ArticleBMJ open2017
How does a physical activity programme in elementary school affect fracture risk? A prospective controlled intervention study in Malmo, Sweden.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00633828 (Determinants for Peak Bone Mass, Skeletal Architecture, Fractures, Adipositas and Cardiovascular Risk Factors During Growth and Adulthood), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determinants for Peak Bone Mass, Skeletal Architecture, Fractures, Adipositas and Cardiovascular Risk Factors During Growth and Adulthood
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Pooled it
- Fracture Incidence With 6-9 Years of Daily School Physical Activity: Lower Relative Fracture Risk at the End of the Intervention But Not After.Scandinavian journal of medicine & science in sports · 2026Article
- Health among Retired Great Britain's Olympic Athletes: A cross-sectional Study of Disease and Multimorbidity.Sports medicine - open · 2025Article
- Levels of Physical Activity in Children with Extremity Fractures a Dutch Observational Cross-Sectional Study.Children (Basel, Switzerland) · 2022Article
- Physical Activity in Late Prepuberty and Early Puberty Is Associated With High Bone Formation and Low Bone Resorption.Frontiers in physiology · 2022Article
- Article
- Musculoskeletal Benefits from a Physical Activity Program in Primary School are Retained 4 Years after the Program is Terminated.Calcified tissue international · 2021Article
- Trends in the U.S. Childhood Emergency Department Visits for Fall-Related Fractures, 2001-2015.Cureus · 2020Article
- Daily School Physical Activity Is Associated with Higher Level of Physical Activity Independently of Other Socioecological Factors.Sports (Basel, Switzerland) · 2020Article
- Daily School Physical Activity Improves Academic Performance.Sports (Basel, Switzerland) · 2020Article
- Exercise and Peak Bone Mass.Current osteoporosis reports · 2020Review
- Daily School Physical Activity from Before to After Puberty Improves Bone Mass and a Musculoskeletal Composite Risk Score for Fracture.Sports (Basel, Switzerland) · 2020Article
- Serum Renin Levels Increase With Age in Boys Resulting in Higher Renin Levels in Young Men Compared to Young Women, and Soluble Angiotensin-Converting Enzyme 2 Correlates With Renin and Body Mass Index.Frontiers in physiology · 2020Article
- Socioecological and biological associations of lower levels of physical activity in 8-year-old children: a 2-year prospective study.BMJ open sport & exercise medicine · 2019Article
- Low physical activity is related to clustering of risk factors for fracture-a 2-year prospective study in children.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesRecent evidence from the 7-year follow-up of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention.
settingThe study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school.
participantsWe included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study.
interventionWe launched an 8-year intervention programme with 40 min of moderate PA per school day, while the controls continued with the Swedish national standard of 60 min of PA per week. PRIMARY OUTCOME MEASURE: We used the regional radiographic archive to register objectively verified fractures and we estimated annual fracture incidences and incidence rate ratios (IRRs).
resultsDuring the first year after initiation of the intervention, the fracture IRR was 1.65 (1.05 to 2.08) (mean 95% CI). For each year of the study, the fracture incidence rate in the control group compared with the intervention group increased by 15.7% (5.6% to 26.8%) (mean 95% CI). After 8 years, the IRR of fractures was 52% lower in the intervention group than in the control group (IRR 0.48 (0.25 to 0.91) (mean 95% CI))].
conclusionsIntroduction of the school-based intervention programme is associated with a higher fracture risk in the intervention group during the first year followed by a gradual reduction, so that during the eighth year, the fracture risk was lower in the intervention group. TRIAL REGISTRATION NUMBER: NCT00633828.
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