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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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Jia S, Si Y, Guo C, Wang P, Li S, Wang J, Wang X. The prediction model of fall risk for the elderly based on gait analysis. BMC Public Health 2024; 24:2206. [PMID: 39138430 PMCID: PMC11323353 DOI: 10.1186/s12889-024-19760-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 08/12/2024] [Indexed: 08/15/2024] Open
Abstract
INTRODUCTION Early screening and identification are crucial for fall prevention, and developing a new method to predict fall risk in the elderly can address the current lack of objectivity in assessment tools. METHODS A total of 132 elderly individuals over 80 years old residing in some nursing homes in Shanghai were selected using a convenient sampling method. Fall history information was collected, and gait data during a 10-meter walk were recorded. Logistic regression was employed to establish the prediction model, and a nomogram was used to assess the importance of the indicators. The Bootstrap method was utilized for internal validation of the model, while the verification set was used for external validation. The predictive performance of the model was evaluated using the area under the ROC curve, calibration curve, and decision curve analysis (DCA) to assess clinical benefits. RESULTS The incidence of falls in the sample population was 36.4%. The Tinetti Gait and Balance Test (TGBT) score (OR = 0.832, 95% CI: 0.734,0.944), stride length (OR = 0.007, 95% CI: 0.000,0.104), difference in standing time (OR = 0.001, 95% CI: 0.000,0.742), and mean stride time (OR = 0.992, 95% CI:0.984,1.000) were identified as significant factors. The area under the ROC curve was 0.878 (95% CI: 0.805, 0.952), with a sensitivity of 0.935 and specificity of 0.726. The Brier score was 0.135, and the Hosmer-Lemeshow test (χ2 = 10.650, P = 0.222) indicated a good fit and calibration of the model. CONCLUSION The TGBT score, stride length, difference in standing time, and stride time are all protective factors associated with fall risk among the elderly. The developed risk prediction model demonstrates good discrimination and calibration, providing valuable insights for early screening and intervention in fall risk among older adults.
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Affiliation(s)
- Shuqi Jia
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yanran Si
- Physical Education and Sport Department, Shanghai International Studies University, Shanghai, China
| | - Chengcheng Guo
- School of Public Administration, Hohai University, Nanjing, China
| | - Peng Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Shufan Li
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Jing Wang
- School of Physical Education and Health, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China.
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Carr JC, Pedagandham SP, Giugni A, Shen C, Kim AM, Cribbin EM, Lin X, Oomatia A, Lu W, Al Muderis M, Xing D, Li JJ. Bone mineral density in osseointegration implant surgery: A review of current studies (Review). Biomed Rep 2024; 21:122. [PMID: 38978538 PMCID: PMC11229397 DOI: 10.3892/br.2024.1809] [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: 04/15/2024] [Accepted: 06/04/2024] [Indexed: 07/10/2024] Open
Abstract
Osseointegration implant (OI) surgery is the latest rehabilitation technology for amputees, where a bone-anchored implant obviates the limitations of traditional socket prostheses. The bone mineral density (BMD) in the periprosthetic and other anatomical regions can be used to assess bone remodelling following OI surgery. Currently, limited studies have used BMD measurements in reporting post-operative OI outcomes and the association between the maintenance of BMD and implant efficacy has remained elusive. This review captured and analysed all studies that have reported the BMD as an objective outcome measure in patients with trans-femoral or trans-tibial OI. The PubMed, Medline, Scopus and Web of Science databases were searched using the terms 'amputation', 'osseointegration' and 'bone mineral density'. A total of 6 studies involving human participants were included for analysis. All studies used dual X-ray absorptiometry and/or X-rays for measuring BMD. Rehabilitation of trans-femoral or trans-tibial amputation using OI may help restore healthy BMD by enabling physiological bone loading. However, there is a low correlation between the BMD around the OI and the success of OI surgery or the risk of periprosthetic fractures. This review summarises the current evidence on BMD assessment in OI for lower limb amputee rehabilitation. Despite the great variability in the results, the available evidence suggests that OI may help restore BMD following surgery. The limited evidence calls for further investigation, as well as the development of a standard BMD measurement protocol.
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Affiliation(s)
- Joshua C Carr
- Kolling Institute, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW 2065, Australia
| | - Sai Pranitha Pedagandham
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
- Osseointegration Group of Australia, Sydney, NSW 2153, Australia
| | - Amelia Giugni
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Christina Shen
- Osseointegration Group of Australia, Sydney, NSW 2153, Australia
| | - Alice M Kim
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Elise M Cribbin
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Xiaoqi Lin
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Atiya Oomatia
- Osseointegration Group of Australia, Sydney, NSW 2153, Australia
| | - William Lu
- Osseointegration Group of Australia, Sydney, NSW 2153, Australia
| | | | - Dan Xing
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Beijing 100044, P.R. China
| | - Jiao Jiao Li
- Kolling Institute, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW 2065, Australia
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Ultimo, NSW 2007, Australia
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Batterham RL, Bedimo RJ, Diaz RS, Guaraldi G, Lo J, Martínez E, McComsey GA, Milinkovic A, Naito T, Noe S, O'Shea D, Paredes R, Schapiro JM, Sulkowski MS, Venter F, Waters L, Yoruk IU, Young B. Cardiometabolic health in people with HIV: expert consensus review. J Antimicrob Chemother 2024; 79:1218-1233. [PMID: 38656584 PMCID: PMC11144490 DOI: 10.1093/jac/dkae116] [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] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. METHODS A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. RESULTS Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. CONCLUSIONS On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population.
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Affiliation(s)
- Rachel L Batterham
- UCL Division of Medicine, UCL School of Life and Medical Sciences, University College London, Gower Street, London WC1E 6BT, UK
- University College London Hospitals Biomedical Research Centre, National Institute for Health and Care Research, Maple House Suite A 1st Floor, 149 Tottenham Court Road, London W1T 7DN, UK
| | - Roger J Bedimo
- Infectious Disease Section, VA North Texas Health Care System, 4500 S Lancaster Road, Dallas, TX 75216, USA
- Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Ricardo S Diaz
- Infectious Diseases Department, Paulista School of Medicine, Federal University of São Paulo, R. Sena Madureira, 1500 Vila Clementino, São Paulo, 04021-001, Brazil
| | - Giovanni Guaraldi
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy
| | - Janet Lo
- Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Esteban Martínez
- Infectious Diseases Unit, Hospital Clinic and University of Barcelona, C. de Villarroel, 170, 08036 Barcelona, Spain
| | - Grace A McComsey
- Case Center for Diabetes, Obesity and Metabolism, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Ana Milinkovic
- Global Medical, ViiV Healthcare, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
- HIV Services, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK
- Imperial College London, Exhibition Road, South Kensington, London SW7 2BX, UK
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, 2 Chome-1-1 Hongo, Bunkyo City, Tokyo 113-8421, Japan
| | - Sebastian Noe
- MVZ Karlsplatz, MVZ Karlsplatz 8, 80335, Munich, Germany
| | - Donal O'Shea
- Health Sciences Centre, University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Roger Paredes
- Department of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain
| | - Jonathan M Schapiro
- National Hemophilia Center, Sheba Medical Center, Derech Sheba 2, Ramat Gan, Tel Aviv, Israel
| | - Mark S Sulkowski
- Department of Medicine, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
| | - François Venter
- Ezintsha, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein 2000, Johannesburg, South Africa
| | - Laura Waters
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, 350 Euston Road, Regent's Place, London NW1 3AX, UK
| | - Ilksen Ungan Yoruk
- General Medicines Europe, GSK, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - Benjamin Young
- Global Medical, ViiV Healthcare, 406 Blackwell Street, Suite 300, Durham, NC 27701, USA
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Walzik D, Wences Chirino TY, Zimmer P, Joisten N. Molecular insights of exercise therapy in disease prevention and treatment. Signal Transduct Target Ther 2024; 9:138. [PMID: 38806473 PMCID: PMC11133400 DOI: 10.1038/s41392-024-01841-0] [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: 01/20/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/30/2024] Open
Abstract
Despite substantial evidence emphasizing the pleiotropic benefits of exercise for the prevention and treatment of various diseases, the underlying biological mechanisms have not been fully elucidated. Several exercise benefits have been attributed to signaling molecules that are released in response to exercise by different tissues such as skeletal muscle, cardiac muscle, adipose, and liver tissue. These signaling molecules, which are collectively termed exerkines, form a heterogenous group of bioactive substances, mediating inter-organ crosstalk as well as structural and functional tissue adaption. Numerous scientific endeavors have focused on identifying and characterizing new biological mediators with such properties. Additionally, some investigations have focused on the molecular targets of exerkines and the cellular signaling cascades that trigger adaption processes. A detailed understanding of the tissue-specific downstream effects of exerkines is crucial to harness the health-related benefits mediated by exercise and improve targeted exercise programs in health and disease. Herein, we review the current in vivo evidence on exerkine-induced signal transduction across multiple target tissues and highlight the preventive and therapeutic value of exerkine signaling in various diseases. By emphasizing different aspects of exerkine research, we provide a comprehensive overview of (i) the molecular underpinnings of exerkine secretion, (ii) the receptor-dependent and receptor-independent signaling cascades mediating tissue adaption, and (iii) the clinical implications of these mechanisms in disease prevention and treatment.
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Affiliation(s)
- David Walzik
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University, 44227, Dortmund, North Rhine-Westphalia, Germany
| | - Tiffany Y Wences Chirino
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University, 44227, Dortmund, North Rhine-Westphalia, Germany
| | - Philipp Zimmer
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University, 44227, Dortmund, North Rhine-Westphalia, Germany.
| | - Niklas Joisten
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University, 44227, Dortmund, North Rhine-Westphalia, Germany.
- Division of Exercise and Movement Science, Institute for Sport Science, University of Göttingen, 37075, Göttingen, Lower Saxony, Germany.
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Petrauskiene V, Hellberg M, Svensson P, Zhou Y, Clyne N. Bone mineral density after exercise training in patients with chronic kidney disease stages 3 to 5: a sub-study of RENEXC-a randomized controlled trial. Clin Kidney J 2024; 17:sfad287. [PMID: 38186908 PMCID: PMC10768767 DOI: 10.1093/ckj/sfad287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background We evaluated the effects of 12 months of exercise training on bone mineral density (BMD) in patients with chronic kidney disease (CKD) stages 3-5 not on kidney replacement therapy (KRT). Methods A total of 151 patients were randomized to 12 months of either balance or strength training, both together with endurance training. Some 112 patients completed and 107 (69 men, 38 women) were analysed, with a mean age 66 ± 13.5 years and 31% having diabetes. The exercise training was self-administered, prescribed and monitored by a physiotherapist. Total body, hip and lumbar BMD, T score and Z score were measured at baseline and after 12 months using dual energy X-ray absorptiometry. Results Both groups showed increased physical performance. The prevalence of osteoporosis and osteopenia was unchanged. The strength group (SG) decreased total body BMD (P < .001), the balance group (BG) increased total body T score (P < .05) and total body Z score (P < .005). Total body ΔT score was negative in the SG and unchanged in the BG (P < .005). Total body ΔZ score was negative in the SG and positive in the BG (P < .001). The proportion of progressors measured by ΔT (P < .05) and ΔZ scores (P < .05) was significantly lower in the BG compared with the SG. In multivariate logistic regression analysis, belonging to the BG was the only factor with a lower risk of deterioration of total body BMD, T and Z scores. Conclusions Twelve months of balance training together with endurance training seemed to be superior to strength training in maintaining and improving BMD in patients with CKD not on KRT.
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Affiliation(s)
- Vaida Petrauskiene
- Lund University, Skåne University Hospital, Faculty of Medicine, Department of Clinical Sciences Lund, Nephrology, Lund, Sweden
| | - Matthias Hellberg
- Lund University, Skåne University Hospital, Faculty of Medicine, Department of Clinical Sciences Lund, Nephrology, Lund, Sweden
| | - Philippa Svensson
- Lund University, Skåne University Hospital, Faculty of Medicine, Department of Clinical Sciences Lund, Nephrology, Lund, Sweden
| | - Yunan Zhou
- Lund University, Skåne University Hospital, Faculty of Medicine, Department of Clinical Sciences Lund, Nephrology, Lund, Sweden
| | - Naomi Clyne
- Lund University, Skåne University Hospital, Faculty of Medicine, Department of Clinical Sciences Lund, Nephrology, Lund, Sweden
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Dsouza C, Komarova SV. Mechanosensitivity and mechanotransductive properties of osteoclasts. Am J Physiol Cell Physiol 2024; 326:C95-C106. [PMID: 37982175 DOI: 10.1152/ajpcell.00347.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
Mechanical loading is essential for maintaining bone health. Here, we aimed to investigate the role of ATP and ADP in the mechanotransduction of bone-resorptive osteoclasts. Single osteoclast in primary cultures from 10 to 12-wk-old mice was mechanically stimulated by a gentle touch with a micropipette. Changes in cytosolic free calcium [Ca2+]i were analyzed in Fura-2 loaded osteoclasts. The cell injury was assessed by analyzing the cellular Fura-2 loss and classified as severe or mild using k-means. Osteoclasts responded to mechanical stimuli with transient calcium elevation (primary responders) and transduced these signals to neighboring cells, which responded with delayed calcium elevations (secondary responders). Severely injured osteoclasts had higher calcium transients than mildly injured cells. Fluid shear stress similarly induced reversible cell injury in osteoclasts. Secondary responses were abolished by treatment with A-804598, a specific inhibitor of P2X7, but not suramin, a broad P2 receptor blocker. Osteoclasts responded to ATP and ADP with concentration-dependent changes in [Ca2+]i. We performed osteoclast micropipette stimulation in the presence of phosphoenolpyruvate and pyruvate kinase which converted all ADP in solution to ATP, or with hexokinase converting all ATP to ADP. Osteoclasts with mild membrane injury demonstrated similar calcium responses in ATP and ADP-rich environments. However, when the mechanotransductive signal to severe osteoclast injury was converted to ADP, the fraction of secondary responders and their [Ca2+]i amplitude was higher. This study suggests the importance of osteoclast mechanobiology and the role of ADP-mediated signaling in conditions of altered mechanical loading associated with bone loss.NEW & NOTEWORTHY Osteoclasts are rarely considered as cells that participate in mechanical signaling in bone. We show that osteoclasts are capable of sensing and transmitting mechanical signals to neighboring cells. Mechanical stimulation commonly induces minor repairable membrane injury in osteoclasts. ATP and especially ADP were found to play important roles in the mechanoresponsiveness of osteoclasts. This study highlights the importance of osteoclast mechanobiology especially in conditions of altered mechanical loading associated with bone loss, such as in microgravity.
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Affiliation(s)
- Chrisanne Dsouza
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
| | - Svetlana V Komarova
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
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Martin H, Redfern A. Bone mineral density fall during aromatase inhibitor treatment may predict lower breast cancer recurrence. Cancer Med 2024; 13:e6846. [PMID: 38186326 PMCID: PMC10807598 DOI: 10.1002/cam4.6846] [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: 08/30/2023] [Revised: 11/26/2023] [Accepted: 12/10/2023] [Indexed: 01/09/2024] Open
Abstract
PURPOSE Aromatase inhibitors (AIs) are associated with reduction in bone mineral density (BMD). The use of bone strengthening agents zoledronic acid and denosumab are associated with improved breast cancer outcomes for post-menopausal patients treated with AIs. This study investigates whether change in BMD with AI therapy is associated with breast cancer recurrence. METHODS A cohort of patients treated at a single institution diagnosed with hormone receptor-positive breast cancer with baseline BMD and subsequent BMD test while receiving adjuvant aromatase inhibitor therapy were studied. Demographic, treatment and outcome data was obtained. Simple and multiple linear regression analysis was performed to investigate predictors of annual percent BMD change at the LS and hip. Univariate and multivariate Cox proportional hazards modelling were undertaken to investigate predictors of breast cancer recurrence. RESULTS 353 patients eligible patients were identified. In multivariate analysis of lumbar spine BMD change, the difference between those in quartile 1, which showed the greatest reduction in BMD, and quartile 3, with substantially less reduction, was significant (HR = 3.02, 95% CI 1.15-7.90 p = 0.025). Hip BMD reduction was also not significantly associated with breast cancer recurrence. The two quartiles with the least reduction in hip BMD showing a non-significant reduced risk of recurrence relative to the quartile with the greatest (p = 0.10). CONCLUSIONS The findings suggest an association may exist between lumbar spine BMD change and breast cancer recurrence for patients treated with adjuvant AI. Further research is required to determine whether BMD change can be utilised as a biomarker.
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Affiliation(s)
- Hilary Martin
- Medical OncologyFiona Stanley HospitalMurdochWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Andrew Redfern
- Medical OncologyFiona Stanley HospitalMurdochWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Hsu TL, Chou YH, Ho CC, Tantoh DM, Lu WY, Lung CC, Jan CF, Wang L, Liaw YP. Spine, hip, and femoral neck bone mineral density in relation to vegetarian type and status among Taiwanese adults. Arch Osteoporos 2023; 18:134. [PMID: 37962721 DOI: 10.1007/s11657-023-01320-z] [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: 06/07/2023] [Accepted: 08/11/2023] [Indexed: 11/15/2023]
Abstract
We determined the association of vegetarian type and status with bone mineral density (BMD) Z-scores at the spine, hip, and femoral neck. Compared to non-vegetarians, current vegetarians, especially vegans, lacto-vegetarians, and lacto-ovo-vegetarians had lower Z-scores at multiple sites. Sole reliance on a vegetarian diet might be detrimental to the bone. PURPOSE The impact of vegetarian diets on BMD is contentious. We determined the association of vegetarian type and status with the spine, hip, and femoral neck BMD Z-scores. METHODS We analyzed data from 20,110 Taiwan Biobank volunteers. BMD was measured using dual-energy X-ray absorptiometry (DXA). The vegetarian status (non-, former, and current vegetarians) and type (non-vegetarians, ovo-vegetarians, lacto-vegetarians, lacto-ovo-vegetarians, and vegans) were determined using questionnaires. RESULTS The participants consisted of 12,910 women and 7200 men, with a mean age of 55.5 years. Based on vegetarian status (reference: non-vegetarians), current vegetarians had significantly lower BMD Z-scores at the spine (unstandardized regression coefficient, B = - 0.195, p = 0.006), left hip (B = - 0.125, p = 0.008), and right hip (B = - 0.100, p = 0.027), respectively. Based on vegetarian status and type (reference: non-vegetarians), current vegans and non-vegans had notably lower BMD Z-scores at specific skeletal sites. For non-vegans, the BMD Z-scores were significant at the spine (B = -0.184, p = 0.010), left hip (B = - 0.124, p = 0.010), and left femoral neck (B = - 0.125, p = 0.012). For current vegans, however, the BMD Z-scores were significant only at the right hip (B = - 0.232; p = 0.028). Nonetheless, after stratifying vegetarian diet into more subgroups, current vegans exhibited a significant reduction in BMD Z-scores at the spine and right hip, with B-coefficients of - 0.326 and - 0.238, respectively. Current lacto-vegetarians also had significantly lower Z-scores (p < 0.05) at the spine (B = - 0.459), left hip (B = - 0.313), and right hip (B = - 0.214). Moreover, current lacto-ovo-vegetarians had significantly lower Z-scores at the spine (B = - 0.175) and left hip (B = - 0.115). CONCLUSION Current vegetarians, particularly vegans, lacto-vegetarians, and lacto-ovo-vegetarians, demonstrated significantly lower BMD Z-scores at various skeletal sites compared to non-vegetarians. Sole reliance on a vegetarian diet might be detrimental to the bone.
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Affiliation(s)
- Tzu-Liang Hsu
- Department of Orthopedic Surgery, Tungs' Taichung Metroharbor Hospital, Taichung City, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
| | - Ying-Hsiang Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung City, Taiwan
- School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung City, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Disline Manli Tantoh
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Wen-Yu Lu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
| | - Chia-Chi Lung
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan
| | - Cheng-Feng Jan
- Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Lee Wang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110 Sec. 1 Jianguo N. Road, Taichung City, 40201, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan.
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10
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Civil R, Dolan E, Swinton PA, Santos L, Varley I, Atherton PJ, Elliott-Sale KJ, Sale C. P1NP and β-CTX-1 Responses to a Prolonged, Continuous Running Bout in Young Healthy Adult Males: A Systematic Review with Individual Participant Data Meta-analysis. SPORTS MEDICINE - OPEN 2023; 9:85. [PMID: 37725246 PMCID: PMC10509102 DOI: 10.1186/s40798-023-00628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Circulating biomarkers of bone formation and resorption are widely used in exercise metabolism research, but their responses to exercise are not clear. This study aimed to quantify group responses and inter-individual variability of P1NP and β-CTX-1 after prolonged, continuous running (60-120 min at 65-75% V̇O2max) in young healthy adult males using individual participant data (IPD) meta-analysis. METHODS The protocol was designed following PRISMA-IPD guidelines and was pre-registered on the Open Science Framework prior to implementation ( https://osf.io/y69nd ). Changes in P1NP and β-CTX-1 relative to baseline were measured during, immediately after, and in the hours and days following exercise. Typical hourly and daily variations were estimated from P1NP and β-CTX-1 changes relative to baseline in non-exercise (control) conditions. Group responses and inter-individual variability were quantified with estimates of the mean and standard deviation of the difference, and the proportion of participants exhibiting an increased response. Models were conducted within a Bayesian framework with random intercepts to account for systematic variation across studies. RESULTS P1NP levels increased during and immediately after running, when the proportion of response was close to 100% (75% CrI: 99 to 100%). P1NP levels returned to baseline levels within 1 h and over the next 4 days, showing comparable mean and standard deviation of the difference with typical hourly (0.1 ± 7.6 ng·mL-1) and daily (- 0.4 ± 5.7 ng·mL-1) variation values. β-CTX-1 levels decreased during and up to 4 h after running with distributions comparable to typical hourly variation (- 0.13 ± 0.11 ng·mL-1). There was no evidence of changes in β-CTX-1 levels during the 4 days after the running bout, when distributions were also similar between the running data and typical daily variation (- 0.03 ± 0.10 ng·mL-1). CONCLUSION Transient increases in P1NP were likely biological artefacts (e.g., connective tissue leakage) and not reflective of bone formation. Comparable small decreases in β-CTX-1 identified in both control and running data, suggested that these changes were due to the markers' circadian rhythm and not the running intervention. Hence, prolonged continuous treadmill running did not elicit bone responses, as determined by P1NP and β-CTX-1, in this population.
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Affiliation(s)
- Rita Civil
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division; Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Paul A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Lívia Santos
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Philip J Atherton
- Centre of Metabolism, Ageing and Physiology (CMAP), MRC-Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research, Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Derby, United Kingdom
| | - Kirsty J Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
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11
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Mohebbi R, Shojaa M, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Lange U, Peters S, Thomasius F, Uder M, Kemmler W. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporos Int 2023; 34:1145-1178. [PMID: 36749350 PMCID: PMC10282053 DOI: 10.1007/s00198-023-06682-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023]
Abstract
The aim of this systematic review and meta-analysis was (1) to determine exercise effects on bone mineral density (BMD) in postmenopausal women and (2) to address the corresponding implication of bone and menopausal status or supervision in postmenopausal women. A comprehensive search of eight electronic databases according to the PRISMA statement up to August 9, 2022, included controlled exercise trials ≥ 6 months. BMD changes (standardized mean differences: SMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) were considered as outcomes. Study group comparisons were conducted for osteopenia/osteoporosis versus normal BMD, early versus late postmenopausal women, and predominantly supervised versus predominantly non-supervised study arms. We applied an inverse heterogeneity (IVhet) model. In summary, 80 studies involving 94 training and 80 control groups with a pooled number of 5581 participants were eligible. The IVhet model determined SMDs of 0.29 (95% CI: 0.16-0.42), 0.27 (95% CI: 0.16-0.39), and 0.41 (95% CI: 0.30-0.52) for LS, FN, and THBMD, respectively. Heterogeneity between the trial results varied from low (I2 = 20%, TH BMD) to substantial (I2 = 68%, LS-BMD). Evidence for publication bias/small study effects was negligibly low (FN-, TH-BMD) to high (LSBMD). We observed no significant differences (p > .09) for exercise effects on LS-, FN-, or TH-BMD-LS between studies/study arms with or without osteopenia/osteoporosis, early versus late postmenopausal women, or predominantly supervised versus non-supervised exercise programs. Using robust statistical methods, the present work provides further evidence for a positive effect of exercise on BMD in postmenopausal women. Differences in bone status (osteopenia/osteoporosis versus normal bone), menopausal status (early versus late postmenopausal), and supervision (yes versus no) did not significantly affect the exercise effects on BMD at LS or proximal femur.
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Affiliation(s)
- Ramin Mohebbi
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Department Population-Based Medicine, Institute of Health Science, University Hospital Tübingen, Tübingen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Simon von Stengel
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum Für Bewegungsforschung, University of Würzburg, Würzburg, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Katharina Kerschan-Schindl
- Austrian Society for Bone and Mineral Research, Vienna, Austria
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Dresden, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Hürth-Efferen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Friederike Thomasius
- Osteology Umbrella Association Germany, Austria, Switzerland
- Frankfurt Center of Bone Health, Frankfurt, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany.
- Research Group On Guideline "Exercise and Fracture Prevention, Frankfurt, Germany.
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12
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Bakhsh N, Banjar M, Baig M. Correlation of bone density measured on CT chest with the severity of COVID-19 infection: A retrospective study. PLoS One 2023; 18:e0286395. [PMID: 37289783 PMCID: PMC10249830 DOI: 10.1371/journal.pone.0286395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
PURPOSE This retrospective study investigated the correlation between bone mineral density (BMD) and COVID-19 severity among COVID-19 patients who underwent chest computed tomography (CT) scans. METHODS This study was carried out at the King Abdullah Medical Complex in Jeddah, Saudi Arabia, one of the largest COVID-19 centers in the western province. All adult COVID-19 patients who had a chest CT between January 2020 and April 2022 were included in the study. The pulmonary severity scores (PSS) and vertebral BMD measurements were obtained from the patient's CT chest. Data from the patients' electronic records were collected. RESULTS The average patient age was 56.4 years, and most (73.5%) patients were men. Diabetes (n = 66, 48.5%), hypertension (n = 56, 41.2%), and coronary artery disease (n = 17, 12.5%) were the most prevalent comorbidities. Approximately two-thirds of hospitalized patients required ICU admission (64%), and one-third died (30%). The average length of stay in the hospital was 28.4 days. The mean CT pneumonia severity score (PSS) was 10.6 at the time of admission. Patients with lower vertebral BMD (< = 100) numbered 12 (8.8%), while those with higher vertebral BMD (>100) numbered 124 (91.2%). Only 46 out of the total survived patients (n = 95) were admitted to the ICU versus all deceased (P<0.01). The logistic regression analysis revealed that an elevated PSS upon admission resulted in a reduced chance of survival. Age, gender, and BMD did not predict survival chances. CONCLUSION The BMD had no prognostic advantage, and the PSS was the significant factor that could have predicted the outcome.
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Affiliation(s)
- Noha Bakhsh
- Faculty of Medicine in Rabigh, Department of Medicine, Division of Radiology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mai Banjar
- Department of Medical Imaging, King Abdullah Medical Complex, Jeddah, Saudi Arabia
| | - Mukhtiar Baig
- Faculty of Medicine in Rabigh, Department of Clinical Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia
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13
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Kellogg AJ, Hancock DW, Cho GY, Reid AE. Reprint of: Community-level age bias and older adult mortality. Soc Sci Med 2023; 320:115699. [PMID: 36739253 DOI: 10.1016/j.socscimed.2023.115699] [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: 03/14/2022] [Revised: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 01/31/2023]
Abstract
RATIONALE As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention. OBJECTIVE We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities. METHODS Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142). RESULTS Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association. CONCLUSIONS Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.
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Affiliation(s)
- Alexander J Kellogg
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - David W Hancock
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Grace Y Cho
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Allecia E Reid
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA.
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14
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Wang Z, Zan X, Li Y, Lu Y, Xia Y, Pan X. Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: A systematic review and network meta-analysis. Front Physiol 2023; 14:1105303. [PMID: 36824476 PMCID: PMC9941565 DOI: 10.3389/fphys.2023.1105303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Objective: To systematically review the effects of different resistance training (RT) protocols on bone mineral density (BMD) in postmenopausal women. Methods: Randomized controlled trials (RCTs) on the resistance training in improving bone mineral density for postmenopausal women were searched in databases including ProQuest, PubMed, Cochrane Library, Embase, and Web of Science. The retrieval time range was from the establishment of the database to May 2022. The included literature was independently screened and relevant data was extracted by two reviewers. The systematic review followed the Joanna Briggs Institute (JBI) methodology for reviews of quantitative evidence. Quality of risk was assessed using the Physical Therapy Evidence Database (PEDro) scale, risk of bias was assessedusing the Cochrane RoB2 tool and a network Meta-analysis was performed on the data using Stata 16.0. Results: A total of 19 studies, which included 919 subjects, were eventually acquired. The results of the network Meta-analysis showed that moderate intensity resistance training was superior in improving lumbar spine bone mineral density (LS BMD) and femoral neck bone mineral density (FN BMD) compared to the control group (as per usual daily life), with a statistically significant difference (p < 0.05). There was, however, no statistically significant difference between the groups in terms of increasing total hip bone mineral density (TH BMD) and trochanter bone mineral density (Troch BMD), although moderate intensity training tends to increase bone mineral density (p > 0.05). In addition, when training frequency is taken into consideration, 3 days/week of moderate intensity training (3MI) was superior to 2 days/week (2MI) in improving lumbar spine bone mineral density , and moderate intensity training was superior to low and high intensity resistance trainings at training frequency of 3 day/week, with statistically significant differences (p < 0.05). The cumulative probability ranking results indicated that 3MI was the optimal option in improving lumbar spine, femoral neck, total hip and Troch bone mineral density. Subgroup analyses combining interventions time showed that for lumbar spine and femoral neck bone mineral density, 3MI protocol with intervention duration within 1 year (≤48 weeks) had a significant advantage over other interventions, while this advantage was no longer significant with the intervention duration of more than 1 year (>48 weeks). Conclusion: Current evidence shows that moderate intensity resistance training for 3 days/week can be preferred clinically to improve bone mineral density in postmenopausal women, and it is recommended that the duration of the same training should not exceed 1 year. Nevertheless, more high-quality studies are needed to verify the above conclusion.
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Affiliation(s)
- Zhenyu Wang
- School of Health Sciences, Wuhan Sports University, Wuhan, China
| | - Xingchun Zan
- Department of Hyperbaric Oxygen, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Yongjie Li
- Department of Rehabilitation Medicine, Beijing Jishuitan HospitalGuizhouHospital, Guiyang, China,*Correspondence: Yongjie Li,
| | - Yue Lu
- Department of Rehabilitation Medicine, Hubei Provincicial Hospital of Integrated Chinese and Western Medicine, Wuhan, China
| | - Yuan Xia
- School of Health Sciences, Wuhan Sports University, Wuhan, China
| | - Xinyong Pan
- School of Health Sciences, Wuhan Sports University, Wuhan, China
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15
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Li J, Gu Q, Li R, Wang R, Cai Y, Huang Y, Wang S, Wang S, Liu X. Effect of Yi Jin Jing exercise plus Elastic Band Resistance exercise on overall bone mineral density in postmenopausal women. J Sci Med Sport 2023; 26:87-92. [PMID: 36707306 DOI: 10.1016/j.jsams.2023.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES This work aimed to study the effects of Yi Jin Jing plus Elastic Band Resistance exercise on bone mineral density at all parts of the body and bone metabolism index levels in postmenopausal women. DESIGN Randomized controlled trial. METHODS Forty postmenopausal women were randomly assigned equally to the exercise or to the control group. The control group maintained their lifestyle behaviors unaltered, whereas the exercise group received Yi Jin Jing plus Elastic Band Resistance exercise. The primary outcome was overall bone mineral density at each part, and the secondary one was bone metabolism indicator levels and bone mineral density on both sides. RESULTS The results after six months showed increased bone mineral density at all parts of the body in the exercise group (spine, P = 0.002; thighs, lumbar, and whole body, P < 0.05) and decreased bone mineral density in the control group (trunk, pelvis, and spine, P < 0.01). In particular, the decrease and increase were greater on the non-preferred (left) side than on the right side. As for bone metabolism indexes, β-Crosslaps levels reduced (P = 0.016) and a significant increase in 1,25-(OH)2-D3 (P < 0.001) can be observed in the exercise group. CONCLUSIONS The results suggested that Yi Jin Jing plus Elastic Band Resistance exercise could delay the overall decrease of bone mineral density in postmenopausal women, especially on the non-preferred side. It also increased bone formation metabolite levels and inhibited bone resorption metabolite levels.
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Affiliation(s)
- Jingyuan Li
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Qing Gu
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, China
| | - Ruixue Li
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Ru Wang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Yanwei Cai
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Yunda Huang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Shasha Wang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Suijun Wang
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, China.
| | - Xiangyun Liu
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China.
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16
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Tagliaferri SD, Belavy DL, Bowe SJ, Clarkson MJ, Connell D, Craige EA, Gollan R, Main LC, Miller CT, Mitchell UH, Mundell NL, Neason C, Samanna CL, Scott D, Tait JL, Vincent GE, Owen PJ. Assessing safety and treatment efficacy of running on intervertebral discs (ASTEROID) in adults with chronic low back pain: protocol for a randomised controlled trial. BMJ Open Sport Exerc Med 2023; 9:e001524. [PMID: 36684712 PMCID: PMC9853241 DOI: 10.1136/bmjsem-2022-001524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/19/2023] Open
Abstract
Poor intervertebral disc (IVD) health is associated with low back pain (LBP). This 12-week parallel randomised controlled trial will evaluate the efficacy of a progressive interval running programme on IVD health and other clinical outcomes in adults with chronic LBP. Participants will be randomised to either a digitally delivered progressive interval running programme or waitlist control. Participants randomised to the running programme will receive three individually tailored 30 min community-based sessions per week over 12 weeks. The waitlist control will undergo no formal intervention. All participants will be assessed at baseline, 6 and 12 weeks. Primary outcomes are IVD health (lumbar IVD T2 via MRI), average LBP intensity over the prior week (100-point visual analogue scale) and disability (Oswestry Disability Index). Secondary outcomes include a range of clinical measures. All outcomes will be analysed using linear mixed models. This study has received ethical approval from the Deakin University Human Research Ethics Committee (ID: 2022-162). All participants will provide informed written consent before participation. Regardless of the results, the findings of this study will be disseminated, and anonymised data will be shared via an online repository. This will be the first study to evaluate whether a progressive interval running programme can improve IVD health in adults with chronic LBP. Identifying conservative options to improve IVD health in this susceptible population group has the potential to markedly reduce the burden of disease. This study was registered via the Australian New Zealand Clinical Trials Registry on 29 September 2022 (ACTRN12622001276741).
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Affiliation(s)
- Scott D Tagliaferri
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Daniel L Belavy
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Steven J Bowe
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Victoria, Australia,Victoria University of Wellington, Wellington, New Zealand
| | - Matthew J Clarkson
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - David Connell
- Imaging @ Olympic Park, AAMI Park, 60 Olympic Boulevard, Melbourne, Victoria, Australia
| | - Emma A Craige
- Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Luana C Main
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Clint T Miller
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Ulrike H Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Niamh L Mundell
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Christopher Neason
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Claire L Samanna
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - David Scott
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia,School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Jamie L Tait
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, South Australia, Australia
| | - Patrick J Owen
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
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17
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Kellogg AJ, Hancock DW, Cho GY, Reid AE. Community-level age bias and older adult mortality. Soc Sci Med 2023; 317:115449. [PMID: 36494219 PMCID: PMC11293901 DOI: 10.1016/j.socscimed.2022.115449] [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: 03/14/2022] [Revised: 08/30/2022] [Accepted: 10/08/2022] [Indexed: 11/22/2022]
Abstract
RATIONALE As the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention. OBJECTIVE We hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities. METHODS Explicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142). RESULTS Contrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association. CONCLUSIONS Results highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.
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Affiliation(s)
- Alexander J Kellogg
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - David W Hancock
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Grace Y Cho
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA
| | - Allecia E Reid
- University of Massachusetts, Amherst; Department of Psychological and Brain Sciences; 135 Hicks Way, Tobin Hall, Amherst, MA, 01003, USA.
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18
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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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19
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Rivera-Paredez B, Quezada-Sánchez AD, Robles-Rivera K, Hidalgo-Bravo A, Denova-Gutiérrez E, León-Reyes G, Flores YN, Salmerón J, Velázquez-Cruz R. Dietary inflammatory index and bone mineral density in Mexican population. Osteoporos Int 2022; 33:1969-1979. [PMID: 35624319 DOI: 10.1007/s00198-022-06434-7] [Citation(s) in RCA: 3] [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: 11/01/2021] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
UNLABELLED Dietary inflammatory index has been associated with bone loss. In this longitudinal study, we reported that changes in dietary inflammatory index were associated with a reduction in bone mineral density of the total hip and femoral neck in males and females ≥ 45 years, but not in individuals < 45 years. PURPOSE Previous studies have suggested that an inflammatory environment can affect bone mineral density (BMD). However, most of the studies have been done in postmenopausal women. Thus, longitudinal studies in different age groups and sex are necessary to evaluate the longitudinal association between dietary inflammatory index (DII) and BMD in Mexican adults. METHODS A total of 1,486 participants of the Health Workers Cohort Study were included in this study. The DII was estimated with data retrieved through a semi-quantitative food frequency questionnaire. Total hip, femoral neck, and lumbar spine BMD were measured by dual-energy X-ray absorptiometry. Linear regression models for cross-sectional associations and fixed effects linear regression models for longitudinal association were estimated, and both models were stratified by sex and age groups (< 45 and ≥ 45 years). RESULTS We did not observe cross-sectional associations between DII and the different BMD sites at baseline. In contrast, women and men ≥ 45 years in the 25th quartile of changes in DII were associated with a gain of 0.067 g/cm2 and 0.062 g/cm2 of total hip BMD, while those in the 75th quartile of DII was associated with a reduction of - 0.108 g/cm2 and - 0.100 g/cm2, respectively. These results were similar for femoral neck BMD in women. In contrast, we did not observe association with femoral neck BMD in men. We did not observe statistically significant changes for lumbar spine BMD. CONCLUSION Our data suggest that changes in the DII score are associated with changes in total hip and femoral neck BMD among Mexican population.
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Affiliation(s)
- Berenice Rivera-Paredez
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
| | - Amado D Quezada-Sánchez
- Center for Evaluation and Surveys Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Karina Robles-Rivera
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Alberto Hidalgo-Bravo
- Department of Genetics, National Institute of Rehabilitation (INR), Mexico City, Mexico
| | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Guadalupe León-Reyes
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Yvonne N Flores
- Epidemiological and Health Services Research Unit, Mexican Institute of Social Security, Morelos DelegationCuernavaca, Morelos, Mexico
- Department of Health Policy and Management and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Center for Cancer Prevention and Control Research, Los Angeles, CA, USA
| | - Jorge Salmerón
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico.
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20
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Zhang J, Parsons C, Fuggle N, Ward KA, Cooper C, Dennison E. Is Regular Weight-Bearing Physical Activity Throughout the Lifecourse Associated with Better Bone Health in Late Adulthood? Calcif Tissue Int 2022; 111:279-287. [PMID: 35713660 PMCID: PMC9395437 DOI: 10.1007/s00223-022-00995-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/24/2022] [Indexed: 11/02/2022]
Abstract
We considered how weight-bearing physical activity (WBPA) through the lifecourse related to bone health in late adulthood in the Hertfordshire Cohort Study (HCS), a cohort of community dwelling adults born 1931-9, to identify sex-specific differences and periods critical for optimal bone health. Available questionnaire data from 258 participants (128 men and 130 women) included current reported lifestyle factors (including physical activity) and WBPA, coded as participation in WBPA aged < 18 years; aged 18-29 years; aged 30-49 years and aged ≥ 50 years. Responses were recorded as none/once a month/once a week/> once a week. Hip bone mineral density (BMD) was measured using a Lunar Prodigy DXA scanner. The mean age was 75.4 (SD 2.5) years in men and 75.7 (SD 2.6) years in women. Men reported significantly higher levels of past WBPA aged < 18 years (p = 0.006) and aged 18-29 years than women (p < 0.001). We observed greater BMD at total hip in women who reported regular WBPA at ages 18-29 years (p = 0.02) and 30-49 years (p = 0.02) compared with those who reported no WBPA (p = 0.019), after adjustment for confounders including current activity levels. In this cohort of older adults, recalled regular WBPA around the time of peak bone mass acquisition was less common in women than men, but associated with higher hip BMD in women in late adulthood.
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Affiliation(s)
- Jean Zhang
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Camille Parsons
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK.
- Victoria University of Wellington, Wellington, New Zealand.
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Acute Effects of Whole-Body Electromyostimulation on Energy Expenditure at Resting and during Uphill Walking in Healthy Young Men. Metabolites 2022; 12:metabo12090781. [PMID: 36144186 PMCID: PMC9504893 DOI: 10.3390/metabo12090781] [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: 07/21/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of the different electrical frequencies of whole-body electrical stimulation (WB-EMS) on energy expenditure (EE) and the respiratory exchange ratio (RER) remain poorly understood. This study aimed to determine the effects of different WB-EMS electrical frequencies on EE and the RER during supine resting and uphill walking. A total of 10 healthy and recreationally active men (21.6 ± 3.3 years old) participated in the present study. Participants completed two testing sessions in a randomized order. In each session, a variety of impulse frequencies (1 hertz (Hz), 2 Hz, 4 Hz, 6 Hz, 8 Hz, and 10 Hz) were applied in a randomized order, allowing a 10 min passive recovery between them. Oxygen consumption and carbon dioxide production were measured to calculate EE and the RER. All frequencies increased EE at rest (all p ≤ 0.001), with 4 Hz being the frequency producing the highest increase (Δ = 8.89 ± 1.49 kcal/min), as did 6 Hz (Δ = 8.05 ± 1.52 kcal/min) and 8 Hz (Δ = 7.04 ± 2.16 kcal/min). An increment in the RER at rest was observed with 4 Hz, 6 Hz, 8 Hz and 10 Hz (all p ≤ 0.016), but not with 1 Hz and 2 Hz (p ≥ 0.923). During uphill walking, the frequency that elicited the highest increase in EE was 6 Hz (Δ = 4.87 ± 0.84 kcal/min) compared to the unstimulated condition. None of the impulse frequencies altered the RER during uphill walking. WB-EMS increases EE in healthy young men both during resting and uphill walking.
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22
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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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23
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Buettmann EG, Goldscheitter GM, Hoppock GA, Friedman MA, Suva LJ, Donahue HJ. Similarities Between Disuse and Age-Induced Bone Loss. J Bone Miner Res 2022; 37:1417-1434. [PMID: 35773785 PMCID: PMC9378610 DOI: 10.1002/jbmr.4643] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/07/2022]
Abstract
Disuse and aging are known risk factors associated with low bone mass and quality deterioration, resulting in increased fracture risk. Indeed, current and emerging evidence implicate a large number of shared skeletal manifestations between disuse and aging scenarios. This review provides a detailed overview of current preclinical models of musculoskeletal disuse and the clinical scenarios they seek to recapitulate. We also explore and summarize the major similarities between bone loss after extreme disuse and advanced aging at multiple length scales, including at the organ/tissue, cellular, and molecular level. Specifically, shared structural and material alterations of bone loss are presented between disuse and aging, including preferential loss of bone at cancellous sites, cortical thinning, and loss of bone strength due to enhanced fragility. At the cellular level bone loss is accompanied, during disuse and aging, by increased bone resorption, decreased formation, and enhanced adipogenesis due to altered gap junction intercellular communication, WNT/β-catenin and RANKL/OPG signaling. Major differences between extreme short-term disuse and aging are discussed, including anatomical specificity, differences in bone turnover rates, periosteal modeling, and the influence of subject sex and genetic variability. The examination also identifies potential shared mechanisms underlying bone loss in aging and disuse that warrant further study such as collagen cross-linking, advanced glycation end products/receptor for advanced glycation end products (AGE-RAGE) signaling, reactive oxygen species (ROS) and nuclear factor κB (NF-κB) signaling, cellular senescence, and altered lacunar-canalicular connectivity (mechanosensation). Understanding the shared structural alterations, changes in bone cell function, and molecular mechanisms common to both extreme disuse and aging are paramount to discovering therapies to combat both age-related and disuse-induced osteoporosis. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Evan G Buettmann
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Galen M Goldscheitter
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabriel A Hoppock
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael A Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Henry J Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
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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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25
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The Bone Biomarker Response to an Acute Bout of Exercise: A Systematic Review with Meta-Analysis. Sports Med 2022; 52:2889-2908. [DOI: 10.1007/s40279-022-01718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 10/16/2022]
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Effects of whole body vibration in postmenopausal osteopenic women on bone mineral density, muscle strength, postural control and quality of life: the T-bone randomized trial. Eur J Appl Physiol 2022; 122:2331-2342. [PMID: 35864343 PMCID: PMC9560973 DOI: 10.1007/s00421-022-05010-5] [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: 01/27/2022] [Accepted: 07/07/2022] [Indexed: 12/03/2022]
Abstract
Purpose Osteopenia is common in postmenopausal women and effective interventions increasing or stabilizing bone mineral density (BMD) to prevent fractures are urgently needed. Methods Sixty-five postmenopausal women diagnosed with osteopenia (T-score between -1.0 and -2.5) were randomly assigned to either a vibration training group (VT), a resistance training group (RT), or a control group (CG). BMD T-score values (primary endpoint) were assessed at baseline (T0) and after 12 months (T12), secondary endpoints (muscle strength, postural control, and health-related quality of life) at baseline (T0), after 6 months (T6), after 12 months (T12), and as follow-up after 15 months (T15). Results After the intervention period, neither the VT nor the RT showed any significant changes in BMD T-score values compared to the CG. Isokinetic strength improved significantly within all training groups, with the exception of the flexors of VT at an angular velocity of 240°/s. Health-related quality of life as well as postural control improved significantly for the RT only. Conclusions We conclude that participants of all three groups were able to maintain their BMD. The improvements in quality of life and postural control after resistance training are nevertheless meaningful for postmenopausal osteopenic women and support the importance of regular loadings of the musculoskeletal system. This study was retrospectively registered in January 2022 at the DRKS (S00027816) as clinical trial. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-022-05010-5.
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Zhao D, Hua R, Riquelme MA, Cheng H, Guda T, Xu H, Gu S, Jiang JX. Osteocytes regulate bone anabolic response to mechanical loading in male mice via activation of integrin α5. Bone Res 2022; 10:49. [PMID: 35851577 PMCID: PMC9293884 DOI: 10.1038/s41413-022-00222-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/25/2022] [Accepted: 06/13/2022] [Indexed: 12/18/2022] Open
Abstract
Physical mechanical stimulation can maintain and even increase bone mass. Here, we report an important role of osteocytic integrin α5 in regulating the anabolic response of bone to mechanical loading using an Itga5 conditional gene knockout (cKO) mouse model. Integrin α5 gene deletion increased apoptotic osteocytes and reduced cortical anabolic responses to tibial compression including decreased endosteal osteoblasts and bone formation, and increased endosteal osteoclasts and bone resorption, contributing to the decreased bone area fraction and biomechanical properties, leading to an enlarged bone marrow area in cKO mice. Similar disruption of anabolic responses to mechanical loading was also detected in cKO trabecular bone. Moreover, integrin α5 deficiency impeded load-induced Cx43 hemichannel opening, and production and release of PGE2, an anabolic factor, resulting in attenuated effects of the loading on catabolic sclerostin (SOST) reduction and anabolic β-catenin increase. Together, this study shows an indispensable role of integrin α5 in osteocytes in the anabolic action of mechanical loading on skeletal tissue through activation of hemichannels and PGE2-evoked gene expression. Integrin α5 could act as a potential new therapeutic target for bone loss, especially in the elderly population with impeded mechanical sensitivity.
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Affiliation(s)
- Dezhi Zhao
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Rui Hua
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Manuel A Riquelme
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Hongyun Cheng
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Teja Guda
- Department of Biomedical Engineering and Chemical Engineering, University of Texas, San Antonio, TX, USA
| | - Huiyun Xu
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Sumin Gu
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jean X Jiang
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA.
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Esmaeilzadeh S, Kumpulainen S, Pesola AJ. Strength-Cognitive Training: A Systemic Review in Adults and Older Adults, and Guidelines to Promote "Strength Exergaming" Innovations. Front Psychol 2022; 13:855703. [PMID: 35712202 PMCID: PMC9197110 DOI: 10.3389/fpsyg.2022.855703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite functional and cognitive benefits, few adults and older adults do strength training twice per week with sufficient intensity. Exercise-based active video games (exergaming) may amplify the cognitive benefits of exercise and increase adherence and motivation toward training. However, the benefits of a well-defined and monitored dose of strength training, executed simultaneously or sequentially with a cognitive element, has received little attention. In this study we have two aims: First, to systematically gather the available evidence; second, to suggest possible ways to promote strength exergaming innovations. Methods We systematically reviewed randomized controlled trials using simultaneous or sequent combined strength and cognitive training or strength exergaming to improve cognitive or functional outcomes in adults and older adults. Results After screening 1,785 studies (Google Scholar, ACM Digital Library, IEEE Xplore Library, PsycARTICLES, Scopus, Cochrane Library and PubMed) we found three eligible studies. Of the two studies using sequent strength and cognitive training, one showed improved functionality, but the other showed negative effects on cognition. The third study using simultaneous intervention, reported a positive influence on both cognition and function, when compared with either strength training alone or a control group. Moderate level of evidence was showed on GRADE analysis. Conclusion The existing little evidence suggests that strength and cognitive training improves cognition and function in adults and older adults. The following suggestions may help to promote further innovation: (1) ensure minimal dosage of strength training (30-60 min, 2 × /week), (2) use machine-based strength training devices to control volume and intensity (to prevent cognitive components from interfering with strength training), (3) include power training by using cognitive tasks requiring rapid reactions, and (4) add cognitive memory tasks (to extend the cognitive benefits of strength training per se), and (5) include motivational exergame elements to increase adherence.
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Affiliation(s)
- Samad Esmaeilzadeh
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
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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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Belavy DL, Miller CT, Owen PJ, Rantalainen T, Connell D, Hahne AJ, Ford JJ, Trudel G. Exercise may impact on lumbar vertebrae marrow adipose tissue: Randomised controlled trial. Bone 2022; 157:116338. [PMID: 35085839 DOI: 10.1016/j.bone.2022.116338] [Citation(s) in RCA: 2] [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: 11/03/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Animal and human cross-sectional data suggest that bone marrow adipose tissue (MAT) may respond to mechanical loads and exercise. We conducted the first randomised controlled trial of exercise on MAT modulations in humans. METHODS Forty patients with chronic non-specific low back pain (NSCLBP) were enrolled in a six-month single-blinded randomised controlled trial (ACTRN12615001270505). Twenty patients loaded their spines via progressive upright aerobic and resistance exercises targeting major muscle groups (Exercise). Twenty patients performed non-weightbearing motor control training and manual therapy (Control). Testing occurred at baseline, 3-months (3mo) and 6-months (6mo). Lumbar vertebral fat fraction (VFF) was measured using magnetic resonance imaging axial mDixon sequences. RESULTS When compared to baseline (percent change), lumbar vertebral fat fraction (VFF; measured using magnetic resonance imaging axial mDixon sequences) was lower in Exercise at 3mo at L2 (-3.7[6.8]%, p = 0.033) and L4 (-2.6[4.1]%, p = 0.015), but not in Control. There were no between-group effects. The effects of Exercise on VFF were sex-specific, with VFF lower in men at L2, L3, L4 at 3mo and at L1, L2, L3 and L4 at 6mo (p all ≤ 0.05), but not in women. Leg and trunk lean mass were increased at 3mo in Exercise. Changes in VFF correlated significantly with changes in total fat (ρ = 0.40) and lean (ρ = -0.41) masses, but not with lumbar BMD (ρ = -0.10) or visceral adipose tissue volume (ρ = 0.23). CONCLUSIONS This trial provided first prospective evidence in humans that a moderate exercise intervention may modulate lumbar VFF as a surrogate measure of MAT at 3mo, yet not 6mo. The effect of exercise on MAT may be more prominent in males than females.
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Affiliation(s)
- Daniel L Belavy
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801 Bochum, Germany; Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia.
| | - Clint T Miller
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia.
| | - Patrick J Owen
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia.
| | - Timo Rantalainen
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia; Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - David Connell
- Imaging@Olympic Park, Melbourne, Victoria, Australia.
| | - Andrew J Hahne
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia.
| | - Jon J Ford
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia; Advance HealthCare, Boronia, Victoria, Australia.
| | - Guy Trudel
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Bone and Joint Research Laboratory, University of Ottawa, The Ottawa Hospital Research Institute, Canada.
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Gardinier JD, Chougule A, Zhang C. The mechanotransduction of MLO-Y4 cells is disrupted by the senescence-associated secretory phenotype of neighboring cells. J Cell Physiol 2022; 237:2249-2257. [PMID: 35102547 PMCID: PMC9052359 DOI: 10.1002/jcp.30690] [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: 06/14/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 01/10/2023]
Abstract
Age-related bone loss is attributed to the accumulation of senescent cells and their increasing production of inflammatory cytokines as part of the senescence-associated secretory phenotype (SASP). In otherwise healthy individuals, osteocytes play a key role in maintaining bone mass through their primary function of responding to skeletal loading. Given that osteocytes' response to loading is known to steadily decline with age, we hypothesized that the increasing presence of senescent cells and their SASP inhibit osteocytes' response to loading. To test this hypothesis, we developed two in vitro models of senescent osteocytes and osteoblasts derived from MLO-Y4 and MC3T3 cell lines, respectively. The senescent phenotype was unique to each cell type based on distinct changes in cell cycle inhibitors and SASP profile. The SASP profile of senescent osteocytes was in part dependent on nuclear factor-κB signaling and presents a new potential mechanism to target the SASP in bone. Nonsenescent MLO-Y4 cells cultured with the SASP of each senescent cell type failed to exhibit changes in gene expression as well as ERK phosphorylation and prostaglandin E2 release. The SASP of senescent osteocytes had the largest effect and neutralizing interleukin-6 (IL-6) as part of the SASP restored osteocytes' response to loading. The loss in mechanotransduction due to IL-6 was attributed to a decrease in P2X7 expression and overall sensitivity to purinergic signaling. Altogether, these findings demonstrate that the SASP of senescent cells have a negative effect on the mechanotransduction of osteocytes and that IL-6 is a key SASP component that contributes to the loss in mechanotransduction.
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Affiliation(s)
- Joseph D Gardinier
- Bone and Joint Center, Henry Ford Health System, Henry Ford Hospital, Detroit, Michigan, USA
| | - Amit Chougule
- Bone and Joint Center, Henry Ford Health System, Henry Ford Hospital, Detroit, Michigan, USA
| | - Chunbin Zhang
- Bone and Joint Center, Henry Ford Health System, Henry Ford Hospital, Detroit, Michigan, USA
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Ng HJH, Tan GKY, Tan RG, Kau CY. Incidence of Radiolucent Lines after Cemented Total Knee Arthroplasty. THE ARCHIVES OF BONE AND JOINT SURGERY 2022; 10:85-91. [PMID: 35291250 PMCID: PMC8889420 DOI: 10.22038/abjs.2021.54610.2723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/07/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cemented Total Knee Arthroplasty (TKA) provides excellent long-term survival rates and functional results, however, radiolucent lines (RLLs) often appear during early post-operative follow-up and their incidence and clinical significance are unknown. The primary aim was to establish the incidence, location, frequency, and time taken for RLLs to appear within the first year after a primary cemented TKA with an anatomic tibial baseplate (Smith and Nephew, LEGION Total Knee System). METHODS This was a retrospective analysis of 135 primary cemented TKA in 131 patients over three years. We compared demographics, serial radiographs, and early clinical and functional outcomes. RESULTS There were 65 TKAs (48%) in 62 patients who had RLLs within the first year post-operatively. Most were females (58.8%). Mean age was 68.3 ± 7.9 years. There were 88 RLLs, with the most and second commonest location at the medial tibial baseplate (38%) and anterior femoral flange (23%). 89% were in the bone-cement interface. The largest average length of RLLs were at the anterior flange of the femoral component (1.98 ± 1.33 mm). The average time to development was 6.5 ± 4.1 months. None of these patients had infections nor required revision. Patients with RLLs did not do worse in functional and clinical scoring at 1-year. CONCLUSION There was a 48% incidence of physiological RLLs after cemented TKA, with the highest occurrence at the medial tibial baseplate at 38%. These radiolucent lines did not affect early post-operative clinical and functional outcomes of patients.
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Affiliation(s)
- Hannah Jia Hui Ng
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
| | | | - Ryan Gabriel Tan
- Yong Loo Lin School Of Medicine, National University of Singapore
| | - Chung Yuan Kau
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
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Zitzmann AL, Shojaa M, Kast S, Kohl M, von Stengel S, Borucki D, Gosch M, Jakob F, Kerschan-Schindl K, Kladny B, Lange U, Middeldorf S, Peters S, Schoene D, Sieber C, Thomasius F, Uder M, Kemmler W. The effect of different training frequency on bone mineral density in older adults. A comparative systematic review and meta-analysis. Bone 2022; 154:116230. [PMID: 34624560 DOI: 10.1016/j.bone.2021.116230] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022]
Abstract
Exercise frequency is a key aspect of exercise protocols. In this systematic review and meta-analysis, we determined the effect of training frequency on (areal) bone mineral density (BMD) at lumbar spine (LS) and hip. Reviewing seven electronic databases up to April 2021, we conducted a systematic review of the literature according to the PRISMA statement. Inclusion criteria were (a) controlled exercise trials (b) with at least two study arms that compared low versus high exercise frequency, (c) an intervention ≥6 months and (d) BMD assessments at lumbar spine (LS) or hip. The analysis was conducted as a mixed-effect meta-analysis and used "type of exercise" and "study duration" as moderators in subgroup analyses. Standardized mean differences (SMD) for LS- and hip-BMD changes were defined as outcome measures. Seven studies with 17 exercise groups were included in the analysis. We observed significantly higher effects of high (≥2 sessions/week) vs. low net training frequency (1-<2 sessions/week) exercise on LS- (SMD 0.55, 95%-CI: 0.20-0.90) but not hip-BMD (0.19, -0.06 to 0.45). Study duration was found to be a significant moderator for the effect of training frequency at LS- but not hip-BMD. In parallel, the type of exercise moderately influences the effect of training frequency on LS- but not on hip-BMD. We observed a superior effect of higher net training frequency on BMD. Longer exercise exposition increases this effect. Considering e.g. holidays, indisposition or other temporary absence, exercise programs on osteoporosis should provide at least 3 sessions/week/year to allow a net training frequency of more than two sessions/week. STUDY REGISTRATION: PROSPERO (CRD42021246804).
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Affiliation(s)
- Anna-Lena Zitzmann
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mahdieh Shojaa
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany; University Hospital Tübingen, Institute of Health Science, Department Population-Based Medicine, Tübingen, Germany
| | - Stephanie Kast
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Diana Borucki
- Deutsche Rheuma-Liga Bundesverband e.V., Bonn, Germany
| | - Markus Gosch
- Paracelsus Medical University Nürnberg and General Hospital Nürnberg, Germany
| | - Franz Jakob
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Germany
| | | | - Bernd Kladny
- German Society for Orthopaedics and Trauma (DGOU), Germany
| | - Uwe Lange
- German Society for Physical and Rehabilitative Medicine, Germany
| | | | - Stefan Peters
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Cornel Sieber
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Germany
| | - Friederike Thomasius
- Osteology umbrella association Germany, Austria, Switzerland; Frankfurt Center of Bone Health, Frankfurt, Germany
| | - Michael Uder
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany; Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Germany.
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Anijs T, Wolfson D, Mercer A, Rock M, Verdonschot N, Janssen D. Experimental measurements of femoral primary stability in two cementless posterior-stabilized knee replacement implants. Med Eng Phys 2022; 99:103734. [DOI: 10.1016/j.medengphy.2021.103734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
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Aghamiri SM, Sarzaeem MM, Shahrezaee M, Omidian M, Amouzadeh Omrani F. Outcomes of Tibial Plateau Fracture Surgical Fixation: a Comparative Study between Younger and Older Age Groups. THE ARCHIVES OF BONE AND JOINT SURGERY 2021; 9:647-652. [PMID: 35106329 PMCID: PMC8765196 DOI: 10.22038/abjs.2021.52884.2629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/07/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Tibial plateau fractures account for approximately 8% of the fractures of the elderly. Low bone quality that is more common in the elderly is one of the major challenges in fixing fractures and may be a barrier to achieving satisfactory outcomes after a surgical fracture treatment. Accordingly, surgical fixation of tibial plateau fractures was controversial in the elderly. This study aimed to investigate and compare the clinical outcomes of surgical fixation in patients over and under 60 years of age. METHODS This study was conducted as a retrospective cohort study of data that were prospectively collected. In total, 48 patients who underwent surgery with open reduction and internal fixation before August 2019 were recruited and followed up at least one year after surgery. Demographic characteristics, the range of motion of the knees, visual analog scale (VAS) score of pain intensity, and the Oxford Knee Score (OKS) were obtained in this study. Furthermore, Short Form-36 (SF-36) questionnaire was used to evaluate patient satisfaction. RESULTS In total, 19 and 29 patients were over and under 60 years of age, respectively. According to Schatzker's classification, the most common type of fracture was type VI. The range of motion in the knees did not differ significantly between the two groups (P>0.05). Moreover, OKS and the VAS of pain intensity were not significantly different in both groups (P>0.05). In addition, SF-36 scores were not significantly different between elderly patients and the age-matched general population. However, younger patients had lower scores in the physical function and vitality scales of SF-36, compared to the age-matched general population. CONCLUSION Based on the results of the present study, it can be stated that increasing age did not affect the surgical outcomes of patients with tibial plateau fractures.
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Affiliation(s)
- Seyed Majid Aghamiri
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
| | | | - Mostafa Shahrezaee
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammadmahdi Omidian
- Department of Orthopedic, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Eid MM, El-Gendy AM, Abdelbasset WK, Elkholi SM, Abdel-fattah MS. The effect of magnetic therapy and moderate aerobic exercise on osteoporotic patients: A randomized clinical study. Medicine (Baltimore) 2021; 100:e27379. [PMID: 34596156 PMCID: PMC8483884 DOI: 10.1097/md.0000000000027379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 09/13/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Osteoporosis is a frequent musculoskeletal condition with significant complications that would be a global health problem and one of the major causes of mortality and morbidity. OBJECTIVES The current study aimed to ascertain the impact of pulsed magnetic therapy, aerobic exercise, and a combination of both modalities on osteoporotic female patients postthyroidectomy. METHODS Between May 2018 and September 2019, 45 female patients with osteoporosis were included in the randomized clinical study, their age ranged from 40 to 50 years, had thyroidectomy for at least 6 months ago, and had an inactive lifestyle for at least the previous 6 months. Patients were assigned randomly into 3 equal groups. Group A (magnetic therapy group): received routine medical treatment (bisphosphonates, calcium, and vitamin D) in addition to pulsed magnetic therapy on the hip region for 12 weeks (3 sessions/week). Group B (exercise group): received routine medical treatment plus moderate-intensity aerobic exercise for 12 weeks (3 sessions/week). Group C (combined magnetic therapy and exercise therapy group): received routine medical treatment plus pulsed magnetic therapy and moderate-intensity aerobic exercise for 12 weeks (3 sessions/week). The 3 groups were assessed for bone mineral density (BMD) at baseline by dual-energy x-ray absorptiometry and after 12 weeks of treatment. RESULTS The results showed that within-group analysis a statistically significant increase was reveled (P < .05) for BMD in the 3 studied groups. Comparing the results among the 3 tested groups revealed a significant increase (P < .05) in posttesting mean values of BMD in group (C) compared to group (A) and group (B). No significant statistical difference in BMD means values between the 2 groups (A) and (B) after testing was detected. CONCLUSION Combination of both pulsed magnetic therapy and moderate-intensity aerobic exercise showed significant improvement in BMD at the hip region than using any of the 2 modalities alone.
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Affiliation(s)
- Marwa M. Eid
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Amira M. El-Gendy
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Safaa Mostafa Elkholi
- Department of Rehabilitation Sciences, Faculty of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mostafa S. Abdel-fattah
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Mesinovic J, Jansons P, Zengin A, de Courten B, Rodriguez AJ, Daly RM, Ebeling PR, Scott D. Exercise attenuates bone mineral density loss during diet-induced weight loss in adults with overweight and obesity: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:550-559. [PMID: 34004388 PMCID: PMC8500851 DOI: 10.1016/j.jshs.2021.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/14/2021] [Accepted: 03/21/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Weight-loss-induced fat loss improves cardiometabolic health in individuals with overweight and obesity; however, weight loss can also result in bone loss and increased fracture risk. Weight-loss-induced bone loss may be attenuated with exercise. Our aim was to compare changes in bone mineral density (BMD) in adults with overweight and obesity who undertook diet-induced weight loss alone or in combination with exercise. METHODS We included randomized controlled trials (RCTs) in adults with overweight or obesity (aged ≥18 years; body mass index ≥25 kg/m2) that prescribed diet-induced weight loss alone or in combination with supervised exercise, and measured any bone structural parameters. Risk of bias was assessed using the Cochrane Risk of Bias tool. Random-effects meta-analyses determined mean changes and net mean differences (95% confidence intervals (95%CIs)) in the percentage of areal BMD (aBMD) change between groups. RESULTS We included 9 RCTs. Diet-induced weight loss led to significant losses in femoral neck aBMD (mean change: -1.73% (95%CI: -2.39% to -1.07%), p < 0.001) and total hip aBMD (-2.19% (95%CI: -3.84% to -0.54%), p = 0.009). Femoral neck aBMD losses were significantly greater in the diet-induced weight loss group compared to the exercise plus diet-induced weight loss group (net difference: -0.88% (95%CI: -1.73% to -0.03%)); however, there were no differences in aBMD changes at any other skeletal site: total hip (-1.96% (95%CI: -4.59% to 0.68%)) and lumbar spine (-0.48% (95%CI: -1.81% to 0.86%)). aBMD changes did not differ significantly according to exercise modality (resistance exercise, aerobic exercise, or a combination of the two) during diet-induced weight loss. CONCLUSION Diet-induced weight loss led to greater femoral neck bone loss compared to diet-induced weight loss plus exercise. Bone loss at the total hip and lumbar spine was not attenuated by exercise during diet-induced weight loss. The lack of consistent skeletal benefits may be due to the insufficient duration and/or training intensities of most exercise interventions. Additional RCTs with appropriate, targeted exercise interventions should be conducted.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia.
| | - Paul Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIA 2134, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia
| | - Alexander J Rodriguez
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIA 2134, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIA 3168, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIA 2134, Australia; Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western Campus, University of Melbourne, St Albans, VIA 3021, Australia
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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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Towards a Standard Approach to Assess Tibial Bone Loss Following Total Knee Arthroplasty. Clin Rev Bone Miner Metab 2021. [DOI: 10.1007/s12018-021-09276-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractLong-term implant failure in the form of aseptic loosening and periprosthetic fracture is the most common cause of revision procedures in total knee arthroplasty (TKA). While early loosening can often be attributed to failure of primary fixation, late implant failure could be associated with loss of fixation secondary to bone resorption, as a result of stress shielding in the proximal tibia. This current review study was performed to identify the clinical effects of different implant-, patient-, and surgery-related biomechanical factors on TKA-related tibial bone loss in clinical reality. Implant-related factors considered were the fixation method, and the implant type, geometry, and stiffness. In terms of patient characteristics, the effects of age, sex, knee alignment, bone density, body weight, and activity level were analyzed. The clinical literature on these topics mostly concerned longitudinal radiographic studies investigating the effect of a single factor on changes in the proximal tibia over time using bone densitometry. Implant stiffness, implant geometry and knee alignment were the only factors consistently found to affect regional bone density changes over time. Each clinical study used its own specific study design, with different definitions used for the baseline density, time points of baseline and follow-up measurements, and regions of interest. Due to the differences in study design, direct comparison between the clinical impact of different biomechanical factors was not possible. Based on the findings over the densitometry studies, a standardized guideline was proposed to allow reliable comparison between consistently reported outcome of future radiographic TKA studies.
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Xu F, Zhang Q, Wang LK, Tang QX, Sun CQ, Deng HW. Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis. Osteoporos Int 2021; 32:1359-1367. [PMID: 33439309 PMCID: PMC8195838 DOI: 10.1007/s00198-020-05786-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/07/2020] [Indexed: 11/27/2022]
Abstract
UNLABELLED This study estimates causality of physical activity (PA) on bone mineral density (BMD) by conducting multivariable Mendelian randomization (MR). The findings suggest that habitual vigorous PA increases lumbar spine BMD, and higher overall acceleration average would improve forearm BMD. The results could promote PA intervention targeting individuals with optimized type. INTRODUCTION Evidence from epidemiologic studies showed type, frequency, and duration of PA influenced BMD. However, these observational studies may be confounded by many factors, resulting in spurious associations. We aimed to conduct multivariable MR to estimate the causal effect of self-reported and device-measured PA on osteoporosis. METHODS Three self-reported and two device-measured PA-related traits were selected as exposures. Outcomes were BMD at different skeletal sites: femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm BMD (FA BMD). Exposure datasets were obtained from UK Biobank with total 377,234 subjects. Outcome datasets were obtained from GEFOS consortium with 53,236 subjects. Standard MR analysis and multivariable MR were conducted to assess the total and direct causal effect of PA on BMD. RESULTS For self-reported PA, inverse-normalized moderate-to-vigorous had a direct causal effect on FN BMD independently (β = - 1.116 (95% confidence interval, 95%CI: - 2.210, - 0.023), P = 0.045); vigorous PA showed a direct effect (β = 3.592 (95%CI: 0.310, 6.874), P = 0.032) on LS BMD independently. While overall acceleration average and fraction of accelerations both had a direct causal effect on FA BMD independently. CONCLUSIONS Habitual vigorous PA could increase LS BMD. Individuals with higher overall acceleration average would have a higher FA BMD.
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Affiliation(s)
- F Xu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Q Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - L-K Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
| | - Q-X Tang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
| | - C-Q Sun
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China.
- School of Nursing, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China.
| | - H-W Deng
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA.
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Fonseca H, Bezerra A, Coelho A, Duarte JA. Association between Visceral and Bone Marrow Adipose Tissue and Bone Quality in Sedentary and Physically Active Ovariectomized Wistar Rats. Life (Basel) 2021; 11:life11060478. [PMID: 34070279 PMCID: PMC8225130 DOI: 10.3390/life11060478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Obesity is considered protective for bone mass, but this view has been progressively challenged. Menopause is characterized by low bone mass and increased adiposity. Our aim was to determine how visceral and bone marrow adiposity change following ovariectomy (OVX), how they correlate with bone quality and if they are influenced by physical activity. Methods: Five-month-old Wistar rats were OVX or sham-operated and maintained in sedentary or physically active conditions for 9 months. Visceral and bone marrow adiposity as well as bone turnover, femur bone quality and biomechanical properties were assessed. Results: OVX resulted in higher weight, visceral and bone marrow adiposity. Visceral adiposity correlated inversely with femur Ct.Th (r = −0.63, p < 0.001), BV/TV (r = −0.67, p < 0.001), Tb.N (r = −0.69, p < 0.001) and positively with Tb.Sp (r = 0.58, p < 0.001). Bone marrow adiposity also correlated with bone resorption (r = 0.47, p < 0.01), bone formation rate (r = −0.63, p < 0.01), BV/TV (r = −0.85, p < 0.001), Ct.Th (r = −0.51, p < 0.0.01), and with higher empty osteocyte lacunae (r = 0.39, p < 0.05), higher percentage of osteocytes with oxidative stress (r = 0.64, p < 0.0.01) and lower femur maximal stress (r = −0.58, p < 0.001). Physical activity correlated inversely with both visceral (r = −0.74, p < 0.01) and bone marrow adiposity (r = −0.92, p < 0.001). Conclusions: OVX increases visceral and bone marrow adiposity which are associated with inferior bone quality and biomechanical properties. Physical activity could contribute to reduce adipose tissue and thereby improve bone quality.
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Affiliation(s)
- Hélder Fonseca
- Faculty of Sport, University of Porto (FADE/UP), 4200-450 Porto, Portugal; (A.B.); (A.C.); (J.A.D.)
- Research Center of Physical Activity, Health and Leisure (CIAFEL), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-220-425-239
| | - Andrea Bezerra
- Faculty of Sport, University of Porto (FADE/UP), 4200-450 Porto, Portugal; (A.B.); (A.C.); (J.A.D.)
- Research Center of Physical Activity, Health and Leisure (CIAFEL), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Ana Coelho
- Faculty of Sport, University of Porto (FADE/UP), 4200-450 Porto, Portugal; (A.B.); (A.C.); (J.A.D.)
- Research Center of Physical Activity, Health and Leisure (CIAFEL), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - José Alberto Duarte
- Faculty of Sport, University of Porto (FADE/UP), 4200-450 Porto, Portugal; (A.B.); (A.C.); (J.A.D.)
- Research Center of Physical Activity, Health and Leisure (CIAFEL), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Polytechnic and University Higher Education Cooperative (CESPU), 4485-116 Gandra Campus, 4050-600 Porto, Portugal
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Yang Z, Miller T, Pang MYC. Relationship between bone strength index of the hemiparetic tibial diaphysis and muscle strength in people with chronic stroke: influence of muscle contraction type and speed. Osteoporos Int 2021; 32:951-959. [PMID: 33161439 DOI: 10.1007/s00198-020-05716-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/25/2020] [Indexed: 01/31/2023]
Abstract
UNLABELLED This study was conducted to examine the association between the tibial bone strength index and leg muscle strength of different contraction types and speeds among people with chronic stroke. We found that concentric muscle power at moderate speed was more associated with tibial bone strength index than other types. INTRODUCTION To compare the influence of muscle strength of different contraction types and speeds on the bone strength index of tibial diaphysis in people with chronic stroke. METHODS Eighty individuals with chronic stroke (age: 62.6 ± 8.0 years; men/women: 46/34; post-stroke duration: 9.0 ± 5.4 years) underwent scanning of the tibia at the 66% site on both sides using peripheral quantitative computed tomography. Each participant was also evaluated for isometric and dynamic (at 60°/s and 120°/s) strength of knee flexors/extensors and ankle dorsiflexors/plantarflexors using an isokinetic dynamometer. For a given contraction type and speed, the strength values of the four muscle groups were summed to yield a composite score. Multiple regression analysis was used to identify the association of the percent side-to-side difference (%SSD) in tibial polar-stress-strain index (p-SSI) with %SSD in muscle strength of different contraction types and speeds. RESULTS The p-SSI and all muscle strength parameters on the paretic side had lower values than the non-paretic side (p ≤ 0.001). The %SSD in concentric muscle power at angular speed of 60°/s (R2 = 0.317, p = 0.006) and 120°/s (R2 = 0.298, p = 0.020) remained independently associated with that in p-SSI, after controlling for age, sex, body mass index, post-stroke duration, motor impairment, spasticity, and physical activity level. The effect of isometric strength and eccentric muscle power was not significant in multivariate analysis. CONCLUSIONS Concentric muscle power was more predictive of %SSD in p-SSI at the tibial diaphysis than other contraction types and may be an important target for intervention to promote bone health in people with chronic stroke.
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Affiliation(s)
- Z Yang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
- Department of Physical Therapy, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - T Miller
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - M Y C Pang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China.
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Leal DV, Ferreira A, Watson EL, Wilund KR, Viana JL. Muscle-Bone Crosstalk in Chronic Kidney Disease: The Potential Modulatory Effects of Exercise. Calcif Tissue Int 2021; 108:461-475. [PMID: 33388899 DOI: 10.1007/s00223-020-00782-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Chronic kidney disease (CKD) is a prevalent worldwide public burden that increasingly compromises overall health as the disease progresses. Two of the most negatively affected tissues are bone and skeletal muscle, with CKD negatively impacting their structure, function and activity, impairing the quality of life of these patients and contributing to morbidity and mortality. Whereas skeletal health in this population has conventionally been associated with bone and mineral disorders, sarcopenia has been observed to impact skeletal muscle health in CKD. Indeed, bone and muscle tissues are linked anatomically and physiologically, and together regulate functional and metabolic mechanisms. With the initial crosstalk between the skeleton and muscle proposed to explain bone formation through muscle contraction, it is now understood that this communication occurs through the interaction of myokines and osteokines, with the skeletal muscle secretome playing a pivotal role in the regulation of bone activity. Regular exercise has been reported to be beneficial to overall health. Also, the positive regulatory effect that exercise has been proposed to have on bone and muscle anatomical, functional, and metabolic activity has led to the proposal of regular physical exercise as a therapeutic strategy for muscle and bone-related disorders. The detection of bone- and muscle-derived cytokine secretion following physical exercise has strengthened the idea of a cross communication between these organs. Hence, this review presents an overview of the impact of CKD in bone and skeletal muscle, and narrates how these tissues intrinsically communicate with each other, with focus on the potential effect of exercise in the modulation of this intercommunication.
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Affiliation(s)
- Diogo V Leal
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | - Aníbal Ferreira
- Department of Nephrology, Curry Cabral Hospital, Hospital Centre of Central Lisbon, Lisbon, Portugal
- Nova Medical School, Lisbon, Portugal
| | - Emma L Watson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois At Urbana-Champaign, Champaign, IL, USA
| | - João L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal.
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Watanabe K, Kamijo Y, Yanagi M, Ishibashi Y, Harada T, Kohzuki M. Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study. BMC Nephrol 2021; 22:98. [PMID: 33736592 PMCID: PMC7977172 DOI: 10.1186/s12882-021-02289-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 03/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD. METHODS Stable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared. RESULTS There was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results. CONCLUSIONS Home-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD. TRIAL REGISTRATION UMIN Clinical Trials Registry, UMIN000041678 . Registered September 4, 2020; retrospectively registered.
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Affiliation(s)
- Kumi Watanabe
- Department of Nephrology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya, Tokyo, 150-8935, Japan.
| | - Yuka Kamijo
- Department of Nephrology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya, Tokyo, 150-8935, Japan
| | - Mai Yanagi
- Department of Nephrology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya, Tokyo, 150-8935, Japan
| | - Yoshitaka Ishibashi
- Department of Nephrology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya, Tokyo, 150-8935, Japan
| | - Taku Harada
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba, Sendai, Miyagi, 980-8574, Japan
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Kottlors J, Große Hokamp N, Fervers P, Bremm J, Fichter F, Persigehl T, Safarov O, Maintz D, Tritt S, Abdullayev N. Early extrapulmonary prognostic features in chest computed tomography in COVID-19 pneumonia: Bone mineral density is a relevant predictor for the clinical outcome - A multicenter feasibility study. Bone 2021; 144:115790. [PMID: 33301962 PMCID: PMC7720732 DOI: 10.1016/j.bone.2020.115790] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Besides throat-nose swab polymerase chain reaction (PCR), unenhanced chest computed tomography (CT) is a recommended diagnostic tool for early detection and quantification of pulmonary changes in COVID-19 pneumonia caused by the novel corona virus. Demographic factors, especially age and comorbidities, are major determinants of the outcome in COVID-19 infection. This study examines the extra pulmonary parameter of bone mineral density (BMD) from an initial chest computed tomography as an associated variable of pre-existing comorbidities like chronic lung disease or demographic factors to determine the later patient's outcome, in particular whether treatment on an intensive care unit (ICU) was necessary in infected patients. METHODS We analyzed 58 PCR-confirmed COVID-19 infections that received an unenhanced CT at admission at one of the included centers. In addition to the extent of pulmonary involvement, we performed a phantomless assessment of bone mineral density of thoracic vertebra 9-12. RESULTS In a univariate regression analysis BMD was found to be a significant predictor of the necessity for intensive care unit treatment of COVID-19 patients. In the subgroup requiring intensive care treatment within the follow-up period a significantly lower BMD was found. In a multivariate logistic regression model considering gender, age and CT measurements of bone mineral density, BMD was eliminated from the regression analysis as a significant predictor. CONCLUSION Phantomless assessed BMD provides prognostic information on the necessity for ICU treatment in course of COVID-19 pneumonia. We recommend using the measurement of BMD in an initial CT image to facilitate a potentially better prediction of severe patient outcomes within the 22 days after an initial CT scan. Consequently, in the present sample, additional bone density analysis did not result in a prognostic advantage over simply considering age. Significantly larger patient cohorts with a more homogenous patient age should be performed in the future to illustrate potential effects. CLINICAL RELEVANCE While clinical capacities such as ICU beds and ventilators are more crucial than ever to help manage the current global corona pandemic, this work introduces an approach that can be used in a cost-effective way to help determine the amount of these rare clinical resources required in the near future.
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Affiliation(s)
- Jonathan Kottlors
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Nils Große Hokamp
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Philipp Fervers
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Johannes Bremm
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Florian Fichter
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | | | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
| | | | - Nuran Abdullayev
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Germany.
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Savikangas T, Sipilä S, Rantalainen T. Associations of physical activity intensities, impact intensities and osteogenic index with proximal femur bone traits among sedentary older adults. Bone 2021; 143:115704. [PMID: 33099029 DOI: 10.1016/j.bone.2020.115704] [Citation(s) in RCA: 3] [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: 05/20/2020] [Revised: 10/09/2020] [Accepted: 10/17/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dynamic high-intensity physical activity is thought to be beneficial for older adults' bone health. Traditional volume-based processing of accelerometer-measured physical activity data, quantified on a minute-per-minute basis, may average out sporadic high impact activity, whereas accelerometer data processing approaches based on identifying impacts can capture also these potentially beneficial short activity bursts. We investigated the associations between habitual physical activity and proximal femur bone traits among sedentary older adults utilizing three different numerical treatments of accelerometer-data to examine, if impact-based processing approaches are more suitable to assess bone loading than volume-based processing of physical activity data among older adults. METHODS This cross-sectional study utilized the baseline data from the PASSWORD-study (n = 284, mean ± SD age 74 ± 4 years, 57% women). Total femur bone mineral content (BMC) and bone mineral density (BMD), femoral neck BMC, BMD, section modulus and minimal width (MNW) were measured with dual energy x-ray absorptiometry. Physical activity was measured for seven consecutive days with a tri-axial accelerometer. Raw acceleration data was processed in three different ways and quantified as i) mean daily minutes in sedentary, light and moderate-to-vigorous-intensity activity, ii) mean daily number of acceleration peaks divided into low (1.5 g to 2.0 g), medium (2.0 g to 2.5 g) and high (>2.5 g) impacts, and iii) mean daily osteogenic index, which is a summary score calculated from log-transformed number of impact peaks in 32 intensity bands (≥1.3 g). Associations between physical activity measures and each bone trait were estimated with multiple linear regression adjusted with covariates (age, sex, weight, height, smoking, physical function, medication). RESULTS Participants recorded on average 10 h sedentary, 2.5 h light and 33 min moderate-to-vigorous activity, and 3937 low, 494 medium and 157 high impacts per day. Mean osteogenic index score was 173. Light physical activity was positively associated with all bone traits (beta = 0.147 to 0.182, p < 0.001 to p = 0.005) except MNW. Sedentary or moderate-to-vigorous activity, low, medium or high impacts or osteogenic index were not associated with any bone parameter. CONCLUSIONS Light physical activity may decelerate the age-related bone loss in older adults who do not meet the physical activity recommendations. In this population, the amount of high impact activity may be insufficient to stimulate bone remodelling.
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Affiliation(s)
- Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Timo Rantalainen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 2): A meta-analysis. Bone 2021; 143:115697. [PMID: 33357834 DOI: 10.1016/j.bone.2020.115697] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous reviews have concluded that exercise has only modest effects on bone mineral density (BMD) in postmenopausal women. Despite the well-recognized strong positive relationship between load magnitude and bone response observed from animal research, the majority of human trials have examined the effects of only low to moderate intensity exercise on bone. We speculated that meta-analysing according to intensity may reveal a more potent exercise effect at higher intensity. OBJECTIVES To determine the effects of low, moderate and high intensity exercise on BMD at the spine and hip in postmenopausal women. METHODS Electronic databases and reference lists were searched for RCTs that examined the effect of exercise compared to control on DXA-derived lumbar spine, femoral neck or total hip BMD in healthy postmenopausal women. Interventions were classified as low, moderate or high intensity and pooled based on classification. Mean differences (MD) were calculated using random effects models and a risk of bias analysis was undertaken. To determine the effect of different exercise types (resistance and impact training) on BMD outcomes, subgroup analyses for all intensity categories and outcomes were conducted. Separate meta-analyses were undertaken to examine the influence of adding exercise to a bone medication intervention and to examine exercise effects on fracture risk. RESULTS Fifty-three trials, testing 63 interventions (19 low, 40 moderate, 4 high intensity) were included. At the lumbar spine, high intensity exercise yielded greater BMD effects (MD = 0.031 g/cm2 95% CI [0.012, 0.049], p = 0.002) than moderate (MD = 0.012 g/cm2 95% CI [0.008, 0.017], p < 0.001) and low intensity (MD = 0.010 g/cm2 95% CI [0.005, 0.015], p < 0.001). Low and moderate intensity exercise was equally effective at the femoral neck (low: 0.011 g/cm2 95% CI [0.006, 0.016], p < 0.001; moderate: 0.011 g/cm2 95% CI [0.007, 0.015], p < 0.001), but no effect of high-intensity exercise was observed. Moderate intensity exercise increased total hip BMD (0.008 g/cm2 95% CI [0.004, 0.012], p < 0.001), but low intensity did not. There were insufficient data to meta-analyse the effect of high intensity exercise at the total hip. Resistance training, potentially in combination with impact training, appears to be the most effective osteogenic stimulus at the spine and hip. Findings from meta-regression analyses were not informative and no influence of exercise on medication efficacy was observed. Risk of bias was mainly low or unclear due to insufficient information reported. CONCLUSION High intensity exercise is a more effective stimulus for lumbar spine BMD than low or moderate intensity, but not femoral neck BMD, however, the latter finding may be due to lack of power. While data from high-intensity exercise interventions are limited, the current comprehensive meta-analysis demonstrates the same positive relationship between load magnitude and bone response in humans that is observed in animal research. Findings have implications for optimal exercise prescription for osteoporosis in postmenopausal women. STUDY REGISTRATION Registered on PROSPERO (CRD42018117254).
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Affiliation(s)
- Melanie Kistler-Fischbacher
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; The Bone Clinic, Brisbane, QLD, Australia.
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Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 1): A systematic review. Bone 2021; 143:115696. [PMID: 33357833 DOI: 10.1016/j.bone.2020.115696] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/21/2020] [Accepted: 10/14/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous systematic reviews and meta-analyses of exercise effects on bone have reported null or modest effect sizes. While animal research has determined that a strong positive relationship exists between load magnitude/intensity and bone adaptation, nevertheless many human exercise interventions have been applied at low intensity. Meta-analytic pooling of exercise interventions irrespective of intensity dilutes the ability to detect efficacy of any one training regimen. Parsing out efficacy of low, moderate and high intensity exercise interventions will assist the determination of optimal exercise prescription for bone. OBJECTIVES First, to summarise and critically evaluate existing evidence of exercise effect on bone mass, bone structure and bone turnover markers (BTMs) in healthy postmenopausal women. Second, to examine the influence of intensity on bone response to exercise. METHODS Electronic databases (Embase, Scopus, CINAHL Plus, SPORTDiscus), database platforms (PubMed, Cochrane CENTRAL, ProQuest Central, Web of Science) and reference lists of included studies were searched for controlled trials and randomised controlled trials that described the effect of any exercise intervention compared to control on bone mass, bone structure or BTMs in healthy postmenopausal women. Fracture incidence was included as an exploratory endpoint. Data was extracted and weighed against the results of a comprehensive risk of bias analysis. RESULTS One hundred trials were included, investigating a total of 120 exercise interventions. Of those, 57 interventions were low intensity, 57 were moderate, and six were high intensity. On balance, low intensity exercise was not an effective stimulus to increase bone mass. Higher quality evidence suggests moderate to high intensity interventions, particularly those that combined high intensity resistance and impact training, were most beneficial for bone mass. Only high intensity exercise appears to improve structural parameters of bone strength, however, data are limited. Only low and moderate intensity interventions have measured BTMs and no notable benefits have been observed. The quality of trials varied greatly, and risk of bias determinations were frequently limited by insufficiently reported detail. CONCLUSION Heterogeneity in both study quality and outcomes limits the ability to draw strong conclusions from this comprehensive systematic review of RCT and CT reports. Nevertheless, there is a tendency in the higher quality data to indicate exercise intensity is positively related to the adaptive bone response. Part 2 of this review series reports a meta-analysis of the RCT data in order to draw quantitative conclusions from the higher quality trials. STUDY REGISTRATION Registered on PROSPERO (CRD42018117254).
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Affiliation(s)
- Melanie Kistler-Fischbacher
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast, QLD, Australia; The Bone Clinic, Brisbane, QLD, Australia.
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Effects of High-Impact Weight-Bearing Exercise on Bone Mineral Density and Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Trial. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study examined the effects of high-impact weight-bearing exercise on bone mineral density (BMD) and bone metabolic markers in middle-aged premenopausal women. Forty middle-aged premenopausal women were initially enrolled, but thirty-one participants (40.34 ± 3.69 years) completed in the study. The subjects were randomly divided into two groups including the high-impact weight-bearing exercise group (HWE, n = 14) and control group (CON, n = 17). The HWE group participated in the exercise for 50 min a day, three days per week for four months, while the CON group maintained their regular lifestyle. The HWE program included 10 different high-impact weight-bearing exercises such as jumping and running. BMD was measured using DXA (Hologic, QDR 4500W, Marlborough, MA, USA). The bone metabolic markers including serum 25-(OH) D, intact parathyroid hormone (PTH), osteoprotegerin (OPG), osteopontin (OPN), receptor activator of nuclear factor κB ligand (RANKL), osteocalcin (OC), C-terminal telopeptide of type 1 collagen (CTX), and calcium were analyzed. The results showed that the BMDs of femur, lumbar, and forearm did not significantly change during the intervention period in both the HWE and CON groups. A significant decrease in bone formation markers such as OC (F = 10.514, p = 0.003, ηp2 = 0.266) and an increase in bone resorption marker including CTX (F = 8.768, p = 0.006, ηp2 = 0.232) were found only in the CON group, while these values did not change in the HWE group. There was a significant increase in serum 25-(OH) D (F = 4.451, p = 0.044, ηp2 = 0.133) in the HWE group. Our findings suggest that four months of HWE is not sufficient to improve BMD and bone metabolic markers, but this impact exercise program may prevent the age-associated changes in bone turnover markers in middle-aged premenopausal women.
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Wei W, Wu Y, Zeng Y, Shen B. [Progress of change in bone mineral density after knee arthroplasty]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:124-129. [PMID: 33448210 DOI: 10.7507/1002-1892.202006068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective To summarize research progress of change in bone mineral density (BMD) after knee arthroplasty and its diagnostic methods, influencing factors, and drug prevention and treatment. Methods The relevant literature at home and abroad was reviewed and summarized from research status of the advantages and disadvantages of BMD assessment methods, the trend of changes in BMD after knee arthroplasty and its influencing factors, and the differences in effectiveness of drugs. Results The central BMD and mean BMD around the prosthesis decrease after knee arthroplasty, which is closely associated with body position, age, weight, daily activities, and the fixation methods, design, and material of prosthesis. Denosumab, bisphosphonates, and teriparatide et al. can decrease BMD loss after knee arthroplasty. Conclusion BMD after knee arthroplasty decreases, which is related to various factors, but the mechanism is unclear. At present, some inhibitors of bone resorption can decrease BMD loss after knee arthroplasty. However, its long-term efficacy remains to be further explored.
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Affiliation(s)
- Wenxing Wei
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Yuangang Wu
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Yi Zeng
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Bin Shen
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
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