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

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.

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.

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.

Increased PA during a 5-year period, starting in the pre-pubertal period, improves the gain in muscle strength without affecting the fracture risk.