Physical Activity in Young People: Difference between revisions
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== Definitions  ==
== Definitions  ==
* Physical activity: any bodily movement produced by skeletal muscles that requires energy expenditure.
* Physical activity: any bodily movement produced by skeletal muscles that requires energy expenditure.
* Infant: newborn to 1 year old child<ref name=":1">World Health Organization. Physical activity [internet]. 2017. [cited 2/1/18]. Available from: <nowiki>http://www.who.int/topics/physical_activity/en/</nowiki></ref>
* Infant: newborn to 1-year-old child<ref name=":1">World Health Organization. Physical activity [internet]. 2017. [cited 2/1/18]. Available from: <nowiki>http://www.who.int/topics/physical_activity/en/</nowiki></ref>
* Toddler: 1-2 years old child
* Toddler: 1-2 years old child
* Preschooler: 3-4 years old child
* Preschooler: 3-4 years old child
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Physical activity can provide both [[Benefits of Physical Activity|immediate and long-term health benefits]], physically, mentally and socially. It can also foster independence and help with learning<ref>Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr. 2005, 146 (6): 732-737. 10.1016/j.jpeds.2005.01.055.</ref>.
Physical activity can provide both [[Benefits of Physical Activity|immediate and long-term health benefits]], physically, mentally and socially. It can also foster independence and help with learning<ref>Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr. 2005, 146 (6): 732-737. 10.1016/j.jpeds.2005.01.055.</ref>.


Some immediate benefits of exercise include: enhanced mood, aid in self-regulation, reduction of blood sugar levels and feeling of well-being.
Some immediate benefits of exercise include:  
* Enhanced mood
* Aid in self-regulation
* Reduction of blood sugar levels
* Feelings of well-being.
Many long-term benefits are observable as well. Moderate impact cardiovascular activities can benefit school-aged children and adolescents by decreasing the risks of [[Diabetes Mellitus Type 2|Type 2 Diabetes]], [[stroke]], heart disease, blood pressure, adiposity levels, anxiety, and [[depression]]<ref name=":0">Janssen I, LeBlanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International journal of behavioral nutrition and physical activity. 2010 Dec;7(1):40.</ref>.  Exercise also helps to increase a child’s self-confidence, strength, physical literacy<ref name=":0" />, cardiovascular fitness, and flexibility.  High-impact activities can increase (or help to maintain) bone density<ref name=":0" />. Furthermore, studies have shown that children who participate in regular physical activity are less likely to use tobacco, alcohol, and drugs and are better able to maintain a healthy body weight<ref name=":0" />.


Many long-term benefits are observable as well. Moderate impact cardiovascular activities can benefit school-aged children and adolescents by decreasing the risks of [[Diabetes Mellitus Type 2|Type 2 Diabetes]], [[stroke]], heart disease, blood pressure, adiposity levels, anxiety, and [[depression]]<ref name=":0">Janssen I, LeBlanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International journal of behavioral nutrition and physical activity. 2010 Dec;7(1):40.</ref>.  Exercise also helps to increase a child’s self-confidence, strength, physical literacy<ref name=":0" />, cardiovascular fitness, and flexibility.  High-impact activities can increase (or help to maintain) bone density<ref name=":0" />. Furthermore, studies have shown that children who participate in regular physical activity are less likely to use tobacco, alcohol and drugs and are better able to maintain a healthy body weight<ref name=":0" />.
[[Physical Inactivity|Physical inactivity]] has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally<ref name=":1" />. It has a detrimental impact on mental and physical health and is preventable. A sedentary lifestyle and use of excessive television viewing and computer games can also lead to poor sleep quality, which then also has an impact on cognition and memory<ref>Dworak M, Schierl T, Bruns T, Strüder HK. Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics. 2007 Nov 1;120(5):978-85.</ref>.
 
[[Physical Inactivity|Physical inactivity]] has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally<ref name=":1" />. It has a detrimental impact on mental and physical health, and is preventable.
 
A sedentary lifestyle, and use of excessive television viewing and computer games can also lead to poor sleep quality, which then also has an impact on cognition and memory<ref>Dworak M, Schierl T, Bruns T, Strüder HK. Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics. 2007 Nov 1;120(5):978-85.</ref>.


The [https://www.activehealthykids.org/ Active Healthy Kids Global Alliance] has created report cards with respect to physical activity and inactivity.   
The [https://www.activehealthykids.org/ Active Healthy Kids Global Alliance] has created report cards with respect to physical activity and inactivity.   


The average grade in the 38 countries included is only “poor” or “D” grade, however the supports required are a “c” grade globally. Interestingly, countries with lower-income seem to score better grades for activity than higher income countries<ref>Active Healthy Kids Global Alliance. The Global Matrix 3.0 on physical activity for children and youth. https://www.activehealthykids.org/ [accessed 15 Oct 2018]</ref>.  
The average grade in the 38 countries included is only “poor” or “D” grade, however, the supports required are a “c” grade globally. Interestingly, countries with lower-income seem to score better grades for activity than higher-income countries<ref>Active Healthy Kids Global Alliance. The Global Matrix 3.0 on physical activity for children and youth. https://www.activehealthykids.org/ [accessed 15 Oct 2018]</ref>.  


== How Much PA is Recommended? ==
== How Much PA is Recommended? ==
* '''Babies''' should be physically active several times daily – particularly through interactive floor-based play. Limit “container” activities such as standers and jumper type containers.
* '''Babies''' should be physically active several times daily – particularly through interactive floor-based play. Limit “container” activities such as standers and jumper type containers.
* '''Toddlers''' (aged 1–2 years) and '''preschoolers''' (aged 3–4 years) should accumulate at least 180 minutes of physical activity at any intensity spread throughout the day<ref>Tucker P. The physical activity levels of preschool-aged children: A systematic review. Early Childhood Research Quarterly. 2008 Oct 1;23(4):547-58.</ref>, including: A variety of activities in different environments; Activities that develop movement skills; Progression toward at least 60 minutes of energetic play by 5 years of age.
* '''Toddlers''' (aged 1–2 years) and '''preschoolers''' (aged 3–4 years) should accumulate at least 180 minutes of physical activity at any intensity spread throughout the day<ref>Tucker P. The physical activity levels of preschool-aged children: A systematic review. Early Childhood Research Quarterly. 2008 Oct 1;23(4):547-58.</ref>, including:  
** A variety of activities in different environments
** Activities that develop movement skills
** Progression toward at least 60 minutes of energetic play by 5 years of age.
* The American Heart Association recommends that '''all children age 2 and older''' participate in a minimum of 60 minutes of enjoyable moderate-intensity physical activities every day<ref>Pate RR, Davis MG, Robinson TN, Stone EJ, McKenzie TL, Young JC. Promoting physical activity in children and youth: a leadership role for schools: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation. 2006 Sep 12;114(11):1214-24.</ref>.
* The American Heart Association recommends that '''all children age 2 and older''' participate in a minimum of 60 minutes of enjoyable moderate-intensity physical activities every day<ref>Pate RR, Davis MG, Robinson TN, Stone EJ, McKenzie TL, Young JC. Promoting physical activity in children and youth: a leadership role for schools: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation. 2006 Sep 12;114(11):1214-24.</ref>.
* According to the Australian Physical Activity Guidelines, a child '''under 6 years of age''' should not be sedentary, restrained, or kept inactive for more than 60 minutes at a time, with the exception of sleeping<ref>Australian Governement Department of Health. Australia's Physical Activity and Sedentary Behaviour Guidelines<nowiki/>http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines</ref>.
* According to the Australian Physical Activity Guidelines, a child '''under 6 years of age''' should not be sedentary, restrained, or kept inactive for more than 60 minutes at a time, with the exception of sleeping<ref>Australian Governement Department of Health. Australia's Physical Activity and Sedentary Behaviour Guidelines<nowiki/>http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines</ref>.
* The World Health Organization (WHO) recommends that '''children aged 5 and older''' accumulate at least 60 minutes of moderate to vigorous intensity activity daily, with additional benefits for even more time<ref name=":2">World Health Organization. Physical activity and young people<nowiki/>http://www.who.int/dietphysicalactivity/factsheet_young_people/en/ </ref>. Their activities should include bone and muscle strengthening at least 3 times per week<ref name=":2" />.
* The World Health Organization (WHO) recommends that '''children aged 5 and older''' accumulate at least 60 minutes of moderate to vigorous intensity activity daily, with additional benefits for even more time<ref name=":2">World Health Organization. Physical activity and young people<nowiki/>http://www.who.int/dietphysicalactivity/factsheet_young_people/en/ </ref>. Their activities should include bone and muscle strengthening at least 3 times per week<ref name=":2" />.


The UK's Department of Health and Social Care has published the following infographics for babies, toddlers and children, with guidelines and explanations of physical activity in the different age groups:   
The UK's Department of Health and Social Care has published the following infographics for babies, toddlers, and children, with guidelines and explanations of physical activity in the different age groups:   


[[File:Children physical activity infographic.jpg|thumb|Department of Health and Social Care, UK<ref>GOV.UK.Start active, stay active: infographics on physical activity<nowiki/>https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity</ref> |left]][[File:Early Years Physical Activity.jpg|thumb|Department of Health and Social Care, UK <ref>GOV.UK.Start active, stay active: infographics on physical activity<nowiki/>https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity</ref>|center]]
[[File:Children physical activity infographic.jpg|thumb|Department of Health and Social Care, UK<ref>GOV.UK.Start active, stay active: infographics on physical activity<nowiki/>https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity</ref> |left]][[File:Early Years Physical Activity.jpg|thumb|Department of Health and Social Care, UK <ref>GOV.UK.Start active, stay active: infographics on physical activity<nowiki/>https://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity</ref>|center]]
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Musculoskeletal injury and concussions are the biggest risks associated with participating in sport and recreation activities. According to the Canadian Paediatric Society, many of these injuries are preventable. The incidence is higher in boys than it is in girls<ref>Morrongiello BA, Dawber T. Mothers' responses to sons and daughters engaging in injury-risk behaviors on a playground: Implications for sex differences in injury rates. Journal of experimental child psychology. 2000 Jun 30;76(2):89-103.</ref>. Children are more vulnerable to injury than are adults as a result of their physical and physiological differences. In many countries, programs and policies have been implemented to try to reduce the risk of injuries from impact, falls and drownings.
Musculoskeletal injury and concussions are the biggest risks associated with participating in sport and recreation activities. According to the Canadian Paediatric Society, many of these injuries are preventable. The incidence is higher in boys than it is in girls<ref>Morrongiello BA, Dawber T. Mothers' responses to sons and daughters engaging in injury-risk behaviors on a playground: Implications for sex differences in injury rates. Journal of experimental child psychology. 2000 Jun 30;76(2):89-103.</ref>. Children are more vulnerable to injury than are adults as a result of their physical and physiological differences. In many countries, programs and policies have been implemented to try to reduce the risk of injuries from impact, falls and drownings.


Recent research is now showing that children under 12 years of age that participate predominantly in one sport are at greater risk of injury<ref>Dallas M E. Injury risk may rise when kids play just one sport [internet]. HealthDay. 2017. [cited 2/1/18]. Available from: <nowiki>https://consumer.healthday.com/fitness-information-14/sports-medicine-news-634/injury-risk-may-rise-when-kids-play-just-one-sport-720634.html</nowiki></ref>. A child’s physical literacy is also improved if they are engaged in a variety of sports and physical activities. Exposure to abuse, bullying and violence by coaches, peers and parents is a potential risk too<ref>Mountjoy M, Rhind DJ, Tiivas A, Leglise M. Safeguarding the child athlete in sport: a review, a framework and recommendations for the IOC youth athlete development model. Br J Sports Med. 2015 Jul 1;49(13):883-6.</ref>. Children in certain populations or with certain disorders/medical conditions are at higher risk of injury with sport participation. These include children with [[Attention Deficit Disorders|ADHD]] and [[Developmental Coordination Disorder and Physical Activity|DCD]]<ref>Tan B, Carnduff R, McKay C, Kang J, Romiti M, Nasuti G, Hurtubise K, Jarus T, Boyd L, Doyle-Baker P, Wilson B. Risk factors for sport injury in elementary school children: are children with developmental coordination disorder or attention deficit hyperactivity disorder at greater risk of injury?. Br J Sports Med. 2014 Apr 1;48(7):663-4.</ref>.
Recent research is now showing that children under 12 years of age that participate predominantly in one sport are at greater risk of injury<ref>Dallas M E. Injury risk may rise when kids play just one sport [internet]. HealthDay. 2017. [cited 2/1/18]. Available from: <nowiki>https://consumer.healthday.com/fitness-information-14/sports-medicine-news-634/injury-risk-may-rise-when-kids-play-just-one-sport-720634.html</nowiki></ref>. A child’s physical literacy is also improved if they are engaged in a variety of sports and physical activities. Exposure to abuse, bullying. and violence by coaches, peers. and parents is a potential risk too<ref>Mountjoy M, Rhind DJ, Tiivas A, Leglise M. Safeguarding the child athlete in sport: a review, a framework and recommendations for the IOC youth athlete development model. Br J Sports Med. 2015 Jul 1;49(13):883-6.</ref>. Children in certain populations or with certain disorders/medical conditions are at higher risk of injury with sport participation. These include children with [[Attention Deficit Disorders|ADHD]] and [[Developmental Coordination Disorder and Physical Activity|DCD]]<ref>Tan B, Carnduff R, McKay C, Kang J, Romiti M, Nasuti G, Hurtubise K, Jarus T, Boyd L, Doyle-Baker P, Wilson B. Risk factors for sport injury in elementary school children: are children with developmental coordination disorder or attention deficit hyperactivity disorder at greater risk of injury?. Br J Sports Med. 2014 Apr 1;48(7):663-4.</ref>.


{{#ev:youtube|rrqhDiqCPKQ|300}}<ref>PRB:Youth and NCDs Available from: https://www.youtube.com/watch?v=rrqhDiqCPKQ </ref>
{{#ev:youtube|rrqhDiqCPKQ|300}}<ref>PRB:Youth and NCDs Available from: https://www.youtube.com/watch?v=rrqhDiqCPKQ </ref>
== Resources ==
== Resources ==
Ideas & recommendations for increasing PA can be found on the following websites:
Ideas and recommendations for increasing PA can be found on the following websites:
* [https://www.cdc.gov/physicalactivity/basics/adding-pa/activities-children.html Centers for Disease Control and Prevention]
* [https://www.cdc.gov/physicalactivity/basics/adding-pa/activities-children.html Centers for Disease Control and Prevention]
* [http://www.who.int/topics/physical_activity/en/ World Health Organisation]
* [http://www.who.int/topics/physical_activity/en/ World Health Organisation]

Revision as of 03:04, 12 January 2020

Original Editor - Michelle Warren

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Introduction[edit | edit source]

Children playing Tag

It is well understood that physical activity (PA) can provide many health benefits to those who partake, and that physical inactivity can have detrimental outcomes on our health. Questions still abound about what qualifies as suitable physical activity, and how much should each child do? Sometimes we have good intentions, but find barriers.

Definitions[edit | edit source]

  • Physical activity: any bodily movement produced by skeletal muscles that requires energy expenditure.
  • Infant: newborn to 1-year-old child[1]
  • Toddler: 1-2 years old child
  • Preschooler: 3-4 years old child
  • Adolescent: 12-17 years old child
  • Adult: 18+ years old.
  • Physical literacy:  is the mastering of fundamental movement skills and fundamental sport skills that permit a child to read their environment and make appropriate decisions, allowing them to move confidently and with control in a wide range of physical activity situations[2].

Physical Literacy[edit | edit source]

Having increased physical literacy helps us to stay more physically active throughout life. Setting the tone for our children when they are young helps to establish good physical literacy. To be physically literate, you must be able to do the following: dodge, kick, run, jump, hop, log roll, dribble, stand on one foot, sidearm strike, and overhand throw[3].

Benefits of PA[edit | edit source]

Physical activity can provide both immediate and long-term health benefits, physically, mentally and socially. It can also foster independence and help with learning[4].

Some immediate benefits of exercise include:

  • Enhanced mood
  • Aid in self-regulation
  • Reduction of blood sugar levels
  • Feelings of well-being.

Many long-term benefits are observable as well. Moderate impact cardiovascular activities can benefit school-aged children and adolescents by decreasing the risks of Type 2 Diabetes, stroke, heart disease, blood pressure, adiposity levels, anxiety, and depression[5]. Exercise also helps to increase a child’s self-confidence, strength, physical literacy[5], cardiovascular fitness, and flexibility.  High-impact activities can increase (or help to maintain) bone density[5]. Furthermore, studies have shown that children who participate in regular physical activity are less likely to use tobacco, alcohol, and drugs and are better able to maintain a healthy body weight[5].

Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally[1]. It has a detrimental impact on mental and physical health and is preventable. A sedentary lifestyle and use of excessive television viewing and computer games can also lead to poor sleep quality, which then also has an impact on cognition and memory[6].

The Active Healthy Kids Global Alliance has created report cards with respect to physical activity and inactivity.

The average grade in the 38 countries included is only “poor” or “D” grade, however, the supports required are a “c” grade globally. Interestingly, countries with lower-income seem to score better grades for activity than higher-income countries[7].

How Much PA is Recommended?[edit | edit source]

  • Babies should be physically active several times daily – particularly through interactive floor-based play. Limit “container” activities such as standers and jumper type containers.
  • Toddlers (aged 1–2 years) and preschoolers (aged 3–4 years) should accumulate at least 180 minutes of physical activity at any intensity spread throughout the day[8], including:
    • A variety of activities in different environments
    • Activities that develop movement skills
    • Progression toward at least 60 minutes of energetic play by 5 years of age.
  • The American Heart Association recommends that all children age 2 and older participate in a minimum of 60 minutes of enjoyable moderate-intensity physical activities every day[9].
  • According to the Australian Physical Activity Guidelines, a child under 6 years of age should not be sedentary, restrained, or kept inactive for more than 60 minutes at a time, with the exception of sleeping[10].
  • The World Health Organization (WHO) recommends that children aged 5 and older accumulate at least 60 minutes of moderate to vigorous intensity activity daily, with additional benefits for even more time[11]. Their activities should include bone and muscle strengthening at least 3 times per week[11].

The UK's Department of Health and Social Care has published the following infographics for babies, toddlers, and children, with guidelines and explanations of physical activity in the different age groups:

Department of Health and Social Care, UK[12]
Department of Health and Social Care, UK [13]

Risks[edit | edit source]

Musculoskeletal injury and concussions are the biggest risks associated with participating in sport and recreation activities. According to the Canadian Paediatric Society, many of these injuries are preventable. The incidence is higher in boys than it is in girls[14]. Children are more vulnerable to injury than are adults as a result of their physical and physiological differences. In many countries, programs and policies have been implemented to try to reduce the risk of injuries from impact, falls and drownings.

Recent research is now showing that children under 12 years of age that participate predominantly in one sport are at greater risk of injury[15]. A child’s physical literacy is also improved if they are engaged in a variety of sports and physical activities. Exposure to abuse, bullying. and violence by coaches, peers. and parents is a potential risk too[16]. Children in certain populations or with certain disorders/medical conditions are at higher risk of injury with sport participation. These include children with ADHD and DCD[17].

[18]

Resources[edit | edit source]

Ideas and recommendations for increasing PA can be found on the following websites:

References[edit | edit source]

  1. ↑ 1.0 1.1 World Health Organization. Physical activity [internet]. 2017. [cited 2/1/18]. Available from: http://www.who.int/topics/physical_activity/en/
  2. ↑ Pacific Institute for Sport excellence. What is physical literacy? [Internet]. 2017. [cited 2/1/18]. Available from: http://www.pise.ca/physical-literacy/
  3. ↑ Hardy LL, King L, Farrell L, Macniven R, Howlett S. Fundamental movement skills among Australian preschool children. Journal of Science and Medicine in Sport. 2010 Sep 1;13(5):503-8.
  4. ↑ Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr. 2005, 146 (6): 732-737. 10.1016/j.jpeds.2005.01.055.
  5. ↑ 5.0 5.1 5.2 5.3 Janssen I, LeBlanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International journal of behavioral nutrition and physical activity. 2010 Dec;7(1):40.
  6. ↑ Dworak M, Schierl T, Bruns T, Strüder HK. Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics. 2007 Nov 1;120(5):978-85.
  7. ↑ Active Healthy Kids Global Alliance. The Global Matrix 3.0 on physical activity for children and youth. https://www.activehealthykids.org/ [accessed 15 Oct 2018]
  8. ↑ Tucker P. The physical activity levels of preschool-aged children: A systematic review. Early Childhood Research Quarterly. 2008 Oct 1;23(4):547-58.
  9. ↑ Pate RR, Davis MG, Robinson TN, Stone EJ, McKenzie TL, Young JC. Promoting physical activity in children and youth: a leadership role for schools: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation. 2006 Sep 12;114(11):1214-24.
  10. ↑ Australian Governement Department of Health. Australia's Physical Activity and Sedentary Behaviour Guidelineshttp://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines
  11. ↑ 11.0 11.1 World Health Organization. Physical activity and young peoplehttp://www.who.int/dietphysicalactivity/factsheet_young_people/en/
  12. ↑ GOV.UK.Start active, stay active: infographics on physical activityhttps://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity
  13. ↑ GOV.UK.Start active, stay active: infographics on physical activityhttps://www.gov.uk/government/publications/start-active-stay-active-infographics-on-physical-activity
  14. ↑ Morrongiello BA, Dawber T. Mothers' responses to sons and daughters engaging in injury-risk behaviors on a playground: Implications for sex differences in injury rates. Journal of experimental child psychology. 2000 Jun 30;76(2):89-103.
  15. ↑ Dallas M E. Injury risk may rise when kids play just one sport [internet]. HealthDay. 2017. [cited 2/1/18]. Available from: https://consumer.healthday.com/fitness-information-14/sports-medicine-news-634/injury-risk-may-rise-when-kids-play-just-one-sport-720634.html
  16. ↑ Mountjoy M, Rhind DJ, Tiivas A, Leglise M. Safeguarding the child athlete in sport: a review, a framework and recommendations for the IOC youth athlete development model. Br J Sports Med. 2015 Jul 1;49(13):883-6.
  17. ↑ Tan B, Carnduff R, McKay C, Kang J, Romiti M, Nasuti G, Hurtubise K, Jarus T, Boyd L, Doyle-Baker P, Wilson B. Risk factors for sport injury in elementary school children: are children with developmental coordination disorder or attention deficit hyperactivity disorder at greater risk of injury?. Br J Sports Med. 2014 Apr 1;48(7):663-4.
  18. ↑ PRB:Youth and NCDs Available from: https://www.youtube.com/watch?v=rrqhDiqCPKQ
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