High-intensity Small-sided Soccer Games for Cardiometabolic Health in Adolescents With Metabolic Dysfunction

High Intensity Training Based on Small-sided Soccer Games for Health: Effects on Cardiometabolic Health, Motor Performance and Adherence to 24-hour Movement Guidelines in Adolescents With Overweight and Metabolic Dysfunction

Pediatric obesity is considered one of the most important public health problems worldwide due to its high prevalence and associated comorbidities. Physical exercise has been shown to have an important role in the treatment of obesity and associated cardiometabolic dysfunction. Small-sided soccer games (SSSG) have been explored as a promising way of increasing physical exercise due to its benefits on cardiometabolic health and high degree of enjoyment, which favors long-term adherence.

The objective of this research is to determine the effects of a 16-week high-intensity SSSG-based exercise intervention on cardiometabolic risk factors, physical fitness, adherence to 24-hour movement patterns, enjoyment and adherence to the intervention in adolescents with metabolic dysfunction and compare them to the effects of a traditional soccer intervention.

The investigators hypothesize that high-intensity SSSG are more effective in improving the obesity-related cardiometabolic risk profile in adolescents with cardiometabolic dysfunction compared to traditional soccer training.

A parallel 3-arm randomized controlled trial will be conducted in adolescents with overweight and metabolic dysfunction between 11 and 15 years of age. The inclusion criteria are: (i) age between 11-15 years at the time of intervention start; (ii) overweight or obesity (BMI> 85th percentile); (iii) Abdominal obesity ≥90th percentile as assessed by waist circumference or a waist-to-height ratio ≥ 0.5; (iv) willing to participate in the study regardless of possible group allocation; (v) informed consent given by participant and legal representatives. Exclusion criteria: (i) health condition not compatible with participation in physical exercise; (ii) history of recent musculoskeletal injury hindering exercise participation; (iii) concurrent participation in a structured weight loss or exercise program.

Those eligible to participate in the study will be randomly assigned to one of three groups: i) SSSG group, ii) traditional soccer play group (TSG), or, iii) non-exercise intervention control group (CG). Participants in both exercise intervention groups will undergo a 16-week intervention. The SSSG group will participate in a high-intensity small-sided soccer games training, while the TSG will undergo a technical and tactical skills training program and traditional soccer training. The CG participants will continue with regular school physical education classes without any additional intervention. Before and after the intervention, all participants will be assessed for cardiometabolic and hepatic biochemical markers, physical fitness, anthropometry and body composition, blood pressure, objective daily physical activity and sleep quality, and perceived enjoyment of participation in SSSG and TSG. The primary outcomes of the study will be waist circumference and cardiorespiratory fitness.

The study protocol was approved by the Ethics Committee of the Faculty of Sport of the University of Porto and by the Scientific Ethics Committee of the Adventist University of Chile.

Study Overview

• Status: Completed
• Conditions: Metabolic Syndrome; Obesity, Adolescent
• Intervention / Treatment: Behavioral: Small-sided soccer games groups (SSSG); Behavioral: Traditional soccer training groups (TSG)

• Study Type: Interventional
• Enrollment (Actual): 51
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Portugal
  • Porto, Portugal, 4200-450
    • Faculty of Sport of the University of Porto

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 11-15 years at the time of intervention start
• Overweight or obesity (BMI> 85th percentile)
• Abdominal obesity ≥90th percentile as assessed by waist circumference or a waist-to- height ratio ≥ 0.5
• Willing to participate in the study regardless of possible group allocation
• Informed consent given by participant and legal representatives

Exclusion Criteria:

• Health condition not compatible with participation in physical exercise
• History of recent musculoskeletal injury hindering exercise participation
• Concurrent participation in a structured weight loss or exercise program

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Small-sided soccer games groups (SSSG); SSSG will perform 16 weeks of training, 3 sessions/week, and ~55 minutes/session. Each session will begin with a 15-minute warm-up, 32 minutes of principal activity, and 5 minutes of cool down. The SSSG will consist of a program based on high-intensity SSSG. The training protocol is based on a pilot study conducted to characterize the exertion profile. The SSSG will be performed in a fractional regimen of 8 sets of 4 minutes and 2 minutes rest. The format of the SSGs will be 3v3, although they can be adapted to 2v2 or 4v4 when necessary. In addition, it will take place in a playing area of 9 x 18 meters equivalent to 27 square meters per player. To encourage high intensity, the following will be used (i) man-to-man marking; (ii) to score a goal, the entire team must be in the opponent's half of the field; (iii) balls will be available to reduce stoppages in play; (iv) the coach will motivate the team to maintain high intensity.	Behavioral: Small-sided soccer games groups (SSSG); Physical exercise intervention
Experimental: Traditional soccer training groups (TSG); SSSG will perform 16 weeks of training, 3 sessions/week, and ~55 minutes/session. Each session will begin with a 15-minute warm-up, 32 minutes of principal activity, and 5 minutes of cool down. The TSG group will base its training on 30 minutes of technical exercises with the ball individually or in pairs (dribbling, shooting and passing), ending with 10 minutes of a match organized according to the original characteristics of an indoor soccer game.	Behavioral: Traditional soccer training groups (TSG); Physical exercise intervention
No Intervention: Control Group (CG); CG will perform only regular school physical education classes without any additional intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Waist circumference	Anthropometric measurement of abdominal obesity; cm	16 weeks
Cardiorespiratory fitness	1-mile walk/run test; minutes to run 1 mile	16 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Variation in fasting blood glucose concentration (mg/dL)	Variation in fasting blood glucose concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in serum insulin concentration (mU/L)	Variation in serum insulin concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in HOMA-IR	Variation in HOMA-IR after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in glycosylated hemoglobin concentration (mg/dL)	Variation in Glycosylated hemoglobin concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in high-density lipoprotein cholesterol concentration (mg/dL)	Variation in High-density lipoprotein cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in low-density lipoprotein cholesterol concentration (mg/dL)	Variation in low-density lipoprotein cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in total cholesterol concentration (mg/dL)	Variation in total cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in blood triglycerides concentration (mg/dL)	Variation in blood triglycerides concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in blood Alanine aminotransferase concentration (U/L)	Variation in blood Alanine aminotransferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in blood Aspartate aminotransferase concentration (U/L)	Variation in blood Aspartate aminotransferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
Variation in blood Gamma glutamyl transferase concentration (U/L)	Variation in blood Gamma glutamyl transferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.	16 weeks
6-minute walk test	Distance covered walking in 6 minutes.	16 weeks
Hand grip strength	Hand grip strength test measured with a digital hand dynamometer	16 weeks
Lower limb strength	Assessed by Horizontal jump test.	16 weeks
Body composition	Assessed by the electrical bioimpedance method	16 weeks
Body mass index	Weight and height will be combined to report BMI in kg/m^2	16 weeks
Neck circumference	Assessed by anthropometric techniques	16 weeks
Blood Pressure (mmHg)	Systolic and diastolic blood pressure measured with digital sphygmomanometer	16 weeks
Physical activity	Physical activity will be assessed objectively with a triaxial accelerometer used 24h/d during 7 consecutive days.	16 weeks
Sleep quality	Sleep quality will be assessed objectively with a triaxial accelerometer used 24h/d during 7 consecutive days.	16 weeks
Perceived enjoyment of physical activity	Assessed by the Physical Activity Enjoyment Scale questionnaire (PACES). Raw scores are transformed into a scale from 16 to 80. Higher scores correspond to higher perceived enjoyment.	16 weeks

Collaborators and Investigators

• Sponsor: Universidade do Porto

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2023
• Primary Completion (Actual): April 10, 2023
• Study Completion (Actual): September 1, 2023

Study Registration Dates

• First Submitted: April 1, 2024
• First Submitted That Met QC Criteria: April 17, 2024
• First Posted (Actual): April 22, 2024

Study Record Updates

• Last Update Posted (Actual): April 22, 2024
• Last Update Submitted That Met QC Criteria: April 17, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Overnutrition; Nutrition Disorders; Overweight; Body Weight; Insulin Resistance; Hyperinsulinism; Obesity; Metabolic Syndrome; Pediatric Obesity
• Other Study ID Numbers: University of the Porto

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No