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Civil R, Brook MS, Santos L, Varley I, Elliott-Sale KJ, Lensu S, Ahtiainen JP, Kainulainen H, Koch LG, Britton SL, Wilkinson DJ, Smith K, Atherton PJ, Sale C. The effects of endurance trainability phenotype, sex, and interval running training on bone collagen synthesis in adult rats. Bone 2024; 189:117257. [PMID: 39299627 DOI: 10.1016/j.bone.2024.117257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 09/12/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024]
Abstract
Bone is influenced by many factors such as genetics and mechanical loading, but the short-term physiological effects of these factors on bone (re)modelling are not well characterised. This study investigated the effects of endurance trainability phenotype, sex, and interval running training (7-week intervention) on bone collagen formation in rats using a deuterium oxide stable isotope tracer method. Bone samples of the femur diaphysis, proximal tibia, mid-shaft tibia, and distal tibia were collected after necropsy from forty-six 9 ± 3-month male and female rats selectively bred for yielding low (LRT) or high (HRT) responses to endurance training. Bone collagen proteins were isolated and hydrolysed, and fractional synthetic rates (FSRs) were determined by the incorporation of deuterium into protein-bound alanine via GC-pyrolysis-IRMS. There was a significant large main effect of phenotype at the femur site (p < 0.001; η2g = 0.473) with HRT rats showing greater bone collagen FSRs than LRT rats. There was a significant large main effect of phenotype (p = 0.008; η2g = 0.178) and a significant large main effect of sex (p = 0.005; η2g = 0.196) at the proximal site of the tibia with HRT rats showing greater bone collagen FSRs than LRT rats, and male rats showing greater bone collagen FSRs compared to female rats. There was a significant large main effect of training at the mid-shaft site of the tibia (p = 0.012; η2g = 0.159), with rats that underwent interval running training having greater bone collagen FSRs than control rats. Similarly, there was a significant large main effect of training at the distal site of the tibia (p = 0.050; η2g = 0.156), with rats in the interval running training group having greater bone collagen FSRs compared to rats in the control group. Collectively, this evidence highlights that bone responses to physiological effects are site-specific, indicating that interval running training has positive effects on bone collagen synthesis at the tibial mid-shaft and distal sites, whilst genetic factors affect bone collagen synthesis at the femur diaphysis (phenotype) and proximal tibia (phenotype and sex) in rats.
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Affiliation(s)
- Rita Civil
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.; Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Matthew S Brook
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences at the University of Nottingham, Nottingham, UK.; Centre of Metabolism, Ageing & Physiology (CMAP), MRC-Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research, Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Derby, UK
| | - Lívia Santos
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Sanna Lensu
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Centre for Interdisciplinary Brain Research, Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Heikki Kainulainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauren G Koch
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Steven L Britton
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel J Wilkinson
- Centre of Metabolism, Ageing & Physiology (CMAP), MRC-Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research, Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Derby, UK
| | - Kenneth Smith
- Centre of Metabolism, Ageing & Physiology (CMAP), MRC-Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research, Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Derby, UK
| | - Philip J Atherton
- Centre of Metabolism, Ageing & Physiology (CMAP), MRC-Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research, Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Derby, UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK.; Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
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Hou J, Mao H, Xie P, Cui Y, Rong M. The effect of different traditional Chinese exercises on bone mineral density in menopausal women: a systematic review and network meta-analysis. Front Public Health 2024; 12:1430608. [PMID: 39328990 PMCID: PMC11425856 DOI: 10.3389/fpubh.2024.1430608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/19/2024] [Indexed: 09/28/2024] Open
Abstract
Objective To evaluate the optimal choice of traditional Chinese exercise (TCE) for improving bone mineral density in postmenopausal women through a network meta-analysis. Methods The Chinese and English databases were searched, including China National Knowledge Infrastructure, Chongqing VIP, PubMed, Web of Science and Cochrane Library. The outcomes included BMD of lumbar L2-L4, femoral neck, ward triangle, and greater trochanter. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to assess the correlation between each group of interventions, and surface under the cumulative ranking (SUCRA) was used to rank the best interventions. Results A total of 20 randomized controlled trials (RCTs) including 1933 subjects and six interventions: [Tai Chi (TC), Baduanjin (BDJ), Wuqinxi (WQX), Yijinjing (YJJ), TA (Tai chi plus calcium supplementation), BA (Baduanjin plus calcium supplementation)] and three control measures: [Calcium supplementation (CA), Aerobic exercise (AE), Not exercise intervention (NEI)] were analyzed. Regarding BMD of lumbar L2-L4: TC [SMD = 0.99 (0.62, 1.37)], BDJ [SMD = 2.12 (1.39, 2.85)], TA [SMD = 1.12(0.17, 2.07)], BA [SMD = 2.24 (1.16, 3.31)] were superior in increasing BMD of lumbar L2-L4 relative to NEI. Regarding BMD of femoral neck: TC [SMD = 1.24 (0.70, 1.78)], BA [SMD = 3.77 (1.98, 5.56)] were superior in increasing BMD of femoral neck relative to NEI. Regarding BMD of ward's triangle: TC [SMD = 1.63 (1.09, 2.17)] was superior in increasing BMD of ward's triangle relative to NEI. Regarding BMD of greater trochanter: TC [SMD = 0.98 (0.28, 1.68)] were superior in increasing BMD of greater trochanter relative to NEI. TC topped the SUCRA with BMD of lumbar L2-L4: 53.8, femoral neck: 74.9, ward's triangle: 86.9 and greater trochanter: 77.7. Conclusion Four TCE (TC, BDJ, TA and BA) are all effective in partially improving BMD indicators in postmenopausal women, while TC was effective on all four BMD indicators, which seems to be recommended as the most suitable exercise modality for postmenopausal women. Systematic review registration This research follows the PRISMA Network statement. The protocol for this study has been registered in the International Prospective Registry of Systematic Reviews (PROSPERO). CRD42023414944.
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Affiliation(s)
- Jun Hou
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Haiping Mao
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Peiyao Xie
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yuemei Cui
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Ming Rong
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
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Hardaker NJ, Hume PA, Sims ST. Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1595-1665. [PMID: 38536647 DOI: 10.1007/s40279-024-02010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist. RESULTS Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition. DISCUSSION Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes. CONCLUSIONS Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury. TRIAL REGISTRY PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).
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Affiliation(s)
- Natalie J Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Tech & Policy Lab, Law School, The University of Western Australia, Perth, Australia
| | - Stacy T Sims
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
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Akai K, Nagai K, Tsuji S, Hirose K, Maruyama D, Matsuzawa R, Tamaki K, Kusunoki H, Wada Y, Shinmura K. Association between Bone Quality and Physical Activity in Community-Dwelling Older Adults. Geriatrics (Basel) 2024; 9:62. [PMID: 38804319 PMCID: PMC11130900 DOI: 10.3390/geriatrics9030062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Bone quality is an essential factor determining bone strength. However, the relationship between physical activity (PA) and bone quality remains unclear. This study aimed to ascertain the relationship between bone quality and PA using a cortical bone quantitative ultrasound device that measures components of bone quality. In this cross-sectional study, bone quality was assessed in community-dwelling older adults by measuring the cortical speed of sound (cSOS) at the mid-tibia using a quantitative ultrasound device. Using a wrist-worn accelerometer, we calculated the daily duration of moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) based on estimated METs from the accelerometer data, without differentiating between types of activities. A multiple regression analysis was performed to examine the association between PA and the cSOS. The participants' physical activity averaged 42.0 min/day for MVPA and 483.6 min/day for LPA. No significant association was observed between PA and bone quality in either men or women in the crude models. Furthermore, PA was not significantly correlated with the cSOS in the models adjusted for age, body mass index, nutrient intake, number of medications, and kidney disease. This study was a cross-sectional study which focused on the association between bone quality in older adults and their current amount of PA. The cSOS, as a measure of bone quality, was not associated with PA in men or women. Higher amounts of daily PA, as estimated from metabolic equivalents with an accelerometer, may not necessarily maintain or improve bone quality in older adults. This study does not rule out the potential for a positive association between PA levels or types and bone quality in younger or middle-aged individuals. It was specifically targeted at older adults, and its findings should not be generalized to younger populations. Further longitudinal studies are required to better understand the relationship between PA and bone quality.
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Affiliation(s)
- Koki Akai
- Department of Rehabilitation, JCHO Osaka Hospital, Osaka 553-0003, Japan;
| | - Koutatsu Nagai
- Department of Physical therapy, School of Rehabilitation, Hyogo Medical University, Kobe 650-8530, Japan;
| | - Shotaro Tsuji
- Department of Orthopedic Surgery, Hyogo Medical University, Nishinomiya 663-8501, Japan;
| | - Katsuyoshi Hirose
- Department of Rehabilitation, Matsushita Memorial Hospital, Osaka 570-8540, Japan;
| | - Daisuke Maruyama
- Department of Rehabilitation, Shimada Hospital, Osaka 583-0875, Japan;
| | - Ryota Matsuzawa
- Department of Physical therapy, School of Rehabilitation, Hyogo Medical University, Kobe 650-8530, Japan;
| | - Kayoko Tamaki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Japan; (K.T.); (H.K.); (Y.W.); (K.S.)
| | - Hiroshi Kusunoki
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Japan; (K.T.); (H.K.); (Y.W.); (K.S.)
- Department of Internal Medicine, Osaka Dental University, Hirakata 573-1121, Japan
| | - Yosuke Wada
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Japan; (K.T.); (H.K.); (Y.W.); (K.S.)
- Roppou Clinic, Toyooka 668-0851, Japan
| | - Ken Shinmura
- Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Japan; (K.T.); (H.K.); (Y.W.); (K.S.)
- Department of General Medicine and Community Health Science, Sasayama Medical Center, Hyogo Medical University, Tambasasayama 669-2321, Japan
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Shailendra P, Baldock KL, Li LSK, Gorzelitz J, Matthews CE, Trabert B, Bennie JA, Boyle T. Weight training and risk of all-cause, cardiovascular disease and cancer mortality among older adults. Int J Epidemiol 2024; 53:dyae074. [PMID: 38831478 PMCID: PMC11147802 DOI: 10.1093/ije/dyae074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 05/25/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND While previous studies indicate muscle-strengthening exercises may reduce mortality risk, further research is needed to increase certainty of the evidence. We investigated overall and dose-response associations between weight training and the risks of all-cause, cardiovascular disease (CVD) and cancer mortality in a large cohort of older adults with long follow-up time and a large number of deaths. We also investigated the joint associations of weight training and aerobic exercise with mortality risk. METHODS Weight training was assessed via self-report in 2004-05 in the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study (USA; n = 216 339), with follow-up to 2019. Cox regression estimated the hazard ratios (HR) and 95% confidence intervals (CI) for the associations between weight training and mortality, after adjusting for confounders including aerobic exercise. RESULTS Around 25% of participants [mean age = 69.9 years (standard deviation = 5.4), 58% men] reported engaging in weight training over the past year, and there were 79 107 (37%) deaths. Engaging in any weight training (vs none) was associated with lower risks of all-cause (HR = 0.94; 95% CI = 0.93-0.96), CVD (HR = 0.92; 95% CI = 0.90-0.95) and cancer mortality (HR = 0.95; 95% CI = 0.92-0.98). More time spent in weight training was associated with only marginally greater risk reductions. Larger risk reductions were observed among women than men. Performing both aerobic exercise and weight training conferred the greatest mortality risk reduction; weight training was not associated with mortality risk among participants who did no aerobic exercise. CONCLUSION Performing any amount of weight training lowered mortality risk.
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Affiliation(s)
- Prathiyankara Shailendra
- Australian Centre for Precision Health (ACPreH), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Katherine L Baldock
- Australian Centre for Precision Health (ACPreH), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Lok Sze Katrina Li
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jessica Gorzelitz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Obstetrics and Gynecology, University of Utah, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Jason A Bennie
- Population Health Unit, Murrumbidgee Primary Health Network, Wagga Wagga, NSW, Australia
| | - Terry Boyle
- Australian Centre for Precision Health (ACPreH), University of South Australia, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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Smit A, Meijer O, Winter E. The multi-faceted nature of age-associated osteoporosis. Bone Rep 2024; 20:101750. [PMID: 38566930 PMCID: PMC10985042 DOI: 10.1016/j.bonr.2024.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Age-associated osteoporosis (AAOP) poses a significant health burden, characterized by increased fracture risk due to declining bone mass and strength. Effective prevention and early treatment strategies are crucial to mitigate the disease burden and the associated healthcare costs. Current therapeutic approaches effectively target the individual contributing factors to AAOP. Nonetheless, the management of AAOP is complicated by the multitude of variables that affect its development. Main intrinsic and extrinsic factors contributing to AAOP risk are reviewed here, including mechanical unloading, nutrient deficiency, hormonal disbalance, disrupted metabolism, cognitive decline, inflammation and circadian disruption. Furthermore, it is discussed how these can be targeted for prevention and treatment. Although valuable as individual targets for intervention, the interconnectedness of these risk factors result in a unique etiology for every patient. Acknowledgement of the multifaceted nature of AAOP will enable the development of more effective and sustainable management strategies, based on a holistic, patient-centered approach.
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Affiliation(s)
- A.E. Smit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - O.C. Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - E.M. Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
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Smith C, Sim M, Dalla Via J, Levinger I, Duque G. The Interconnection Between Muscle and Bone: A Common Clinical Management Pathway. Calcif Tissue Int 2024; 114:24-37. [PMID: 37922021 DOI: 10.1007/s00223-023-01146-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/26/2023] [Indexed: 11/05/2023]
Abstract
Often observed with aging, the loss of skeletal muscle (sarcopenia) and bone (osteoporosis) mass, strength, and quality, is associated with reduced physical function contributing to falls and fractures. Such events can lead to a loss of independence and poorer quality of life. Physical inactivity (mechanical unloading), especially in older adults, has detrimental effects on the mass and quality of bone as well as muscle, while increases in activity (mechanical loading) have positive effects. Emerging evidence suggests that the relationship between bone and muscle is driven, at least in part, by bone-muscle crosstalk. Bone and muscle are closely linked anatomically, mechanically, and biochemically, and both have the capacity to function with paracrine and endocrine-like action. However, the exact mechanisms involved in this crosstalk remain only partially explored. Given older adults with lower bone mass are more likely to present with impaired muscle function, and vice versa, strategies capable of targeting both bone and muscle are critical. Exercise is the primary evidence-based prevention strategy capable of simultaneously improving muscle and bone health. Unfortunately, holistic treatment plans including exercise in conjunction with other allied health services to prevent or treat musculoskeletal disease remain underutilized. With a focus on sarcopenia and osteoporosis, the aim of this review is to (i) briefly describe the mechanical and biochemical interactions between bone and muscle; (ii) provide a summary of therapeutic strategies, specifically exercise, nutrition and pharmacological approaches; and (iii) highlight a holistic clinical pathway for the assessment and management of sarcopenia and osteoporosis.
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Affiliation(s)
- Cassandra Smith
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Jack Dalla Via
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Gustavo Duque
- Bone, Muscle & Geroscience Research Group, Research Institute of the MUHC, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
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8
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Fausto DY, Martins JBB, Machado AC, Saraiva PS, Pelegrini A, Guimarães ACA. What is the evidence for the effect of physical exercise on bone health in menopausal women? An umbrella systematic review. Climacteric 2023; 26:550-559. [PMID: 37673101 DOI: 10.1080/13697137.2023.2249819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/01/2023] [Accepted: 08/12/2023] [Indexed: 09/08/2023]
Abstract
This study aimed to analyze the effects of physical exercise (PE) on bone health in menopausal women through an umbrella review and to assess the quality of systematic reviews (SRs) and meta-analyses (MAs) included. The review was registered in PROSPERO (CRD42020208130) and the Rayyan application was used. The methodological quality of the included studies was evaluated by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to assess the level of evidence of the results. The results showed that low-intensity jumping exercises with longer sessions proved to be efficient in the hip segment. Swimming requires further investigation, as it showed high heterogeneity. Aerobic and resistance exercises showed inconsistent results, requiring further studies with these modalities of PE. Concurrent training showed improvements in the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance exercises are effective in preserving bone mineral density (BMD) of the femoral neck and lumbar spine in postmenopausal women. In conclusion, jumping exercises were efficient in the hip, while aerobic and resistance exercises are still inconsistent. Concurrent training showed improvements in BMD of the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance protocols are effective in preserving BMD of the femoral neck and lumbar spine in postmenopausal women.
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Affiliation(s)
- D Y Fausto
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - J B B Martins
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A C Machado
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - P S Saraiva
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A Pelegrini
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A C A Guimarães
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
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Schlacht TZ, Haque I, Skelton DA. What are the Effects of Exercise on Trabecular Microarchitecture in Older Adults? A Systematic Review and Meta-analysis of HR-pQCT Studies. Calcif Tissue Int 2023; 113:359-382. [PMID: 37725127 PMCID: PMC10516781 DOI: 10.1007/s00223-023-01127-7] [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: 07/18/2023] [Accepted: 08/14/2023] [Indexed: 09/21/2023]
Abstract
The objective of this review was to determine the effects of exercise on high-resolution peripheral quantitative computed tomography (HR-pQCT) derived trabecular microarchitecture parameters in older adults. Five electronic databases were systematically searched by two independent reviewers. Inclusion criteria were adults age ≥ 50, any type of exercise as part of the intervention, and trabecular microarchitecture assessed via HR-pQCT. Data was extracted from included studies, and where suitable, included in a meta-analysis. Quality of included studies was appraised. Seven studies (397 participants) were included. All participants were postmenopausal women. Interventions included jumping, whole-body vibration, and power/plyometric training. All studies were rated as either weak or moderate quality. Meta-analysis (5 studies) showed no significant changes in any parameters when considering all exercise or sub-analysing based on type. Exercise was not found to have significant effects on trabecular microarchitecture in postmenopausal women over the age of 50. These findings should be interpreted with caution due to the small number of studies investigating few modes of exercise, their weak to moderate quality, and risk of bias. High-quality studies are needed to determine the effects of additional types of exercise in a more diverse population of older adults, including men.
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Affiliation(s)
- Thomas Z Schlacht
- Research Centre for Health (ReaCH), Physiotherapy and Paramedicine, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Inaya Haque
- Research Centre for Health (ReaCH), Physiotherapy and Paramedicine, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), Physiotherapy and Paramedicine, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
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10
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Maged AM. Response to Letter to Editor. Menopause 2023; 30:989-990. [PMID: 37625092 DOI: 10.1097/gme.0000000000002253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department Kasr AlAiny Medical School Cairo University Giza, Egypt
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11
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Zouita A, Darragi M, Bousselmi M, Sghaeir Z, Clark CCT, Hackney AC, Granacher U, Zouhal H. The Effects of Resistance Training on Muscular Fitness, Muscle Morphology, and Body Composition in Elite Female Athletes: A Systematic Review. Sports Med 2023; 53:1709-1735. [PMID: 37289331 PMCID: PMC10432341 DOI: 10.1007/s40279-023-01859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Well programmed strength and conditioning training is an indispensable part of the long-term training process for athletes in individual and team sports to improve performance and prevent injuries. Yet, there is a limited number of studies available that examine the effects of resistance training (RT) on muscular fitness and physiological adaptations in elite female athletes. OBJECTIVES This systematic review aimed to summarize recent evidence on the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. MATERIALS AND METHODS A systematic literature search was conducted in nine electronic databases (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until March 2022. Key search terms from the MeSH database such as RT and strength training were included and combined using the operators "AND," "OR," and "NOT". The search syntax initially identified 181 records. After screening for titles, abstracts, and full texts, 33 studies remained that examined the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. RESULTS Twenty-four studies used single-mode RT or plyometric training and nine studies investigated the effects of combined training programs such as resistance with plyometric or agility training, resistance and speed training, and resistance and power training. The training duration lasted at least 4 weeks, but most studies used ~ 12 weeks. Studies were generally classified as 'high-quality' with a mean PEDro score of 6.8 (median 7). Irrespective of the type or combination of RT with other strength-dominated exercise regimens (type of exercise, exercise duration, or intensity), 24 out of 33 studies reported increases in muscle power (e.g., maximal and mean power; effect size [ES]: 0.23 < Cohen's d < 1.83, small to large), strength (e.g., one-repetition-maximum [1RM]; ES: 0.15 < d < 6.80, small to very large), speed (e.g., sprint times; ES: 0.01 < d < 1.26, small to large), and jump performance (e.g., countermovement/squat jump; ES: 0.02 < d < 1.04, small to large). The nine studies that examined the effects of combined training showed significant increases on maximal strength (ES: 0.08 < d < 2.41, small to very large), muscle power (ES: 0.08 < d < 2.41, small to very large), jump and sprint performance (ES: 0.08 < d < 2.41, small to very large). Four out of six studies observed no changes in body mass or percentage of body fat after resistance or plyometric training or combined training (ES: 0.026 < d < 0.492, small to medium). Five out of six studies observed significant changes in muscle morphology (e.g., muscle thickness, muscle fiber cross-sectional area; ES: 0.23 < d < 3.21, small to very large). However, one study did not find any changes in muscle morphology (i.e., muscle thickness, pennation angle; ES: 0.1 < d < 0.19, small). CONCLUSION Findings from this systematic review suggest that RT or combined RT with other strength-dominated exercise types leads to significant increases in measures of muscle power, strength, speed, and jump performance in elite female athletes. However, the optimal dosage of programming parameters such as training intensity and duration necessary to induce large effects in measures of muscular fitness and their physiological adaptations remain to be resolved in female elite athletes.
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Affiliation(s)
- Amira Zouita
- Higher Institute of Sport and Physical Education of Ksar-Said, Research Unit "Sports Performance, Health & Society" (UR17JS01), University of Manouba, Manouba, Tunisia
| | - Manel Darragi
- Higher Institute of Sport and Physical Education of Ksar-Said, Research Unit "Sports Performance, Health & Society" (UR17JS01), University of Manouba, Manouba, Tunisia
| | - Mariem Bousselmi
- Higher Institute of Sport and Physical Education of Ksar-Said, Research Unit "Sports Performance, Health & Society" (UR17JS01), University of Manouba, Manouba, Tunisia
| | - Zouita Sghaeir
- Higher Institute of Sport and Physical Education of Ksar-Said, University of Manouba, Manouba, Tunisia
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany.
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé), EA 1274, 35000, Rennes, France.
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12
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Lu X, Wei J, Liu Y, Lu Y. Effects of exercise on bone mineral density in middle-aged and older men: A comprehensive meta-analysis. Arch Osteoporos 2023; 18:108. [PMID: 37548809 DOI: 10.1007/s11657-023-01317-8] [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: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
This meta-analysis including 10 randomised controlled trials suggests that exercise is associated with a statistically significant, but relatively mild, improvement effect on bone mineral density in middle-aged and older men, indicating that exercise has the potential to be a safe and effective way toavert bone loss in men. PURPOSE To determine the effect of exercise on bone mineral density (BMD) in middle-aged and older men. METHODS We searched three electronic databases up to March 21, 2022. A systematic review of the literature according to the PRISMA statement included (1) randomised controlled trials (RCTs), with (2) at least one exercise group as an intervention versus a control group, (3) men aged ≥ 45 years old, and (4) areal BMD of the lumbar spine (LS) and/or femoral neck (FN) and/or total hip (TH) and/or trochanter region. Mean differences (MD) for BMD changes at the LS, FN, TH, and trochanter were defined as outcome measures. RESULTS A total of 10 eligible RCTs were included (N = 555 participants). Exercise significantly improved BMD, and the summarised MD was 0.02 (95% CI: 0.00 to 0.05) for LS BMD, 0.01 (95% CI: 0.00 to 0.02) for FN BMD, 0.01 (95% CI: 0.00 to 0.01) for TH BMD, and 0.03 (95% CI: 0.00 to 0.05) for trochanter BMD. Subgoup analyses showed the improvement effect was statistically significant in trials with longer duration and higher intensity in LS (≥ 12 months: MD, 0.01, 95% CI:0.00 to 0.03; higher intensity: MD, 0.01, 95% CI:0.00 to 0.03) and FN (≥ 12 months: MD, 0.02, 95% CI:0.01 to 0.02; higher intensity: MD, 0.01, 95% CI:0.01 to 0.02). CONCLUSION Our results suggested a relatively mild, improvement effect of exercise on LS and proximal femur BMD. Exercise has the potential to be an effective way to avert bone loss in middle-aged and older men.
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Affiliation(s)
- Xiaoqin Lu
- Department of General Practice, Dongyang People's Hospital, Dongyang, 322100, China
| | - Jiapei Wei
- Department of General Practice, Dongyang People's Hospital, Dongyang, 322100, China
| | - Yupeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325000, China.
| | - Yangzhen Lu
- Department of General Practice, Dongyang People's Hospital, Dongyang, 322100, China.
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13
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Olek RA, Samborowska E, Wisniewski P, Wojtkiewicz P, Wochna K, Zielinski J. Effect of a 3-month L-carnitine supplementation and resistance training program on circulating markers and bone mineral density in postmenopausal women: a randomized controlled trial. Nutr Metab (Lond) 2023; 20:32. [PMID: 37533033 PMCID: PMC10394783 DOI: 10.1186/s12986-023-00752-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 07/26/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Higher circulating levels of trimethylamine N-oxide (TMAO), which is a metabolite that can be produced by the gut microbiota from L-carnitine (LC), have been associated with bone mineral density (BMD). Because LC supplementation can improve bone density and microstructural properties in animal models, this study aimed to examine the effects of 12 weeks of LC supplementation on BMD and selected blood markers involved in bone metabolism of postmenopausal women participating in a resistance training (RT) program. METHODS Twenty-seven postmenopausal women, who had not been treated for osteoporosis, with a total T-score above - 3.0 and no diet differences completed 12 weeks of RT. The participants' diets were supplemented with either 1 g of LC-L-tartrate and 3 g of leucine per day (LC group) or 4 g of leucine per day as a placebo (PLA group), in a double-blind fashion. RESULTS After the intervention in the LC group, plasma total carnitine and serum decorin levels were higher than the corresponding preintervention values (p = 0.040 and p = 0.042, respectively). Moreover, plasma TMAO and serum SPARC levels were higher in the LC group than the corresponding postintervention values in the PLA group (p < 0.001 and p = 0.030, respectively). No changes in the BMD were observed after 3 months of the intervention. CONCLUSIONS Twelve weeks of LC supplementation during RT program increased plasma TMAO levels and appeared to affect signaling molecules, as indicated by the increase in the resting SPARC and decorin levels, with no significant modification in the BMD. TRIAL REGISTRATION Retrospectively registered at the ClinicalTrials.gov (NCT05120011).
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Affiliation(s)
- Robert A Olek
- Department of Athletics, Strength, and Conditioning, Poznan University of Physical Education, Krolowej Jadwigi 27/39, Poznan, 61-871, Poland.
| | - Emilia Samborowska
- Mass Spectrometry Laboratory, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Piotr Wisniewski
- Chair and Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Pawel Wojtkiewicz
- Endoscopy and Metabolic Disorders, Seventh Navy Hospital, Gdansk, Poland
| | - Krystian Wochna
- Department of Swimming and Water Lifesaving, Poznan University of Physical Education, Poznan, Poland
| | - Jacek Zielinski
- Department of Athletics, Strength, and Conditioning, Poznan University of Physical Education, Krolowej Jadwigi 27/39, Poznan, 61-871, Poland
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14
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Feng F, Xu H, Sun Y, Zhang X, Li N, Sun X, Tian X, Zhao R. Exercise for prevention of falls and fall-related injuries in neurodegenerative diseases and aging-related risk conditions: a meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1187325. [PMID: 37534209 PMCID: PMC10393124 DOI: 10.3389/fendo.2023.1187325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Neurodegenerative diseases often cause motor and cognitive deterioration that leads to postural instability and motor impairment, while aging-associated frailty frequently results in reduced muscle mass, balance, and mobility. These conditions increase the risk of falls and injuries in these populations. This study aimed to determine the effects of exercise on falls and consequent injuries among individuals with neurodegenerative diseases and frail aging people. Methods Electronic database searches were conducted in PubMed, Cochrane Library, SportDiscus, and Web of Science up to 1 January 2023. Randomized controlled trials that reported the effects of exercise on falls and fall-related injuries in neurodegenerative disease and frail aging people were eligible for inclusion. The intervention effects for falls, fractures, and injuries were evaluated by calculating the rate ratio (RaR) or risk ratio (RR) with 95% confidence interval (CI). Results Sixty-four studies with 13,241 participants met the inclusion criteria. Exercise is effective in reducing falls for frail aging people (RaR, 0.75; 95% CI, 0.68-0.82) and participants with ND (0.53, 0.43-0.65) [dementia (0.64, 0.51-0.82), Parkinson's disease (0.49, 0.39-0.69), and stroke survivors (0.40, 0.27-0.57)]. Exercise also reduced fall-related injuries in ND patients (RR, 0.66; 95% CI, 0.48-0.90) and decreased fractures (0.63, 0.41-0.95) and fall-related injuries (0.89, 0.84-0.95) among frail aging people. For fall prevention, balance and combined exercise protocols are both effective, and either short-, moderate-, or long-term intervention duration is beneficial. More importantly, exercise only induced a very low injury rate per participant year (0.007%; 95% CI, 0-0.016) and show relatively good compliance with exercise (74.8; 95% CI, 69.7%-79.9%). Discussion Exercise is effective in reducing neurodegenerative disease- and aging-associated falls and consequent injuries, suggesting that exercise is an effective and feasible strategy for the prevention of falls.
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Affiliation(s)
- Feifei Feng
- College of Physical Education, Yangzhou University, Yangzhou, China
- School of Humanities and Education, Guangzhou Nanyang Polytechnic College, Guangzhou, China
| | - Haocheng Xu
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Yu Sun
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xin Zhang
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Nan Li
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xun Sun
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Xin Tian
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Renqing Zhao
- College of Physical Education, Yangzhou University, Yangzhou, China
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15
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Greendale GA, Jackson NJ, Shieh A, Cauley JA, Karvonen-Gutierrez C, Ylitalo KR, Gabriel KP, Sternfeld B, Karlamangla AS. Leisure time physical activity and bone mineral density preservation during the menopause transition and postmenopause: a longitudinal cohort analysis from the Study of Women's Health Across the Nation (SWAN). LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100481. [PMID: 37008197 PMCID: PMC10060105 DOI: 10.1016/j.lana.2023.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/28/2023]
Abstract
Background Whether greater leisure time physical activity (LTPA) is associated with less bone mineral density (BMD) loss during the menopause transition (MT) remains an open question. We hypothesized that: 1) larger increases in LTPA from pre-/early perimenopause (period 1) to late perimenopause/postmenopause (period 2) would be associated with a slower period 2 BMD loss rate; and 2) greater entire-study LTPA levels would be associated with better final absolute BMD (g/cm2). Methods Data were from of the Study of Women's Health Across the Nation (1996-2017). Exclusions were: bone beneficial medications, inability to identify start of the MT, and extreme BMD change rates. LTPA measures were a validated ordinal scale and number of metabolic equivalents per hour per week (MET hr wk-1) from sport/exercise. Multiply adjusted, linear regression models estimated: 1) BMD decline rate (annualized %) as a function of LTPA change; and 2) final BMD as a function of entire-study LTPA. Findings Median [p25, p75] MET hr wk-1 were 4.2 [0.9, 10.1] and 4.9 [1.4, 11.2] in periods 1 and 2, respectively; walking was the commonest activity. In adjusted models (N = 875), greater increases in LTPA ordinal score and MET hr wk-1 were statistically significantly associated with a slower decline in femoral neck (FN) BMD. Larger entire-study averages of each LTPA measure were statistically significantly related to better final FN and lumbar spine BMD levels. Interpretation Findings suggest that LTPA, at modest levels, mitigate MT-related BMD decline and even small increases in intensity, duration or frequency of common activities may lessen bone loss at the population level. Funding US-NIH.
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Affiliation(s)
- Gail A. Greendale
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, CA, USA
| | - Nicholas J. Jackson
- Department of Medicine, Division of General Internal Medicine, UCLA, Los Angeles, CA, USA
| | - Albert Shieh
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, CA, USA
| | - Jane A. Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kelly R. Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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16
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Bae S, Lee S, Park H, Ju Y, Min SK, Cho J, Kim H, Ha YC, Rhee Y, Kim YP, Kim C. Position Statement: Exercise Guidelines for Osteoporosis Management and Fall Prevention in Osteoporosis Patients. J Bone Metab 2023; 30:149-165. [PMID: 37449348 PMCID: PMC10345999 DOI: 10.11005/jbm.2023.30.2.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations. METHODS A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations. RESULTS The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended. CONCLUSIONS A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.
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Affiliation(s)
- Seongryu Bae
- Department of Health Care and Science, Dong-A University, Busan,
Korea
| | - Seungyong Lee
- Department of Physical Education, Incheon National University, Incheon,
Korea
| | - Hyuntae Park
- Department of Health Sciences, Graduate School, Dong-A University, Busan,
Korea
| | - Yongin Ju
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kawasaki,
Japan
| | - Seok-Ki Min
- Department of Sport Science, Korea Institute of Sport Science, Seoul,
Korea
| | - Jinkyung Cho
- Department of Sport Science, Korea Institute of Sport Science, Seoul,
Korea
| | - Hyojin Kim
- Department of Physical Education, Dongduk Women’s University, Seoul,
Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul,
Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul,
Korea
| | - Young-Pyo Kim
- Department of Kinesiology, College of Natural Science, Jeju National University, Jeju,
Korea
| | - Changsun Kim
- Department of Physical Education, Dongduk Women’s University, Seoul,
Korea
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17
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Liu L, Rosen CJ. New Insights into Calorie Restriction Induced Bone Loss. Endocrinol Metab (Seoul) 2023; 38:203-213. [PMID: 37150516 PMCID: PMC10164494 DOI: 10.3803/enm.2023.1673] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Caloric restriction (CR) is now a popular lifestyle choice due to its ability in experimental animals to improve lifespan, reduce body weight, and lessen oxidative stress. However, more and more emerging evidence suggests this treatment requires careful consideration because of its detrimental effects on the skeletal system. Experimental and clinical studies show that CR can suppress bone growth and raise the risk of fracture, but the specific mechanisms are poorly understood. Reduced mechanical loading has long been thought to be the primary cause of weight loss-induced bone loss from calorie restriction. Despite fat loss in peripheral depots with calorie restriction, bone marrow adipose tissue (BMAT) increases, and this may play a significant role in this pathological process. Here, we update recent advances in our understanding of the effects of CR on the skeleton, the possible pathogenic role of BMAT in CR-induced bone loss, and some strategies to mitigate any potential side effects on the skeletal system.
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Affiliation(s)
- Linyi Liu
- MaineHealth Institute for Research, Scarborough, ME, USA
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18
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Manaye S, Cheran K, Murthy C, Bornemann EA, Kamma HK, Alabbas M, Elashahab M, Abid N, Arcia Franchini AP. The Role of High-intensity and High-impact Exercises in Improving Bone Health in Postmenopausal Women: A Systematic Review. Cureus 2023; 15:e34644. [PMID: 36895528 PMCID: PMC9990535 DOI: 10.7759/cureus.34644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/05/2023] [Indexed: 02/07/2023] Open
Abstract
Postmenopausal osteoporosis is a chronic condition with decreased bone mass and altered bone structure, leading to a greater risk of fractures among older women. Exercise has been proposed as a potentially effective non-pharmacological method to prevent this condition. In this systematic review, we investigate the effects and safety of high-impact and high-intensity exercises in improving bone density at popular sites of fragility fractures, namely, the hip and spine. This review also highlights the mechanism of these exercises in improving bone density and other aspects of bone health in postmenopausal women. This study is done adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After applying the eligibility criteria, we selected 10 articles from PubMed and Google Scholar to be included in our study. Based on the findings from the studies, we established that high-intensity and high-impact exercises are effective in improving, or at the very least maintaining, bone density in the lumbar spine and femur in postmenopausal women. An exercise protocol including high-intensity resistance exercises and high-impact training is shown to be most effective in improving bone density and other parameters of bone health. These exercises were found to be safe in older women, however, careful supervision is recommended. All limitations considered, high-intensity and high-impact exercises are an effective strategy to enhance bone density, and potentially reduce the burden of fragility as well as compression fractures in postmenopausal women.
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Affiliation(s)
- Sara Manaye
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kaaviya Cheran
- Department of General Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chinmayee Murthy
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Elisa A Bornemann
- Department of Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Hari Krishna Kamma
- Department of Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammad Alabbas
- Department of Internal Medicine, University of Debrecen, Debrecen, HUN
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammad Elashahab
- Department of Radiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Naushad Abid
- Department of Internal Medicine, King Faisal University, Alahsa, SAU
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ana P Arcia Franchini
- Department of Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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19
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Li F, Xie W, Han Y, Li Z, Xiao J. Bibliometric and visualized analysis of exercise and osteoporosis from 2002 to 2021. Front Med (Lausanne) 2022; 9:944444. [PMID: 36569140 PMCID: PMC9773261 DOI: 10.3389/fmed.2022.944444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
Background Bibliometric analysis was designed to investigate a systematic understanding of developments in exercise and osteoporosis research over the past 20 years. Methods Relevant publications from the Web of Science Core Collection were downloaded on April 26, 2022. CiteSpace, VOSviewer, and the online bibliometric analysis platform were used to conduct this scientometric study. Results A total of 5518 publications were in 1202 academic journals with 137405 co-cited references in by 5637 institutions from 98 countries/regions. The country leading the research was the USA. The University of Melbourne was the most active institution. Osteoporosis International was the most productive journal concerning exercise and osteoporosis research. According to the burst references, "low-level vibration," "high-frequency" and "resistance exercise" have been recognized as the hotspots research in the domain. The keywords co-occurrence analysis identified "skeletal muscle," "sarcopenia" and "mesenchymal stem cell" as the important future research directions. Conclusion This study was the first comprehensive metrological and statistical analysis of exercise and osteoporosis research over the past 20 years. Our findings would provide guidance to understand the research frontiers and hot directions in the near future.
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Affiliation(s)
- Fan Li
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weixin Xie
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Han
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhanchun Li
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Zhanchun Li,
| | - Jie Xiao
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,Jie Xiao,
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20
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Effect of resistance exercise on bone health of old aged individuals: Review. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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21
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Smith C, Hiam D, Tacey A, Lin X, Woessner MN, Zarekookandeh N, Garnham A, Chubb P, Lewis JR, Sim M, Herrmann M, Duque G, Levinger I. Higher bone remodeling biomarkers are related to a higher muscle function in older adults: Effects of acute exercise. Bone 2022; 165:116545. [PMID: 36108920 DOI: 10.1016/j.bone.2022.116545] [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: 03/29/2022] [Revised: 08/14/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Bone and muscle are closely linked mechanically and biochemically. Bone hormones secreted during bone remodeling might be linked to muscle mass and strength maintenance. Exercise elicits high mechanical strain and is essential for bone health. However, the relationship between commonly used bone turnover markers (BTMs) and muscle function in community dwelling older adults remains unclear. It is also unknown how acute exercise with differing mechanical strain may affect BTMs, and whether baseline muscle function alters BTM responses differently. We tested the hypothesis that BTMs are associated with muscle function, and that acute exercise could change the circulating levels of BTMs. Thirty-five older adults (25 females/10 males, 72.8 ± 6.0 years) participated. Baseline assessments included body composition (DXA), handgrip strength and a physical performance test (PPT) (gait speed, timed-up-and-go [TUG], stair ascent/descent). Leg muscle quality (LMQ) and stair climb power (SCP) were calculated. Participants performed (randomized) 30 min aerobic (AE) (cycling 70%HRPeak) and resistance (RE) (leg press 70%RM, jumping) exercise. Serum β-isomerized C-terminal telopeptides (β-CTX), procollagen of type I propeptide (P1NP), total osteocalcin (t)OC and ucOC were assessed at baseline and post-exercise. Data were analyzed using linear mixed models and simple regressions, adjusted for sex. At baseline, higher muscle strength (LMQ, handgrip) was related to higher P1NP, higher SCP was related to higher P1NP and β-CTX, and better physical performance (lower PPT) related to higher P1NP and β-CTX (p < 0.05). Exercise, regardless of mode, decreased β-CTX and tOC (all p < 0.05), while P1NP and ucOC remained unaltered. Higher baseline handgrip strength, SCP and LMQ was associated with lower post-exercise β-CTX responses, and poorer baseline mobility (increased TUG time) was associated with higher post-exercise β-CTX. Independently of exercise mode, acute exercise decreased β-CTX and tOC. Our data suggest that in older adults at baseline, increased BTM levels were linked to better muscle function. Altogether, our data strengthens the evidence for bone-muscle interaction, however, mechanisms behind this specific component of bone-muscle crostalk remain unclear.
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Affiliation(s)
- Cassandra Smith
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Danielle Hiam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Alexander Tacey
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Xuzhu Lin
- Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Mary N Woessner
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Navabeh Zarekookandeh
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Andrew Garnham
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Paul Chubb
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, Australia; Medical School, University Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, University Western Australia, Perth, WA, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Health and Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; Medical School, University Western Australia, Perth, WA, Australia
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia; Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
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22
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Bhatnagar A, Kekatpure AL. Postmenopausal Osteoporosis: A Literature Review. Cureus 2022; 14:e29367. [PMID: 36299953 PMCID: PMC9586717 DOI: 10.7759/cureus.29367] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
A substantial proportion of the population of females in India falls in the perimenopausal and postmenopausal age groups. One of the complications associated with older age in women is the weakening of bones and the fall in bone mineral density (BMD). This has a severe debilitating consequence in a woman’s life and leads to reduced quality of life along with a greater incidence of fractures. If the fracture involves the hip or the vertebrae, it can cause immobility and be devastating. Postmenopausal osteoporosis is linked with the deficiency of estrogen that occurs with the cessation of the function of the ovaries as age progresses. The function of estrogen in the bone remodeling process is very well understood after years of research; estrogen plays a part in both the formation of bone as well as the prevention of the resorption of bone. A diagnosis can be made by dual-energy X-ray absorptiometry (DEXA). It is the gold standard and can spot low bone density at particular sites. The treatment options are selected according to the severity and rate of progression and factors pertaining to each patient. All postmenopausal women should be made aware of this disorder, and they should be encouraged to cultivate a healthy lifestyle through the implementation of a proper diet and inculcation of a regular exercise routine. Smoking and drinking alcohol should be limited, and calcium and vitamin D supplementation should be started in all women of the postmenopausal age group with or without osteoporosis. In patients who have been diagnosed with the disorder, pharmacological intervention is done. Drugs should be selected based on their side effects and contradictions. Follow-up is essential, and patient compliance should be carefully monitored. This article attempts to review the existing literature on this very prevalent disorder to spread awareness about it so that all postmenopausal women can take the necessary steps to prevent the weakening of their bones, and deal with its progression.
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Liu X, Jiang C, Fan R, Liu T, Li Y, Zhong D, Zhou L, Liu T, Li J, Jin R. The effect and safety of Tai Chi on bone health in postmenopausal women: A meta-analysis and trial sequential analysis. Front Aging Neurosci 2022; 14:935326. [PMID: 36177477 PMCID: PMC9513206 DOI: 10.3389/fnagi.2022.935326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTai Chi may be a promising exercise to prevent and control bone loss in postmenopausal women. This meta-analysis and trial sequential analysis aimed to evaluate the effect and safety of Tai Chi on bone health in postmenopausal women.MethodSeven databases were searched from their inceptions to 11 May 2022 to collect randomized controlled trials (RCTs) investigating the effect and safety of Tai Chi on bone health in postmenopausal women. Two independent reviewers identified the eligible studies, extracted data, and assessed the risk of bias of included studies using the revised Cochrane risk-of-bias tool for randomized trials. The primary outcome was the bone mineral density (BMD), and secondary outcomes included bone turnover markers and calcaneus quantitative ultrasound. Subgroup analyses were conducted based on the duration of Tai Chi. Sensitivity analyses and publication bias assessment were performed. RevMan software (version 5.4.1) and R software (version 3.6.1) were used for data synthesis. The certainty of evidence was rated with the Grading of recommendations assessment, development, and evaluation (GRADE) system. We also performed the trial sequential analysis to evaluate the reliability of the evidence.ResultsA total of 25 reports involving 24 studies were included. Four studies were considered as high overall risk of bias, and the rest were some concerns. Among included studies, there were three comparisons including Tai Chi vs. non-intervention, Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. Compared with non-intervention, Tai Chi was more effective to improve BMD of lumbar spine (MD = 0.04, 95% CI 0.02 to 0.07, I2 = 0%, low certainty), femoral neck (MD = 0.04, 95% CI 0.02 to 0.06, I2 = 0%, low certainty), and trochanter (MD = 0.02, 95% CI 0.00 to 0.03, I2 = 0%, very low certainty), but there was no significant difference in increasing the BMD of Ward's triangle (MD = 0.02, 95% CI −0.01 to 0.04, I2 = 0%, very low certainty). Trial sequential analysis showed that the effect of Tai Chi vs. non-intervention on the BMD of lumbar spine and femoral neck was reliable, but the effect on the BMD of trochanter and Ward's triangle needed further verification. The subgroup analyses suggested that Tai Chi training for over 6 months had greater improvement in BMD of the lumbar spine, femoral neck, and trochanter than non-intervention. No significant differences were observed in the above outcomes of Tai Chi vs. other exercises, and Tai Chi plus nutraceutical vs. nutraceutical. There was insufficient evidence to support the effect of Tai Chi on bone turnover markers and calcaneus quantitative ultrasound. Few Tai Chi relevant adverse events occurred.ConclusionTai Chi may be an optional and safe exercise for improving BMD loss in postmenopausal women, and practicing Tai Chi for more than 6 months may yield greater benefits. However, more rigorously designed RCTs are required to verify the benefits and to explore the optimal protocol of Tai Chi exercise for bone health.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309148, identifier: CRD42022309148.
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Affiliation(s)
- Xiaobo Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengzhi Jiang
- Department of Rehabilitation Medicine, Sichuan Science City Hospital, Mianyang, China
| | - Rong Fan
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Tianyu Liu
- School of Sport and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Luxiang Zhou
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Liu
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Juan Li
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Integrated Traditional Chinese and Western Medicine Hospital of Panzhihua City, Panzhihua, China
- Rongjiang Jin
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Lopes KG, das Graças Coelho de Souza M, da Costa Tavares Bezerra M, Bessa LM, Farinatti P, Bouskela E, Madeira M, Kraemer-Aguiar LG. Effects of physical training on physical and functional fitness, physical activity level, endothelial function, hemodynamic variables, bone metabolism, and quality of life of post-bariatric patients: study protocol for a randomized controlled trial. Trials 2022; 23:733. [PMID: 36056396 PMCID: PMC9438121 DOI: 10.1186/s13063-022-06677-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence of the benefits induced from resistance exercise on health markers of post-bariatric patients is limited. The study will investigate the effects of a resistance training (RT) program on muscle mass and strength, bone metabolism biomarkers, bone mineral density (BMD), bone microarchitecture, and endothelial function of patients subjected to Roux-en-Y gastric bypass. METHODS/DESIGN This randomized controlled trial will include 60 post-bariatric patients, physically inactive, aging 18 to 50 years, with a post-surgery period ≥ 12 months. They will be randomly assigned into two groups: (i) the non-exercised control group, which will receive the standard clinical follow-up, or (ii) the intervention group which will consist of RT (60 min/session; 3 times/week, for 6 months). The primary outcomes will include muscle mass and strength, bone metabolism biomarkers, BMD, and bone microarchitecture. The secondary outcomes will be anthropometry, hemodynamic measurements, cardiovascular risk factors, health-related quality of life (QoL), and endothelial function. Outcomes will be assessed by blood biomarkers of bone formation and reabsorption, dual X-ray absorptiometry, repetition maximum and handgrip strength tests, high-resolution peripheral quantitative computed tomography, 36-Item Short-Form Health Survey, venous occlusion plethysmography, and nailfold videocapillaroscopy. DISCUSSION It is expected that there are greater benefits from the RT program, possibly improving muscle mass and strength, bone metabolism, density and microarchitecture, QoL, and cardiovascular risk. TRIAL REGISTRATION ClinicalTrials.gov NCT04193397. Registered on 7 December 2019.
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Affiliation(s)
- Karynne Grutter Lopes
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Maria das Graças Coelho de Souza
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle da Costa Tavares Bezerra
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucas Miranda Bessa
- Federal University of Rio de Janeiro - Endocrinology Division, Rio de Janeiro, RJ, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.,Postgraduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil
| | - Eliete Bouskela
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Miguel Madeira
- Federal University of Rio de Janeiro - Endocrinology Division, Rio de Janeiro, RJ, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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25
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Shailendra P, Baldock KL, Li LSK, Bennie JA, Boyle T. Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. Am J Prev Med 2022; 63:277-285. [PMID: 35599175 DOI: 10.1016/j.amepre.2022.03.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study aimed to systematically review and meta-analyze the relationship between resistance training and all-cause, cardiovascular disease, and cancer mortality. METHODS Systematic review and meta-analysis following PRISMA guidelines (International Prospective Register of Systematic Reviews Registration Number CRD42019136654) was conducted. MEDLINE (OVID), Embase, Emcare, SPORTDiscus, The Cochrane Library, and SCOPUS were searched from inception to June 6, 2021. Included studies reported resistance training as the exposure and all-cause mortality, cardiovascular disease‒specific mortality, and/or cancer-specific mortality as outcome/s. Only studies conducted among nonclinical adult populations (aged ≥18 years) and written in English were included. RESULTS A total of 10 studies were included in the meta-analyses. Compared with undertaking no resistance training, undertaking any amount of resistance training reduced the risk of all-cause mortality by 15% (RR of 6 studies=0.85; 95% CI=0.77, 0.93), cardiovascular disease mortality by 19% (RR of 4 studies=0.81; 95% CI=0.66, 1.00), and cancer mortality by 14% (RR of 5 studies=0.86; 95% CI=0.78, 0.95). A dose-response meta-analysis of 4 studies suggested a nonlinear relationship between resistance training and the risk of all-cause mortality. A maximum risk reduction of 27% was observed at around 60 minutes per week of resistance training (RR=0.74; 95% CI=0.64, 0.86). Mortality risk reductions diminished at higher volumes. DISCUSSION This systematic review and meta-analysis provides the strongest evidence to date that resistance training is associated with reduced risk of all-cause, cardiovascular disease, and cancer-specific mortality. More research is needed to determine whether any potential mortality benefits gained from resistance training diminish at higher volumes.
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Affiliation(s)
- Prathiyankara Shailendra
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Katherine L Baldock
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - L S Katrina Li
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Jason A Bennie
- Physically Active Lifestyles Group, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia.; UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia.
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26
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O'Bryan SJ, Giuliano C, Woessner MN, Vogrin S, Smith C, Duque G, Levinger I. Progressive Resistance Training for Concomitant Increases in Muscle Strength and Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 2022; 52:1939-1960. [PMID: 35608815 PMCID: PMC9325860 DOI: 10.1007/s40279-022-01675-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Older adults experience considerable muscle and bone loss that are closely interconnected. The efficacy of progressive resistance training programs to concurrently reverse/slow the age-related decline in muscle strength and bone mineral density (BMD) in older adults remains unclear. OBJECTIVES We aimed to quantify concomitant changes in lower-body muscle strength and BMD in older adults following a progressive resistance training program and to determine how these changes are influenced by mode (resistance only vs. combined resistance and weight-bearing exercises), frequency, volume, load, and program length. METHODS MEDLINE/PubMed and Embase databases were searched for articles published in English before 1 June, 2021. Randomized controlled trials reporting changes in leg press or knee extension one repetition maximum and femur/hip or lumbar spine BMD following progressive resistance training in men and/or women ≥ 65 years of age were included. A random-effects meta-analysis and meta-regression determined the effects of resistance training and the individual training characteristics on the percent change (∆%) in muscle strength (standardized mean difference) and BMD (mean difference). The quality of the evidence was assessed using the Cochrane risk-of-bias tool (version 2.0) and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria. RESULTS Seven hundred and eighty studies were identified and 14 were included. Progressive resistance training increased muscle strength (∆ standardized mean difference = 1.1%; 95% confidence interval 0.73, 1.47; p ≤ 0.001) and femur/hip BMD (∆ mean difference = 2.77%; 95% confidence interval 0.44, 5.10; p = 0.02), but not BMD of the lumbar spine (∆ mean difference = 1.60%; 95% confidence interval - 1.44, 4.63; p = 0.30). The certainty for improvement was greater for muscle strength compared with BMD, evidenced by less heterogeneity (I2 = 78.1% vs 98.6%) and a higher overall quality of evidence. No training characteristic significantly affected both outcomes (p > 0.05), although concomitant increases in strength and BMD were favored by higher training frequencies, increases in strength were favored by resistance only and higher volumes, and increases in BMD were favored by combined resistance plus weight-bearing exercises, lower volumes, and higher loads. CONCLUSIONS Progressive resistance training programs concomitantly increase lower-limb muscle strength and femur/hip bone mineral density in older adults, with greater certainty for strength improvement. Thus, to maximize the efficacy of progressive resistance training programs to concurrently prevent muscle and bone loss in older adults, it is recommended to incorporate training characteristics more likely to improve BMD.
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Affiliation(s)
- Steven J O'Bryan
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia.
| | - Catherine Giuliano
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
| | - Mary N Woessner
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Cassandra Smith
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia
- Institute for Nutrition Research, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
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Effects of physical exercise on bone mineral density in older postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Arch Osteoporos 2022; 17:102. [PMID: 35896850 DOI: 10.1007/s11657-022-01140-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/05/2022] [Indexed: 02/03/2023]
Abstract
Osteoporosis or decreased bone mineral density (BMD) is the most important risk factor for fractures, especially in older postmenopausal women (PMW). However, the interactions between exercise training and bone mineral density are not completely understood. We evaluated the effects of physical exercise on BMD in women aged ≥ 60 years postmenopausal. PURPOSE This systematic review and meta-analysis sets out to determine the effects of physical exercise on BMD in older postmenopausal women. METHODS A systematic search was conducted in Medline, Science Direct, Cochrane, PubMed, CINAHL, Google Scholar, Scopus, and ProQuest up to December 25, 2021. Fifty-three studies, which assessed a total of 2896 participants (mean age: between 60 and 82 years), were included and analyzed using a random-effects model to estimate weighted mean differences (WMD) with 95% confidence intervals (CI). RESULTS The meta-analysis found that exercise training significantly (p < 0.05) increased femoral neck (WMD: 0.01 g/cm2; 95% CI, 0.00 to 0.01], p = 0.0005; I2 = 57%; p < 0.0001), lumbar spine (WMD: 0.01 g/cm2, 95% CI, 0.01 to 0.02], I2 = 81%; p = 0.0001), and trochanter (WMD: 0.01 g/cm2, 95% CI 0.00, 0.02]; p = 0.009; I2 = 17%; p = 0.23). There were no significant differences between the intervention and control groups for total body and total hip BMD. CONCLUSION Our findings suggest that exercise training may improve bone mineral density in older PMW. This improvement is mediated by increases in the femoral neck, lumbar spine, and trochanter BMD. Further long-term studies are required to confirm these findings.
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Li Y, Gao H, Zhao L, Wang J. Osteoporosis in COPD patients: Risk factors and pulmonary rehabilitation. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:487-496. [PMID: 35688435 PMCID: PMC9329018 DOI: 10.1111/crj.13514] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 12/15/2022]
Abstract
Objectives To present a review on the pathogenesis, risk factor and treatment of chronic obstructive pulmonary disease complicated with osteoporosis and provide new ideas for the diagnosis and treatment. Data source A systematic search is carried out using keywords as chronic obstructive pulmonary disease, osteoporosis, risk factors, and pulmonary rehabilitation. Results Patients with chronic obstructive pulmonary disease have a high prevalence of osteoporosis and a high risk of fracture. The mechanisms of osteoporosis in COPD patients are associated with general risk factors, such as smoking, reduced physical activity, low weight, and disease‐specific risk factors, such as systemic inflammatory, Vitamin D deficiency, use of glucocorticoid, anemia, hypoxemia, and hypercapnia. The treatment of osteoporosis in COPD emphasizes comprehensive intervention, which mainly include basic treatment and anti‐osteoporosis drugs. Noticeably, pulmonary rehabilitation program is an important part of treatment. Conclusions This work summarizes the pathogenesis, risk factor, prevention, and treatment of chronic obstructive pulmonary disease complicated with osteoporosis, and the latest progress of studies on chronic obstructive pulmonary disease and osteoporosis is discussed.
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Affiliation(s)
- Yujuan Li
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Hongchang Gao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Lei Zhao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Jinrui Wang
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, China
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The Effect of Resistance Training on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10061129. [PMID: 35742181 PMCID: PMC9222380 DOI: 10.3390/healthcare10061129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Resistance training (RT) has been considered an intervention with effective stimulus on bone mineral formation and is, therefore, recommended to decrease the rate of bone morpho-functional proprieties loss with aging. Thus, this meta-analysis aimed to analyze the effectiveness of RT protocols in promoting changes in bone mineral density (BMD) in older adults. The systematic reviews and meta-analysis followed the PRISMA guidelines (PROSPERO CRD42020170859). The searches were performed in the electronic databases using descriptors according to the PICO strategy. The methodological quality and risk of bias were assessed with the PEDro scale, and the magnitude of the results was determined by Hedges’ g. Seven studies involving 370 elderlies, with the RT planned as a unique exercise mode of intervention, showed designs with four to five exercises for upper- and lower-limbs musculature, two to three sets per exercise, eight to twelve repetitions to failure at 70–90% 1 RM, 60–120 s of rest between sets, and executed three times per week for 12–52 weeks. The RT protocols were classified between good and excellent and evidenced a positive effect on the BMD at the hip (0.64%) and spine (0.62%) but not in the femoral neck (−0.22%) regardless of the intervention length. The narrow range of either positive or negative changes in the BMD after the RT intervention support, at best, a preventive effect against the increasing risk of bone frailty in an older population, which is evident beyond 12 weeks of RT practice engagement.
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Brooke-Wavell K, Skelton DA, Barker KL, Clark EM, De Biase S, Arnold S, Paskins Z, Robinson KR, Lewis RM, Tobias JH, Ward KA, Whitney J, Leyland S. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med 2022; 56:bjsports-2021-104634. [PMID: 35577538 PMCID: PMC9304091 DOI: 10.1136/bjsports-2021-104634] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/11/2022]
Abstract
Exercise and physical activity can improve bone strength and the risk of falls, which may offer benefits in the prevention and management of osteoporosis. However, uncertainty about the types of exercise that are safe and effective instigates lack of confidence in people with osteoporosis and health professionals. Existing guidelines leave some questions unresolved. This consensus statement aimed to determine the physical activity and exercise needed to optimise bone strength, reduce fall and fracture risk, improve posture and manage vertebral fracture symptoms, while minimising potential risks in people with osteoporosis. The scope of this statement was developed following stakeholder consultation. Meta-analyses were reviewed and where evidence was lacking, individual studies or expert opinion were used to develop recommendations. A multidisciplinary expert group reviewed evidence to make recommendations, by consensus when evidence was not available. Key recommendations are that people with osteoporosis should undertake (1) resistance and impact exercise to maximise bone strength; (2) activities to improve strength and balance to reduce falls; (3) spinal extension exercise to improve posture and potentially reduce risk of falls and vertebral fractures. For safety, we recommend avoiding postures involving a high degree of spinal flexion during exercise or daily life. People with vertebral fracture or multiple low trauma fractures should usually exercise only up to an impact equivalent to brisk walking. Those at risk of falls should start with targeted strength and balance training. Vertebral fracture symptoms may benefit from exercise to reduce pain, improve mobility and quality of life, ideally with specialist advice to encourage return to normal activities. Everyone with osteoporosis may benefit from guidance on adapting postures and movements. There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.
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Affiliation(s)
- Katherine Brooke-Wavell
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Karen L Barker
- Physiotherapy Department, Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK
| | - Emma M Clark
- Bristol Medical School, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - Sarah De Biase
- Older People's Mental Health Service, Bradford District Care NHS Foundation Trust, Bradford, UK
- AGILE, Chartered Society of Physiotherapy, London, UK
| | - Susanne Arnold
- AGILE, Chartered Society of Physiotherapy, London, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Zoe Paskins
- Primary Care Versus Arthritis Centre, Keele University, Keele, UK
| | - Katie R Robinson
- Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Jonathan H Tobias
- Bristol Medical School, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Julie Whitney
- Department of Physiotherapy, King's College London, London, UK
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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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Li X, Xu R, Ye JX, Yuan FL. Suppression of bone remodeling associated with long-term bisphosphonate treatment is mediated by microRNA-30a-5p. Bioengineered 2022; 13:9741-9753. [PMID: 35412438 PMCID: PMC9161941 DOI: 10.1080/21655979.2022.2060584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Oral bisphosphonates (BPs) are a first-line treatment for osteoporosis. It is becoming a hot topic to identify new indicators for the early prediction of therapeutic effects and adverse reactions during the long-term use of BPs. To determine whether microRNA (miRNA) expression is modulated by long-term BPs treatment, we performed miRNA expression profiling analysis in patients receiving long-term BP treatment for postmenopausal OP. To assess the effect of BPs on miRNA expression, we used an Affymetrix Genechip miRNA array to analyze serum samples obtained from postmenopausal OP patients on long-term BP treatment and healthy controls. MiRNAs affected by BPs and their predicted targets were examined. We also investigated the effects of miRNA on osteoblast differentiation in vitro and on ovariectomy-induced bone loss in vivo. We observed that the level of miR-30a-5p was significantly increased in patients receiving long-term BP treatment for postmenopausal OP. Furthermore, miR-30a-5p was negatively correlated with bone formation. Consistent with this, in vitro osteoblast activity and matrix mineralization were increased by an antagomir of miR-30a-5p and decreased by an agomir of miR-30a-5p. We also found that miR-30a-5p directly targeted RUNX1 to inhibit osteoblastic differentiation. Consistent with the in vitro results, miR-30a-5p antagomir administration promoted bone formation in ovariectomized mice. Our findings identified miR-30a-5p as a novel mediator of long-term BP treatment that regulates bone formation in postmenopausal OP patients.
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Affiliation(s)
- Xia Li
- Institute of Integrated Chinese and Western Medicine, The Hospital Affiliated to Jiangnan University, Wuxi, Jiangsu, China
| | - Ruisheng Xu
- Institute of Integrated Chinese and Western Medicine, The Hospital Affiliated to Jiangnan University, Wuxi, Jiangsu, China
| | - Jun-Xing Ye
- Institute of Integrated Chinese and Western Medicine, The Hospital Affiliated to Jiangnan University, Wuxi, Jiangsu, China.,Department of Orthopaedics and Central Laboratory, The Third Hospital Affiliated to Nantong University, Wuxi, Jiangsu, China
| | - Feng-Lai Yuan
- Institute of Integrated Chinese and Western Medicine, The Hospital Affiliated to Jiangnan University, Wuxi, Jiangsu, China.,Department of Orthopaedics, The Hospital Affiliated to Jiangnan University, Wuxi, Jiangsu, China
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Abstract
This Perspectives provides a back-to-basics rationale for the ideal exercise prescription for osteoporosis. The relevance of fundamental principles of mechanical loading and bone adaptation determined from early animal studies is revisited. The application to human trials is presented, including recent advances. A model of broadscale implementation is described, and areas for further investigation are identified.
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Affiliation(s)
- Belinda R Beck
- Griffith University, Gold Coast, and The Bone Clinic, Coorparoo, QLD, Australia
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34
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de Oliveira RG, Anami GEU, Coelho EA, de Oliveira LC. Effects of Pilates Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis. J Geriatr Phys Ther 2022; 45:107-114. [PMID: 33967223 DOI: 10.1519/jpt.0000000000000309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Despite the popularity of Pilates exercises among postmenopausal women, few studies have devoted attention to verifying the effects of the technique on bone mineral density (BMD), and, to date, no systematic review and meta-analysis have been conducted on this topic. Our objective was to conduct a systematic review and meta-analysis of randomized controlled trials examining the effect of Pilates on BMD. METHODS Randomized controlled trials were considered eligible, with follow-up of 6 months and more, which verified the effects of Pilates exercise on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the Pilates exercise and control groups, through the absolute change between pre- and postintervention in the areal bone mineral density. RESULTS Three randomized controlled trials met the inclusion criteria and were included in the meta-analysis. Only 1 study presented satisfactory methodological quality. Pilates exercises did not offer significant effects to improve areal bone mineral density of the lumbar spine (0.019 g/cm2 [95% confidence interval (CI), -0.018 to 0.057], P = .32), total hip (0.012 g/cm2 [95% CI, -0.002 to 0.027], P = .10), or femoral neck (0.000 g/cm2 [95% CI, -0.021 to 0.022], P = .97). CONCLUSIONS Pilates exercises had no significant effects on BMD in postmenopausal women. However, the few studies included in the meta-analysis and the low methodological quality of the majority of the studies do not allow safe extrapolation of the results at this time. More robust randomized controlled trials with high methodological quality are needed so that the results of this meta-analysis can be confirmed.
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Affiliation(s)
- Raphael Gonçalves de Oliveira
- Universidade Estadual do Norte do Paraná (UENP), Jacarezinho, Paraná, Brazil
- Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil
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35
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Lu M, Li M, Yi L, Li F, Feng L, Ji T, Zang Y, Qiu J. Effects of 8-week High-Intensity Interval Training and Moderate-Intensity Continuous Training on Bone Metabolism in Sedentary Young Females. J Exerc Sci Fit 2022; 20:77-83. [PMID: 35096081 PMCID: PMC8762074 DOI: 10.1016/j.jesf.2022.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/23/2021] [Accepted: 01/01/2022] [Indexed: 12/15/2022] Open
Abstract
Objective High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have been reported as effective exercise modes on bone metabolism. However, very few studies focused on young women with sedentary behavior. The purpose of this study was to investigate the effects of 8-week HIIT on bone metabolism in sedentary young women. Methods 26 healthy, sedentary female participants were randomly assigned to either the HIIT (n = 13, age 23.2 ± 2.9 yr, weight 59.2 ± 7.2 kg, height 162.9 ± 3.3 cm, body mass index 22.3 ± 2.7 kg/m2) or MICT (n = 13, age 21.9 ± 1.7 yr, weight 59.3 ± 6.6 kg, height 160.9 ± 4.4 cm, body mass index 21.6 ± 2.4 kg/m2) group. Both groups completed 8 weeks (3 sessions/week) of training on the treadmill, where the HIIT group were asked to complete 6 × 3-min bouts of running at the intensity of 80–90% maximum oxygen uptake (VO2max) separated by 2-min active recovery at 30–40% VO2max and the MICT group completed 30-min continuous running at the intensity of 60–70% VO2max. The body composition, bone mineral density (BMD), calcaneus quantitative ultrasound, bone turnover markers, and lower limb muscle strength were measured pre and post interventions. Results After 8-week interventions, 1) The total body BMD (HIIT, +8.5%; MICT, +5.5%) significantly increased (p < 0.05) without difference between the two groups (p > 0.05). The calcaneus broadband ultrasound attenuation (CBUA) (HIIT, +16.0%; MICT, +4.6%) and calcaneus stiffness index (CSI) (HIIT, +16.7%; MICT, +2.5%) significantly increased in HIIT group (p < 0.05), but not in MICT group (p > 0.05). 2) The 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) (HIIT, +42.8%; MICT, +24.9%) level increased in both groups with significantly higher changes in HIIT (p < 0.05). 3) The score of standing long jump (HIIT, +10.3%; MICT, +3.8%) and vertical jump (HIIT, +5.3%; MICT, +2.0%) increased in both groups with significantly higher changes in HIIT (p < 0.05). Conclusions It suggested that 8-week HIIT and MICT interventions could improve bone metabolism. Compared with a similar workload of MICT, HIIT elicited superior benefits on bone metabolism.
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Affiliation(s)
- Mingyue Lu
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Mingxing Li
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Longyan Yi
- Institute of Sport and Health Sciences, Beijing Sport University, Beijing, China
| | - Feifei Li
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Lin Feng
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Tianyi Ji
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Yanpeng Zang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Junqiang Qiu
- College of Sport Science School, Beijing Sport University, Beijing, China
- Corresponding author.
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36
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Bemben DA, Sherk VD, Buchanan SR, Kim S, Sherk K, Bemben MG. Acute and Chronic Bone Marker and Endocrine Responses to Resistance Exercise With and Without Blood Flow Restriction in Young Men. Front Physiol 2022; 13:837631. [PMID: 35370772 PMCID: PMC8969015 DOI: 10.3389/fphys.2022.837631] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/22/2022] [Indexed: 12/28/2022] Open
Abstract
In this study, we compared acute and chronic bone marker and hormone responses to 6 weeks of low intensity (20% 1RM) blood flow restriction (BFR20) resistance training to high intensity (70% 1RM) traditional resistance training (TR70) and moderate intensity (45% 1RM) traditional resistance training (TR45) in young men (18–35 years). Participants were randomized to one of the training groups or to a control group (CON). The following training programs were performed 3 days per week for 6 weeks for knee extension and knee flexion exercises: BFR20, 20%1RM, 4 sets (30, 15, 15, 15 reps) wearing blood flow restriction cuffs around the proximal thighs; TR70, 70% 1RM 3 sets 10 reps; and TR45, 45% 1RM 3 sets 15 reps. Muscle strength and thigh cross-sectional area were assessed at baseline, between week 3 and 6 of training. Acute bone marker (Bone ALP, CTX-I) and hormone (testosterone, IGF-1, IGFBP-3, cortisol) responses were assessed at weeks 1 and 6, with blood collection done in the morning after an overnight fast. The main findings were that the acute bone formation marker (Bone ALP) showed significant changes for TR70 and BFR20 but there was no difference between weeks 1 and 6. TR70 had acute increases in testosterone, IGF-1, and IGFBP-3 (weeks 1 and 6). BFR20 had significant acute increases in testosterone (weeks 1 and 6) and in IGF-1 at week 6, while TR45 had significant acute increases in testosterone (week 1), IGF-1 (week 6), and IGFBP-3 (week 6). Strength and muscle size gains were similar for the training groups. In conclusion, low intensity BFR resistance training was effective for stimulating acute bone formation marker and hormone responses, although TR70 showed the more consistent hormone responses than the other training groups.
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Affiliation(s)
- Debra A. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
- *Correspondence: Debra A. Bemben,
| | - Vanessa D. Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Samuel R. Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - SoJung Kim
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, United States
| | - Kyle Sherk
- Hanger Clinic, Denver, CO, United States
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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Shakespear-Druery J, De Cocker K, Biddle SJH, Bennie J. Muscle-Strengthening Exercise Questionnaire (MSEQ): an assessment of concurrent validity and test–retest reliability. BMJ Open Sport Exerc Med 2022; 8:e001225. [PMID: 35237446 PMCID: PMC8845318 DOI: 10.1136/bmjsem-2021-001225] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 11/04/2022] Open
Abstract
ObjectivesMuscle-strengthening exercise (MSE) has multiple independent health benefits and is a component of global physical activity guidelines. However, the assessment of MSE in health surveillance is often limited to the constructs of frequency (days/week), with little focus on constructs such as MSE type, muscle groups targeted and intensity. This study describes the test–retest reliability and concurrent validity of the Muscle-Strengthening Exercise Questionnaire (MSEQ), which was developed to assess multiple MSE participation constructs.MethodsThe MSEQ was developed to assess the weekly frequency, session duration and intensity, types of MSE (eg, weight machines, bodyweight exercise) and muscle groups targeted. Two convenience samples of adult participants were recruited. Test–retest reliability was completed online by 85 participants. Concurrent validity was assessed for 54 participants using an online 7-day MSE log.ResultsThe MSEQ shows high test–retest reliability for frequency, duration and level of intensity for each of the four MSE types (using weight machines, bodyweight exercises, resistance exercises and holistic exercises), and for the four types combined (ρ range 0.76–0.91). For muscle groups targeted, the reliability ranged mostly from moderate-to-substantial for each of the four MSE types (κ range 0.44–0.78) and fair-to-moderate for the four types combined (κ range 0.35–0.51). Concurrent validity for frequency, duration and level of intensity for each of the four MSE types, and the four types combined, was moderate-to-high (ρ range 0.30–0.77).ConclusionThe MSEQ shows acceptable reliability and validity for four key MSE constructs. This new MSEQ survey instrument could be used to assess adults’ MSE.
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Affiliation(s)
- Jane Shakespear-Druery
- Physically Active Lifestyles Research Group (USQ-PALs), Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Katrien De Cocker
- Physically Active Lifestyles Research Group (USQ-PALs), Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Stuart J H Biddle
- Physically Active Lifestyles Research Group (USQ-PALs), Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Jason Bennie
- Physically Active Lifestyles Research Group (USQ-PALs), Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
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Regular Exercise and Weight-Control Behavior Are Protective Factors against Osteoporosis for General Population: A Propensity Score-Matched Analysis from Taiwan Biobank Participants. Nutrients 2022; 14:nu14030641. [PMID: 35277000 PMCID: PMC8838409 DOI: 10.3390/nu14030641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/22/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
The rising prevalence of osteoporosis, which can lead to osteoporotic fractures, increases morbidity, mortality, and socioeconomic burden. Multiple factors influencing bone mass have already been identified. The aim of this study was to investigate whether exercise habits and weight-control behaviors can lower the incidence of osteoporosis in the general population. This retrospective study recruited all participants aged 35–70 years who underwent dual-energy X-ray absorptiometry (DXA) from Taiwan Biobank (TWB). The final analysis consisted of 3320 eligible participants divided into two groups; demographic characteristics, prevalence of clinical symptoms, comorbidities, and daily behavior were collected using a self-reported questionnaire. After propensity score matching with a 1:1 ratio, 1107 out of 2214 individuals were classified into the osteoporosis group. Age, body fat rate, body shape, diabetes mellitus, and social status were found to affect the incidence of osteoporosis. Subjects with a habit of regular exercise and weight-control behavior showed decreased odds of osteoporosis. (odds ratio: 0.709 and 0.753, 95% confidence interval: 0.599–0.839 and 0.636–0.890). In the general population, regular exercise or weight-control behavior lowers the incidence of osteoporosis.
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Rose GL, Skinner TL, Keating SE, Friedrich NK, Bolam KA. The effects of exercise on the bone health of people with cancer: a systematic review and meta-analysis. Osteoporos Int 2022; 33:327-338. [PMID: 34532766 DOI: 10.1007/s00198-021-06131-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the pooled effect of exercise on the bone health of people diagnosed with cancer. METHODS Four electronic databases were systematically searched. Controlled trials that assessed the effect of exercise on the bone mineral density (BMD) or content (BMC) measured by dual-energy x-ray absorptiometry or peripheral quantitative computed tomography in people who had been diagnosed with cancer were included in the study. Random-effect meta-analyses of effect size (ES) were conducted. Sub-group analyses were performed to explore the influence of intervention duration, prescription and participant characteristics. RESULTS Of 66 full-text articles screened, 22 studies, from 21 interventions, were included (primarily breast/prostate cancer, sample range n = 36-498). When all interventions were grouped, a significant pooled ES was observed for exercise on hip (ES = 0.112, 95% CI: 0.026 to 0.198; p = 0.011) and lumbar spine BMD (ES = 0.269, 95% CI: 0.036 to 0.501; p = 0.024) compared to control. There was also an influence of sex, where females had greater improvements in hip (ES = 0.120, 95% CI: 0.017 to 0.223; p = 0.022) and spine BMD (ES = 0.415, 95% CI: 0.056 to 0.774; p = 0.23) compared to males. CONCLUSION Overall, exercise regimens of studies included in this review appear to improve bone health at the hip and spine in people diagnosed with cancer. Sub-analyses suggest some influence of sex, where females had greater improvements in BMD compared to males. It is essential that future studies evaluate the dose-response of exercise training on bone health and create exercise protocols that better align with the laws of bone modelling to enhance osteogenic potential.
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Affiliation(s)
- Grace L Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Nina K Friedrich
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
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Beck B, Rubin C, Harding A, Paul S, Forwood M. The effect of low-intensity whole-body vibration with or without high-intensity resistance and impact training on risk factors for proximal femur fragility fracture in postmenopausal women with low bone mass: study protocol for the VIBMOR randomized controlled trial. Trials 2022; 23:15. [PMID: 34991684 PMCID: PMC8734256 DOI: 10.1186/s13063-021-05911-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevailing medical opinion is that medication is the primary (some might argue, only) effective intervention for osteoporosis. It is nevertheless recognized that osteoporosis medications are not universally effective, tolerated, or acceptable to patients. Mechanical loading, such as vibration and exercise, can also be osteogenic but the degree, relative efficacy, and combined effect is unknown. The purpose of the VIBMOR trial is to determine the efficacy of low-intensity whole-body vibration (LIV), bone-targeted, high-intensity resistance and impact training (HiRIT), or the combination of LIV and HiRIT on risk factors for hip fracture in postmenopausal women with osteopenia and osteoporosis. METHODS Postmenopausal women with low areal bone mineral density (aBMD) at the proximal femur and/or lumbar spine, with or without a history of fragility fracture, and either on or off osteoporosis medications will be recruited. Eligible participants will be randomly allocated to one of four trial arms for 9 months: LIV, HiRIT, LIV + HiRIT, or control (low-intensity, home-based exercise). Allocation will be block-randomized, stratified by use of osteoporosis medications. Testing will be performed at three time points: baseline (T0), post-intervention (T1; 9 months), and 1 year thereafter (T2; 21 months) to examine detraining effects. The primary outcome measure will be total hip aBMD determined by dual-energy X-ray absorptiometry (DXA). Secondary outcomes will include aBMD at other regions, anthropometrics, and other indices of bone strength, body composition, physical function, kyphosis, muscle strength and power, balance, falls, and intervention compliance. Exploratory outcomes include bone turnover markers, pelvic floor health, quality of life, physical activity enjoyment, adverse events, and fracture. An economic evaluation will also be conducted. DISCUSSION No previous studies have compared the effect of LIV alone or in combination with bone-targeted HiRIT (with or without osteoporosis medications) on risk factors for hip fracture in postmenopausal women with low bone mass. Should either, both, or combined mechanical interventions be safe and efficacious, alternative therapeutic avenues will be available to individuals at elevated risk of fragility fracture who are unresponsive to or unwilling or unable to take osteoporosis medications. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (www. anzctr.org.au ) (Trial number ANZCTR12615000848505, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 368962 ); date of registration 14/08/2015 (prospectively registered). Universal Trial Number: U1111-1172-3652.
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Affiliation(s)
- Belinda Beck
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Clinton Rubin
- Department of Biomedical Engineering, State University of New York at Stony Brook, New York, NY USA
| | - Amy Harding
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Sanjoy Paul
- Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, VIC Australia
| | - Mark Forwood
- School of Pharmacy and Medical Sciences, Gold Coast, QLD Australia
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Viecelli C, Aguayo D. May the Force and Mass Be With You-Evidence-Based Contribution of Mechano-Biological Descriptors of Resistance Exercise. Front Physiol 2022; 12:686119. [PMID: 35069229 PMCID: PMC8769283 DOI: 10.3389/fphys.2021.686119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/13/2021] [Indexed: 12/28/2022] Open
Abstract
Skeletal muscle is one of the most important tissues of the human body. It comprises up to 40% of the body mass and is crucial to survival. Hence, the maintenance of skeletal muscle mass and strength is pivotal. It is well-established that resistance exercise provides a potent anabolic stimulus to increase muscle mass and strength in men and women of all ages. Resistance exercise consists of mechano-biological descriptors, such as load, muscle action, number of repetitions, repetition duration, number of sets, rest interval between sets, frequency, volitional muscular failure, and range of motion, which can be manipulated. Herein, we discuss the evidence-based contribution of these mechano-biological descriptors to muscle mass and strength.
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Affiliation(s)
- Claudio Viecelli
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
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Buchanan SR, Miller RM, Nguyen M, Black CD, Kellawan JM, Bemben MG, Bemben DA. Circulating microRNA responses to acute whole-body vibration and resistance exercise in postmenopausal women. Front Endocrinol (Lausanne) 2022; 13:1038371. [PMID: 36440217 PMCID: PMC9692005 DOI: 10.3389/fendo.2022.1038371] [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: 09/08/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022] Open
Abstract
Evaluating alterations in circulating microRNA (c-miRNA) expression may provide deeper insight into the role of exercise in the attenuation of the negative effects of aging on musculoskeletal health. Currently, there are sparse data on c-miRNA responses to acute exercise in postmenopausal women. The purpose of this study was to characterize the effects of acute bouts of resistance exercise and whole-body vibration on expression of selected c-miRNAs in postmenopausal women aged 65-76 years (n=10). We also examined relationships between c-miRNAs and muscle strength and bone characteristics. This randomized crossover design study compared c-miRNA responses to a bout of resistance exercise (RE) (3 sets 10 reps 70% 1 repetition maximum (1RM), 5 exercises) and a bout of whole-body vibration (WBV) (5 sets 1 min bouts 20Hz 3.38mm peak to peak displacement, Vibraflex vibration platform). DXA was used to measure body composition and areal bone mineral density (aBMD) of the total body, AP lumbar spine, and dual proximal femur. pQCT was used to measure tibia bone characteristics (4%, 38%, 66% sites). Blood samples were collected before exercise (Pre), immediately-post (IP), 60 minutes post (60P), 24 hours (24H), and 48 hours (48H) after exercise to measure serum miR-21-5p, -23a-3p, -133a-3p, -148a-3p (qPCR) and TRAP5b (ELISA). There was a significant modality × time interaction for c-miR-21-5p expression (p=0.019), which decreased from 60P to 24H after WBV only. TRAP5b serum concentrations significantly increased IP then decreased below Pre at 24H for both WBV and RE (p<0.01). Absolute changes in TRAP5b were negatively correlated with c-miR-21-5p fold changes (r= -0.642 to -0.724, p<0.05) for both exercise modalities. There were significant negative correlations between baseline c-miRNAs and bone status variables (r= -0.639 to -0.877, p<0.05). Our findings suggest that whole-body vibration is a sufficient mechanical stimulus for altering c-miR-21-5p expression, whereas a high intensity resistance exercise protocol did not elicit any c-miRNA responses in postmenopausal women. Increases in the bone resorption marker, TRAP5b, were associated with greater downregulation of c-miR-21-5p expression.
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Affiliation(s)
- Samuel R. Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, United States
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
- *Correspondence: Samuel R. Buchanan,
| | - Ryan M. Miller
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Michelle Nguyen
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Christopher D. Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - J. Mikhail Kellawan
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Debra A. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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Ma J, Ye M, Li Y, Chai S, Huang H, Lian X, Huang H. Zhuanggu Zhitong Capsule alleviates osteosarcopenia in rats by up-regulating PI3K/Akt/Bcl2 signaling pathway. Biomed Pharmacother 2021; 142:111939. [PMID: 34311171 DOI: 10.1016/j.biopha.2021.111939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND AIMS Osteosarcopenia (OS), characterized by the coexistence of osteoporosis (OP) and sarcopenia (SP), is associated with high morbidity and mortality in the elderly. Nevertheless, its pathogenesis and treatment remain unclear. The aim of this study was to investigate the effect and mechanism of Zhuanggu Zhitong Capsule (ZGZT) in OS rats. METHODS All the related targets of OS, corresponding targets for bioactive ingredients of ZGZT, intersection targets of ZGZT against OS, and signaling pathways were predicted and analyzed by network pharmacology. Next, a rat OS model was established by ovariectomy (OVX) and injection of dexamethasone (DXM). Rats were then randomly divided into a Control group, a Sham operation group, an OS model group, an OS+ZGZT group, and an OS+E2 group. The drug was given for 12 weeks. During treatment, body weight, forelimb grip and body composition were measured. In addition, bone mineral density (BMD) and micro CT were used to assess the left femur. After treatment, the left femur, left gastrocnemius, and left soleus, as well as uterus, liver, and kidney, were separated and analyzed using Histomorphology, Western blot, and quantitative real-time PCR (qRT-PCR). RESULTS ZGZT could effectively improve the phenotypes of OS by increasing forelimb grip strength, percentage lean mass of the whole body (SMI) or appendicular lean (RSMI), BMD, levels of bone formation markers, improving the microstructure of femur, and decreasing apoptotic rate in femur and gastrocnemius in OS rats by up-regulating PI3K/Akt/Bcl2 signal pathway. CONCLUSIONS ZGZT may be a new treatment option for the prevention and treatment of OS.
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Affiliation(s)
- Jiangtao Ma
- The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan provincial Orthopedic Hospital), Zhengzhou 450046, China; Laboratory of Orthopaedics and Traumatology of Chinese Medicine of Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Maolin Ye
- Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan provincial Orthopedic Hospital), Zhengzhou 450046, China
| | - Ying Li
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510375, China
| | - Shuang Chai
- Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan provincial Orthopedic Hospital), Zhengzhou 450046, China
| | - Hong Huang
- College of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Xiaohang Lian
- The Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Laboratory of Orthopaedics and Traumatology of Chinese Medicine of Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Hongxing Huang
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510375, China.
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Kitsuda Y, Wada T, Noma H, Osaki M, Hagino H. Impact of high-load resistance training on bone mineral density in osteoporosis and osteopenia: a meta-analysis. J Bone Miner Metab 2021; 39:787-803. [PMID: 33851269 DOI: 10.1007/s00774-021-01218-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/23/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to examine the effect of high-load resistance training (HLRT) on bone mineral density (BMD) in patients with osteoporosis and osteopenia using a meta-analysis. MATERIALS AND METHODS We searched for randomized controlled trials (RCTs) on HLRT in patients with osteoporosis and osteopenia from medical databases. Our meta-analysis was performed with the primary endpoints being the standardized mean difference (SMD) of the change in BMD of the lumbar spine (LS), femoral neck (FN), and total hip (TH). The robustness of the results was assessed by subgroup analysis. Heterogeneity factors were examined by meta-regression. Publication bias was evaluated using a funnel plot. RESULTS We selected nine RCTs, with 259 patients in the HLRT group (women, 55.2%) and 236 patients in the control group (women, 62.7%). The HLRT group showed a significant increase in BMD in the LS [SMD = 1.40, 95% confidence interval (CI) = 0.68-2.12, p < 0.001, I2 = 90%], the FN (SMD = 0.86, 95% CI = 0.05-1.67, p = 0.04, I2 = 92%), and the TH (SMD = 1.26, 95% CI = 0.45-2.08, p = 0.002, I2 = 91%). Subgroup analysis confirmed the robustness of the results only in LS. Total sessions and a high risk of bias were identified as the factors of heterogeneity in FN and TH (p < 0.05). The funnel plot showed asymmetry in all measurement sites. CONCLUSION This study suggested that HLRT can be effective in increasing BMD, mainly of LS, in patients with osteoporosis and osteopenia. However, due to high heterogeneity and publication bias, additional studies with a low risk of bias should be conducted to generalize our findings.
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Affiliation(s)
- Yuki Kitsuda
- Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
| | - Takashi Wada
- Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8562, Japan
| | - Mari Osaki
- Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan
| | - Hiroshi Hagino
- Rehabilitation Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
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Osteoporosis Prevention, Screening, and Diagnosis: ACOG Clinical Practice Guideline No. 1. Obstet Gynecol 2021; 138:494-506. [PMID: 34412075 DOI: 10.1097/aog.0000000000004514] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To provide updated evidence-based recommendations for the prevention, screening, and diagnosis of postmenopausal osteoporosis. TARGET POPULATION Postmenopausal patients without identified risk factors for fracture, low bone mineral density, or secondary osteoporosis related to medication or a medical condition. METHODS This guideline was developed using an a priori protocol in conjunction with a writing team consisting of two specialists in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines-Gynecology and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within the Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team on the basis of standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations, Assessment, Development and Evaluations) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS This Clinical Practice Guideline includes updated recommendations on the role of exercise, calcium, and vitamin D in osteoporosis prevention; osteoporosis screening and diagnosis; rescreening intervals; and interventions to prevent falls. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.
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Singh B, Toohey K. The effect of exercise for improving bone health in cancer survivors - A systematic review and meta-analysis. J Sci Med Sport 2021; 25:31-40. [PMID: 34465518 DOI: 10.1016/j.jsams.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/14/2021] [Accepted: 08/10/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of exercise for improving bone-related outcomes among cancer survivors. DESIGN Systematic review and meta-analysis. METHODS An electronic search using the following databases: SPORTDiscus, Science Direct, CINAHL, MEDLINE, Cochrane, Pubmed, Ebscohost, ProQuest Nursing and Allied Health Source. Randomised, controlled, exercise trials involving cancer survivors were eligible. Effect data on bone mineral content (BMC) and density (BMD) outcomes were extracted. Risk of bias was assessed using the Physiotherapy Evidence Database tool. Standardised mean differences (SMD) were calculated to compare differences between exercise and usual care. Subgroup analyses were conducted to assess whether effect differed by exercise mode, intervention length, supervision, treatment, cancer type and risk of bias. RESULTS Twenty-six trials were included, with intervention durations ranging between 12 weeks and 2 years. Most trials involved breast cancer (n = 13, 50%), and most interventions were supervised (n = 18, 69%) and evaluated mixed-mode (i.e., combined aerobic and resistance) exercise (n = 13, 50%). Significant effects in favour of exercise (aerobic, resistance, mixed-mode and other exercise) were observed for whole body BMD, hip BMD, trochanter BMD and femoral neck BMD (SMD range: 0.19-0.39, all p < 0.05) compared to usual care. CONCLUSION Participation in various modes (aerobic, resistance, mixed-mode and other) of supervised and unsupervised exercise is associated with improvements in BMD. The present results provide evidence for clinicians and other health care professionals (e.g., exercise physiologists and physiotherapists) to recommend exercise for cancer survivors to prevent bone loss during and following treatment.
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Affiliation(s)
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Australia
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Effects of DHA-Rich n-3 Fatty Acid Supplementation and/or Resistance Training on Body Composition and Cardiometabolic Biomarkers in Overweight and Obese Post-Menopausal Women. Nutrients 2021; 13:nu13072465. [PMID: 34371972 PMCID: PMC8308734 DOI: 10.3390/nu13072465] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/27/2021] [Indexed: 01/04/2023] Open
Abstract
Resistance training (RT) and n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation have emerged as strategies to improve muscle function in older adults. Overweight/obese postmenopausal women (55–70 years) were randomly allocated to one of four experimental groups, receiving placebo (olive oil) or docosahexaenoic acid (DHA)-rich n-3 PUFA supplementation alone or in combination with a supervised RT-program for 16 weeks. At baseline and at end of the trial, body composition, anthropometrical measures, blood pressure and serum glucose and lipid biomarkers were analyzed. Oral glucose tolerance tests (OGTT) and strength tests were also performed. All groups exhibit a similar moderate reduction in body weight and fat mass, but the RT-groups maintained bone mineral content, increased upper limbs lean mass, decreased lower limbs fat mass, and increased muscle strength and quality compared to untrained-groups. The RT-program also improved glucose tolerance (lowering the OGTT incremental area under the curve). The DHA-rich supplementation lowered diastolic blood pressure and circulating triglycerides and increased muscle quality in lower limbs. In conclusion, 16-week RT-program improved segmented body composition, bone mineral content, and glucose tolerance, while the DHA-rich supplement had beneficial effects on cardiovascular health markers in overweight/obese postmenopausal women. No synergistic effects were observed for DHA supplementation and RT-program combination.
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Daly RM, Dalla Via J, Fyfe JJ, Nikander R, Kukuljan S. Effects of exercise frequency and training volume on bone changes following a multi-component exercise intervention in middle aged and older men: Secondary analysis of an 18-month randomized controlled trial. Bone 2021; 148:115944. [PMID: 33836310 DOI: 10.1016/j.bone.2021.115944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/01/2021] [Accepted: 03/30/2021] [Indexed: 01/09/2023]
Abstract
Progressive resistance training (PRT) combined with weight-bearing impact exercise are recommended to optimize bone health, but the optimal frequency and dose of training remains uncertain. This study, which is a secondary analysis of an 18-month intervention in men aged 50-79 years, examined the association between exercise frequency and the volume of training with changes in DXA and QCT-derived femoral neck (FN) and lumbar spine (LS) bone outcomes, respectively. Men were allocated to either thrice-weekly PRT plus impact exercise training (n = 87) or a non-exercising (n = 85) group. Average weekly exercise frequency (ExFreq) and training volume per session [PRT volume (weight lifted, kg), number of weight-bearing impacts (jumps completed) and total training volume] over the 18-months were calculated from the participants' exercise cards. Regression analysis showed that average weekly ExFreq and training volume per session were positively associated with the 18-month changes in FN BMD and LS trabecular volumetric BMD. Men completing on average 1 to <2 and ≥2 sessions/week had a 1.6 to 2.2% greater net gain in FN BMD relative to non-exercising men, while those completing ≥2 sessions/week had 3.9 to 5.2% net gain in LS trabecular vBMD compared to non-exercising men and those completing <1 session/week. Further analysis showed that the average number of impact loads per session, but not the average PRT weight-lifted, was positively associated with changes in BMD. Every 10 impact loads per session over 18 months was associated with a 0.3% and 1.3% increase in FN BMD and LS trabecular vBMD, respectively. In conclusion, this study indicates that exercise frequency and training volume were predictors of the changes in hip and spine BMD following a multi-component exercise program, and that the number of impact loads rather than PRT weight lifted per session was more important for eliciting positive skeletal responses in middle-aged and older men.
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Affiliation(s)
- Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Jackson J Fyfe
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Riku Nikander
- Faculty of Sports Science, Gerontology Research Centre (Gerec), University of Jyväskylä, Finland; Central Hospital of Central Finland, Jyväskylä, Finland; GeroCenter Foundation for Aging Research & Development, Jyväskylä, Finland.
| | - Sonja Kukuljan
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
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Choi W, Choi JH, Chung CY, Sung KH, Lee KM. Can gait kinetic data predict femoral bone mineral density in elderly men and women aged 50 years and older? J Biomech 2021; 123:110520. [PMID: 34022533 DOI: 10.1016/j.jbiomech.2021.110520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 05/01/2021] [Accepted: 05/03/2021] [Indexed: 12/21/2022]
Abstract
This retrospective study was conducted to investigate the correlation between kinetic gait parameters and femoral bone mineral density (BMD) in elderly subjects aged 50 years and older that could walk independently. Four hundred and twenty-six subjects (158 men and 258 women; mean age 68.7 years, standard deviation (SD) 7.9 years) were included in the study. BMDs (g/cm2) of the femoral neck, trochanter, shaft, and total proximal femur were collected. Kinetic data including maximum hip power and hip power-time integral was obtained from a three-dimensional gait analysis with self-selected walking speed. Correlation between BMDs of proximal femur and gait kinetic data was analyzed. Multiple regression analysis was also performed to identify factors significantly associated with BMD. Correlation between BMD and hip kinetic data was not prominent in elderly men. In women, BMD was significantly correlated with hip kinetic data. Hip power-time integral showed greater correlation with BMD than maximum hip power during gait in elderly women. Age (p < 0.001), weight (p = 0.007) and hip power-time integral (p = 0.008) were significant factors associated with femoral neck BMD, and these factors explained 25.4% of femoral neck BMD. In conclusion, the association between the mechanical load and BMD in the different sexes provokes future research into these issues. The effects of various types of exercises on BMD should be investigated more precisely using a gait analysis tool.
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Affiliation(s)
- Wooyoung Choi
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea.
| | - Ji Hye Choi
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea
| | - Chin Youb Chung
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea
| | - Ki Hyuk Sung
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea.
| | - Kyoung Min Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea.
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Wherry SJ, Miller RM, Jeong SH, Beavers KM. The Ability of Exercise to Mitigate Caloric Restriction-Induced Bone Loss in Older Adults: A Structured Review of RCTs and Narrative Review of Exercise-Induced Changes in Bone Biomarkers. Nutrients 2021; 13:1250. [PMID: 33920153 PMCID: PMC8070587 DOI: 10.3390/nu13041250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Despite the adverse metabolic and functional consequences of obesity, caloric restriction- (CR) induced weight loss is often contra-indicated in older adults with obesity due to the accompanying loss of areal bone mineral density (aBMD) and subsequent increased risk of fracture. Several studies show a positive effect of exercise on aBMD among weight-stable older adults; however, data on the ability of exercise to mitigate bone loss secondary to CR are surprisingly equivocal. The purpose of this review is to provide a focused update of the randomized controlled trial literature assessing the efficacy of exercise as a countermeasure to CR-induced bone loss among older adults. Secondarily, we present data demonstrating the occurrence of exercise-induced changes in bone biomarkers, offering insight into why exercise is not more effective than observed in mitigating CR-induced bone loss.
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Affiliation(s)
- Sarah J. Wherry
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, USA
| | - Ryan M. Miller
- Department of Internal Medicine, Sections on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Sarah H. Jeong
- Z. Smith Reynolds Library, Wake Forest University, Winston-Salem, NC 27109, USA;
| | - Kristen M. Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA
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