Children with low muscle strength are at an increased risk of fracture with exposure to exercise

Abstract

Objectives: To use objective measures of physical fitness and muscle function to assess the interplay between exercise, muscle and fractures during childhood.

Methods: A cross-sectional analysis was performed using The Young Hearts Project, a population-based cohort recruited from Northern Ireland. Grip strength was assessed with a hand-held dynamometer. Aerobic fitness was assessed using the 20-metre endurance shuttle run. The outcome of interest was reported fractures. Data were also collected on other potential confounders.

Results: There were 787 boys (49.5%) and 803 girls aged 13.9±1.5 years. 414 (26.0%) children reported a fracture at anytime since birth. There was a positive association between higher aerobic fitness and reported fracture (OR 1.23, 95%CI 1.05 to 1.45, P=0.012) greatest in those with lowest grip strength (OR 2.10, 95%CI 1.23 to 3.31, P=0.005). Conversely, in those with highest grip strength, no association was seen between aerobic fitness and reported fractures.

Conclusion: In children, higher levels of aerobic fitness are associated with an increased risk of fractures, with the greatest risk seen in those with low muscle strength. Our results suggest that there is the potential for exercise protocols that aim to strengthen forearm musculature to reduce upper limb fractures in adolescents.