Clodagh M Toomey1,2,3,4, Jackie L Whittaker1,5,6, Sarah A Richmond1,7,8, Oluwatoyosi B Owoeye1, Declan A Patton1,9, Carolyn A Emery1,2,3,10. 1. Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada. 2. McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada. 3. Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada. 4. School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland. 5. Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 6. Arthritis Research Canada, Richmond, BC, Canada. 7. Health Promotion, Chronic Disease, and Injury Prevention, Public Health Ontario, Toronto, ON, Canada. 8. Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 9. Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, VIC, Australia; and. 10. Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Abstract
OBJECTIVE: To determine whether high or low adiposity is associated with youth sport-related injury. DATA SOURCES: Ten electronic databases were searched to identify prospective studies examining the association between adiposity [body mass index (BMI) or body fat] and a future time-loss or medical attention sport-related musculoskeletal injury or concussion in youth aged 20 years and younger. Two independent raters assessed the quality (Downs and Black criteria) and risk of bias (Joanna Briggs Institute Critical Appraisal Tool). Random-effects meta-analyses were used to calculate pooled odds ratio [95% confidence interval (CI)] of injury. MAIN RESULTS: Of 11 424 potentially relevant records, 38 articles were included with 17 eligible for meta-analyses. In qualitative synthesis, no clear association was identified between adiposity and any sport injury; however, 16/22 studies identified high adiposity as a significant risk factor for lower-extremity injury. Meta-analyses revealed higher BMI in youth with any sport-related injury and lower BMI in youth who developed a bone stress injury (BSI) compared with noninjured controls. The pooled OR (95% CI) examining the association of BMI and injury risk (excluding bone injury) was 1.18 (95% CI: 1.03-1.34). A major source of bias in included articles was inconsistent adjustment for age, sex, and physical activity participation. CONCLUSIONS: Level 2b evidence suggests that high BMI is associated with greater risk of youth sport injury, particularly lower-extremity injury and excluding BSI or fracture. Although pooled mean differences were low, anthropometric risk of injury seems to be dependent on type and site of injury in youth sport.
OBJECTIVE: To determine whether high or low adiposity is associated with youth sport-related injury. DATA SOURCES: Ten electronic databases were searched to identify prospective studies examining the association between adiposity [body mass index (BMI) or body fat] and a future time-loss or medical attention sport-related musculoskeletal injury or concussion in youth aged 20 years and younger. Two independent raters assessed the quality (Downs and Black criteria) and risk of bias (Joanna Briggs Institute Critical Appraisal Tool). Random-effects meta-analyses were used to calculate pooled odds ratio [95% confidence interval (CI)] of injury. MAIN RESULTS: Of 11 424 potentially relevant records, 38 articles were included with 17 eligible for meta-analyses. In qualitative synthesis, no clear association was identified between adiposity and any sport injury; however, 16/22 studies identified high adiposity as a significant risk factor for lower-extremity injury. Meta-analyses revealed higher BMI in youth with any sport-related injury and lower BMI in youth who developed a bone stress injury (BSI) compared with noninjured controls. The pooled OR (95% CI) examining the association of BMI and injury risk (excluding bone injury) was 1.18 (95% CI: 1.03-1.34). A major source of bias in included articles was inconsistent adjustment for age, sex, and physical activity participation. CONCLUSIONS: Level 2b evidence suggests that high BMI is associated with greater risk of youth sport injury, particularly lower-extremity injury and excluding BSI or fracture. Although pooled mean differences were low, anthropometric risk of injury seems to be dependent on type and site of injury in youth sport.