Integrative neuromuscular training and sex-specific fitness performance in 7-year-old children: an exploratory investigation

Abstract

Context: Integrative neuromuscular training (INT) has successfully enhanced physical fitness and reduced abnormal biomechanics, which appear to decrease injury rates in adolescent female athletes. If not addressed at the proper time, low levels of physical fitness and abnormal mechanics may predispose female athletes to an increased risk of musculoskeletal injuries.

Objectives: To evaluate sex-specific effects of INT on selected measures of health- and skill-related fitness in children during physical education (PE).

Design: Cohort study.

Setting: Public primary school.

Patients or other participants: Forty children (16 boys, 24 girls; age = 7.6 ± 0.3 years, height = 124.5 ± 6.4 cm, mass = 29.5 ± 7.6 kg) from 2 second-grade PE classes.

Intervention(s): The classes were randomized into the PE-plus-INT group (10 boys, 11 girls) or the control group (6 boys, 13 girls) that participated in traditional PE. The INT was performed 2 times per week during the first approximately 15 minutes of each PE class and consisted of body weight exercises.

Main outcome measure(s): Push-up, curl-up, standing long jump, single-legged hop, single-legged balance, sit-and-reach flexibility test, shuttle run, and 0.8-km run.

Results: At baseline, the boys demonstrated higher levels of performance in most of the fitness measurements as evidenced by greater performance on the push-up, standing long jump, single-legged hop, shuttle run, and 0.8-km run (P < .05). In the evaluation of the training effects, we found intervention effects in the girls for enhanced INT-induced gains in performance relative to the control group on the curl-up, long jump, single-legged hop, and 0.8-km run (P < .05) after controlling for baseline. Boys did not demonstrate similar adaptations from the INT program (P ≥ .05).

Conclusions: These data indicate that INT is an effective and time-efficient addition to PE for enhancing motor skills and promoting physical activity in children. Seven-year-old girls appeared to be more sensitive to the effects of INT than 7-year-old boys. Future research is warranted to confirm these effects in larger cohorts of children.

Figure 1.

Curl-up performance. For the curl-up test, we found a time-by-group-by-sex interaction that indicated sex differences in the response to integrative neuromuscular training (INT; P = .01). In girls, the INT program increased the maximal number of curl-ups from after the intervention. In boys, we noted a main effect of time: both the standard physical education (PE) and PE-plus-INT groups increased scores from pretest to posttest. Plots represent adjusted mean ± standard error of the mean. Abbreviation: CON, control.

Figure 2.

The 0.8-km run performance. For the 0.8-km timed-performance run, we found a time-by-group-by-sex interaction at posttest that indicated sex differences in the response to integrative neuromuscular training (INT; P = .03). In the sex-specific female model, performance on the 0.8-km run also revealed a time-by-group interaction for improved performance in the group participating in physical education (PE) plus INT. The endurance run showed the greatest improvement after INT relative to the control (CON) group, with a reduced time from pretest to posttest in the girls. In boys, we did not find a measured effect of either standard PE or PE plus INT toward improved posttest score relative to pretest assessment. Plots represent adjusted mean ± standard error of the mean.

Figure 3.

Push-up performance. For the push-up test, the overall time-by-group-by-sex interaction was not different between sexes (P > .05). However, in the sex-specific model, the girls who participated in physical education (PE) plus integrative neuromuscular training (INT) increased the maximal number of push-ups. Plots represent adjusted mean ± standard error of the mean. Abbreviation: CON, control.

Figure 4.

Single-legged–hop performance. For the single-legged–hop test, a time-by-group-by-sex interaction indicated sex differences in the response to integrative neuromuscular training (INT; P = .02). In the sex-specific models evaluating the single-legged–hop test, we observed greater improvement for the girls performing physical education (PE) plus INT than girls in the control (CON) group. In the male-specific model, we also observed a main effect of time: both the CON and PE-plus-INT groups improved their pretest single-legged–hop distance. Plots represent adjusted mean ± standard error of the mean.

Figure 5.

Standing–long-jump performance. For the standing–long-jump test, the time-by-group-by-sex interaction was not different between sexes (P > .05). However, in the female-specific model, the group performing physical education (PE) plus integrative neuromuscular training (INT) showed greater improvement than the control (CON) group from pretest to posttest. In boys, we noted a main effect of time: both the CON and PE-plus-INT groups increased long-jump distance from pretest to posttest. Plots represent adjusted mean ± standard error of the mean.