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Injury prevention in youth : What is learned in the cradle is carried in the tomb ?
Evert VERHAGEN
Friday, Sept. 22, 2017 · 1:46 p.m. · 24m 33s
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thank you boss i'm thank you very much for for inviting me over this was
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a really interesting program to see even before i said yes i'm coming
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i'm not only because there's a beautiful lake outside which makes for good strolls
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um most importantly because my fiance said well this is about youth
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and she obviously things i'm a bit childish at times or she said
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is finally a conference that is about your so that's good
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their act explain well it's it's not really about me and so i defined what uses and and maybe
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i can take you through the process as well so you know what i'm talking about here um
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well we have adults we have we have children we have adolescence
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but where this you've in my opinion actually and comes in
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if you if you google what we'll do you find different got of points but
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i i feel these kind of set the town because between soon to you you can talk about
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in friends then you talk about topless then you start to talk about children and youngsters
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but there's a difference in there too because before the age of
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six physical activity uh maybe bit sports too is about development
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not so much about sports yet to really be p. c. sports as it's being
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seen on t. v. it's more about the fellow p. model performance motor
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skills after the age of twelve you start to participate in sports
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so in between it's more but play playful thanks so you've developed your skills now
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you practised seen the skills in a sports like environment and then later on
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you participate in sports when i talk about use i thought talk about these
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this age group from six to twelve years old that are about play
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and that's really important to make that distinction because at the younger ages use ages
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is a lot of copying going on as a lot of education going
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no no not being held responsible yet for directions on the field but this is the
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age where we can learn what responsibility is and what they need to do
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and not only responsibility in regards to what the place but also responsibility in regards their own health and warm up
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and and and injury prevention because if they grow older and they get into the sports like participation
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they need to have all the skills to make that a safe and healthy infant as possible
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and we're not only preventing what is happening later does that
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data from children from six to twelve years old
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and what you can see here is their overall these children still
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have like a point five injury but thousand hours of participation
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if you compare that to regular sports at all they just of course it's less but it's still relatively high
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and this is overall that's physical education classes leisure time physical activity so
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this is playing outside like going with your bike and above all
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or participating in sports sports has the highest risk also in this age group but this is the most time gets spent
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the time code in absolute numbers leisure time physical activity has
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the most number of injuries but the lowest risk fortunately
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this is another survey i found online and you can check that website is beautifully information
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we'll why every twenty five seconds a young athletes visit
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is hospital emergency room with sports related injury does
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only the sports related injuries not the others so this is a high prevalence of injuries here
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so we need to do something about it so why do we need to do something about it we say exercises madison
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we say that you participate in sports as well as exercise do you do with physical activity
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that's good for your health but if i prescribe appeal to someone
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and one out of a thousand chance you get a headache
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from that bill i need to write that on the bottom of the package that there's a chance you get a headache
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when we talk about physical activity we never talk about the adverse effects
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i mean we publish this editorial really simply trying to put this for
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that was a lot of critique from the physical activity promotions side
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they said are your contract you come to our during our facts you saying that what we're doing in physical activity we switch
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is wrong and and you're the one that's wrong because now because you set as adverse effects less children will or
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less participants will participate in physical activity well i think
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it's the other way around by neglecting these risks
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we're doing now because
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how do you make it takes puerto trying to not look at batteries effects
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seventy percent of children leave organised sports by the age of thirty
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because of injury mostly because of injury concert is marketing
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and this was a really nice quote if seventy percent of wal marts customers walked out of a store
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and said this is not for me i am not coming back walmart will do something about that
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seventy percent of our children leaving this leaving sports by the age of thirteen we're
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not doing much about that especially that from the risk partly just neglected
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so there's there's a lot of ground to cover and there's mostly ground
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to cover because the kids are at highest risk of injury
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are the ones that need physical activity the most those are the ones we're targeting the physical activity program
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what you see here is data from a prospective go again the sixty twelve euros
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and what we did is this is how the show physical activity levels but then import that
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so these are the least physically active gets these are the second level things collected
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gets these are the most this the actors gets an easy target of ports
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an interesting what we see is that the new guidelines in holland just came out children need
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to be one hour physically active per day for at least five days a week
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moderate to figures whose collective it this exactly this kind of point between quite
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are one import out to see this is less than five oh
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now if you take injury risk so the number of injuries but thousand hours of play
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or support these kits the lowest physical activity levels have the highest risk
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and these are just the incidences compared to each other but if you put
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that in a in a statistical model you can see how much
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those hasn't rituals kind of increase so the risque here is already
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five times as high level as compared to that uh control
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so there is something going on these lease physically active gets they
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have something at the moment they become physically active something
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gets them injured for some reason we think it's mulder face unless we looked at that and i'm sorry for this
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blurry picture trying to change it but i forgot to save my file
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before lunch because it was so hungry probably sorry for the um
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you can check you can check the paper that let me explain this is data
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from nineteen eighty we dated euro fit test in seven hundred children in
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the middle one hundred percent we put the ninety i eighty data
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and this is like the standing high job it's gotta be better in two thousand and six
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so they got about a hundred and eighty percent as opposed to nineteen eighty but for the others they got words
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bent arm hang a shot to run test um stand um system
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which test hand hand a force they all got worse
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and they got worse even despite we corrected for uh the in line and
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physical activity levels so they something going on here mulder fitness set
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so just to go build on it is important to to prevent injuries
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in sports especially use boards because they are reason for drop out
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so it should not only be a be a goal for
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us as researchers but also for clinicians hand policymakers and
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this problem is bigger than just a sprained ankle or a torn a. c. l. or a sore shoulder
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i'm also because more children nowadays are undertaking multiple sports at early ages and more intense training
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it is kind of common sense to prevent injuries in you it is not
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an invisible spray we can't just put it under the carpet we
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need to do something about it but most of these injuries uh most
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of these measures to be honest are not really well studied
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the true facts in this specific population children are not
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miniature adults children a completely different they played
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play differently they have different risk factors they have different fees eek they are drawing the learning
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so all these measures that have not been studied it's too good extent in this population in
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the younger population we we can only guess that they will work but they did
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what makes common sense that if you protect yourself you prevent
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injury and if there's supervision of competitive sports that
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if the good supervision is good that the risk will be minimise to managed
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what is one binding factor in all that especially in these younger ages that is responsibility because
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can we hold the six to twelve year old children accountable for their own actions
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if they don't do vocal warm up or if they don't wear the helmet when they go out is it their fault
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or is it our for the supervises but they do that i would say it's our fault because
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we need to educate them and we need to teach them and also for the motor control
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and so what can we do then if we think about behaviour we can have proper qualification of coaches and trainers
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especially at the grass roots level if you stand beside the field in holland that
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is i don't know how that is in switzerland or in other countries
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if my if i put my kid in a in a a soccer team
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i have to do once or twice a month be to coach
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because they can't get proper coaches and it's not because i'm a good
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go genevieve at college but the the the parents need to
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be there at the top and they don't have any any documentation
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or they they they don't have any education to do that
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so qualification coaches and trainers specially tuned to this target group is is really important
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because they can enhance complies with safety rules and they know
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how to properly training guide to chill which out within
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the specific sports so mote performance goes up as well we need to improve adult knowledge about game rules
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and also like concussion guidelines it's it's it's would be shopping for you to know how many
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fans of this i think i'd be beside the the page should don't know what's going on manic it comes off with pain
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is this big round to cover and we also need to avoid excessive pressures
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from parents and it was a nice talk about that yesterday on psychology
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in the last one we would hope that would be amazing but i don't think it's gonna happen supervision of all competitive sports
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but these are some goals that we can uh put in our in our policies
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and all we want to do is teach proper percent different player behaviour to younger ages
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we did a study and this one i play starting in schools and what we thought is well
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there was a there was a big increase in number of injuries in sixteen year
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old at least sixteen year old athletes so we thought let's go to schools
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because then we get all the athletes all the all the kids if we go to sports club you only get tolls did a member of
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the sports go but is goals we can get them on the hashish
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you get physical education classes schools would be a great great reach
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and then we went to the physical education teachers in said okay you have a problem
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how can we solve that and they said no we don't have a problem
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these injuries that they are experience right now is not our full when we get them at
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the age of twelve they come from primary school to secondary school the first four years
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we need to teach them proper motor skills we need to teach them how to charm we need
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to teach them how to throw and catch a ball because at younger ages it's cool
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two hours of physical education they had is only one hour a week now uh now it ends
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with out of true physical education teacher um usually it's the normal teacher was happy
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to get some going for an hour so she can take a breath
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and then monday at the age of twelve they go to secondary school where they are supposed
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to do in sports but they don't even have the skills yet to play sports
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so that made us think like okay if we wanna intervene in the sixteen year old kids maybe we should go before
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so we did this study in primary schools so we went to primary schools
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are we developed this program about behaviour about skills education of children also malta control
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so we had a kind of a warmer programming the physical education classes where where
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wasn't really warm up but we taught them these little skills they could you see me educated also
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parents and the teachers on how to incorporate it's yeah it comes pretty good to be owns
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is the overall reduction of injuries thirty percent of the injuries we did in sixty
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each week six to twelve year old kids and he you see the
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same rate we saw before in in my my first graph point five so
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this control group was that perspective control code and use your production
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in intervention simply by teaching children how to move how to behave in
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teaching parents how to deal with that on the sports page
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it's quite good option for doing not much to be on so there's there's so much more to gain so much more possible
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so we thought let's incorporate that because if these children who are least physically active
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have the highest risk of injury maybe we should also increase physical activity levels
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with some luck with increased physical activity levels they get more active they
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get better skills they have less injury so let's see what happens
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and then we looked at the primary schools and this is a normal primary school playground
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it's busy gets don't have any movement all the kids out there the same time
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the six year olds the ten year olds the twelve year old if
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there's a socket bitch the twelve year olds will take that under the six
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year olds don't have a chance to play soccer that fifteen minutes
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so we thought let's change that so there was a student you can buy said okay uh i
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wanna i wanna give more power to the physical education teachers so maybe this is a chance
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and what we did we incorporated really simply in physical education classes which was
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that one hour of breath what of for the teacher we incorporated
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exercise is that in increased motor skills but we also contact gets old games
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you remembered is going with the cone and the football and you have teens and and the thing is that the trick is to
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with the ball kick the cone of your opponent but you also need to defend your uncle they didn't play this anymore
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so we taught them these little games of rogue broke skipping games and then all we did was to
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provide the materials of the games we taught them in if in the classes at the playground
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and what you see without any further intervention gets take up these materials and they
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start to play the games that you teach them doing physical education class
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and they have twice a break of fifteen minutes a day and doing these breaks gets got
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more active it's only thirty minutes a day of physical activity that you give to chow
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it's half the physical activity they need during the day simply by teaching them again then in full small the skills
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simple as can be
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you think implementation is a different story though but it works
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and then i was function was if they get more active maybe they get better motor control as well what they did
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so we get the same euro fit test here locally this one this slide is better
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but he you see that almost normal outcomes there's an improvement to be
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seen so play tapping when fast the screen thing was faster
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the bent on anger get longer sit and reach the you were better
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this is the only one that didn't change got stronger hand group and they got improved in the
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short run test not all of them are significantly improved but by simply doing physical activity
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finding his activity motor performance increased in general
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so no implementation you go to school you tell the schools okay
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we have this perfect program it will increase physical activity levels
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it will provide you with a program to to do in physical education classes
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you would be dues you injurious can in the children will will have joy in in
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physical activity sports which is important and then schools and now we are about education
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we're not about sports were not about physical activity if you wanna increase help of the nation don't come to us
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so then we we we asked him so what do you want so what what do we need
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to show you to make this interesting for your d. set
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will show was that is improved big it's educational capacities
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so we do it because we don't know physical activities good for for
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your brain as well so we really simply we took a selective attention
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tests yeah actually involved u. f. o.'s not cats and dogs but
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what what the kids had to do to have to find paris within a limited amount of time
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so they get a sheet they they will over the sheet and as spans of u. f. o.'s on
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that shit and i need to as quickly as possible find appears together and we time that
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and we did this in a controlled starting so we gave gets no break and we did
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three test and the post test so this is the mean amount of time it takes them to find one pair of spatial
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so if you don't give gets a break this is like the control condition there's no difference
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so they do just as well
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and if you give them a passive break so you you do
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not make them work but the teacher tells a story
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no improvement not much a bit so gets kind of reset the brain probably
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this is moderate to vigorous activity we control this all that it's got a heart rate monitor and we had
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a fitness instructor in front of the gates for fifteen minutes doing
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moderate to vigorous physical activity involving place so the same
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things we taught them during during the uh physical education classes
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easy you know almost a second improvement in finding paris
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and this was figures activity really let them run and and get tired
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so these are the ones we actually this is the type of activity we're actually trying to improve we did improve
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that actually also improves selective attention a lot and now schools were hooked
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because we provide the full out physical education program that hold the teacher to to
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organise that one hour they have gets get more active doing uh the brakes
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gets have better model performance so they perform also betting
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physical education classes by which they have less injuries
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plus after such a break they get back into class and they pay better attention to what the teachers saying
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all by one intervention
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so much magic would say
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so this is what we did your problems in school administered to fisk education class it promotes physical activity
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it increases motor control it increases academic performance and it decreases changes
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so it all ties together and this is where we can learn teach
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children educate children the skills they need when they go on
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but when they go on the going sports and also i'm inside
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a a school they they are in sports and my oh
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the next speaker will tell you something about the fifth eleven plus problems what did those lights out
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we did something similar in hockey youth feel talking big sport in the netherlands we're better in this than in zagreb
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and fortunately i i'm one minute left good
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we developed a warm up program and it won't program was again teaching
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the parent to standing next to the bitch on how to safely
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uh uh start the training schedule a training program or a match
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and these were warm up exercises that involved playful scales
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then involved motor skills but also all we're not really about injury prevention
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yet they were more about teaching children that warm up is normal
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so these are again six to twelve year old kids when they get more
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than than that many gold and they participate in sports and then
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you introduce it really injury prevention program for them it's normal to do
00:21:34
these exercises that is what was this what this was about
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and we just finished data collection like four weeks ago so we don't have the full analysis at yet
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but he you can see the intervention group visit the control is the number of injuries to wanna ninety one children
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forty two any intervention group sixty three in the control group and we still need to do the analysis like i said
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but this is already showing promising by doing something simple as that and these days of time or should see lester
00:22:07
so i think on the right track a and the good thing about such an approach
00:22:11
is the compliance and reach your get this is train is compliance to the intervention
00:22:17
almost on the present the problem with hockey dozing winter they go inside so they have less
00:22:23
um opportunities to really do all the exercises in that because they involve the playing field
00:22:28
one of our mistakes in this intervention but nearly hundred percent
00:22:32
and the translate to a really good exposure to places
00:22:36
well not all play shopper training so this is the mean exposure of planes to warm up of the season
00:22:42
so not only to be decreased injuries we also had a good exposure with
00:22:46
with this program this program was initiated by d. v. hockey association
00:22:51
i think that is what what brought us where we are because the hockey
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association was going to full weight in it and this was mandatory
00:22:59
for the coaches to follow as well because it was part of their accreditation system so maybe that is the way to do it
00:23:08
we're not there yet so this is like a normal pyramid of of you know of of studies
00:23:16
you do a lot of general epidemiology a bit of a geology
00:23:19
and there's a less effects that it's it's it's almost similar
00:23:23
to to to draw off that uh um we saw in the in the previous session by going that's us and
00:23:30
there's not much in youth and what we should not do is extrapolate
00:23:35
results model studies to younger population because children are not adults so
00:23:39
does a lot of ground to cover for as research here um but i think we're finding a way as as we go along
00:23:47
so we short what is learned a great was carried in the tomb i think we can teach young children motor
00:23:54
skills how important safety is and how important it is
00:23:59
for them to do these exercising comply to programs
00:24:03
because if we increase mote control use they will benefit later from that
00:24:07
if we make injury prevention normal brecht us they take a prevention easier when they
00:24:12
moved to real sports and if we can guide their parents in keeping
00:24:17
sports saving found not only to chill the children will benefit from that but
00:24:21
also the parents themselves they will have more joy to thank you
00:24:26
hi
Conference Program
Opening address
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Resistance training during long-term athlete development
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The development of aerobic power in young athletes
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Combine sport and studies, are the schools doing enough ?
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COACHING, PARENTING AND DEVELOPMENT - Q&A
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Sept. 21, 2017 · 6:28 p.m.
DÉBAT PUBLIC (IN FRENCH) : Children and competitive sport, for the best or the worst ?
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THE COMPLEX MEDICAL PROBLEMS - Q&A
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Injury prevention in youth : What is learned in the cradle is carried in the tomb ?
Evert VERHAGEN
Sept. 22, 2017 · 1:46 p.m.
176 views
Injury prevention programs : The 11+ Kids Project
Mario BIZZINI
Sept. 22, 2017 · 2:12 p.m.
185 views
Sports specialized training: what are the true effects and is it really all bad ?
Neeru JAYANTHI
Sept. 22, 2017 · 2:29 p.m.
141 views
What is “load” and how does it impact athletes’s risk of injury ?
Torbjorn SOLIGARD
Sept. 22, 2017 · 2:49 p.m.
344 views
Instituting a unique public health approach to ACL injury risk management
Joseph Janoski
Sept. 22, 2017 · 3:47 p.m.
Instituting a unique public health approach to ACL injury risk management - Q&A
Joseph Janoski
Sept. 22, 2017 · 3:54 p.m.
Parents’ Knowledge of Sport Psychology and Nutrition
Dr Camilla J. Knight
Sept. 22, 2017 · 3:57 p.m.
152 views
Injuries and injury risk factors in youth alpine ski racing: A two-season prospective study
Lisa, Müller
Sept. 22, 2017 · 4:09 p.m.
FREE COMMUNICATION AND BEST ABSTRACT PRESENTATION - Q&A
Panel
Sept. 22, 2017 · 4:21 p.m.
610 views
Closing Address
Frederic Koehn, President Young Athletes Forum Foundation
Sept. 22, 2017 · 6:04 p.m.
140 views