Associations between physical activity, pain, injuries and joint loading in children, and how these factors may affect recommendations regarding the type of physical activity that children should perform whilst taking environmental and personal barriers into consideration

Abstract

Physical activity recommendations advise children to engage in weight bearing activities to optimise bone health. However, in certain populations, e.g. children with overweight and obesity, weight bearing activities may lead to increased joint loading and consequently, lower limb pain. Cycling, as a non-weight bearing activity, may generate less joint loading and potentially less pain than weight bearing activities. Understanding the interactions between joint loading, pain and activity may help to make recommendations regarding physical activity for children. However, even if cycling is favourable to weight bearing activity in terms of joint loading and pain, other barriers to participation in cycling, such as the environmental and personal factors, may exist. Therefore, the overall goal of this thesis was to investigate associations between physical activity, pain, injuries and, joint loading in children, and how these factors may affect recommendations regarding the type of physical activity that children should perform whilst taking environmental and personal barriers into consideration. The thesis used a multimethod research design with a QUAN → qual combination and a deductive theoretical drive. Findings indicated that there is no evidence that moderate physical activity and vigorous physical activity, respectively, are associated with pain and injuries in children. Findings also indicated that, at similar physiological loads, joint loading is less during cycling than during walking among children, but there is no difference in pain between walking and cycling. Lastly, barriers such as parental concerns regarding safety, limited resources, the environment including traffic and weather, and lack of infrastructure prevent children from using a bicycle to actively commute. Together, these findings provide information to support health professionals when making physical activity recommendations for children. While cycling may be more suitable than weight bearing activities for some children because of reduced joint loading, environmental and personal barriers to cycling should be considered when making recommendations.