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?

Abstract

BackgroundStudies examining risk factors for sport injury in elementary school children are few. The risk of sport injury in special populations including Developmental Coordination Disorder (DCD) and Attention Deficit Hyperactivity Disorder (ADHD) has not been previously examined.ObjectiveTo examine risk factors for sport injury in elementary school students (ages 9–12), including special populations (DCD and ADHD).DesignCross-sectional study.SettingA survey was sent home with students in 26 randomly selected Calgary (Canada) elementary schools.ParticipantsChildren ages 9–12 years (n=540).Risk factor assessmentThe primary risk factors of interest were probable DCD (pDCD) and ADHD. Other risk factors considered included age, sex, ethnicity, highest level of parent education, stressful life events (previous year), receiving coaching in at least 1 sport, and body mass index.Main outcome measurementsInjury definitions included any sport injury in the previous year and sport injury in the previous year requiring medical attention.ResultsBased on univariate Poisson regression (adjusted for exposure hours and cluster) the risk of all sport injury in the previous year in typically developing children did not differ from children with either pDCD (n=150, Incidence Rate Ratio (IRR=1.02 [95% CI 0.7–1.5]) or ADHD (n=87, IRR=0.94 [95% CI 0.58–1.55]). Children with ADHD were at a greater risk of sport injury requiring medical attention compared to those without ADHD (IRR: 1.82 [95% CI 1.23–2.68]). No other risk factors were identified based on univariate analysis.ConclusionsChildren (9–12 years) with pDCD and ADHD were at a similar risk of sport injury in the previous year as typically developing children. Children with ADHD were at an 82% greater risk of sport injury requiring medical attention than children without the disorder. This study will inform the development of injury prevention strategies for future studies in elementary school targeting children with ADHD.

Risk of injuries requiring hospitalization in attention deficit hyperactivity disorder and the preventive effects of medication

“…The covariates included sex, age group (children: 6–11; adolescents: 12–18 years), and urbanization level (urban, suburban, and rural). Other potential comorbidity confounders associated with the risk of injuries requiring hospitalization were defined as follows: oppositional defiant disorder (ODD; ICD‐9‐CM code 313.81), 14 conduct disorder (CD; ICD‐9‐CM code 312.x), 4,14 autism spectrum disorder (ASD; ICD‐9‐CM code 299.x), 20 tic disorder (Tics; ICD‐9‐CM code 307.2x), 21 intellectual disabilities (ID; ICD‐9‐CM codes 317–319), 22 anxiety‐related disorder (Anxiety; ICD‐9‐CM code 300.X except 300.4), 23 depressive related disorder (Depression; ICD‐9‐CM codes 296.2, 296.3, 300.4, and 311), 24 seizure (ICD‐9‐CM code 345), 25 and developmental coordination disorder (DCD; ICD‐9‐CM code 315.4) 26 . We also considered patients with a history of injuries requiring hospitalization (Hx of injury; ICD‐9‐CM code 800‐989) before the index date as having a comorbidity confounder because such hospitalization may influence subsequent injuries requiring hospitalization 27 …”