The authors have no conflict of interest.
Television, Computer, and Video Viewing; Physical Activity; and Upper Limb Fracture Risk in Children: A Population-Based Case Control Study†
Article first published online: 1 NOV 2003
Copyright © 2003 ASBMR
Journal of Bone and Mineral Research
Volume 18, Issue 11, pages 1970–1977, November 2003
How to Cite
MA, D. and Jones, G. (2003), Television, Computer, and Video Viewing; Physical Activity; and Upper Limb Fracture Risk in Children: A Population-Based Case Control Study. J Bone Miner Res, 18: 1970–1977. doi: 10.1359/jbmr.2003.18.11.1970
- Issue published online: 2 DEC 2009
- Article first published online: 1 NOV 2003
- Manuscript Accepted: 8 JUL 2003
- Manuscript Revised: 7 JUL 2003
- Manuscript Received: 1 MAY 2003
- physical activity;
- upper limb fracture;
- children and case control study;
- growth and development
The effect of physical activity on upper limb fractures was examined in this population-based case control study with 321 age- and gender-matched pairs. Sports participation increased fracture risk in boys and decreased risk in girls. Television viewing had a deleterious dose response association with wrist and forearm fractures while light physical activity was protective.
Introduction: The aim of this population-based case control study was to examine the association between television, computer, and video viewing; types and levels of physical activity; and upper limb fractures in children 9–16 years of age.
Materials and Methods: A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. Television, computer, and video viewing and types and levels of physical activity were determined by interview-administered questionnaire. Bone strength was assessed by DXA and metacarpal morphometry.
Results: In general, sports participation increased total upper limb fracture risk in boys and decreased risk in girls. Gender-specific risk estimates were significantly different for total, contact, noncontact, and high-risk sports participation as well as four individual sports (soccer, cricket, surfing, and swimming). In multivariate analysis, time spent television, computer, and video viewing in both sexes was positively associated with wrist and forearm fracture risk (OR 1.6/category, 95% CI: 1.1–2.2), whereas days involved in light physical activity participation decreased fracture risk (OR 0.8/category, 95% CI: 0.7–1.0). Sports participation increased hand (OR 1.5/sport, 95% CI: 1.1–2.0) and upper arm (OR 29.8/sport, 95% CI: 1.7–535) fracture risk in boys only and decreased wrist and forearm fracture risk in girls only (OR 0.5/sport, 95% CI: 0.3–0.9). Adjustment for bone density and metacarpal morphometry did not alter these associations.
Conclusion: There is gender discordance with regard to sports participation and fracture risk in children, which may reflect different approaches to sport. Importantly, television, computer, and video viewing has a dose-dependent association with wrist and forearm fractures, whereas light physical activity is protective. The mechanism is unclear but may involve bone-independent factors, or less likely, changes in bone quality not detected by DXA or metacarpal morphometry.