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Warden SJ, Dick A, Simon JE, Manini TM, Russ DW, Lyssikatos C, Clark LA, Clark BC. Fracture discrimination capability of ulnar flexural rigidity measured via Cortical Bone Mechanics Technology: study protocol for The STRONGER Study. JBMR Plus 2024; 8:ziad002. [PMID: 38690126 PMCID: PMC11059995 DOI: 10.1093/jbmrpl/ziad002] [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] [Indexed: 05/02/2024] Open
Abstract
Osteoporosis is characterized by low bone mass and structural deterioration of bone tissue, which leads to bone fragility (ie, weakness) and an increased risk for fracture. The current standard for assessing bone health and diagnosing osteoporosis is DXA, which quantifies areal BMD, typically at the hip and spine. However, DXA-derived BMD assesses only one component of bone health and is notably limited in evaluating the bone strength, a critical factor in fracture resistance. Although multifrequency vibration analysis can quickly and painlessly assay bone strength, there has been limited success in advancing a device of this nature. Recent progress has resulted in the development of Cortical Bone Mechanics Technology (CBMT), which conducts a dynamic 3-point bending test to assess the flexural rigidity (EI) of ulnar cortical bone. Data indicate that ulnar EI accurately estimates ulnar whole bone strength and provides unique and independent information about cortical bone compared to DXA-derived BMD. Consequently, CBMT has the potential to address a critical unmet need: Better identification of patients with diminished bone strength who are at high risk of experiencing a fragility fracture. However, the clinical utility of CBMT-derived EI has not yet been demonstrated. We have designed a clinical study to assess the accuracy of CBMT-derived ulnar EI in discriminating post-menopausal women who have suffered a fragility fracture from those who have not. These data will be compared to DXA-derived peripheral and central measures of BMD obtained from the same subjects. In this article, we describe the study protocol for this multi-center fracture discrimination study (The STRONGER Study).
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Affiliation(s)
- Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, 46202, United States
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Andrew Dick
- OsteoDx Inc., Athens, OH, 45701, United States
| | - Janet E Simon
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, 45701, United States
- School of Applied Health and Wellness, Ohio University, Athens, OH, 45701, United States
| | - Todd M Manini
- Institute on Aging, University of Florida, Gainesville, FL, 32611, United States
| | - David W Russ
- School of Physical Therapy and Rehabilitation, University of South Florida, Tampa, FL, 33620, United States
| | - Charalampos Lyssikatos
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Leatha A Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, 45701, United States
- Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, United States
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, 45701, United States
- Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, United States
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Rocha-Rangel J, Liang MTC, Tsai AHT, Auslander AT, Robles P, Kwoh YL, Arnaud SB. Bone bending strength and BMD of female athletes in volleyball, soccer, and long-distance running. Eur J Appl Physiol 2023; 123:2213-2223. [PMID: 37256294 DOI: 10.1007/s00421-023-05231-2] [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: 07/09/2022] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of the study was to determine whether sports training comprised of (1) high-impact loading sport in volleyball (VOL), (2) odd impact loading sport in soccer (SOC), and (3) low impact sport in distance running (RUN) were associated with tibial bending strength and calcaneus bone mineral density (BMD), and ulnar bending strength and wrist BMD. METHOD Female athletes comprised of 13 VOL, 22 SOC, and 22 RUN participated in the study. Twenty-three female non-athletes (NA) served as the comparison group. Tibial and ulnar bending strength (EI, Nm2) were assessed using a mechanical response tissue analyzer (MRTA). Calcaneus and wrist BMD were assessed using a peripheral X-ray absorptiometry. Group means differences among the study groups were determined using ANCOVA with age, weight, height, percent body fat, ethnicity/race, and training history serving as covariates. RESULTS Tibial EI of VOL (228.3 ± 138 Nm2) and SOC (208.6 ± 115 Nm2) were greater (p < 0.05) compared to NA (101.2 ± 42 Nm2). Ulnar EI of SOC (54.9 ± 51 Nm2) was higher (p < 0.05) than NA (27.2 ± 9 Nm2). Calcaneus BMD of VOL (0.618 ± 0.12 g/cm2), SOC (0.621 ± 0.009 g/cm2), and RUN (0.572 ± 0.007 g/cm2) were higher (p < 0.05) than NA (0.501 ± 0.08 g/cm2), but not different between athletic groups. Wrist BMD of VOL (0.484 ± .06 g/cm2) and SOC (0.480 ± 0.06 g/cm2) were higher (p < 0.05) than NA (0.443 ± 0.04 g/cm2). CONCLUSIONS Female VOL athletes exhibit greater tibial bending strength than RUN and NA, but not greater than SOC. Female SOC athletes exhibit greater ulnar bending strength and wrist BMD than NA.
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Affiliation(s)
- Jose Rocha-Rangel
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Michael T C Liang
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA.
| | | | - Alexandra T Auslander
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Patricia Robles
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Yuan-Lieh Kwoh
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Sara B Arnaud
- Life Science Division, NASA Ames Research Center, Moffett Field, CA, 94035, USA
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Wong AKO, Fung HJW, Chan ACH, Szabo E, Mathur S, Giangregorio L, Cheung AM. Ankle flexor torque, size and density are differential determinants of distal tibia trabecular plate-rod morphometry and bone strength: The Ankle Quality Study. Bone 2023; 166:116582. [PMID: 36243400 DOI: 10.1016/j.bone.2022.116582] [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: 08/11/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
HYPOTHESIS Greater peak torque and higher myotendinous density at the ankle are associated with a more plate-like architecture at the distal tibia. METHODS In this cross-sectional study, women and men ≥ 50 years old with no metal implants, reconstructive surgery, muscular dystrophies, or tendinopathies in any leg were recruited by convenience. Isometric ankle dorsi-plantar flexion and inversion-eversion peak torques were measured using dynamometry. HR-pQCT distal tibia scans were completed. Both assessments were completed on the same day on the non-dominant leg. Integral and trabecular vBMD were derived from standard analyses, failure load (FL) was obtained from finite element analysis, plate-specific parameters were computed from individual trabecula segmentation (ITS) analysis, myotendinous density (MyD) and volume fraction (MyV/TV) were computed from soft tissue analysis. pQCT scans of the 66 % mid-leg were performed (500 μm at 15 mm/s) to obtain muscle density (MD) and muscle cross-sectional area (MCSA). STATISTICAL ANALYSIS General linear models estimated how ankle muscle group torque and muscle size and density differentially related, both separately and together, to whole-bone properties (integral vBMD, FL) and trabecular morphometry (ITS plate parameters). Models were adjusted for age, sex, BMI, use of glucocorticoids, current osteoarthritis, and participation in moderate to vigorous recreational or sport activities. RESULTS Among 105 participants (77 % female, mean age: 63 (10) years, BMI: 25.8 (5.4) kg/m2, 25 % with OA, 17 % fracture history, 42 % falls history), all torque measures, particularly ankle dorsiflexion and eversion, were correlates of plate-plate/rod junction density and failure load. However, muscle size and density measures were further associated with vBMD. The effect of greater ankle flexor-extensor torque on more connected bone was stronger when MyD was higher (interaction p < 0.001). CONCLUSION Strength of muscles around the ankle are correlates of plate-like trabeculae at the distal tibia, while leaner muscle and myotendinous tissues facilitates better quality bone for stronger ankle muscle torque.
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Affiliation(s)
- Andy K O Wong
- Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Hugo J W Fung
- Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada; Department of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Adrian C H Chan
- Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Eva Szabo
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Osteoporosis Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
| | - Sunita Mathur
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Lora Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Angela M Cheung
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Osteoporosis Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Bowman L, Loucks AB. Improvements to mechanical response tissue analysis. MethodsX 2019; 6:2408-2419. [PMID: 31687360 PMCID: PMC6820268 DOI: 10.1016/j.mex.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 10/03/2019] [Indexed: 11/29/2022] Open
Abstract
Cortical Bone Mechanics Technology™ (CBMT) comprises certain improvements over a previous method known as Mechanical Response Tissue Analysis (MRTA). Both methods are dynamic 3-point bending tests intended for measuring the mechanical properties of cortical bone in living people. MRTA presented a theoretical potential for direct measurement of skeletal fragility, but it had acquired a reputation for error and fallen into disuse. We found sources of error in both MRTA data collection and data analysis. We describe here the fundamentals of MRTA, the major sources of error we found in MRTA, and our innovations for avoiding them. •Data collection at many sites across the mid-shaft of the ulna bone in the forearm.•Parameter estimation by fitting analytical complex compliance and stiffness transfer functions to empirical complex compliance and stiffness frequency response functions.•Optimization by selecting results from frequency response functions with the smallest deviations between fits to compliance and stiffness frequency response functions.
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Affiliation(s)
- Lyn Bowman
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States.,Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States
| | - Anne B Loucks
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States.,Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States
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Bowman L, Ellerbrock ER, Hausfeld GC, Neumeyer JM, Loucks AB. A new noninvasive mechanical bending test accurately predicts ulna bending strength in cadaveric human arms. Bone 2019; 120:336-346. [PMID: 30496886 DOI: 10.1016/j.bone.2018.11.018] [Citation(s) in RCA: 5] [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: 07/23/2018] [Revised: 11/05/2018] [Accepted: 11/25/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND High error rates in the prediction of fragility fractures by bone mineral density have motivated searches for better clinical indicators of bone strength, and the high incidence of non-hip, non-spine fractures has raised interest in cortical bone. The aim of this study was to assess the accuracy of Cortical Bone Mechanics Technology™. CBMT is a new non-invasive 3-point bending technique for measuring the mechanical properties of cortical bone in the ulnas of living humans. METHODS 35 cadaveric human arms were obtained from small women and large men ranging widely in age (17 < Age < 99 years) and body size (14 < BMI < 40 kg/m2). Noninvasive CBMT measurements of the flexural rigidity of the ulna bones within these arms (EICBMT) were compared to measurements of EI by Quasistatic Mechanical Testing in the ulnas excised from those arms (EIQMT). Ulna bending strength was also measured by QMT as the peak moment before fracture (Mpeak). The open source BoneJ plugin to ImageJ image processing software was used to calculate cortical porosity (CP) in micro-computed tomography images of a 2 mm length of the mid-shaft of each fractured ulna, and the interosseous diameter (IOD) of each ulna was also measured in those images. RESULTS EICBMT measurements (13 < EICBMT < 97 Nm2) explained 99% of the variance in QMT measurements of ulna bending strength (11 < Mpeak < 90 Nm), but EICBMT was biased high by 30% (p < 0.0001) relative to EIQMT (11 < EIQMT < 69 Nm2). After correcting this bias, EICBMT and EIQMT measurements lay along the identity line (y = 1.00x, R2 = 0.99, SEE = 3.1 Nm2). Predictions of Mpeak by EICBMT were less accurate than predictions by EIQMT (both R2 = 0.99; SEECBMT = 5.9 Nm vs SEEQMT = 4.5 Nm, F = 2.92, p = 0.001), but EICBMT predictions were substantially more accurate than those by IOD (R2 = 0.79; SEEIOD = 10.6 Nm, F = 3.30, p < 0.001) and CP (R2 = 0.35; SEECP = 18.9 Nm, F = 10.45, p < 10-9). Predictions by EICBMT were also more accurate than predictions by arm donor height (R2 = 0.63; SEE = 14.3 Nm, F = 5.87, p < 10-6), body weight (R2 = 0.77; SEE = 11.1 Nm, F = 3.54, p < 0.001) and BMI (R2 = 0.64; SEE = 14.1 Nm, F = 2.39, p < 0.01). In forward stepwise multiple regression beginning with EICBMT, only age explained any additional variance in ulna bending strength (ΔR2 = 0.3%, F = 8.03, p = 0.008). CONCLUSION Noninvasive CBMT measurements of ulna EI explain 99% of individual differences in QMT measurements of ulna bending strength in cadaveric human arms.
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Affiliation(s)
- Lyn Bowman
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States of America; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States of America
| | - Emily R Ellerbrock
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States of America
| | - Gabrielle C Hausfeld
- Honors Tutorial College, Ohio University, Athens, OH 45701, United States of America
| | - Jennifer M Neumeyer
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States of America
| | - Anne B Loucks
- Department of Biological Sciences, Ohio University, Athens, OH 45701, United States of America; Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH 45701, United States of America.
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Schoenfeld BJ, Ogborn DI, Vigotsky AD, Franchi MV, Krieger JW. Hypertrophic Effects of Concentric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis. J Strength Cond Res 2017; 31:2599-2608. [DOI: 10.1519/jsc.0000000000001983] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Loucks AB, Clark BC, Bowman L. Response to "Clinical Evaluation of Bone Strength and Fracture Risk". Curr Osteoporos Rep 2017; 15:396-397. [PMID: 28660374 PMCID: PMC5558602 DOI: 10.1007/s11914-017-0386-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We read with great interest the recent review by de Bakker et al that summarized the state of several existing and emerging technologies for estimating bone strength and fracture risk in vivo. Much of their review focused on how well the measurements of selected technologies predicted experimental measurements of bone strength by ex vivo quasistatic mechanical testing (QMT) and on how well they tracked changes in mechanical properties of bone. The authors noted that the association of many common skeletal health measurements (e.g., DXA measures of trabecular bone score and areal and volumetric BMD) are only moderately associated with bone strength. The authors did not include mechanical response tissue analysis (MRTA) in their review. MRTA is a dynamic mechanical bending test that uses a vibration analysis technique to make immediate, direct, functional measurements of the mechanical properties (mass, stiffness, and damping) of long bones in humans in vivo. In this article we note our interest in the ability of MRTA to detect large changes in bone stiffness that go undetected by DXA. We also highlight results of our proprietary improvements to MRTA technology that have resulted in unmatched accuracy in QMT-validated measurements of the bending stiffness and estimates of the bending strength (both R2 = 0.99) of human ulna bones. To distinguish our improved technique from the legacy MRTA technology, we refer to it as Cortical Bone Mechanics Technology (CBMT). Further research will determine whether such CBMT measurements are clinically useful.
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Affiliation(s)
- Anne B Loucks
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, USA
- Department of Biological Sciences, Ohio University, Athens, OH, USA
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, USA.
- Department of Biomedical Sciences, Ohio University, Athens, OH, USA.
- Division of Geriatric Medicine, Ohio University, Athens, OH, USA.
| | - Lyn Bowman
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, USA
- Department of Biological Sciences, Ohio University, Athens, OH, USA
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Tang L, Gao X, Yang X, Liu C, Wang X, Han Y, Zhao X, Chi A, Sun L. Ladder-Climbing Training Prevents Bone Loss and Microarchitecture Deterioration in Diet-Induced Obese Rats. Calcif Tissue Int 2016; 98:85-93. [PMID: 26410845 DOI: 10.1007/s00223-015-0063-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/21/2015] [Indexed: 12/28/2022]
Abstract
Resistance exercise has been proved to be effective in improving bone quality in both animal and human studies. However, the issue about whether resistance exercise can inhibit obesity-induced bone loss has not been previously investigated. In the present study, we have evaluated the effects of ladder-climbing training, one of the resistance exercises, on bone mechanical properties and microarchitecture in high-fat (HF) diet-induced obese rats. Twenty-four rats were randomly assigned to the Control, HF + sedentary (HF-S) and HF + ladder-climbing training (HF-LCT) groups. Rats in the HF-LCT group performed ladder-climbing training for 8 weeks. The results showed that ladder-climbing training significantly reduced body and fat weight, and increased muscle mass along with a trend toward enhanced muscle strength in diet-induced obese rats. MicroCT analysis demonstrated that obesity-induced bone loss and architecture deterioration were significantly mitigated by ladder-climbing training, as evidenced by increased trabecular bone mineral density, bone volume over total volume, trabecular number and thickness, and decreased trabecular separation and structure model index. However, neither HF diet nor ladder-climbing training had an impact on femoral biomechanical properties. Moreover, ladder-climbing training significantly increased serum adiponectin, decreased serum leptin, TNF-α, IL-6 levels, and downregulated myostatin (MSTN) expression in diet-induced obese rats. Taken together, ladder-climbing training prevents bone loss and microarchitecture deterioration in diet-induced obese rats through multiple mechanisms including increasing mechanical loading on bone due to improved skeletal muscle mass and strength, regulating the levels of myokines and adipokines, and suppressing the release of pro-inflammatory cytokines. It indicates that resistance exercise may be a promising therapy for treating obesity-induced bone loss.
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Affiliation(s)
- Liang Tang
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Xiaohang Gao
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Xiaoying Yang
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Chentao Liu
- Department of Physical Education, Northwest University, Xi'an, 710069, China
| | - Xudan Wang
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Yanqi Han
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Xinjuan Zhao
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Aiping Chi
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China
| | - Lijun Sun
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, 710119, China.
- Postdoctoral Research Station of Biology, Shaanxi Normal University, Xi'an, 710119, China.
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Urbanek JK, Metzgar CJ, Hsiao PY, Piehowski KE, Nickols-Richardson SM. Increase in cognitive eating restraint predicts weight loss and change in other anthropometric measurements in overweight/obese premenopausal women. Appetite 2015; 87:244-50. [DOI: 10.1016/j.appet.2014.12.230] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/23/2014] [Accepted: 12/30/2014] [Indexed: 12/01/2022]
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Bielemann RM, Martinez-Mesa J, Gigante DP. Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults. BMC Musculoskelet Disord 2013; 14:77. [PMID: 23497066 PMCID: PMC3599107 DOI: 10.1186/1471-2474-14-77] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 02/19/2013] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of this paper was to review the literature of the cohort studies which evaluated the association between physical activity during the life course and bone mineral content or density in young adults. Methods Prospective cohort studies with bone mineral density or content measured in the whole body, lumbar spine and femoral neck by dual energy x-ray absorptiometry as outcome and physical activity as exposure were searched. Two independent reviewers selected studies retrieved from electronic databases (Medline, Lilacs, Web of Science and Scielo) and reviewed references of all selected full text articles. Downs & Black criterion was used in the quality assessment of these studies. Results Nineteen manuscripts met inclusion criteria. Lumbar spine was the skeletal site most studied (n = 15). Different questionnaires were used for physical activity evaluation. Peak strain score was also used to evaluate physical activity in 5 manuscripts. Lack of statistical power calculation was the main problem found in the quality assessment. Positive associations between physical activity and bone mass were found more in males than in females; in weight bearing anatomical sites (lumbar spine and femoral neck) than in total body and when physical activity measurements were done from adolescence to adulthood – than when evaluated in only one period. Physical activity during growth period was associated with greater bone mass in males. It was not possible to conduct pooled analyses due to the heterogeneity of the studies, considering mainly the different instruments used for physical activity measurements. Conclusions Physical activity seems to be important for bone mass in all periods of life, but especially the growth period should be taking into account due to its important direct effect on bone mass and its influence in physical activity practice in later life. Low participation in peak strain activities may also explain the lower number of associations found in females.
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Affiliation(s)
- Renata M Bielemann
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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Miller LE, Ramp WK, Steele CR, Nickols-Richardson SM, Herbert WG. Rationale, design and clinical performance of the mechanical response tissue analyser: a non-invasive technology for measurement of long bone bending stiffness. J Med Eng Technol 2013; 37:144-9. [DOI: 10.3109/03091902.2012.753128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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