Peer-reviewed article
Handball participation and bone mineral accrual during growth: A 1-year longitudinal controlled study in young male athletes.
Missawi K, Gasmi M, Muscella A, Aslan TV, Eken Ö et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study examined bone mineral density in 72 male children aged 10-12 years, comparing those who played handball regularly with age-matched controls over one year. Handball players showed greater bone mineral density at multiple skeletal sites, particularly the lumbar spine. The study used dual-energy X-ray absorptiometry to measure bone outcomes and found associations between increases in lean mass and bone mineral gains. While the research is methodologically sound, it addresses physical development outcomes rather than child well-being in the sense of health, survival, protection, or participation outcomes.
Key points
- Handball players had significantly greater adjusted bone mineral density at follow-up compared to controls, with largest effect at lumbar spine (difference = 0.034 g/cm²)
- Higher bone mineral content was observed in handball players at lumbar spine, total hip, lower limbs, and radial regions
- Increases in lean mass were positively associated with bone mineral density gains at whole body, hip, and femoral neck sites
- Study followed 72 healthy male children aged 10-12 years over one year using a non-randomized longitudinal design
- Findings suggest multidirectional sports like handball provide beneficial mechanical stimuli for skeletal mineral accrual during growth
Limitations
The study was non-randomized and cannot establish causation, only association. The sample was limited to healthy male children in one age group, so findings may not generalize to girls, younger children, or those with existing health conditions.
Abstract
Multidirectional sports such as handball may provide beneficial mechanical stimuli, but longitudinal evidence in male children remains limited. This study examined one-year differences in bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) between male children engaged in regular handball practice and age-matched controls. This non-randomized longitudinal study included 72 healthy male children aged 10-12 years: handball group (HG, n = 36) and control group (CG, n = 36). Whole-body and regional bone outcomes were assessed using dual-energy X-ray absorptiometry. Between-group differences at follow-up were evaluated using ANCOVA, while longitudinal changes were examined using linear mixed-effects models. Handball players exhibited greater adjusted BMD at follow-up than controls, with the largest effect at the lumbar spine (adjusted mean difference = 0.034 g/cm2; 95% CI: 0.012-0.056; η2p = 0.14). Higher BMD was also observed at the whole body, total hip, lower limbs, femoral neck, and selected upper-limb sites. Adjusted BMC was greater at the lumbar spine, total hip, lower limbs, and selected radial regions. Increases in lean mass were positively associated with BMD gains at the whole body, hip, and femoral neck, whereas associations with BMC were more localized and those with BA were limited. These findings suggest that handball participation is associated with greater skeletal mineral accrual during growth.