How does a physical activity programme in elementary school affect fracture risk? A prospective controlled...

Area of Science:

• Pediatric health
• Bone health and fractures
• Public health interventions

Background:

• Childhood fractures are a significant concern.
• Previous studies suggested a link between physical activity and reduced fracture risk.
• A prior 7-year intervention showed a trend but lacked statistical significance, necessitating an extended study.

Purpose of the Study:

• To evaluate the long-term effect of a school-based physical activity intervention on fracture risk in children.
• To determine if extending the intervention would lead to a statistically significant reduction in fractures.

Main Methods:

• An 8-year intervention involving 40 minutes of daily moderate physical activity was implemented in one elementary school.
• A control group from neighboring schools followed the national standard of 60 minutes of physical activity per week.
• Fracture data were objectively verified through a regional radiographic archive, and incidence rates were calculated.

Main Results:

• The intervention group initially showed a higher fracture incidence rate (IRR 1.65) in the first year.
• Each subsequent year, the fracture incidence rate in the control group increased by 15.7% relative to the intervention group.
• By the end of the 8-year study, the fracture IRR was 52% lower in the intervention group (IRR 0.48) compared to the control group.

Conclusions:

• A school-based physical activity intervention can significantly reduce fracture risk in children over time.
• While initial fracture risk may increase, sustained participation leads to substantial long-term benefits.
• Implementing daily moderate physical activity in schools is an effective strategy for improving pediatric bone health.