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Geometry and bone mineral density determinants of femoral neck strength changes following exercise. Biomech Model Mechanobiol 2023; 22:207-216. [PMID: 36271264 PMCID: PMC9958140 DOI: 10.1007/s10237-022-01642-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/20/2022] [Indexed: 11/02/2022]
Abstract
Physical exercise induces spatially heterogeneous adaptation in bone. However, it remains unclear where the changes in BMD and geometry have the greatest impact on femoral neck strength. The aim of this study was to determine the principal BMD-and-geometry changes induced by exercise that have the greatest effect on femoral neck strength. Pre- and post-exercise 3D-DXA images of the proximal femur were collected of male participants from the LIFTMOR-M exercise intervention trial. Meshes with element-by-element correspondence were generated by morphing a template mesh to each bone to calculate changes in BMD and geometry. Finite element (FE) models predicted femoral neck strength changes under single-leg stance and sideways fall load. Partial least squares regression (PLSR) models were developed with BMD-only, geometry-only, and BMD-and-geometry changes to determine the principal modes that explained the greatest variation in neck strength changes. The PLSR models explained over 90% of the strength variation with 3 PLS components using BMD-only (R2 > 0.92, RMSE < 0.06 N) and 8 PLS components with geometry-only (R2 > 0.93, RMSE < 0.06 N). Changes in the superior neck and distal cortex were most important during single-leg stance while the superior neck, medial head, and lateral trochanter were most important during a sideways fall. Local changes in femoral neck and head geometry could differentiate the exercise groups from the control group. Exercise interventions may target BMD changes in the superior neck, inferior neck, and greater trochanter for improved femoral neck strength in single-leg stance and sideways fall.
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Abe S, Kouhia R, Nikander R, Narra N, Hyttinen J, Sievänen H. Effect of fall direction on the lower hip fracture risk in athletes with different loading histories: A finite element modeling study in multiple sideways fall configurations. Bone 2022; 158:116351. [PMID: 35131487 DOI: 10.1016/j.bone.2022.116351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
Physical loading makes bones stronger through structural adaptation. Finding effective modes of exercise to improve proximal femur strength has the potential to decrease hip fracture risk. Previous proximal femur finite element (FE) modeling studies have indicated that the loading history comprising impact exercises is associated with substantially higher fracture load. However, those results were limited only to one specified fall direction. It remains thus unclear whether exercise-induced higher fracture load depends on the fall direction. To address this, using magnetic resonance images of proximal femora from 91 female athletes (mean age 24.7 years with >8 years competitive career) and their 20 non-athletic but physically active controls (mean age 23.7 years), proximal femur FE models were created in 12 different sideways fall configurations. The athletes were divided into five groups by typical loading patterns of their sports: high-impact (H-I: 9 triple- and 10 high-jumpers), odd-impact (O-I: 9 soccer and 10 squash players), high-magnitude (H-M: 17 powerlifters), repetitive-impact (R-I: 18 endurance runners), and repetitive non-impact (R-NI: 18 swimmers). Compared to the controls, the FE models showed that the H-I and R-I groups had significantly (p < 0.05) higher fracture loads, 11-17% and 22-28% respectively, in all fall directions while the O-I group had significantly 10-11% higher fracture loads in four fall directions. The H-M and R-NI groups did not show significant benefit in any direction. Also, the analyses of the minimum fall strength (MFS) among these multiple fall configurations confirmed significantly 15%, 11%, and 14% higher MFSs in these impact groups, respectively, compared to the controls. These results suggest that the lower hip fracture risk indicated by higher fracture loads in athletes engaged in high impact or repetitive impact sports is independent of fall direction whereas the lower fracture risk attributed to odd-impact exercise is more modest and specific to the fall direction. Moreover, in concordance with the literature, the present study also confirmed that the fracture risk increases if the impact is imposed on the more posterolateral aspect of the hip. The present results highlight the importance of engaging in the impact exercises to prevent hip fractures and call for retrospective studies to investigate whether specific impact exercise history in adolescence and young adulthood is also associated with lower incidence of hip fractures in later life.
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Affiliation(s)
- Shinya Abe
- Structural Mechanics, Faculty of Built Environment, Tampere University, Tampere, Finland.
| | - Reijo Kouhia
- Structural Mechanics, Faculty of Built Environment, Tampere University, Tampere, Finland
| | - Riku Nikander
- Gerontology Research Center, Faculty of Sports Sciences, University of Jyväskylä, Jyväskylä, Finland; Central Hospital of Central Finland, Jyväskylä, Finland
| | - Nathaniel Narra
- BioMediTech Unit, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Hyttinen
- BioMediTech Unit, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
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Stattin K, Höijer J, Hållmarker U, Baron JA, Larsson SC, Wolk A, Michaëlsson K, Byberg L. Fracture risk across a wide range of physical activity levels, from sedentary individuals to elite athletes. Bone 2021; 153:116128. [PMID: 34302997 DOI: 10.1016/j.bone.2021.116128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine how physical activity is associated with risk of different fracture outcomes across the full range of physical activity. METHODS By combining information from three cohort studies and using generalized structural equation modelling, we estimated a continuous unitless latent variable reflecting physical activity that ranged from sedentary through elite athlete levels. Associations between physical activity and fracture outcomes were assessed with proportional hazards regression using restricted cubic splines with the mean physical activity (corresponding to 20-40 min walking or bicycling/day or 2-3 h exercise/week) as reference. RESULTS Among 63,980 men and women (49-68 years) and during 13 years of follow-up, 8506 fractures occurred, including 2164 distal forearm, 779 proximal humerus, 346 clinical spine, and 908 hip fractures. Both lower and higher physical activity was associated with higher risk of any fracture compared to the mean. Physical activity at 1 standard deviation (SD) below the mean, corresponding to walking/bicycling <20 min/day or exercising <1-1 h/week, was associated with a lower risk of distal forearm fracture (hazard ratio [HR]: 0.92, 95% confidence interval [CI]: 0.85-0.99) and higher risk of hip fracture (HR: 1.24, 95% CI: 1.13-1.37), but no associations were seen above the mean physical activity level for these fractures. Physical activity was not associated with proximal humerus fracture but had a possible U-shaped association with clinical spine fracture. CONCLUSION Physical activity was non-linearly associated with fracture risk and the association differed across fracture sites. Up to 2-3 h weekly exercise is beneficial for the prevention of hip fracture but may increase the risk of distal forearm fracture.
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Affiliation(s)
- Karl Stattin
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Jonas Höijer
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Ulf Hållmarker
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Internal Medicine, Mora Lasarett, Mora, Sweden
| | - John A Baron
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Susanna C Larsson
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Alicja Wolk
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden; Unit of Cardiovascular and Nutritional Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden.
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Fuchs RK, Carballido-Gamio J, Keyak JH, Kersh ME, Warden SJ. Physical activity induced adaptation can increase proximal femur strength under loading from a fall onto the greater trochanter. Bone 2021; 152:116090. [PMID: 34175500 PMCID: PMC8316435 DOI: 10.1016/j.bone.2021.116090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
Physical activity enhances proximal femur bone mass, but it remains unclear whether the benefits translate into an enhanced ability to resist fracture related loading. We recently used baseball pitchers as a within-subject controlled model to demonstrate physical activity induced proximal femur adaptation in regions associated with weight bearing and increased strength under single-leg stance loading. However, there was no measurable benefit to resisting common injurious loading (e.g. a fall onto the greater trochanter). A lack of power and a small physical activity effect size may have contributed to the latter null finding. Softball pitchers represent an alternative within-subject controlled model to explore adaptation of the proximal femur to physical activity, exhibiting greater dominant-to-nondominant (D-to-ND) leg differences than baseball pitchers. The current study used quantitative computed tomography, statistical parametric mapping, and subject-specific finite element (FE) modeling to explore adaptation of the proximal femur to physical activity in female softball pitchers (n = 25). Female cross-country runners (n = 15) were included as symmetrically loaded controls, showing very limited D-to-ND leg differences. Softball pitchers had D-to-ND leg differences in proximal femur, femoral neck, and trochanteric volumetric bone mineral density and content, and femoral neck volume. Voxel-based morphometry analyses and cortical bone mapping showed D-to-ND leg differences within a large region connecting the superior femoral head, inferior femoral neck and medial intertrochanteric region, and within the greater trochanter. FE modeling revealed pitchers had 19.4% (95%CI, 15.0 to 23.9%) and 4.9% (95%CI, 1.7 to 8.2%) D-to-ND leg differences in predicted ultimate strength under single-leg stance loading and a fall onto the greater trochanter, respectively. These data affirm the spatial and strength adaptation of the proximal femur to weight bearing directed loading and demonstrate that the changes can also have benefits, albeit smaller, on resisting loads associated with a sideways fall onto the greater trochanter.
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Affiliation(s)
- Robyn K Fuchs
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America.
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
| | - Joyce H Keyak
- Department of Radiological Sciences, University of California, Irvine, Irvine, CA, United States of America; Department of Mechanical and Aerospace Engineering, University of California, Irvine, Irvine, CA, United States of America; Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States of America.
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, United States of America.
| | - Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States of America; Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, United States of America; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
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Vehmanen L, Sievänen H, Kellokumpu-Lehtinen P, Nikander R, Huovinen R, Ruohola J, Penttinen HM, Utriainen M, Tokola K, Blomqvist C, Saarto T. Five-year follow-up results of aerobic and impact training on bone mineral density in early breast cancer patients. Osteoporos Int 2021; 32:473-482. [PMID: 32886189 PMCID: PMC7929955 DOI: 10.1007/s00198-020-05611-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
UNLABELLED A 12-month exercise program reversibly prevented hip bone loss in premenopausal women with early breast cancer. The bone-protective effect was maintained for 2 years after the end of the program but was lost thereafter. PURPOSE Breast cancer survivors are at an increased risk for osteoporosis and fracture. This 5-year follow-up of a randomized impact exercise intervention trial evaluated the maintenance of training effects on bone among breast cancer patients. METHODS Five hundred seventy-three early breast cancer patients aged 35-68 years and treated with adjuvant therapy were allocated into a 12-month exercise program or a control group. Four hundred forty-four patients (77%) were included in the 5-year analysis. The exercise intervention comprised weekly supervised step aerobics, circuit exercises, and home training. Areal bone mineral density (aBMD) was measured by dual-energy X-ray absorptiometry. Physical activity was estimated in metabolic equivalent (MET) hours per week and physical performance assessed by 2-km walking and figure-8 running tests. RESULTS In premenopausal patients, the 12-month exercise program maintained femoral neck (FN) and total hip (TH) aBMD for 3 years, but the protective effect was lost thereafter. The mean FN aBMD change in the exercise and control groups was - 0.2% and - 1.5% 1 year, - 1.1% and - 2.1% 3 years and - 3.3% versus - 2.4% 5 years after the beginning of the intervention, respectively. Lumbar spine (LS) bone loss was not prevented in premenopausal women and no training effects on aBMD were seen in postmenopausal women. The main confounding element of the study was the unexpected rise in physical activity among patients in the control group. The physical performance improved among premenopausal women in the exercise group compared with the controls. CONCLUSION The 12-month exercise program prevented FN and TH bone loss in premenopausal breast cancer patients for 3 years. The bone-protective effect was reversible and lost thereafter.
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Affiliation(s)
- L Vehmanen
- Department of Oncology, Helsinki University Central Hospital, Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland.
| | - H Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - P Kellokumpu-Lehtinen
- Department of Oncology, Faculty of Medicine, Tampere University Central Hospital, University of Tampere, Tampere, Finland
| | - R Nikander
- Department of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - R Huovinen
- Department of Oncology, Turku University Central Hospital, Turku, Finland
| | - J Ruohola
- Department of Oncology, Turku University Central Hospital, Turku, Finland
| | | | - M Utriainen
- Department of Oncology, Helsinki University Central Hospital, Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
| | - K Tokola
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - C Blomqvist
- Department of Oncology, Helsinki University Central Hospital, Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - T Saarto
- Department of Oncology, Helsinki University Central Hospital, Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
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Jeon W, Harrison JM, Stanforth PR, Griffin L. Bone Mineral Density Differences Across Female Olympic Lifters, Power Lifters, and Soccer Players. J Strength Cond Res 2021; 35:638-643. [PMID: 33587547 DOI: 10.1519/jsc.0000000000003944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Jeon, W, Harrison, JM, Stanforth, PR, and Griffin, L. Bone mineral density differences across female Olympic lifters, power lifters, and soccer players. J Strength Cond Res 35(3): 638-643, 2021-Athletic training improves bone mineral density (BMD) through repeated mechanical loading. The location, intensity, and direction of applied mechanical pressure play an important role in determining BMD, making some sports more advantageous at improving BMD at specific regions. Thirty-seven (10 power lifters [PL], 8 Olympic lifters [OL], 8 soccer players [SP], and 11 recreationally active [RA]) women participated in a cross-sectional study. We measured lumbar spine (L1-L4), femoral neck, total-body BMD, and overall body composition (total fat mass, lean mass, percent body fat) with dual-energy x-ray absorptiometry. All athletic groups had greater total BMD than RA (p = 0.01 [PL]; p < 0.001 [OL]; p = 0.01 [SP]). Olympic lifters had the highest total BMD than all other athletic groups. Olympic lifters had the significantly greater total BMD than PL (p = 0.018), but there was no difference in total BMD between PL and SP. As compared with RA, OL showed greater BMD at both the total lumbar spine (p = 0.002) and the femoral neck (p = 0.007), whereas PL showed greater BMD only for the total lumbar spine (p = 0.019) and SP showed greater BMD only for the femoral neck (p = 0.002). Olympic-style lifting includes both high-impact and odd-impact loading modalities that are associated with the highest BMD at both the lumbar spine and femoral neck.
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Affiliation(s)
- Woohyoung Jeon
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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7
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Six-month table tennis training improves body composition, bone health and physical performance in untrained older men; a randomized controlled trial. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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8
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Aparisi Gómez MP, Weidekamm C, Aparisi F, Bazzocchi A. Sports and Metabolic Bone Disease. Semin Musculoskelet Radiol 2020; 24:277-289. [PMID: 32987426 DOI: 10.1055/s-0040-1709483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical activity (PA) increases bone mass and bone strength through different mechanisms and also reduces the risk of falls in the elderly, through proprioception and balance training. The benefits seen in adolescence continue into adulthood. Exercise delays and attenuates the effects of osteoporosis, and particular sports activities may be recommended to improve bone mineral density (BMD) of the spine or regional BMD, improve balance, and prevent falls. Stress injuries related to exercise are more common in osteopenic and osteoporotic individuals.Sports activity may in some cases be detrimental for bone health, with nutrition restriction a frequent cause for negative effects of the practice of PA on bone. The examples are the so-called female athlete triad of menstrual dysfunction resulting in reduced estrogen levels, low energy due to malnutrition, and decreased BMD. A similar triad is described in male athletes. This review analyzes the effects of sport on bone metabolism and in particular its relationship with metabolic bone disease.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | | | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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9
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Warden SJ, Carballido-Gamio J, Weatherholt AM, Keyak JH, Yan C, Kersh ME, Lang TF, Fuchs RK. Heterogeneous Spatial and Strength Adaptation of the Proximal Femur to Physical Activity: A Within-Subject Controlled Cross-Sectional Study. J Bone Miner Res 2020; 35:681-690. [PMID: 31826314 PMCID: PMC7145739 DOI: 10.1002/jbmr.3939] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/06/2019] [Accepted: 12/03/2019] [Indexed: 11/10/2022]
Abstract
Physical activity (PA) enhances proximal femur bone mass, as assessed using projectional imaging techniques. However, these techniques average data over large volumes, obscuring spatially heterogeneous adaptations. The current study used quantitative computed tomography, statistical parameter mapping, and subject-specific finite element (FE) modeling to explore spatial adaptation of the proximal femur to PA. In particular, we were interested in adaptation occurring at the superior femoral neck and improving strength under loading from a fall onto the greater trochanter. High/long jump athletes (n = 16) and baseball pitchers (n = 16) were utilized as within-subject controlled models as they preferentially load their take-off leg and leg contralateral to their throwing arm, respectively. Controls (n = 15) were included but did not show any dominant-to-nondominant (D-to-ND) leg differences. Jumping athletes showed some D-to-ND leg differences but less than pitchers. Pitchers had 5.8% (95% confidence interval [CI] 3.9%-7.6%) D-to-ND leg differences in total hip volumetric bone mineral density (vBMD), with increased vBMD in the cortical compartment of the femoral neck and trochanteric cortical and trabecular compartments. Voxel-based morphometry analyses and cortical bone mapping showed pitchers had D-to-ND leg differences within the regions of the primary compressive trabeculae, inferior femoral neck, and greater trochanter but not the superior femoral neck. FE modeling revealed pitchers had 4.1% (95% CI 1.4%-6.7%) D-to-ND leg differences in ultimate strength under single-leg stance loading but no differences in ultimate strength to a fall onto the greater trochanter. These data indicate the asymmetrical loading associated with baseball pitching induces proximal femur adaptation in regions associated with weight bearing and muscle contractile forces and increases strength under single-leg stance loading. However, there were no benefits evident at the superior femoral neck and no measurable improvement in ultimate strength to common injurious loading during aging (ie, fall onto the greater trochanter), raising questions as to how to better target these variables with PA. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Stuart J. Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Alyssa M. Weatherholt
- Department of Kinesiology and Sport, Pott College of Science, Engineering, and Education, University of Southern Indiana, Evansville, IN
| | - Joyce H. Keyak
- Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California Irvine, Irvine CA
| | - Chenxi Yan
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Mariana E. Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL
| | - Thomas F. Lang
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Robyn K. Fuchs
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN
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10
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Baptista F, Lopes E, Matute-Llorente Á, Teles J, Zymbal V. Adaptation of Proximal Femur to Mechanical Loading in Young Adults: Standard Vs Localized Regions Evaluated by DXA. J Clin Densitom 2020; 23:73-81. [PMID: 30274880 DOI: 10.1016/j.jocd.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/28/2022]
Abstract
Regions of the proximal femur with less adaptive protection by mechanical loading may be at increased risk of structural failure. Since the size and location of these regions diverge from those defined by the dual-energy X-ray absorptiometry manufacturers the purpose of this study was to compare areal bone mineral density (aBMD) of different regions of the proximal femur considering impact loads from physical activity (PA). The participants were 134 young adults divided into 2 groups according to the impact of PA performed in the last 12 mo: high-impact PA and low-impact PA. The aBMD of the proximal femur was assessed by dual-energy X-ray absorptiometry at the standard femoral neck, intertrochanter, and trochanter, and at specific locations of the superolateral femoral neck and intertrochanteric region. The bone-specific physical activity questionnaire was used to estimate the impact load of PA. Comparisons between groups were adjusted for body height and body lean mass. Interaction analysis between sex and PA groups were conducted with analysis of variance. Comparisons of aBMD between bone regions were analyzed separately for men and women with repeated measures analysis of variance. In the high-impact PA group, men benefit more than women at all bone regions, except the aBMD at intertrochanteric region. Analyses of repeated measures did not reveal any significant interaction effect between bone regions (standard vs specific) and PA groups (low vs high-impact). In conclusion, aBMD differences due to mechanical loading were more pronounced in men than in women; the magnitude of the aBMD differences as a result of different levels of PA was similar between standard and localized regions.
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Affiliation(s)
- Fátima Baptista
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.
| | - Edgar Lopes
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Ángel Matute-Llorente
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiatry and Nursing, Faculty of Health and Sports Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Júlia Teles
- Mathematics Unit, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Vera Zymbal
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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11
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Halonen HT, Ihalainen TO, Hyväri L, Miettinen S, Hyttinen JAK. Cell adhesion and culture medium dependent changes in the high frequency mechanical vibration induced proliferation, osteogenesis, and intracellular organization of human adipose stem cells. J Mech Behav Biomed Mater 2019; 101:103419. [PMID: 31518945 DOI: 10.1016/j.jmbbm.2019.103419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/05/2019] [Accepted: 09/03/2019] [Indexed: 01/21/2023]
Abstract
High frequency (HF) mechanical vibration appears beneficial for in vitro osteogenesis of mesenchymal stem cells (MSCs). However, the current mechanobiological understanding of the method remains insufficient. We designed high-throughput stimulators to apply horizontal or vertical high magnitude HF (HMHF; 2.5 Gpeak, 100 Hz) vibration on human adipose stem cells (hASCs). We analyzed proliferation, alkaline phosphatase (ALP) activity, mineralization, and effects on the actin cytoskeleton and nuclei using immunocytochemical stainings. Proliferation was studied on a standard tissue culture plastic (sTCP) surface and on an adhesion supporting tissue culture plastic (asTCP) surface in basal (BM) and osteogenic (OM) culture medium conditions. We discovered that the improved cell adhesion was a prerequisite for vibration induced changes in the proliferation of hASCs. Similarly, the adhesion supporting surface enabled us to observe vibration initiated ALP activity and mineralization changes in OM condition. The horizontal vibration increased ALP activity, while vertical stimulation reduced ALP activity. However, mineralization was not enhanced by the HMHF vibration. We performed image-based analysis of actin and nuclei to obtain novel data of the intracellular-level responses to HF vibration in BM and OM conditions. Our quantitative results suggest that actin organizations were culture medium and stimulation direction dependent. Both stimulation directions decreased OM induced changes in nuclear size and elongation. Consequently, our findings of the nuclear deformations provide supportive evidence for the involvement of the nuclei in the mechanocoupling of HF vibration. Taken together, the results of this study enhanced the knowledge of the intracellular mechanisms of HF vibration induced osteogenesis of MSCs.
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Affiliation(s)
- H T Halonen
- Computational Biophysics and Imaging Group, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - T O Ihalainen
- Cellular Biophysics Group, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - L Hyväri
- Adult Stem Cell Group, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland; Research, Development and Innovation Centre, Tampere University Hospital, Biokatu 6, 33520, Tampere, Finland.
| | - S Miettinen
- Adult Stem Cell Group, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland; Research, Development and Innovation Centre, Tampere University Hospital, Biokatu 6, 33520, Tampere, Finland.
| | - J A K Hyttinen
- Computational Biophysics and Imaging Group, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
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12
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Niinimäki S, Narra N, Härkönen L, Abe S, Nikander R, Hyttinen J, Knüsel CJ, Sievänen H. Do bone geometric properties of the proximal femoral diaphysis reflect loading history, muscle properties, or body dimensions? Am J Hum Biol 2019; 31:e23246. [PMID: 31004392 DOI: 10.1002/ajhb.23246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/12/2019] [Accepted: 03/31/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to investigate activity-induced effects from bone geometric properties of the proximal femur in athletic vs nonathletic healthy females by statistically controlling for variation in body size, lower limb isometric, and dynamic muscle strength, and cross-sectional area of Musculus gluteus maximus. METHODS The material consists of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in either high jump, triple jump, soccer, squash, powerlifting, endurance running or swimming, and a group of physically active nonathletic women (N = 20). Cross-sectional bone geometric properties were calculated for the lesser trochanter, sub-trochanter, and mid-shaft of the femur regions. Bone geometric properties were analyzed using a general linear model that included body size, muscle size, and muscle strength as covariates. RESULTS Body size and isometric muscle strength were positively associated with bone geometric properties at all three cross-sectional levels of the femur, while muscle size was positively associated with bone properties only at the femur mid-shaft. When athletes were compared to nonathletic females, triple jump, soccer, and squash resulted in greater values in all studied cross-sections; high jump and endurance running resulted in greater values at the femoral mid-shaft cross-section; and swimming resulted in lower values at sub-trochanter and femur mid-shaft cross-sections. CONCLUSIONS Activity effects from ground impact loading were associated with higher bone geometric values, especially at the femur mid-shaft, but also at lesser and sub-trochanter cross-sections. Bone geometric properties along the femur can be used to assess the mechanical stimuli experienced, where ground impact loading seems to be more important than muscle loading.
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Affiliation(s)
| | - Nathaniel Narra
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
| | - Laura Härkönen
- Aquatic population dynamics Natural Resources Institute Finland (Luke), Oulu, Finland
| | - Shinya Abe
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Riku Nikander
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland.,Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Jari Hyttinen
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
| | - Christopher J Knüsel
- De la Préhistoire à l'Actuel: Culture, Environnement, et Anthropologie (PACEA), Université de Bordeaux, Bordeaux, France
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
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13
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Anthropometric profile of female handball players is related to bone mineral density. ANTHROPOLOGICAL REVIEW 2018. [DOI: 10.2478/anre-2018-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to evaluate the relationship of a wide range of anthropometric parameters with BMD in normal-weight women: handball players and healthy untrained students. Thirteen former female handball players, (age 21.2±0.9 years, body mass 64.2±6.1 kg, training experience 6.7±2.4 years) and 51 randomly selected untrained students (age 20.6±1.2 years, body mass 58.1±6.8 kg), were examined. The anthropometric measurements included 16 variables. BMD was measured on the radius of the non-dominant hand at distal and proximal points with dual-energy X-ray absorptiometry (DXA), using a Norland pDEXA densitometer. Relationships between BMD and anthropometric variables were assessed in 64 normal-weight women (BMI≥18.5 and ≤ 24.99 kg/m2), by calculating Pearson’s linear correlation coefficient. We found a significant positive relationship between bone mass characteristics and biacromial breadth (0.30-0.53), calf (0.28-0.47) and arm (0.27-0.42) girth corrected, and lean body mass (LBM) (kg) (0.38-0.61) and (%) (0,27) in the group of normal-weight women. The student groups were significantly different (analysis of variance with Scheffé post hoc test, p<0.001) in BMD, bone mineral content (BMC) and Z-score at both measured points. The former handball players were also characterized by higher body mass and LBM (kg), as well as corrected body girths and biacromial breadth (p<0.001), compared to untrained students. The groups did not differ significantly in body height or total fat. The morphological profile of the female handball players is conducive to BMD. Skeletal characteristics and muscle tissue had a significant beneficial effect on bone mineral characteristics in young women with normal weight.
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14
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Skoradal MB, Helge EW, Jørgensen NR, Mortensen J, Weihe P, Krustrup P, Mohr M. Osteogenic impact of football training in 55- to 70-year-old women and men with prediabetes. Scand J Med Sci Sports 2018; 28 Suppl 1:52-60. [DOI: 10.1111/sms.13252] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2018] [Indexed: 12/24/2022]
Affiliation(s)
- May-Britt Skoradal
- Faculty of Health Sciences; Centre of Health Science; University of the Faroe Islands; Tórshavn Faroe Islands
| | - Eva Wulff Helge
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - Niklas R. Jørgensen
- Department of Clinical Biochemistry; Rigshospitalet, Copenhagen University Hospital; Glostrup Denmark
| | - Jann Mortensen
- Department of Medicine; The Faroese National Hospital; Tórshavn Faroe Islands
- Department of Clinical Physiology; Nuclear Medicine & PET; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Pál Weihe
- Faculty of Health Sciences; Centre of Health Science; University of the Faroe Islands; Tórshavn Faroe Islands
- Department of Occupational Medicine and Public Health; The Faroese Hospital System; Tórshavn Faroe Islands
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics; SDU Sport and Health Sciences Cluster (SHSC); Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
- Sport and Health Sciences; University of Exeter; Exeter UK
| | - Magni Mohr
- Faculty of Health Sciences; Centre of Health Science; University of the Faroe Islands; Tórshavn Faroe Islands
- Department of Sports Science and Clinical Biomechanics; SDU Sport and Health Sciences Cluster (SHSC); Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
- Center for Health and Performance; Department of Food and Nutrition, and Sport Science; University of Gothenburg; Gothenburg Sweden
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15
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Reina-Romo E, Rodríguez-Vallés J, Sanz-Herrera JA. In silico dynamic characterization of the femur: Physiological versus mechanical boundary conditions. Med Eng Phys 2018; 58:S1350-4533(18)30090-0. [PMID: 29945761 DOI: 10.1016/j.medengphy.2018.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 02/06/2023]
Abstract
It is established that bone tissue adapts and responds to mechanical loading. Several studies have suggested an existence of positive influence of vibration on the bone mass maintenance. Thus, some bone regeneration therapies are based on vibration of bone tissue under circumstances of disease to stimulate its formation. Frequency of loading should be properly selected and therefore a correct characterization of the dynamic properties of this tissue may be critical for the success of such orthopedic techniques. On the other hand, many studies implement vibration techniques with in silico models. Numerical results are exclusively dependent on properties of bone tissue, i.e. geometry, density distribution and stiffness, as well as boundary conditions. In the present study, the influence of boundary conditions and material properties on the dynamic characteristics of bone tissue was explored in a human femur. Bone shape and density were directly reconstructed from computer tomographies, whereas natural frequencies and modes of vibration were obtained for different boundary conditions including physiological and mechanical ones. Results of this study show the moderate effect of material properties compared to the much substantial effect of boundary conditions. A factor of 2 in the natural frequency was obtained depending on imposed boundary conditions, highlighting the importance in the selection of appropriate conditions in the analysis of the bone organ.
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Affiliation(s)
- E Reina-Romo
- School of Engineering, University of Seville, 41092 Seville, Spain
| | | | - J A Sanz-Herrera
- School of Engineering, University of Seville, 41092 Seville, Spain.
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16
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Freitas L, Amorim T, Humbert L, Fonollá R, Flouris AD, Metsios GS, Jamurtas AZ, Koutedakis Y. Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case–control study. J Sports Sci 2018; 37:82-89. [DOI: 10.1080/02640414.2018.1483178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Laura Freitas
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
| | - Tânia Amorim
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | | | - Roger Fonollá
- Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
| | - Andreas D. Flouris
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
| | - George S. Metsios
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
| | | | - Yiannis Koutedakis
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
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17
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Abe S, Narra N, Nikander R, Hyttinen J, Kouhia R, Sievänen H. Impact loading history modulates hip fracture load and location: A finite element simulation study of the proximal femur in female athletes. J Biomech 2018; 76:136-143. [PMID: 29921524 DOI: 10.1016/j.jbiomech.2018.05.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 04/11/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
Abstract
Sideways falls impose high stress on the thin superolateral cortical bone of the femoral neck, the region regarded as a fracture-prone region of the hip. Exercise training is a natural mode of mechanical loading to make bone more robust. Exercise-induced adaptation of cortical bone along the femoral neck has been previously demonstrated. However, it is unknown whether this adaption modulates hip fracture behavior. The purpose of this study was to investigate the influence of specific exercise loading history on fall-induced hip fracture behavior by estimating fracture load and location with proximal femur finite element (FE) models created from magnetic resonance images (MRI) of 111 women with distinct exercise histories: 91 athletes (aged 24.7 ± 6.1 years, >8 years competitive career) and 20 women as controls (aged 23.7 ± 3.8 years). The athletes were divided into five groups based on typical loading patterns of their sports: high-impact (H-I: 9 triple-jumpers and 10 high jumpers), odd-impact (O-I: 9 soccer and 10 squash players), high-magnitude (H-M: 17 power-lifters), repetitive-impact (R-I: 18 endurance runners), and repetitive non-impact (R-NI: 18 swimmers). Compared to the controls, the H-I, O-I, and R-I groups had significantly higher (11-26%, p < 0.05) fracture loads. Also, the fracture location in the H-I and O-I groups was significantly more proximal (7-10%) compared to the controls. These results suggest that an exercise loading history of high impacts, impacts from unusual directions, or repetitive impacts increases the fracture load and may lower the risk of fall-induced hip fracture.
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Affiliation(s)
- Shinya Abe
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland.
| | - Nathaniel Narra
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Riku Nikander
- Gerontology Research Center, Faculty of Sports Sciences, University of Jyväskylä, Jyväskylä, Finland; Central Hospital of Central Finland, Jyväskylä, Finland; GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland
| | - Jari Hyttinen
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
| | - Reijo Kouhia
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland.
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18
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Narra N, Abe S, Dimitrov V, Nikander R, Kouhia R, Sievänen H, Hyttinen J. Ricci-flow based conformal mapping of the proximal femur to identify exercise loading effects. Sci Rep 2018; 8:4823. [PMID: 29555952 PMCID: PMC5859094 DOI: 10.1038/s41598-018-23248-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/07/2018] [Indexed: 11/26/2022] Open
Abstract
The causal relationship between habitual loading and adaptive response in bone morphology is commonly explored by analysing the spatial distribution of mechanically relevant features. In this study, 3D distribution of features in the proximal femur of 91 female athletes (5 exercise loading groups representing habitual loading) is contrasted with 20 controls. A femur specific Ricci-flow based conformal mapping procedure was developed for establishing correspondence among the periosteal surfaces. The procedure leverages the invariance of the conformal mapping method to isometric shape differences to align surfaces in the 2D parametric domain, to produce dense correspondences across an isotopological set of surfaces. This is implemented through a multi-parametrisation approach to detect surface features and to overcome the issue of inconsistency in the anatomical extent present in the data. Subsequently, the group-wise distribution of two mechanically relevant features was studied – cortical thickness and surface principal strains (simulation results of a sideways fall). Statistical inferences over the surfaces were made by contrasting the athlete groups with the controls through statistical parametric mapping. With the aid of group-wise and composite-group maps, proximal femur regions affected by specific loading groups were identified with a high degree of spatial localisation.
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Affiliation(s)
- Nathaniel Narra
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland.
| | - Shinya Abe
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Vassil Dimitrov
- Department of Electrical and Computer Engineering, University of Calgary, Calgary, Canada.,Geometric Energy Corporation, Calgary, Canada
| | - Riku Nikander
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland.,Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Reijo Kouhia
- Laboratory of Civil Engineering, Tampere University of Technology, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Hyttinen
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland
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19
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Higher step count is associated with greater bone mass and strength in women but not in men. Arch Osteoporos 2018; 13:20. [PMID: 29511893 DOI: 10.1007/s11657-018-0425-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/09/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED In this cross-sectional study, peripheral bone traits were examined relative to total daily steps measured with pedometer. Higher number of steps was associated with greater bone values at the calcaneus and tibia in women, but not in men. In women, dose-dependent associations at the radius were congruent with the weight-bearing bones. INTRODUCTION Habitual physical activity measured as daily steps may contribute to bone density and strength at the calcaneus and other weight-bearing bones. METHODS Subgroups of 705-837 women and 480-615 men aged 31-46 years from the Cardiovascular Risk in Young Finns Study participated in the present study. Participants were instructed to use pedometer for 1 week, and the total daily steps, divided into tertiles, were evaluated relative to quantitative ultrasound-measured bone traits at the calcaneus and peripheral quantitative computed tomography-measured bone traits at the tibia and radius. Analysis of covariance was used to examine the between-group differences. RESULTS In women, significant dose-dependent between-group differences were found in the weight-bearing bones and in non-weight-bearing radius. The differences in broadband ultrasound attenuation and speed of sound at the calcaneus were 3.8 and 0.5% greater in women within the highest tertile of daily steps compared to the lowest tertile (p values for trend ≤ 0.04). In tibia, women in the highest tertile (> 8765 steps/day) had on average 1-5.4% greater bone cross-sectional area, bone mineral content (BMC), trabecular density, and bone strength index at the distal site and 1.6-2.7% greater bone areas, BMC and strength strain index (SSI) at the shaft compared to women with less daily steps (p values for trend ≤ 0.02). Similarly, in radius, BMC and BSI at the distal site, and bone cross-sectional areas, BMC and SSI at the shaft were 1.7-3.4% greater in women within the highest tertile of daily steps compared to their peers (p values for trend ≤ 0.04). In men, the differences in calcaneal, tibial, and radial bone traits were mainly non-significant between the tertiles of daily steps. CONCLUSION Observed significant positive associations between daily steps and various bone traits at the calcaneus, tibia, and radius in women suggest that habitual physical activity may benefit skeletal health in adulthood.
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20
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Ridzwan MIZ, Sukjamsri C, Pal B, van Arkel RJ, Bell A, Khanna M, Baskaradas A, Abel R, Boughton O, Cobb J, Hansen UN. Femoral fracture type can be predicted from femoral structure: A finite element study validated by digital volume correlation experiments. J Orthop Res 2018; 36:993-1001. [PMID: 28762563 DOI: 10.1002/jor.23669] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/24/2017] [Indexed: 02/04/2023]
Abstract
Proximal femoral fractures can be categorized into two main types: Neck and intertrochanteric fractures accounting for 53% and 43% of all proximal femoral fractures, respectively. The possibility to predict the type of fracture a specific patient is predisposed to would allow drug and exercise therapies, hip protector design, and prophylactic surgery to be better targeted for this patient rendering fracture preventing strategies more effective. This study hypothesized that the type of fracture is closely related to the patient-specific femoral structure and predictable by finite element (FE) methods. Fourteen femora were DXA scanned, CT scanned, and mechanically tested to fracture. FE-predicted fracture patterns were compared to experimentally observed fracture patterns. Measurements of strain patterns to explain neck and intertrochanteric fracture patterns were performed using a digital volume correlation (DVC) technique and compared to FE-predicted strains and experimentally observed fracture patterns. Although loaded identically, the femora exhibited different fracture types (six neck and eight intertrochanteric fractures). CT-based FE models matched the experimental observations well (86%) demonstrating that the fracture type can be predicted. DVC-measured and FE-predicted strains showed obvious consistency. Neither DXA-based BMD nor any morphologic characteristics such as neck diameter, femoral neck length, or neck shaft angle were associated with fracture type. In conclusion, patient-specific femoral structure correlates with fracture type and FE analyses were able to predict these fracture types. Also, the demonstration of FE and DVC as metrics of the strains in bones may be of substantial clinical value, informing treatment strategies and device selection and design. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:993-1001, 2018.
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Affiliation(s)
- Mohamad Ikhwan Zaini Ridzwan
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom.,School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia, Penang, 14300, Malaysia
| | - Chamaiporn Sukjamsri
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom.,Faculty of Engineering, Department of Biomedical Engineering, Srinakharinwirot University, Nakhonnayok, 26120, Thailand
| | - Bidyut Pal
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom.,School of Engineering, University of Portsmouth, Portsmouth, PO1 3DJ, United Kingdom
| | - Richard J van Arkel
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
| | - Andrew Bell
- MSC Software Ltd., 4 Archipelago, Lyon Way, Frimley, Surrey, GU16 7ER, United Kingdom
| | - Monica Khanna
- Department of Clinical Imaging, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Aroon Baskaradas
- Trauma and Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Richard Abel
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, W6 8RF, United Kingdom
| | - Oliver Boughton
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, W6 8RF, United Kingdom
| | - Justin Cobb
- Department of Surgery and Cancer, Imperial College London, Charing Cross Hospital, London, W6 8RF, United Kingdom
| | - Ulrich N Hansen
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, United Kingdom
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21
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Naderi A, Zagatto AM, Akbari F, Sakinepoor A. Body composition and lipid profile of regular recreational table tennis participants: a cross-sectional study of older adult men. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-017-0422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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22
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Gomez-Bruton A, Gonzalez-Aguero A, Matute-Llorente A, Gomez-Cabello A, Casajus JA, Vicente-Rodríguez G. Longitudinal effects of swimming on bone in adolescents: a pQCT and DXA study. Biol Sport 2017; 34:361-370. [PMID: 29472739 PMCID: PMC5819466 DOI: 10.5114/biolsport.2017.69824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/26/2017] [Accepted: 03/22/2017] [Indexed: 11/21/2022] Open
Abstract
The aims of the present study were, firstly, to evaluate areal bone mineral density (aBMD), bone strength and structure during a swimming season and compare them to those of normo-active controls (CG), and secondly to ascertain whether practising an additional weight-bearing sport other than swimming might improve bone. Twenty-three swimmers who only swam (SWI-PURE; 14 males, 9 females), 11 swimmers who combined swimming with an additional weight-bearing sport (SWI-SPORT; 8 males, 3 females) and 28 controls (CG; 16 males, 12 females) participated in the present study. aBMD was assessed with dual energy X-ray (DXA). Bone mass, area, structure and strength of the non-dominant tibia and radius were measured with peripheral quantitative computed tomography (pQCT). Measurements were performed at the beginning of the swimming season and 8 months later. The only difference among groups for DXA and pQCT variables was found for arm aBMD, which was higher in the SWI-SPORT than in the CG group at both pre- and post-evaluation. Group by time interactions (GxT) were found for trochanter aBMD when comparing SWI-SPORT to CG and SWI-SPORT to SWI-PURE, favouring in both cases SWI-SPORT. No GxT were found for the radius. For the tibia, GxT were found between SWI-SPORT and CG and between SWI-PURE and CG, in both cases favouring the swimmers. A season of swimming does not confer any additional benefits to aBMD, but may confer minor benefits to structure and mass. Complementing swimming with a weight-bearing activity is beneficial to bone.
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Affiliation(s)
- Alejandro Gomez-Bruton
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain
- Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)
| | - Alejandro Gonzalez-Aguero
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain
- Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)
| | - Angel Matute-Llorente
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain
- Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)
| | - Alba Gomez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
| | - Jose A Casajus
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain
- Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)
| | - German Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Spain
- Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn)
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Krustrup P, Helge EW, Hansen PR, Aagaard P, Hagman M, Randers MB, de Sousa M, Mohr M. Effects of recreational football on women's fitness and health: adaptations and mechanisms. Eur J Appl Physiol 2017; 118:11-32. [PMID: 29164325 DOI: 10.1007/s00421-017-3733-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/28/2017] [Indexed: 12/30/2022]
Abstract
The review describes the fitness and health effects of recreational football in women aged 18-65 years. The review documents that 2 × 1 h of recreational football training for 12-16 weeks causes marked improvements in maximal oxygen uptake (5-15%) and myocardial function in women. Moreover, mean arterial blood pressure was shown to decrease by 2-5 mmHg in normotensive women and 6-8 mmHg in hypertensive women. This review also show that short-term (< 4 months) and medium-term (4-16 months) recreational football training has major beneficial impact on metabolic health profile in women, with fat losses of 1-3 kg and improvements in blood lipid profile. Lastly, 2 × 1 h per week of recreational football training for women elevates lower extremity bone mineralisation by 1-5% and whole-body bone mineralization by 1-2% within 4-12-month interventions. These training adaptations are related to the high heart rates, high number of fast runs, and multiple changes of direction and speed occurring during recreational football training for untrained women. In conclusion, regular small-sided football training for women is an intense and versatile type of training that combines elements of high-intensity interval training (HIIT), endurance training and strength training, thereby providing optimal stimuli for cardiovascular, metabolic and musculoskeletal fitness. Recreational football, therefore, seems to be an effective tool for prevention and treatment of lifestyle diseases in young and middle-aged women, including hypertension, type 2 diabetes and osteopenia. Future research should elucidate effects of football training for elderly women, and as treatment and rehabilitation of breast cancer patients and other women patient groups.
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Affiliation(s)
- Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 3450, Odense, Denmark. .,Sport and Health Sciences, College of Life and Environmental Sciences, St Luke's Campus, University of Exeter, Exeter, UK.
| | - Eva Wulff Helge
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter R Hansen
- Department of Cardiology, Herlev-Gentofte University Hospital, Gentofte, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 3450, Odense, Denmark
| | - Marie Hagman
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 3450, Odense, Denmark
| | - Morten B Randers
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 3450, Odense, Denmark
| | - Maysa de Sousa
- Laboratory of Medical Investigation, LIM-18, Endocrinology Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 3450, Odense, Denmark.,Centre of Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.,Center of Health and Human Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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Understanding Hip Fracture by QCT-Based Finite Element Modeling. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lagerros YT, Hantikainen E, Michaëlsson K, Ye W, Adami HO, Bellocco R. Physical activity and the risk of hip fracture in the elderly: a prospective cohort study. Eur J Epidemiol 2017; 32:983-991. [PMID: 28940092 PMCID: PMC5684287 DOI: 10.1007/s10654-017-0312-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/06/2017] [Indexed: 11/26/2022]
Abstract
Physical activity has been inversely associated with the risk of hip fracture, however, few studies have been conducted on the contributions from different domains of physical activity. This study was performed to investigate the association between daily household activities, leisure time physical activity, work-related physical activity and total physical activity during a 24-h period, and the risk of hip fracture. In the Swedish National March Cohort we followed 23,881 men and women aged of 50 and over from 1997 until 2010. Information on domain-specific physical activity was collected at baseline using a questionnaire. We fitted separate multivariable adjusted Cox proportional hazard models to each domain to obtain hazard ratios (HRs) with 95% confidence intervals (CIs). Each model was mutually adjusted for the other domains of physical activity. During a mean follow-up period of 12.2 years we identified 824 incidents of hip fracture. Subjects who spent less than 1 h per week engaged in daily household activities had an 85% higher risk of hip fracture than subjects spending ≥6 h per week carrying out daily household activities (HR 1.85; 95% CI 1.01–3.38). Subjects engaged in leisure time physical activities for >3.1 MET-h/day had a 24% lower risk of hip fracture (HR 0.76; 95% CI 0.59–0.98) than subjects spending <1.1 MET-h/day performing such activities. No association was found between hip fracture and work-related or total physical activity. We conclude that daily household activities and leisure time physical activity may independently decrease the risk of hip fracture in those aged 50 and over.
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Affiliation(s)
- Ylva Trolle Lagerros
- Department of Medicine, Clinical Epidemiology Unit T2, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Huddinge, C2:84, 141 86, Stockholm, Sweden.
| | - Essi Hantikainen
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala Clinical Research Center, Akademiska sjukhuset ing. 61 6 tr, 751 85, Uppsala, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
- Department of Epidemiology, Harvard University T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Sognsvannsveien 21, 0372, Oslo, Norway
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
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Clinical Characteristics and the Dietary Response in Celiac Disease Patients Presenting With or Without Anemia. J Clin Gastroenterol 2017; 51:412-416. [PMID: 27306936 DOI: 10.1097/mcg.0000000000000556] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS It remains unclear as to what are the clinical characteristics associated with the presence of anemia at celiac disease diagnosis, and how these are affected by a gluten-free diet. We investigated these issues in a prospective study. METHODS Clinical and demographic data, small-bowel mucosal histology, serology, and laboratory parameters, body mass index (BMI), and bone mineral density (BMD) both at diagnosis and after 1 year on a gluten-free diet were investigated in 163 adults with celiac disease. Gastrointestinal symptoms and psychological well-being were evaluated by validated Gastrointestinal Symptom Rating Scale and Psychological General Well-Being questionnaires. All study variables were compared between participants with and without anemia at celiac disease diagnosis. RESULTS Altogether, 23% of the patients had anemia at diagnosis. Anemic patients were more often women (P=0.001) and had more gastrointestinal symptoms (P=0.004) and were less often screen detected (P=0.009). Further, they had higher celiac antibody values (P=0.007) and a lower total iron (P<0.001), BMI (P=0.003), and density of mucosal γδ+ intraepithelial lymphocytes (P=0.033). After 1 year on a gluten-free diet, the anemia group had a lower mucosal villous height-crypt depth ratio (P=0.008) and BMI (P=0.050), and higher antibody values (P=0.012) and densities of CD3 (P=0.008) and αβ+ intraepithelial lymphocytes (P=0.022). There was no significant difference between the groups in their bone mineral density, Gastrointestinal Symptom Rating Scale and Psychological General Well-Being. CONCLUSIONS Celiac patients with anemia had more severe disease than nonanemic patients in terms of the serology and a lower BMI. Further, they evinced a slower histologic response to the dietary treatment. An early diagnosis and careful follow-up are important in these patients.
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Hannam K, Deere KC, Hartley A, Clark EM, Coulson J, Ireland A, Moss C, Edwards MH, Dennison E, Gaysin T, Cooper R, Wong A, McPhee JS, Cooper C, Kuh D, Tobias JH. A novel accelerometer-based method to describe day-to-day exposure to potentially osteogenic vertical impacts in older adults: findings from a multi-cohort study. Osteoporos Int 2017; 28:1001-1011. [PMID: 27798733 PMCID: PMC5306163 DOI: 10.1007/s00198-016-3810-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/12/2016] [Indexed: 10/26/2022]
Abstract
UNLABELLED This observational study assessed vertical impacts experienced in older adults as part of their day-to-day physical activity using accelerometry and questionnaire data. Population-based older adults experienced very limited high-impact activity. The accelerometry method utilised appeared to be valid based on comparisons between different cohorts and with self-reported activity. INTRODUCTION We aimed to validate a novel method for evaluating day-to-day higher impact weight-bearing physical activity (PA) in older adults, thought to be important in protecting against osteoporosis, by comparing results between four cohorts varying in age and activity levels, and with self-reported PA levels. METHODS Participants were from three population-based cohorts, MRC National Survey of Health and Development (NSHD), Hertfordshire Cohort Study (HCS) and Cohort for Skeletal Health in Bristol and Avon (COSHIBA), and the Master Athlete Cohort (MAC). Y-axis peaks (reflecting the vertical when an individual is upright) from a triaxial accelerometer (sampling frequency 50 Hz, range 0-16 g) worn at the waist for 7 days were classified as low (0.5-1.0 g), medium (1.0-1.5 g) or higher (≥1.5 g) impacts. RESULTS There were a median of 90, 41 and 39 higher impacts/week in NSHD (age 69.5), COSHIBA (age 76.8) and HCS (age 78.5) participants, respectively (total n = 1512). In contrast, MAC participants (age 68.5) had a median of 14,322 higher impacts/week. In the three population cohorts combined, based on comparison of beta coefficients, moderate-high-impact activities as assessed by PA questionnaire were suggestive of stronger association with higher impacts from accelerometers (0.25 [0.17, 0.34]), compared with medium (0.18 [0.09, 0.27]) and low impacts (0.13 [0.07,0.19]) (beta coefficient, with 95 % CI). Likewise in MAC, reported moderate-high-impact activities showed a stronger association with higher impacts (0.26 [0.14, 0.37]), compared with medium (0.14 [0.05, 0.22]) and low impacts (0.03 [-0.02, 0.08]). CONCLUSIONS Our new accelerometer method appears to provide valid measures of higher vertical impacts in older adults. Results obtained from the three population-based cohorts indicate that older adults generally experience very limited higher impact weight-bearing PA.
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Affiliation(s)
- K Hannam
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - K C Deere
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - A Hartley
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - E M Clark
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - J Coulson
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - A Ireland
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - C Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - T Gaysin
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - R Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - A Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - J S McPhee
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - D Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - J H Tobias
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK.
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Niinimäki S, Narra N, Härkönen L, Abe S, Nikander R, Hyttinen J, Knüsel C, Sievänen H. The relationship between loading history and proximal femoral diaphysis cross-sectional geometry. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.22965] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 11/09/2016] [Accepted: 12/22/2016] [Indexed: 01/02/2023] Open
Affiliation(s)
- Sirpa Niinimäki
- Archaeology; P.O. Box 1000, University of Oulu; Oulu 90014 Finland
| | - Nathaniel Narra
- Department of Electronics and Communications Engineering; BioMediTech, Tampere University of Technology; Tampere Finland
| | - Laura Härkönen
- Department of Ecology; P.O. Box 3000, University of Oulu; Oulu 90014 Finland
- Department of Environmental and Biological Sciences; P.O. 111, University of Eastern Finland; Joensuu 80101 Finland
| | - Shinya Abe
- Department of Mechanical Engineering and Industrial Systems; P.O. Box 589, Tampere University of Technology; Tampere 33101 Finland
| | - Riku Nikander
- Unit of Health Sciences, Faculty of Sport and Health Sciences; P.O. Box 35, (L328); 40014 University of Jyväskylä Finland
- GeroCenter Foundation for Aging Research and Development; Rautpohjankatu 8 Jyväskylä 40700 Finland
- Unit of Research & Education, Central Hospital of Central Finland; Keskussairaalantie 19 Jyväskylä 40620 Finland
| | - Jari Hyttinen
- Department of Electronics and Communications Engineering; BioMediTech, Tampere University of Technology; Tampere Finland
| | - Christopher Knüsel
- UMR5199, De la Prehistoire a l?Actuel: Culture, Environnement, et Anthropologie (PACEA); Bâtiment B8, Allée Géoffroy Saint Hilaire, CS 50023 Pessac Cedex 33615 France
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research; P.O. Box 30, Kaupinpuistonkatu 1 Tampere 33501 Finland
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Fuchs RK, Kersh ME, Carballido-Gamio J, Thompson WR, Keyak JH, Warden SJ. Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur. Curr Osteoporos Rep 2017; 15:43-52. [PMID: 28133707 PMCID: PMC5317179 DOI: 10.1007/s11914-017-0343-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted. RECENT FINDINGS The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction. Sideways falls heighten femoral neck fracture risk by loading the relatively weak superolateral region of femoral neck. Recent studies exploring regional adaptation of the femoral neck to physical activity have identified heterogeneous adaptation, with adaptation principally occurring within inferomedial weight-bearing regions and little to no adaptation occurring in the superolateral femoral neck. There is a need to develop novel physical activities that better target and strengthen the superolateral femoral neck within the proximal femur. Design of these activities may be guided by subject-specific musculoskeletal modeling and finite-element modeling approaches.
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Affiliation(s)
- Robyn K Fuchs
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA
| | - William R Thompson
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA
| | - Joyce H Keyak
- Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California, Irvine, CA, USA
| | - Stuart J Warden
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA.
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Relationship between Social Isolation and Indoor and Outdoor Physical Activity in Community-Dwelling Older Adults in Germany: Findings from the ActiFE Study. J Aging Phys Act 2016; 25:387-394. [PMID: 26421605 PMCID: PMC4857800 DOI: 10.1123/japa.2016-0060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (–0.53; –0.77, –0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (–0.39; –0.63, –0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.
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Abe S, Narra N, Nikander R, Hyttinen J, Kouhia R, Sievänen H. Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study. Bone 2016; 92:9-17. [PMID: 27477004 DOI: 10.1016/j.bone.2016.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 07/27/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
Over 90% of hip fractures are caused by falls. Due to a fall-induced impact on the greater trochanter, the posterior part of the thin superolateral cortex of the femoral neck is known to experience the highest stress, making it a fracture-prone region. Cortical geometry of the proximal femur, in turn, reflects a mechanically appropriate form with respect to habitual exercise loading. In this finite element (FE) modeling study, we investigated whether specific exercise loading history is associated with femoral neck structural strength and estimated fall-induced stresses along the femoral neck. One hundred and eleven three-dimensional (3D) proximal femur FE models for a sideways falling situation were constructed from magnetic resonance (MR) images of 91 female athletes (aged 24.7±6.1years, >8years competitive career) and 20 non-competitive habitually active women (aged 23.7±3.8years) that served as a control group. The athletes were divided into five distinct groups based on the typical loading pattern of their sports: high-impact (H-I: triple-jumpers and high-jumpers), odd-impact (O-I: soccer and squash players), high-magnitude (H-M: power-lifters), repetitive-impact (R-I: endurance runners), and repetitive non-impact (R-NI: swimmers). The von Mises stresses obtained from the FE models were used to estimate mean fall-induced stresses in eight anatomical octants of the cortical bone cross-sections at the proximal, middle, and distal sites along the femoral neck axis. Significantly (p<0.05) lower stresses compared to the control group were observed: the H-I group - in the superoposterior (10%) and posterior (19%) octants at the middle site, and in the superoposterior (13%) and posterior (22%) octants at the distal site; the O-I group - in the superior (16%), superoposterior (16%), and posterior (12%) octants at the middle site, and in the superoposterior (14%) octant at the distal site; the H-M group - in the superior (13%) and superoposterior (15%) octants at the middle site, and a trend (p=0.07, 9%) in the superoposterior octant at the distal site; the R-I group - in the superior (14%), superoposterior (23%) and posterior (22%) octants at the middle site, and in the superoposterior (19%) and posterior (20%) octants at the distal site. The R-NI group did not differ significantly from the control group. These results suggest that exercise loading history comprising various impacts in particular is associated with a stronger femoral neck in a falling situation and may have potential to reduce hip fragility.
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Affiliation(s)
- Shinya Abe
- Department of Mechanical Engineering and Industrial Systems, Tampere University of Technology, Tampere, Finland.
| | - Nathaniel Narra
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
| | - Riku Nikander
- Gerontology Research Center, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Central Hospital of Central Finland, Jyväskylä, Finland; GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland
| | - Jari Hyttinen
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
| | - Reijo Kouhia
- Department of Mechanical Engineering and Industrial Systems, Tampere University of Technology, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland.
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Stanforth D, Lu T, Stults-Kolehmainen MA, Crim BN, Stanforth PR. Bone Mineral Content and Density Among Female NCAA Division I Athletes Across the Competitive Season and Over a Multi-Year Time Frame. J Strength Cond Res 2016; 30:2828-38. [DOI: 10.1519/jsc.0000000000000785] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tabor E, Zagórski P, Martela K, Glinkowski W, Kuźniewicz R, Pluskiewicz W. The role of physical activity in early adulthood and middle-age on bone health after menopause in epidemiological population from Silesia Osteo Active Study. Int J Clin Pract 2016; 70:835-842. [PMID: 27655014 DOI: 10.1111/ijcp.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/14/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Osteoporosis is a growing problem in women after menopause. Among factors protecting from this disease is a physical activity (PA). AIM The objective of the study was to evaluate the influence of PA in early adulthood and at middle-age on bone health after menopause. MATERIAL AND METHODS The study group consisted of 362 randomly recruited postmenopausal women after menopause. Mean age was 65.2±6.9 years. Medical history was collected from all participants, and they completed questionnaires assessing PA in early adulthood and at middle-age. Physical capacity was estimated using the Duke scale. Bone status was measured with use of densitometry (DXA) for lumbar spine and hip and calcaneus quantitative ultrasound (QUS) measurements. RESULTS Physical activity and healthy lifestyle activity in early adulthood did not correlate with bone health, but current PA did (for QUS parameters r=.11; P<.05). Physical capacity correlated with all QUS parameters (r=.2 to .22; P<.05) and femoral neck (FN) BMD and T-score (for both r=.16; P<.05). Current PA frequency at the level of several times a week has the highest positive impact on FN DXA results (P=.01). Bone mass in DXA and QUS variables is related to the type of exercises (P<.05). CONCLUSION Physical activity, especially several times a week, at middle-age is a major factor influencing bone health in women after menopause. Further studies concerning the type of exercises are needed.
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Affiliation(s)
- Elżbieta Tabor
- Doctoral Studies, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland.
| | - Piotr Zagórski
- Department of Orthopaedic Surgery, Sports-Clinic, Żory, Poland
| | - Katarzyna Martela
- Doctoral Studies, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Wojciech Glinkowski
- Department of Medical Informatics and Telemedicine, Center of Excellence "TeleOrto" for Telediagnostics and Treatment of Disorders and Injuries of Locomotor System, Medical University of Warsaw, Warsaw, Poland
| | - Roman Kuźniewicz
- Department and Clinic of Internal Diseases, Diabetology, and Nephrology, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Wojciech Pluskiewicz
- Department and Clinic of Internal Diseases, Diabetology, and Nephrology, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Medical University of Silesia in Katowice, Zabrze, Poland
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Serum transglutaminase 3 antibodies correlate with age at celiac disease diagnosis. Dig Liver Dis 2016; 48:632-7. [PMID: 27026081 DOI: 10.1016/j.dld.2016.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Transglutaminase (TG)2 is the autoantigen in celiac disease, but also TG3 antibodies have been detected in the serum of celiac disease patients. AIMS To investigate the correlations between serum TG3 antibodies and clinical and histological manifestations of celiac disease and to assess gluten-dependency of TG3 antibodies. METHODS Correlations between serum TG3 antibody levels measured from 119 adults and children with untreated coeliac disease and the demographic data, clinical symptoms, celiac antibodies, histological data and results of laboratory tests and bone mineral densities were tested. TG3 antibodies were reinvestigated in 97 celiac disease patients after 12 months on a gluten-free diet (GFD). RESULTS TG3 antibody titers were shown to correlate with the age at celiac disease diagnosis. Further, negative correlation with TG3 antibodies and intestinal γδ+ cells at diagnosis and on GFD was detected. Correlations were not detected with the clinical manifestation of celiac disease, TG2 or endomysial autoantibodies, laboratory values, severity of mucosal villous atrophy, associated diseases or complications. TG3 antibody titers decreased on GFD in 56% of the TG3 antibody positive patients. CONCLUSION Serum TG3 antibody positivity in celiac disease increases as the diagnostic age rises. TG3 antibodies did not show similar gluten-dependency as TG2 antibodies.
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Uth J, Hornstrup T, Christensen JF, Christensen KB, Jørgensen NR, Schmidt JF, Brasso K, Jakobsen MD, Sundstrup E, Andersen LL, Rørth M, Midtgaard J, Krustrup P, Helge EW. Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy: 32-week follow-up of the FC prostate randomised controlled trial. Osteoporos Int 2016; 27:1507-1518. [PMID: 26572756 DOI: 10.1007/s00198-015-3399-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 11/03/2015] [Indexed: 01/17/2023]
Abstract
UNLABELLED Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD and physical functioning parameters compared to control. INTRODUCTION ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone turnover markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT. METHODS Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28) for 32 weeks. Outcomes were total hip, femoral shaft, femoral neck and lumbar spine (L2-L4) BMD and systemic BTMs (procollagen type 1 amino-terminal propeptide, osteocalcin, C-terminal telopeptide of type 1 collagen). Additionally, physical functioning (postural balance, jump height, repeated chair rise, stair climbing) was evaluated. RESULTS Thirty-two-week follow-up measures were obtained for FTG (n = 21) and for CON (n = 20), respectively. Analysis of mean changes from baseline to 32 weeks showed significant differences between FTG and CON in right (0.015 g/cm(2)) and left (0.017 g/cm(2)) total hip and in right (0.018 g/cm(2)) and left (0.024 g/cm(2)) femoral shaft BMD, jump height (1.7 cm) and stair climbing (-0.21 s) all in favour of FTG (p < 0.05). No other significant between-group differences were observed. CONCLUSIONS Compared to standard care, 32 weeks of football training improved BMD at clinically important femoral sites and parameters of physical functioning in men undergoing ADT for PCa.
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Affiliation(s)
- J Uth
- The University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, 2100, Denmark.
| | - T Hornstrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen, 2200, Denmark
| | - J F Christensen
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - K B Christensen
- Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1014, Denmark
| | - N R Jørgensen
- Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Ndr. Ringvej 57, Glostrup, 2600, Denmark
- Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, Odense, 5000, Denmark
| | - J F Schmidt
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen, 2200, Denmark
| | - K Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - M D Jakobsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - E Sundstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - L L Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
- Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, 9220, Aalborg, Denmark
| | - M Rørth
- Department of Oncology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - J Midtgaard
- The University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, 2100, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - P Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen, 2200, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Heavitree Road, Exeter, UK
| | - E W Helge
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen, 2200, Denmark
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Marycz K, Lewandowski D, Tomaszewski KA, Henry BM, Golec EB, Marędziak M. Low-frequency, low-magnitude vibrations (LFLM) enhances chondrogenic differentiation potential of human adipose derived mesenchymal stromal stem cells (hASCs). PeerJ 2016; 4:e1637. [PMID: 26966645 PMCID: PMC4782709 DOI: 10.7717/peerj.1637] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/07/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to evaluate if low-frequency, low-magnitude vibrations (LFLM) could enhance chondrogenic differentiation potential of human adipose derived mesenchymal stem cells (hASCs) with simultaneous inhibition of their adipogenic properties for biomedical purposes. We developed a prototype device that induces low-magnitude (0.3 g) low-frequency vibrations with the following frequencies: 25, 35 and 45 Hz. Afterwards, we used human adipose derived mesenchymal stem cell (hASCS), to investigate their cellular response to the mechanical signals. We have also evaluated hASCs morphological and proliferative activity changes in response to each frequency. Induction of chondrogenesis in hASCs, under the influence of a 35 Hz signal leads to most effective and stable cartilaginous tissue formation through highest secretion of Bone Morphogenetic Protein 2 (BMP-2), and Collagen type II, with low concentration of Collagen type I. These results correlated well with appropriate gene expression level. Simultaneously, we observed significant up-regulation of α3, α4, β1 and β3 integrins in chondroblast progenitor cells treated with 35 Hz vibrations, as well as Sox-9. Interestingly, we noticed that application of 35 Hz frequencies significantly inhibited adipogenesis of hASCs. The obtained results suggest that application of LFLM vibrations together with stem cell therapy might be a promising tool in cartilage regeneration.
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Affiliation(s)
- Krzysztof Marycz
- Faculty of Biology, University of Environmental and Life Sciences, Wroclaw, Poland; Wroclaw Research Centre EIT +, Wroclaw, Poland
| | - Daniel Lewandowski
- Department of Mechanics, Materials Science and Engineering, Wrocław University of Technology , Wrocław , Poland
| | - Krzysztof A Tomaszewski
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland; Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital and Polyclinic, Krakow, Poland
| | - Brandon M Henry
- Department of Anatomy, Jagiellonian University Medical College , Krakow , Poland
| | - Edward B Golec
- Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital and Polyclinic, Krakow, Poland; Faculty of Motor Rehabilitation, Bronislaw Czech University School of Physical Education, Krakow, Poland
| | - Monika Marędziak
- Faculty of Veterinary Medicine, Department of Animal Physiology and Biostructure, University of Environmental and Life Sciences , Wroclaw , Poland
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Football training in men with prostate cancer undergoing androgen deprivation therapy: activity profile and short-term skeletal and postural balance adaptations. Eur J Appl Physiol 2015; 116:471-80. [DOI: 10.1007/s00421-015-3301-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/16/2015] [Indexed: 01/26/2023]
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Ben Yehuda A, Singer C, Katz J. About gravity and occlusal forces in the jaws: Review. World J Stomatol 2015; 4:126-128. [DOI: 10.5321/wjs.v4.i4.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/09/2015] [Accepted: 08/31/2015] [Indexed: 02/06/2023] Open
Abstract
Mechanical forces resulting from gravitation seem to be essential for structural adaptation and remodeling of skeletal bones. These forces have the capability of delivering powerfully distorting stimuli to skeletal bones in a very short time, several times a day, in a uniform direction. Facial and jaw bones are not subjected to gravity impact forces. These bones need a mechanism of “compensation” for this deficiency. The goal is achieved by a unique mechanism that substitutes for gravity impact forces - the mechanism of occlusal load transmission to the bone via the periodontal apparatus space. In cases of early loss of teeth and loss of periodontal ligament this mechanism will be missing resulting in premature bone aging.
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Christoffersen T, Winther A, Nilsen OA, Ahmed LA, Furberg AS, Grimnes G, Dennison E, Emaus N. Does the frequency and intensity of physical activity in adolescence have an impact on bone? The Tromsø Study, Fit Futures. BMC Sports Sci Med Rehabil 2015; 7:26. [PMID: 26561526 PMCID: PMC4641333 DOI: 10.1186/s13102-015-0020-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/03/2015] [Indexed: 01/05/2023]
Abstract
Background Optimization of the genetic potential for bone accrual in early life may prevent future fractures. Possible modification factors include lifestyle factors such as nutrition and physical activity. Measured levels of bone mineral density (BMD) and bone mass content (BMC) are indicators of bone strength, and are correlated with fracture risk. This study explored the impact of self-reported physical activity frequencies and intensity on BMD and BMC in Norwegian adolescents. Methods In 2010–2011 school students in two North-Norwegian municipalities were invited to a health survey, the Fit Future study. 508 girls and 530 boys aged 15–18 years attended. BMD and BMC were measured by dual X-ray absorptiometry. Physical activity and other lifestyle-factors were reported by questionnaires and clinical interviews. Statistical analyses were performed sex stratified, using ANOVA for comparison of means and linear regression models adjusting for factors known to affect bone. Results Approximately 2/3 of girls and boys reported themselves as physically active outside school hours. Active participants had a significantly higher BMD and BMC at all sites (p < 0.001), except for BMC total body in girls, compared to inactive participants. In multiple linear regression analyses, increased physical activity measured as days a week, categorized into seldom, moderate and highly, was positively associated with BMD (g/cm2) at all sites in girls. Girls reporting themselves as highly active had BMD levels 0.093 g/cm2, 0.090 g/cm2 and 0.046 g/cm2 higher (p < 0.001) than their more seldom active peers at femoral neck, total hip and total body respectively. Corresponding values for boys were 0.125 g/cm2, 0.133 g/cm2 and 0.66 g/cm2. BMC measures showed similar trends at femoral neck and total hip. Conclusions Increased level of physical activity is associated with higher BMD and BMC levels in adolescents. For both sexes high activity frequency seems to be essential, whilst boys reporting quite hard intensity has an additional impact. The differential effects of physical activity on bone strength in adolescence have clinical implications, especially in preventive strategies.
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Affiliation(s)
- Tore Christoffersen
- Department of Health and Care Sciences, UIT The Arctic University of Norway, Forskningsparken, Sykehusveien 21, NO-9037 Tromsø, Norway ; Finnmark Hospital Trust, Alta, Norway
| | - Anne Winther
- Department of Health and Care Sciences, UIT The Arctic University of Norway, Forskningsparken, Sykehusveien 21, NO-9037 Tromsø, Norway ; Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway
| | - Ole Andreas Nilsen
- Department of Health and Care Sciences, UIT The Arctic University of Norway, Forskningsparken, Sykehusveien 21, NO-9037 Tromsø, Norway
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, UIT The Arctic University of Norway, Forskningsparken, Sykehusveien 21, NO-9037 Tromsø, Norway ; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Anne-Sofie Furberg
- Department of Community Medicine, UIT the Arctic University of Norway, Tromsø, Norway
| | - Guri Grimnes
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway ; Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, UK ; Victoria University, Wellington, New Zealand
| | - Nina Emaus
- Department of Health and Care Sciences, UIT The Arctic University of Norway, Forskningsparken, Sykehusveien 21, NO-9037 Tromsø, Norway
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Assessment of Hip Fracture Risk Using Cross-Section Strain Energy Determined by QCT-Based Finite Element Modeling. BIOMED RESEARCH INTERNATIONAL 2015; 2015:413839. [PMID: 26601105 PMCID: PMC4637043 DOI: 10.1155/2015/413839] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/28/2015] [Accepted: 06/29/2015] [Indexed: 01/25/2023]
Abstract
Accurate assessment of hip fracture risk is very important to prevent hip fracture and to monitor the effect of a treatment. A subject-specific QCT-based finite element model was constructed to assess hip fracture risk at the critical locations of femur during the single-leg stance and the sideways fall. The aim of this study was to improve the prediction of hip fracture risk by introducing a novel failure criterion to more accurately describe bone failure mechanism. Hip fracture risk index was defined using cross-section strain energy, which is able to integrate information of stresses, strains, and material properties affecting bone failure. It was found that the femoral neck and the intertrochanteric region have higher fracture risk than other parts of the femur, probably owing to the larger content of cancellous bone in these regions. The study results also suggested that women are more prone to hip fracture than men. The findings in this study have a good agreement with those clinical observations reported in the literature. The proposed hip fracture risk index based on strain energy has the potential of more accurate assessment of hip fracture risk. However, experimental validation should be conducted before its clinical applications.
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[New strategies for exercise training in osteoporosis]. Unfallchirurg 2015; 118:933-7. [PMID: 26467265 DOI: 10.1007/s00113-015-0080-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the prevention and treatment of osteoporosis, movement with muscle strengthening and proprioceptive training plays a major role. This was taken into consideration in the guidelines by the governing body on osteoporosis (Dachverband Osteoporose, DVO) from 2014 on prophylaxis, diagnosis and treatment of osteoporosis and in the DVO guidelines from 2008 on physiotherapy and exercise therapy for osteoporosis. Increases in lumbar bone density of between 0.5 % and 2.5 % can be achieved in women by strengthening exercises with high resistance. With this combination and strengthening of the quadriceps muscle a reduction of falls and hence the fracture risk could also be achieved. In traumatology, training for muscle strengthening is not always possible, especially for elderly patients. Practically relevant alternatives are regular walking and aquatraining, which may also lead to a significant increase in bone mineral density. Furthermore, large effects can be achieved with alternating side whole-body vibration (WBV) training with whole body vibration plates with only 3 days of training per week and with short training periods (15-20 min). Rates of increase in leg strength between 20 % and almost 40 % and in bone density between 0.5 % and 4 % in 6 months have been described. Whether and with what intensity whole body vibration therapy could be used for e.g. more rapid healing of fractures, is currently unclear. Initial positive results have been described in animal models.
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Relationships between self-reported lifetime physical activity, estimates of current physical fitness, and aBMD in adult premenopausal women. Arch Osteoporos 2015; 10:34. [PMID: 26424470 DOI: 10.1007/s11657-015-0239-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 09/21/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED Osteoporosis is common, and physical activity is important in its prevention and treatment. Of the categories of historical physical activity (PA) examined, we found that weight-bearing and very hard physical activity had the strongest relationships with areal bone mineral density (aBMD) throughout growth and into adulthood, while for measures of strength, only grip strength proved to be an independent predictor of aBMD. PURPOSE/INTRODUCTION To examine relationships between aBMD (total body, lumbar spine, proximal femur, tibial shaft, distal radius) and estimates of historical PA, current strength, and cardiovascular fitness in adult premenopausal women. METHODS One hundred fifty-two adult premenopausal women (40 ± 9.6 years) undertook aBMD (dual-energy X-ray absorptiometry (DXA)) and completed surveys to estimate historical physical activity representative of three decades (Kriska et al. [1]), while subsets underwent functional tests of isokinetic strength (hamstrings and quadriceps), grip strength (hand dynamometer), and maximum oxygen uptake (MaxV02; cycle ergometer). Historical PA was characterized by demand (metabolic equivalents, PA > 3 METS; PA > 7 METS) and type (weight-bearing; high impact). RESULTS Significant positive independent predictors varied by decade and site, with weight-bearing exercise and PA > 3 METS significant for the tibial shaft (10-19 decade) and only PA > 7 METS significant for the final two decades (20-29 and 30-39 years; total body and total hip). A significant negative correlation between high impact activity and tibial shaft aBMD appeared for the final decade. For strength measures, only grip strength was an independent predictor (total body, total hip), while MaxV02 provided a significant independent prediction for the tibial shaft. CONCLUSIONS Past PA > 7 METS was positively associated with aBMD, and such activity should probably constitute a relatively high proportion of all weekly PA to positively affect aBMD. The findings warrant more detailed investigations in a prospective study, specifically also investigating the potentially negative effects of high impact PA on tibial aBMD.
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Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts. J Aging Phys Act 2015; 24:268-74. [PMID: 26421605 DOI: 10.1123/japa.2015-0060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (-0.53; -0.77, -0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (-0.39; -0.63, -0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.
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Niinimäki S, Härkönen L, Nikander R, Abe S, Knüsel C, Sievänen H. The cross-sectional area of the gluteus maximus muscle varies according to habitual exercise loading: Implications for activity-related and evolutionary studies. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2015; 67:125-37. [PMID: 26384568 DOI: 10.1016/j.jchb.2015.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 06/22/2015] [Indexed: 12/25/2022]
Abstract
Greater size of the gluteus maximus muscle in humans compared to non-human primates has been considered an indication of its function in bipedal posture and gait, especially running capabilities. Our aim was to find out how the size of the gluteus maximus muscle varies according to sports while controlling for variation in muscle strength and body weight. Data on gluteus maximus muscle cross-sectional area (MCA) were acquired from magnetic resonance images of the hip region of female athletes (N=91), and physically active controls (N=20). Dynamic muscle force was measured as counter movement jump and isometric knee extension force as leg press. Five exercise loading groups were created: high impact (triple-jumpers and high-jumpers), odd impact (soccer and squash players), high magnitude (power-lifters), repetitive impact (endurance runners) and repetitive non-impact (swimmers) loadings. Individuals in high impact, odd impact or high-magnitude loading groups had greater MCA compared to those of controls, requiring powerful hip extension, trunk stabilization in rapid directional change and high explosive muscle force. Larger body size and greater muscle strength were associated with larger MCA. An increase in dynamic force was associated with larger MCA, but the strength of this relationship varied with body weight. Thus, gluteal adaptation in humans promotes powerful lower limb movements required in sprinting and rapid changes in direction, as well as maintenance and stabilization of an erect trunk which also provides a platform for powerful motions of the upper limbs. These movements have likely evolved to facilitate food acquisition, including hunting.
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Affiliation(s)
- Sirpa Niinimäki
- Department of Archaeology, University of Oulu, PO Box 1000, 90014 Oulu, Finland; Department of Ecology, University of Oulu, PO Box 3000, 90014 Oulu, Finland.
| | - Laura Härkönen
- Department of Ecology, University of Oulu, PO Box 3000, 90014 Oulu, Finland; Department of Biology, University of Eastern Finland, PO Box 111, 80101 Joensuu, Finland
| | - Riku Nikander
- Department of Health Sciences, University of Jyväskylä, PO BOX 35, 40014 Jyväskylä, Finland; GeroCenter Foundation for Aging Research and Development, Rautpohjankatu 8, 40700 Jyväskylä, Finland; Jyväskylä Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland
| | - Shinya Abe
- Department of Mechanical Engineering and Industrial Systems, Tampere University of Technology, PO Box 589, 33101 Tampere, Finland
| | - Christopher Knüsel
- De la Préhistoire à l'Actuel-Culture, Environnement, et Anthropologie (PACEA), UMR5199 PACEA, Bâtiment B8, Allée Geoffroy Saint Hilaire, CS 50023, Pessac Cedex 33615, France
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, PO Box 30, 33501 Tampere, Finland
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Allison SJ, Poole KES, Treece GM, Gee AH, Tonkin C, Rennie WJ, Folland JP, Summers GD, Brooke-Wavell K. The Influence of High-Impact Exercise on Cortical and Trabecular Bone Mineral Content and 3D Distribution Across the Proximal Femur in Older Men: A Randomized Controlled Unilateral Intervention. J Bone Miner Res 2015; 30:1709-16. [PMID: 25753495 DOI: 10.1002/jbmr.2499] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/23/2015] [Accepted: 03/03/2015] [Indexed: 02/02/2023]
Abstract
Regular exercisers have lower fracture risk, despite modest effects of exercise on bone mineral content (BMC). Exercise may produce localized cortical and trabecular bone changes that affect bone strength independently of BMC. We previously demonstrated that brief, daily unilateral hopping exercises increased femoral neck BMC in the exercise leg versus the control leg of older men. This study evaluated the effects of these exercises on cortical and trabecular bone and its 3D distribution across the proximal femur, using clinical CT. Fifty healthy men had pelvic CT scans before and after the exercise intervention. We used hip QCT analysis to quantify BMC in traditional regions of interest and estimate biomechanical variables. Cortical bone mapping localized cortical mass surface density and endocortical trabecular density changes across each proximal femur, which involved registration to a canonical proximal femur model. Following statistical parametric mapping, we visualized and quantified statistically significant changes of variables over time in both legs, and significant differences between legs. Thirty-four men aged mean (SD) 70 (4) years exercised for 12-months, attending 92% of prescribed sessions. In traditional regions of interest, cortical and trabecular BMC increased over time in both legs. Cortical BMC at the trochanter increased more in the exercise than control leg, whereas femoral neck buckling ratio declined more in the exercise than control leg. Across the entire proximal femur, cortical mass surface density increased significantly with exercise (2.7%; p < 0.001), with larger changes (> 6%) at anterior and posterior aspects of the femoral neck and anterior shaft. Endocortical trabecular density also increased (6.4%; p < 0.001), with localized changes of > 12% at the anterior femoral neck, trochanter, and inferior femoral head. Odd impact exercise increased cortical mass surface density and endocortical trabecular density, at regions that may be important to structural integrity. These exercise-induced changes were localized rather than being evenly distributed across the proximal femur.
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Affiliation(s)
- Sarah J Allison
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | | | | | - Andrew H Gee
- Department of Engineering, University of Cambridge
| | - Carol Tonkin
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Winston J Rennie
- Department of Radiology, University Hospitals of Leicester, Leicester, UK
| | - Jonathan P Folland
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Gregory D Summers
- Department of Rheumatology, Derby Hospitals NHS Foundation Trust, Derby, UK
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Tolonen S, Sievänen H, Mikkilä V, Telama R, Oikonen M, Laaksonen M, Viikari J, Kähönen M, Raitakari OT. Adolescence physical activity is associated with higher tibial pQCT bone values in adulthood after 28-years of follow-up--the Cardiovascular Risk in Young Finns Study. Bone 2015; 75:77-83. [PMID: 25697084 DOI: 10.1016/j.bone.2015.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 01/30/2015] [Accepted: 02/09/2015] [Indexed: 11/16/2022]
Abstract
High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3-18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3-6-years (N=395-421) and 9-18-years (N=923-965). At the age of 31-46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm(2)), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm(3)), stress-strain index (SSI; mm(3), for the shaft only), bone strength index (BSI; mg(2)/cm(4), for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9-18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33-0.53, P≤0.05; P-values for trend 0.002-0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48-0.53, P≤0.05; P-values for trend 0.01-0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low energy fractures during the follow-up. In conclusion, frequent habitual physical activity in adolescence seems to confer benefits on tibial bone size and geometry in adulthood.
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Affiliation(s)
- S Tolonen
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Vaasa Central Hospital, Vaasa, Finland.
| | - H Sievänen
- The UKK-institute for Health Promotion Research, Tampere, Finland
| | - V Mikkilä
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - R Telama
- LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - M Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - M Laaksonen
- Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland
| | - J Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Finland
| | - M Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - O T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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47
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Moreira LDF, Oliveira MLD, Lirani-Galvão AP, Marin-Mio RV, Santos RND, Lazaretti-Castro M. Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. ACTA ACUST UNITED AC 2015; 58:514-22. [PMID: 25166042 DOI: 10.1590/0004-2730000003374] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/28/2014] [Indexed: 11/21/2022]
Abstract
Physical exercise is an important stimulus for osteoporosis prevention and treatment. However, it is not clear yet which modality would be better to stimulate bone metabolism and enhance physical function of postmenopausal women. This review paper aims to summarize and update present knowledge on the effects of different kinds of aquatic and ground physical exercises on bone metabolism and physical function of postmenopausal women. Moderate to intense exercises, performed in a high speed during short intervals of time, in water or on the ground, can be part of a program to prevent and treat postmenopausal osteoporosis. Mechanical vibration has proven to be beneficial for bone microarchitecture, improving bone density and bone strength, as well as increasing physical function. Although impact exercises are recognized as beneficial for the stimulation of bone tissue, other variables such as muscle strength, type of muscle contraction, duration and intensity of exercises are also determinants to induce changes in bone metabolism of postmenopausal women. Not only osteoanabolic exercises should be recommended; activities aimed to develop muscle strength and body balance and improve the proprioception should be encouraged to prevent falls and fractures.
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Affiliation(s)
| | - Mônica Longo de Oliveira
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Ana Paula Lirani-Galvão
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Rosângela Villa Marin-Mio
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Marise Lazaretti-Castro
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
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48
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Florio CS. Development and implementation of a coupled computational muscle force optimization bone shape adaptation modeling method. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2015; 31:e02699. [PMID: 25645885 DOI: 10.1002/cnm.2699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/14/2014] [Accepted: 11/17/2014] [Indexed: 06/04/2023]
Abstract
Improved methods to analyze and compare the muscle-based influences that drive bone strength adaptation can aid in the understanding of the wide array of experimental observations about the effectiveness of various mechanical countermeasures to losses in bone strength that result from age, disuse, and reduced gravity environments. The coupling of gradient-based and gradientless numerical optimization routines with finite element methods in this work results in a modeling technique that determines the individual magnitudes of the muscle forces acting in a multisegment musculoskeletal system and predicts the improvement in the stress state uniformity and, therefore, strength, of a targeted bone through simulated local cortical material accretion and resorption. With a performance-based stopping criteria, no experimentally based or system-based parameters, and designed to include the direct and indirect effects of muscles attached to the targeted bone as well as to its neighbors, shape and strength alterations resulting from a wide range of boundary conditions can be consistently quantified. As demonstrated in a representative parametric study, the developed technique effectively provides a clearer foundation for the study of the relationships between muscle forces and the induced changes in bone strength. Its use can lead to the better control of such adaptive phenomena.
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Affiliation(s)
- C S Florio
- Department of Mechanical and Industrial Engineering, Newark College of Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, 07102, U.S.A
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49
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Abstract
Bone fragility is a major health concern, as the increased risk of bone fractures has devastating outcomes in terms of mortality, decreased autonomy, and healthcare costs. Efforts made to address this problem have considerably increased our knowledge about the mechanisms that regulate bone formation and resorption. In particular, we now have a much better understanding of the cellular events that are triggered when bones are mechanically stimulated and how these events can lead to improvements in bone mass. Despite these findings at the molecular level, most exercise intervention studies reveal either no effects or only minor benefits of exercise programs in improving bone mineral density (BMD) in osteoporotic patients. Nevertheless, and despite that BMD is the gold standard for diagnosing osteoporosis, this measure is only able to provide insights regarding the quantity of bone tissue. In this article, we review the complex structure of bone tissue and highlight the concept that its mechanical strength stems from the interaction of several different features. We revisited the available data showing that bone mineralization degree, hydroxyapatite crystal size and heterogeneity, collagen properties, osteocyte density, trabecular and cortical microarchitecture, as well as whole bone geometry, are determinants of bone strength and that each one of these properties may independently contribute to the increased or decreased risk of fracture, even without meaningful changes in aBMD. Based on these findings, we emphasize that while osteoporosis (almost) always causes bone fragility, bone fragility is not always caused just by osteoporosis, as other important variables also play a major role in this etiology. Furthermore, the results of several studies showing compelling data that physical exercise has the potential to improve bone quality and to decrease fracture risk by influencing each one of these determinants are also reviewed. These findings have meaningful clinical repercussions as they emphasize the fact that, even without leading to improvements in BMD, exercise interventions in patients with osteoporosis may be beneficial by improving other determinants of bone strength.
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50
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Tveit M, Rosengren BE, Nilsson JÅ, Karlsson MK. Exercise in youth: High bone mass, large bone size, and low fracture risk in old age. Scand J Med Sci Sports 2014; 25:453-61. [DOI: 10.1111/sms.12305] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 01/09/2023]
Affiliation(s)
- M. Tveit
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopaedics and Clinical Sciences; Skåne University Hospital, Lund University; Malmö Sweden
| | - B. E. Rosengren
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopaedics and Clinical Sciences; Skåne University Hospital, Lund University; Malmö Sweden
| | - J. Å. Nilsson
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopaedics and Clinical Sciences; Skåne University Hospital, Lund University; Malmö Sweden
| | - M. K. Karlsson
- Clinical and Molecular Osteoporosis Research Unit; Department of Orthopaedics and Clinical Sciences; Skåne University Hospital, Lund University; Malmö Sweden
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