Am J Epidemiol. 2022 Mar 24;191(4):665-673. doi: 10.1093/aje/kwab280.
Limited research exists on the relationship between changes in physical activity levels and injury in children. In this study, we investigated the prognostic relationship between changes in activity, measured by the acute:chronic workload ratio (ACWR), and injury in children. We used data from the Childhood Health, Activity, and Motor Performance School Study Denmark (2008-2014), a prospective cohort study of 1,660 children aged 6-17 years. We modeled the relationship between the uncoupled 5-week ACWR and injury, defined as patient-reported musculoskeletal pain, using generalized additive mixed models. These methods accounted for repeated measures, and they improved model fit and precision compared with previous studies that used logistic models. The prognostic model predicted an injury risk of approximately 3% between decreases in activity level of up to 60% and increases of up to 30%. Predicted risk was lower when activity decreased by more than 60% (minimum of 0.5% with no recreational activity). Predicted risk was higher when activity increased by more than 30% (4.5% with a 3-fold increase in activity). Girls were at significantly higher risk of injury than boys. We observed similar patterns but lower absolute risks when we restricted the outcome to clinician-diagnosed injury. Predicted increases in injury risk with increasing activity were much lower than those of previous studies carried out in adults.
关于体力活动水平变化与儿童损伤之间的关系，相关研究有限。本研究旨在通过急性：慢性工作量比（ACWR）来调查儿童活动变化与损伤之间的预后关系，该研究使用了丹麦儿童健康、活动和运动表现学校研究（2008-2014 年）的数据，这是一项针对 6-17 岁儿童的前瞻性队列研究。我们采用广义加性混合模型来构建不相关的 5 周 ACWR 与损伤（定义为患者报告的肌肉骨骼疼痛）之间的关系模型。与以往使用逻辑模型的研究相比，这些方法考虑了重复测量，提高了模型拟合度和精度。预后模型预测，活动水平下降 60%以内和增加 30%以内，损伤风险约为 3%。活动水平下降超过 60%（无娱乐活动时至少下降 0.5%）时，预测风险较低。活动增加超过 30%（活动增加 3 倍时为 4.5%）时，预测风险较高。与男孩相比，女孩受伤的风险显著更高。当我们将结果限制为临床医生诊断的损伤时，我们观察到了类似的模式，但绝对风险较低。与以往在成年人中进行的研究相比，活动增加导致损伤风险增加的预测值要低得多。
