone age (χ2(2) = 7.196, p = .027) were the final predictors. The odds of having a strain or a fracture, relatively to a sprain, increased 1.04 times for each minute of time spent in moderate PA. Likewise the odds of having a strain or a fracture, relatively to a sprain, decreased 1.7 times for year of bone age.Discussion and conclusions: There were not found meaningful associations between injury occurrence, injury rate and body area injury location and the evaluated predictors. Several studies have already discussed the association between injuries and higher intensity PA [4 Soprano J V., Fuchs SM. Common Overuse Injuries in the Pediatric and Adolescent Athlete. Clin Pediatr Emerg Med. 2007;8(1):7–14. doi:10.1016/j.cpem.2007.02.009[Crossref] , [Google Scholar],5 Malisoux L, Frisch A, Urhausen A, et al. Monitoring of sport participation and injury risk in young athletes. J Sci Med Sport. Sports Medicine Australia; 2013;16(6):504–508. doi:10.1016/j.jsams.2013.01.008[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. However considering the present results and previous studies by Costa e Silva et al. [6 Costa e Silva L, Fragoso I, Teles J. Prevalence and injury profile in Portuguese children and adolescents according to their level of sports participation. J Sports Med Phys Fitness. 2018;58(3):271–279.[PubMed], [Web of Science ®] , [Google Scholar],7 Costa e Silva L, Fragoso MI, Teles J. Physical Activity–Related Injury Profile in Children and Adolescents According to Their Age, Maturation, and Level of Sports Participation. Sports Health. 2017;9(2):118–125. doi:10.1177/1941738116686964[Crossref], [PubMed] , [Google Scholar]] PA volume and level of sports participation seem to influence in a more significant way these three variables. Nonotheless PA intensity and bone age proved to be injury predictors of the growing athlete, with expression over injury type.