The Effectiveness of a Combined Sport in jury and Obesity Prevention Program in Junior High School

Abstract

Introduction: There are high sport injury rates in youth in Canada. The rate of overweight and obesity are also rising. Purpose: The purpose of this research was to examine the feasibility and effectiveness of a combined sport injury and obesity prevention training program in reducing the risk of injury and increasing healthy outcomes in a junior high school population. Methodology: This was a pilot cluster-randomized controlled trial (RCT). The participants were 725 male and female physical education (PE) participants (ages 11-15) from two junior high schools. Study participants were randomized to the training group or control group by school. All training school classes completed a 12 week, 3x/week, 15 minute moderate to high intensity neuromuscular warm-up routine in each PE class. The training group warm-up included components of dynamic stretching, lower extremity and core strength, agility and balance training exercises. The control group warm-up was equivalent in length but contained components of a more standard of care warm-up practice. A physiotherapist, blinded to the training group allocation, assessed any sport injury on a weekly basis. The injury definition included any sport injury occurring during the study period that required medical attention and/or removal from a session and/or missing a subsequent session. Changes in VO2 maximum was estimated based on the 20 m shuttle run. Results: Individual level univaiate analysis demonstrates that the warmup program was protective of injury (IRR = 0.47 [95% CI; 0.3-0.72]), lower extremity Injury (IRR = 0.3 [95% CI; 0.18-0.48) and injury resulting in more than one week of time loss from sport (IRR = 0.42 [95% CI; 0.15-1.1]). In addition, there was evidence of a greater improvement in VO2 maximum in the training group (2.14 ml/kg/min [95% CI; 1.17-2.59]) compared to the control group (0.91 ml/kg/min [95% CI; 0.46-1.36]) (t= -3.86, p=0.0001). Conclusions: This pilot study suggests that a neuromuscular training program which incorporates a high intensity exercise component is protective of overall sport injury, lower extremity injury and injury resulting in greater than 1 week time loss from sport when delivered in PE class in a junior high school setting. There is also some indication of a greater improvement in VO2 maximum in the training group compared to the control group. A follow-up quasi-experimental study is underway to examine the effectiveness of the training program in the control study school the following school year. This study demonstrates the feasibility of such a cluster-RCT in a junior high school setting. The analysis is limited to an individual level analysis in this pilot study because of only two schools, but the results will inform a larger cluster-RCT study.