The theory behind using soccer as a health intervention for individuals experiencing homelessness was based on a belief that low levels of moderate and high intensity physical activity (or “PA”) may be, in part, related to the extensive health problems plaguing this group. The authors suggest that in addition to the general benefits of increased physical activity, improved neuromuscular coordination and skeletal and postural benefits might help to reduce fall and sudden trauma risks known to occur to homeless people more often.
The researchers captured several measurements of physical health before and after the study time period. They looked for specific markers in the blood of the participants, performed physical exams with postural balance tests, and had each participant undergo a whole-body x-ray scanning technique known as DXA scanning to evaluate bone density and fat-free mass. These evaluations were done for a group of 22 homeless individuals participating in the soccer program and another 10 individuals involved as controls (who had no change in their physical activity during the study period).
Low and behold, in a matter of a few months, it was clear that playing soccer made a pretty big difference in these guys’ bodies. Osteocalcin (indicating new bone formation) shot way up (a 27% increase!). TRACP5b (bone breakdown) and leptin (a hormone tied to appetite and weight control) remained pretty much the same. Postural balance measures were dramatically improved in both legs and bone mineral density in the upper body increased for the soccer participants as well.
Now… this was a small study of course, with a fairly niche sample, so it’s hard to see this as a call for action of street soccer programs across the country. The study only involved men and what’s more, not every man (especially here in America!) would necessarily opt for playing soccer as their choice of activity. The study also doesn’t mention the risk of injuries or the other social and psychological factors involved with introducing a physical exercise regimen to a, largely, physically-inactive population. But it makes you wonder...
Perhaps the most interesting piece of this study is the simple feasibility of a physical activity program in this population. If more of the dots between improved bone density/growth, leg balancing and well-being of people experiencing homelessness can be connected, it leads to a very interesting question about the potential for prevention approaches in the health of the homeless. With Medicaid and other insurers looking for innovative ways to reduce their costs and expand coverage, there may be room for a policy around this kind of programming in the future!
Who’s to say recommending moderate and high intensity physical activity can’t become part of the medical model providers use to work with clients who are experiencing homelessness? Perhaps non-profit programs who are already working with homeless clients could be encouraged or supported to begin putting efforts like this into place.
Ultimately, what this study does say is that there is room to support this kind of intervention on a case-by-case level to perhaps improve the specific problems studied in the report (bone density, balance, maybe even trauma prevention). It may even change the way some people look at this group of individuals in our society.
Written by:
Ben King
Ben King is a research scientist at the Seton Healthcare network in Austin, TX and the President of Methods and Results Consulting, LLC. He is also a doctoral program applicant at the University of Texas Health Science Center at Houston School of Public Health Austin Regional Campus (or UTHSCHSPHARC for short).
[image source: flickr/derekbruff]
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