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Kindlovits R, Sousa AC, Viana JL, Milheiro J, Oliveira BMPM, Marques F, Santos A, Teixeira VH. Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes. Nutrients 2024; 16:1624. [PMID: 38892557 PMCID: PMC11173956 DOI: 10.3390/nu16111624] [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: 05/07/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
In an increasingly aging and overweight population, osteoporosis and type 2 diabetes (T2DM) are major public health concerns. T2DM patients experience prejudicial effects on their bone health, affecting their physical capacity. Exercise in hypoxia (EH) and a low-carbohydrate diet (LCD) have been suggested for therapeutic benefits in T2DM, improving bone mineral content (BMC) and glycemic control. This study investigated the effects of EH combined with an LCD on body composition and functional and physiologic capacity in T2DM patients. Older T2DM patients (n = 42) were randomly assigned to the following groups: (1) control group: control diet + exercise in normoxia; (2) EH group: control diet + EH; (3) intervention group: LCD + EH. Cardiopulmonary tests (BRUCE protocol), body composition (DEXA), and functional capacity (6MWT, handgrip strength) were evaluated. Body mass index (kg/m2) and body fat (%) decreased in all groups (p < 0.001). BMC (kg) increased in all groups (p < 0.001) and was significantly higher in the EH and EH + LCD groups (p < 0.001). VO2peak improved in all groups (p < 0.001), but more so in the hypoxia groups (p = 0.019). Functional capacity was increased in all groups (p < 0.001), but more so in the EH group in 6MWT (p = 0.030). EH with and without an LCD is a therapeutic strategy for improving bone mass in T2DM, which is associated with cardiorespiratory and functional improvements.
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Affiliation(s)
- Raquel Kindlovits
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
| | - Ana Catarina Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal; (A.C.S.); (J.L.V.)
| | - João Luís Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal; (A.C.S.); (J.L.V.)
| | - Jaime Milheiro
- CMEP, Exercise Medical Centre Laboratory, 4150-044 Porto, Portugal;
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-540 Porto, Portugal
| | - Bruno M. P. M. Oliveira
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIAAD, INESC-TEC), 4200-465 Porto, Portugal
| | - Franklim Marques
- Laboratory of Biochemistry, Department of Biological Sciences, UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Alejandro Santos
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Institute for Research and Innovation in Health, i3S, 4200-135 Porto, Portugal
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal; (R.K.); (B.M.P.M.O.); (A.S.)
- Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sports, University of Porto, FADEUP, 4200-540 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, ITR, 4050-600 Porto, Portugal
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Ross JA, Heebner NR. No pain, no gain: The military overtraining hypothesis of musculoskeletal stress and injury. Physiother Theory Pract 2023; 39:2289-2299. [PMID: 35695302 DOI: 10.1080/09593985.2022.2082346] [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: 06/25/2021] [Revised: 04/16/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
The purpose of this manuscript is to present a model of military overtraining and subsequent injury, discharge, and disability. Military training and combat operations are physically and physiologically demanding, placing great strain on the musculoskeletal system of warfighters. Non-battle musculoskeletal injuries (MSKI) are common and present a serious threat to operational readiness in today's military. MSKI risk stratification and prevention are an active area of research and is steeped in the background of sports science. Here, a model is proposed that incorporates the theory of General Adaptation Syndrome to describe how military training stressors may exceed that of training in traditional athletics and may induce sub-optimal training stressors. Positive feedback loops are discussed to explain how military overtraining (MOT) creates a system of ever-increasing stressors that can only be fully understood in the greater context of all environmental factors leading to overtraining. The Military Overtraining Hypothesis (MOTH) is proposed as a model that encapsulates the elevated MSKI risk in combat arms and other operational military personnel as an effort to broaden understanding of multifactorial military MSKI etiologies and as a tool for researchers and commanders to contextualize MSKI research and risk mitigation interventions.
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Affiliation(s)
- Jeremy A Ross
- Sports Medicine Research Institute, University of Kentucky, Lexington USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, Lexington USA
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Ng CA, Gandham A, Mesinovic J, Owen PJ, Ebeling PR, Scott D. Effects of Moderate- to High-Impact Exercise Training on Bone Structure Across the Lifespan: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Bone Miner Res 2023; 38:1612-1634. [PMID: 37555459 DOI: 10.1002/jbmr.4899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/19/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
Moderate- to high-impact exercise improves bone mineral density (BMD) across the lifespan, but its effects on bone structure, which predicts fracture independent of areal BMD, are unclear. This systematic review and meta-analysis investigated effects of impact exercise on volumetric BMD (vBMD) and bone structure. Four databases (PubMed, Embase, SPORTDiscus, Web of Science) were searched up to March 2022 for randomized controlled trials (RCTs) investigating the effects of impact exercise, with ground reaction forces equal to or greater than running, compared with sham or habitual activity, on bone vBMD and structure. Bone variables were measured by quantitative computed tomography or magnetic resonance imaging at the tibia, radius, lumbar spine, and femur. Percentage changes in bone variables were compared among groups using mean differences (MD) and 95% confidence intervals (CI) calculated via random effects meta-analyses. Subgroup analyses were performed in children/adolescents (<18 years), adults (18-50 years), postmenopausal women, and older men. Twenty-eight RCTs (n = 2985) were included. Across all studies, impact exercise improved trabecular vBMD at the distal tibia (MD = 0.54% [95% CI 0.17, 0.90%]), total vBMD at the proximal femur (3.11% [1.07, 5.14%]), and cortical thickness at the mid/proximal radius (1.78% [0.21, 3.36%]). There was no effect on vBMD and bone structure at the distal radius, femoral shaft, or lumbar spine across all studies or in any subgroup. In adults, impact exercise decreased mid/proximal tibia cortical vBMD (-0.20% [-0.24, -0.15%]). In postmenopausal women, impact exercise improved distal tibia trabecular vBMD (0.79% [0.32, 1.25%]). There was no effect on bone parameters in children/adolescents in overall analyses, and there were insufficient studies in older men to perform meta-analyses. Impact exercise may have beneficial effects on bone structure and vBMD at various skeletal sites, but additional high-quality RCTs in different age and sex subgroups are needed to identify optimal exercise protocols for improving bone health across the lifespan. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Carrie-Anne Ng
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, Australia
| | - Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
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Sekel NM, Hughes JM, Sterczala AJ, Mroz KH, Lovalekar M, Cauley J, Greeves JP, Nindl BC. Utility of HR-pQCT in detecting training-induced changes in healthy adult bone morphology and microstructure. Front Physiol 2023; 14:1266292. [PMID: 37929211 PMCID: PMC10623356 DOI: 10.3389/fphys.2023.1266292] [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: 08/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Healthy bone adjusts its traits in an exceptionally coordinated, compensatory process. Recent advancements in skeletal imaging via High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) allows for the in vivo 3-dimensional and longitudinal quantification of bone density, microarchitecture, geometry, and parameters of mechanical strength in response to varying strain stimuli including those resulting from exercise or military training. Further, the voxel size of 61 microns has the potential to capture subtle changes in human bone in as little as 8 weeks. Given the typical time course of bone remodeling, short-term detection of skeletal changes in bone microstructure and morphology is indicative of adaptive bone formation, the deposition of new bone formation, uncoupled from prior resorption, that can occur at mechanistically advantageous regions. This review aims to synthesize existing training-induced HR-pQCT data in three distinct populations of healthy adults excluding disease states, pharmacological intervention and nutritional supplementation. Those included are: 1) military basic or officer training 2) general population and 3) non-osteoporotic aging. This review aims to further identify similarities and contrasts with prior modalities and cumulatively interpret results within the scope of bone functional adaptation.
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Affiliation(s)
- Nicole M. Sekel
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie M. Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Adam J. Sterczala
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kelly H. Mroz
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jane Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie P. Greeves
- Army Health and Performance Research, UK Army, Andover, United Kingdom
| | - Bradley C. Nindl
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
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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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Ozawa M, Hirawa N, Haze T, Haruna A, Kawano R, Komiya S, Ohki Y, Suzuki S, Kobayashi Y, Fujiwara A, Saka S, Hanaoka M, Mitsuhashi H, Yamaguchi S, Ohnishi T, Tamura K. The implication of calf circumference and grip strength in osteoporosis and bone mineral density among hemodialysis patients. Clin Exp Nephrol 2023; 27:365-373. [PMID: 36574105 PMCID: PMC10023647 DOI: 10.1007/s10157-022-02308-8] [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: 10/16/2022] [Accepted: 12/02/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Chronic kidney disease-mineral and bone disorder (CKD-MBD), nutritional status, and uremia management have been emphasized for bone management in hemodialysis patients. Nevertheless, valuable data on the importance of muscle mass in bone management are limited, including whether conventional management alone can prevent osteoporosis. Thus, the importance of muscle mass and strength, independent of the conventional management in osteoporosis prevention among hemodialysis patients, was evaluated. METHODS Patients with a history of hemodialysis 6 months or longer were selected. We assessed the risk for osteoporosis associated with calf circumference or grip strength using multivariable adjustment for indices of CKD-MBD, nutrition, and dialysis adequacy. Moreover, the associations between bone mineral density (BMD), calf circumference, grip strength, and bone metabolic markers were also evaluated. RESULTS A total of 136 patients were included. The odds ratios (95% confidence interval) for osteoporosis at the femoral neck were 1.25 (1.04-1.54, P < 0.05) and 1.08 (1.00-1.18, P < 0.05) per 1 cm shorter calf circumference or 1 kg weaker grip strength, respectively. Shorter calf circumference was significantly associated with a lower BMD at the femoral neck and lumbar spine (P < 0.001). Weaker grip strength was also associated with lower BMD at the femoral neck (P < 0.01). Calf circumference or grip strength was negatively correlated with bone metabolic marker values. CONCLUSION Shorter calf circumference or weaker grip strength was associated with osteoporosis risk and lower BMD among hemodialysis patients, independent of the conventional therapies.
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Affiliation(s)
- Moe Ozawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuhito Hirawa
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan.
| | - Tatsuya Haze
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan
| | - Aiko Haruna
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Rina Kawano
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shiro Komiya
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuki Ohki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Shota Suzuki
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Yusuke Kobayashi
- YCU Center for Novel and Exploratory Clinical Trials (Y-NEXT), Yokohama City University Hospital, Yokohama, Japan
| | - Akira Fujiwara
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Sanae Saka
- Department of Nephrology and Hypertension, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama, Japan
| | - Masaaki Hanaoka
- Kamiooka Jinsei Clinic, Kousaikai Medical Corporation, Yokohama, Japan
| | | | - Satoshi Yamaguchi
- Yokohama Jinsei Hospital, Kousaikai Medical Corporation, Yokohama, Japan
| | - Toshimasa Ohnishi
- Kamiooka Jinsei Clinic, Kousaikai Medical Corporation, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Camacho-Cardenosa A, Camacho-Cardenosa M, Martínez-Guardado I, Leal A, Andrada JMV, Timón R. Resistance circuit training combined with hypoxia stimulates bone system of older adults: A randomized trial. Exp Gerontol 2022; 169:111983. [PMID: 36243220 DOI: 10.1016/j.exger.2022.111983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Aging leads to gradual irreversible decline in bone mass. As adherence to pharmacological treatment is poor, hypoxia combined with strength training has been suggested for therapeutic benefit for clinical populations. The present study investigated the effects of normobaric cyclic hypoxic exposure combined with resistance circuit training on bone of older adults. METHODS Healthy older adults (n = 50) were randomly assigned to a (1) control group (CON; n = 20), who were instructed to continue with their normal daily activities, (2) a group that performed resistance training in normoxia (RTN; n = 17) and (3) a group that performed resistance training in hypoxia (RTH; n = 13). During 24 weeks, RTH group performed resistance training with elastic bands under normobaric hypoxic conditions (16.1 % FiO2). A session of both exercise groups included nine exercises of several body areas with a structure of 3 sets × 12-15 repetitions per exercise, with a 1-minute rest between sets. Bone mineral density (g·cm-2) was measured using dual-energy X-ray absorptiometry. Bone turnover markers of formation (N-terminal propeptide of type I procollagen; PINP) and resorption (C-terminal telopeptide of type I collagen; bCTX) were analysed with enzyme-linked immunosorbent assay (ELISA) microplate reader. RESULTS Values of bCTX and bCTX/PINP significant decreased in RTN (bCTX: 47.79 %; p = 0.002; bCTX/PINP: 61.43 %; p = 0.007) and RTH (bCTX: 59.09 %; p = 0.001; bCTX/PINP: 62.61 %; p = 0.003) groups compared with CON group. Change in bone mineral density was not significantly different between groups. Based on clinically significant change, 23 % of the participants in the RTH group reached this value for femoral neck and trochanter bone mineral density (vs 0 % and 6 % of the RTN group, respectively). CONCLUSIONS 24-Weeks of normobaric cyclic hypoxic exposure combined with resistance circuit training has potential to generate positive effects on bone in older adults. TRIAL REGISTRATION NUMBER NCT04281264 (date of registration: February 24, 2020).
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Affiliation(s)
- Alba Camacho-Cardenosa
- PROFITH (PROmoting FITness and Health through Physical Activity) Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18007 Granada, Spain.
| | - Marta Camacho-Cardenosa
- Clinical Management Unit of Endocrinology and Nutrition - GC17. Maimónides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofía University Hospital, 14004, Córdoba, Spain.
| | | | - Alejo Leal
- Medical Center Alejo Leal, 10001 Cáceres, Spain.
| | | | - Rafael Timón
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain.
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8
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de Vasconcelos RF, Costa V, Araujo B, Maia TAC, Dias R, Vasconcelos L, Silveira H, Carneiro B, Thiers D, Costa FWG, Kurita L, Ayala A, Leitão R, Pereira KMA, Gondim DV, Goes P. Milk kefir therapy improves the skeletal response to resistance exercise in rats submitted to glucocorticoid-induced osteoporosis. Exp Gerontol 2022; 167:111921. [PMID: 35964897 DOI: 10.1016/j.exger.2022.111921] [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: 04/19/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/04/2022]
Abstract
Glucocorticoid-induced osteoporosis (GIO) has emerged as a challenge after long-term glucocorticoids (GCs) administration. Exercise has been an important non-pharmacological option, while medications modulate bone remodeling despite adverse effects. In this way, milk Kefir (MK) therapy stands out as a safe alternative to improve bone metabolism. Our study aimed to investigate the effect of MK associated to resistance exercise on bone loss in rats with GIO. For this, sixty male Wistar rats were divided into 2 groups: normal (N) and subjected to GIO, which was subdivided into 4 groups: control (C), milk kefir therapy (K), Exercise (Ex), and Exercise+K (ExK). GIO was induced by dexamethasone (7 mg/kg - i.m.; 1×/wk, 5 wk). MK was administered daily (1×/day; 0.7 ml/animal) and the climb exercise with load was performed 3×/wk; both for 16 wk. Femur was collected for assessment of bone microarchitecture, quality and metabolism. GIO markedly reduced trabecular bone volume density (BV/TV) (-35 %), trabecular thickness (Tb.Th) (-33 %), mineral content of femur (-26 %) as well as bone collagen content (-56 %). Bone strength and its biomechanical properties given by flexural strength (-81 %), fracture load (-80 %), and the number of osteocytes (-84 %) were lowered after GIO. GCs reduced osteoblast number and function while increased osteoclast number, altering bone remodeling (p < 0.05). On the other hand, ExK significantly improved bone microarchitecture and quality, marked by fractal dimension increase (+38 %), cortical volume (+34 %), BV/TV (+34 %), Tb.Th (+33 %), mineral content and collagen maturity, while reduced the space between trabecula (-34 %). The Ex and ExK increased the number of osteocytes (p < 0.05) and they were able to reverse the lower osteoblast number. Both treatments used alone significantly enhanced bone biomechanical properties, but the ExK showed a more significant improvement. ExK ameliorated bone strength and biomechanics (p < 0.05) and stimulated bone formation and modulated bone remodeling (p < 0.05). MK and exercise administered isolated or in association increased the percentage of collagen bone filling after GIO (p < 0.05), but only ExK improved collagen maturity. Our results showed that MK associated to resistance exercise enhanced bone microarchitecture, quality and metabolism, being therefore an interesting tool to improve skeletal response during GIO.
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Affiliation(s)
- Raquel Felipe de Vasconcelos
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Vanessa Costa
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Bruno Araujo
- Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Thays Allane Cordeiro Maia
- Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Romero Dias
- Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Lorena Vasconcelos
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Helson Silveira
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Bárbara Carneiro
- Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-Graduation Program in Dentistry, Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Diego Thiers
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Fábio Wildson Gurgel Costa
- Post-Graduation Program in Dentistry, Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil; Oral Radiology Unit, Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Lúcio Kurita
- Oral Radiology Unit, Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Alejandro Ayala
- Post-graduation Program in Physics, Department of Physics, Federal University of Ceará, Fortaleza, Brazil
| | - Renata Leitão
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, Brazil
| | - Karuza Maria Alves Pereira
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, Brazil
| | - Delane Viana Gondim
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, Brazil
| | - Paula Goes
- Post-Graduation Program in Morphofunctional Science, Department of Morphology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, Brazil.
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9
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Vints WAJ, Levin O, Fujiyama H, Verbunt J, Masiulis N. Exerkines and long-term synaptic potentiation: Mechanisms of exercise-induced neuroplasticity. Front Neuroendocrinol 2022; 66:100993. [PMID: 35283168 DOI: 10.1016/j.yfrne.2022.100993] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 01/30/2023]
Abstract
Physical exercise may improve cognitive function by modulating molecular and cellular mechanisms within the brain. We propose that the facilitation of long-term synaptic potentiation (LTP)-related pathways, by products induced by physical exercise (i.e., exerkines), is a crucial aspect of the exercise-effect on the brain. This review summarizes synaptic pathways that are activated by exerkines and may potentiate LTP. For a total of 16 exerkines, we indicated how blood and brain exerkine levels are altered depending on the type of physical exercise (i.e., cardiovascular or resistance exercise) and how they respond to a single bout (i.e., acute exercise) or multiple bouts of physical exercise (i.e., chronic exercise). This information may be used for designing individualized physical exercise programs. Finally, this review may serve to direct future research towards fundamental gaps in our current knowledge regarding the biophysical interactions between muscle activity and the brain at both cellular and system levels.
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Affiliation(s)
- Wouter A J Vints
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Sporto str. 6, LT-44221 Kaunas, Lithuania; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Centre of Expertise in Rehabilitation and Audiology, Adelante Zorggroep, P.O. Box 88, 6430 AB Hoensbroek, the Netherlands.
| | - Oron Levin
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Sporto str. 6, LT-44221 Kaunas, Lithuania; Movement Control & Neuroplasticity Research Group, Group Biomedical Sciences, Catholic University Leuven, Tervuursevest 101, 3001 Heverlee, Belgium.
| | - Hakuei Fujiyama
- Department of Psychology, Murdoch University, 90 South St., WA 6150 Perth, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South St., WA 6150 Perth, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, 90 South St., WA 6150 Perth, Australia.
| | - Jeanine Verbunt
- Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands; Centre of Expertise in Rehabilitation and Audiology, Adelante Zorggroep, P.O. Box 88, 6430 AB Hoensbroek, the Netherlands.
| | - Nerijus Masiulis
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Sporto str. 6, LT-44221 Kaunas, Lithuania; Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Science, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania.
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10
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The Relationship Between Usual Daily Physical Activity With Serum Markers Related to Bone Metabolism and Demographic Characteristics in Postmenopausal Women Aged 50-65 Years. J Phys Act Health 2022; 19:417-424. [PMID: 35551114 DOI: 10.1123/jpah.2021-0495] [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: 07/20/2021] [Revised: 04/09/2022] [Accepted: 04/24/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bone turnover markers can predict subsequent changes in bone status. This study aimed to investigate the relationship between usual daily physical activity (PA) with bone markers. METHODS This cross-sectional study was conducted on 500 postmenopausal women aged 50-65 years in Tabriz-Iran in 2018. The women were recruited by a simple random method. The International Physical Activity Questionnaire was used to assess PA. The laboratory tests of 25-Hydroxyvitamin D3, alkaline phosphatase, calcium, and phosphorus were also used to examine bone function. RESULTS The education, income, employment status, sun exposure, and history of exercise were significantly correlated with PA. Among reproductive characteristics, only menopausal age showed a significant relationship with total PA levels (r = .285, P = .048). None of the anthropometric indices showed a statistically significant relationship with total PA. Serum calcium (r = -.242) and phosphorus (r = -.045) levels showed negative and inverse relationships with total PA. The intensity of this association was statistically significant only for the calcium (β = -0.108, 95% confidence interval, -0.117 to 0.098; P = .023). 25-Hydroxyvitamin D3 (r = .007) and alkaline phosphatase (r = .046) were directly and positively but nonsignificantly correlated to the intensity of total PA. CONCLUSION Usual daily physical activity with any levels has no effect on bone markers except for calcium. Despite of the beneficial effects of PA, our findings showed that usual daily physical activity without increasing total PA cannot affect bone health. For maximal effects of PA on bone health, it seems that a degree of intensity, continuity, and regularity of PA programs should be considered to stimulate bone formation.
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11
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Davidović Cvetko E, Nešić N, Matić A, Milas Ahić J, Drenjančević I. Effects of 8-week increment aerobic exercise program on bone metabolism and body composition in young non-athletes. Eur J Appl Physiol 2022; 122:1019-1034. [PMID: 35141785 DOI: 10.1007/s00421-022-04900-y] [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: 07/08/2021] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The effects of aerobic exercise on bone metabolism are still unclear. Thus, the main goal of this study was to explore if there was an effect of the short-term aerobic exercise program on the bone remodeling process and if there were sex differences in the effect of the training program on bone metabolism. METHODS Twenty-one participants (men and women) aged 20-23 performed an 8-week aerobic exercise program three times per week in 1-h sessions with increases in the exercise load every 2 weeks. Bone density, bone mineral content and concentration of markers of bone metabolism: osteocalcin, C-terminal procollagen type I peptide, pyridinoline, parathyroid hormone, osteoprotegerin, and the receptor activator of nuclear kappa B ligand by ELISA were measured at the start and at the end of the study, while changes in body composition were assessed by a bioelectric impedance analysis method 6 times during the study. RESULTS The aerobic exercise program increased the concentration of osteocalcin (11.34 vs 14.24 ng/ml), pyridinoline (67.51 vs 73.99 nmol/l), and the receptor activator of nuclear kappa B ligand (95.122 vs 158.15 pg/ml). A statistically significant increase in bone density at neck mean (1.122 vs 1.176 g/cm3) and in bone mineral content at dual femur (33.485 vs 33.700 g) was found in women, while there was no statistically significant change at any site in men. CONCLUSION 8 weeks of the aerobic exercise program with increment in intensity increased some of bone remodeling biomarkers and showed different effects for men and women.
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Affiliation(s)
- Erna Davidović Cvetko
- Health Studies Department, College of Applied Sciences Lavoslav Ruzicka in Vukovar, Županijska 50, 32000, Vukovar, Croatia
| | - Nebojša Nešić
- Health Studies Department, College of Applied Sciences Lavoslav Ruzicka in Vukovar, Županijska 50, 32000, Vukovar, Croatia
| | - Anita Matić
- Department of Physiology and Immunology, Faculty of Medicine Osijek, University of Josip Juraj Strossmayer Osijek, J. Huttlera 4, 31000, Osijek, Croatia.,Scientific Centre of Excellence for Personalized Health Care, University of Josip Juraj Strossmayer Osijek, Trg Svetog Trojstva 3, 31000, Osijek, Croatia
| | - Jasminka Milas Ahić
- Department of Pathophysiology, Faculty of Medicine Osijek, University of Josip Juraj Strossmayer Osijek, J. Huttlera 4, 31000, Osijek, Croatia.,Department of Internal Medicine, Clinical Hospital Centre Osijek, J. Huttlera 4, 31000, Osijek, Croatia
| | - Ines Drenjančević
- Department of Physiology and Immunology, Faculty of Medicine Osijek, University of Josip Juraj Strossmayer Osijek, J. Huttlera 4, 31000, Osijek, Croatia. .,Scientific Centre of Excellence for Personalized Health Care, University of Josip Juraj Strossmayer Osijek, Trg Svetog Trojstva 3, 31000, Osijek, Croatia.
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12
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Gaffney-Stomberg E, Hughes JM, Guerriere KI, Staab JS, Cable SJ, Bouxsein ML, McClung JP. Once daily calcium (1000 mg) and vitamin D (1000 IU) supplementation during military training prevents increases in biochemical markers of bone resorption but does not affect tibial microarchitecture in Army recruits. Bone 2022; 155:116269. [PMID: 34861430 DOI: 10.1016/j.bone.2021.116269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Abstract
Basic combat training (BCT) is a period of novel physical training including load carriage resulting in higher risk of stress fracture compared to any other time during military service. Prior trials reported a 20% reduction in stress fracture incidence with Ca and vitamin D (Ca + D) supplementation (2000 mg Ca, 800 IU vitamin D), and greater increases in tibia vBMD during BCT compared to placebo. The primary objective of this randomized, double-blind, placebo-controlled trial was to determine the efficacy of a lower dose of Ca (1000 mg/d Ca, 1000 IU vit D) on PTH, bone biomarkers and tibial microarchitecture during BCT. One hundred volunteers (50 males, 50 females; mean age 21.8 ± 3.5 y) were block randomized by race and sex to receive a daily Ca + D fortified food bar or placebo. Anthropometrics, dietary intake, fasted blood draws and high resolution pQCT scans of the distal and mid-shaft tibia were obtained at the start of BCT and 8 wks later at the conclusion of training. As compliance was 98% in both treatment groups, an intent-to-treat analysis was used. At the distal tibia, total vBMD, Tb.vBMD, Tb.N, Th.Th and Tb.BV/TV increased (+1.07 to 2.12% for all, p < 0.05) and Tb.Sp decreased (0.96 to 1.09%, p < 0.05) in both treatment groups. At the mid-shaft, Ct.Pm increased (+0.18 to 0.21%, p = 0.01) and Ct.vBMD decreased (-0.48 to -0.77%, p < 0.001) in both groups. Ca + D prevented increases in CTX and TRAP, which were observed in the placebo group (group-by-time, p < 0.05). Mean circulating 25OHD, BAP, P1NP and iCa increased and PTH decreased in both treatment groups (p < 0.05). These results, in agreement with other studies, suggest that bone microarchitectural changes indicative of bone formation occur during BCT. While Ca + D supplementation at lower doses than those tested in previous studies prevented increases in biochemical markers of bone resorption in this study, there were no significant changes in bone tissue after 8 wks of Army BCT.
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Affiliation(s)
- Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America.
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
| | - Sonya J Cable
- Womack Army Medical Center, Ft Bragg, NC 28310, United States of America
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States of America; Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Cente, United States of America; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02215, United States of America
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States of America
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Mancuso ME, Wilzman AR, Murdock KE, Troy KL. Effect of External Mechanical Stimuli on Human Bone: a narrative review. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2022; 4:012006. [PMID: 36310606 PMCID: PMC9616042 DOI: 10.1088/2516-1091/ac41bc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Bone is a living composite material that has the capacity to adapt and respond to both internal and external stimuli. This capacity allows bone to adapt its structure to habitual loads and repair microdamage. Although human bone evolved to adapt to normal physiologic loading (for example from gravitational and muscle forces), these same biological pathways can potentially be activated through other types of external stimuli such as pulsed electromagnetic fields, mechanical vibration, and others. This review summarizes what is currently known about how human bone adapts to various types of external stimuli. We highlight how studies on sports-specific athletes and other exercise interventions have clarified the role of mechanical loading on bone structure. We also discuss clinical scenarios, such as spinal cord injury, where mechanical loading is drastically reduced, leading to rapid bone loss and permanent alterations to bone structure. Finally, we highlight areas of emerging research and unmet clinical need.
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14
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Zhao Y, Suo Y, Yang Z, Hao Y, Li W, Su Y, Shi Y, Gao Y, Song L, Yin X, Shi H. Inspiration for the prevention and treatment of neuropsychiatric disorders: New insight from the bone-brain-axis. Brain Res Bull 2021; 177:263-272. [PMID: 34678443 DOI: 10.1016/j.brainresbull.2021.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/09/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Abstract
Bone is the main supporting structure of the body and the main organ involved in body movement and calcium and phosphorus metabolism. Recent studies have shown that bone is also a potential new endocrine organ that participates in the physiological and pathophysiological processes of the cardiovascular, digestive, and endocrine systems through various bioactive cytokines secreted by bone cells and bone marrow. Bone-derived active cytokines can also directly act on the central nervous system and regulate brain function and individual behavior. The bidirectional regulation of the bone-brain axis has gradually attracted attention in the field of neuroscience. This paper reviews the regulatory effects of bone-derived active cytokines and bone-derived cells on individual brain function and brain diseases, as well as the occurrence and development of related neuropsychiatric diseases. The central regulatory mechanism function is briefly introduced, which will broaden the scope for mechanistic research and help establish prevention and treatment strategies for neuropsychiatric diseases based on the bone-brain axis.
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Affiliation(s)
- Ye Zhao
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China
| | - Yining Suo
- Child Health Department, Hebei Children's Hospital, Shijiazhuang 050031, China
| | - Zhenbang Yang
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China
| | - Ying Hao
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China
| | - Wenshuya Li
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China
| | - Yujiao Su
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China
| | - Yun Shi
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Department of Biochemistry and Molecular Biology, College of Basic Medicine, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Yuan Gao
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China; Department of Biochemistry and Molecular Biology, College of Basic Medicine, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Li Song
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China; Department of Biochemistry and Molecular Biology, College of Basic Medicine, Hebei Medicinal University, Shijiazhuang 050017, China
| | - Xi Yin
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Department of Functional Region of Diagnosis, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
| | - Haishui Shi
- Neuroscience Research Center, Institute of Medical and Health Science of HeBMU, Hebei Medical University, Shijiazhuang 050017, China; Hebei Key laboratory of Neurophysiology, Hebei Medicinal University, 050017, China; Department of Biochemistry and Molecular Biology, College of Basic Medicine, Hebei Medicinal University, Shijiazhuang 050017, China.
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15
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Effects of Interval Exercise Training on Serum Biochemistry and Bone Mineral Density in Dogs. Animals (Basel) 2021; 11:ani11092528. [PMID: 34573494 PMCID: PMC8468388 DOI: 10.3390/ani11092528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
Simple Summary In this study, six male beagle dogs underwent 12 weeks of interval exercise following the Frequency, Intensity, Time/duration, Type, Volume, and Progression (FITT-VP) training principle. The heart rate (HR) response was measured during the entire exercise period, and changes in bone mineral density (BMD), muscle volume (MV), and hematology and serum biomarkers were evaluated at the pre-exercise training period and post-exercise training period. We showed that exercise training increased BMD in the femur and serum total alkaline phosphatase (TALP), aspartate aminotransferase, and creatine kinase levels. In addition, our data suggest a positive correlation between BMD and TALP, demonstrating that increased TALP might be an important contributing factor for enhancing BMD with physical training in dogs. Abstract Exercise has been suggested as a powerful intervention for health care and fitness management in humans; however, few studies have demonstrated the benefits of exercise training in dogs. The purpose of this study was to examine the effects of exercise training on heart rate (HR), bone mineral density (BMD), muscle volume (MV), and hematological and serum biomarkers in dogs. Six healthy beagles completed the interval treadmill exercise, developed on the basis of the FITT principle, two times a week for 12 weeks. To evaluate the physiological parameters, the HR values were analyzed using the Polar H10 system during the entire exercise period. At pre-and post-exercise, quantitative computed tomography and hematological and serum biochemical parameters were analyzed. The interval exercise resulted in a normal HR response and no adverse behavioral or physiological effects on the dogs. We showed that exercise improved BMD in the femur (541.6 ± 16.7 vs. 610.2 ± 27.8 HA, p < 0.01) and increased serum total alkaline phosphatase (TALP; 68.6 ± 9.2 vs. 81.3 ± 17.2, p < 0.01), aspartate aminotransferase (23.5 ± 1.0 vs. 33.5 ± 1.6, p < 0.01), and creatine kinase (114.8 ± 5.3 vs. 214.0 ± 20.8, p < 0.01) levels. There was a positive relationship between BMD and TALP (femur: r = 0.760, p = 0.004; vertebrae: r = 0.637; p = 0.025). Our findings suggest that interval exercise training is beneficial to increase BMD in the femur, and an increased TALP level would be a concomitant mechanism for enhancing BMD with exercise in dogs.
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16
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Baker BS, Buchanan SR, Black CD, Bemben MG, Bemben DA. Bone, Biomarker, Body Composition, and Performance Responses to 8 Weeks of ROTC Training. J Athl Train 2021; 57:571-580. [PMID: 34279654 DOI: 10.4085/1062-6050-0634.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Military personnel engage in vigorous exercise, often resulting in higher bone mineral density; however, lower leg bone injuries are common in this population. Predictors of change in tibial bone quality and strength need to be characterized in this high-risk population. OBJECTIVE This study aimed to examine the effects of an eight-week military training intervention on total body and site-specific bone density and tibial bone quality, serum biomarkers (parathyroid hormone and sclerostin), body composition, and physical performance. Additionally, we sought to investigate what outcome variables (biomarkers, body composition, physical performance) would be predictive of estimated tibial bone strength in college-aged Reserve Officers' Training Corps (ROTC) members. DESIGN Prospective Cohort Study. SETTING XXX University. Patients of Other Participants: ROTC (n=14 male; n=4 female) were matched for sex, age, and body mass to physically active Controls (n=14 male; n=4 female). ROTC engaged in an eight-week training intervention, while physically active Controls made no changes to their exercise routines. MAIN OUTCOME MEASURES Pre general health questionnaires and pre, mid, and post intervention bone scans (DXA, pQCT), serum blood draws (parathyroid hormone and sclerostin), and physical performance measures (muscle strength and aerobic capacity) were tested. RESULTS ROTC participants exhibited significantly increased hip bone density and content (all p≤0.03) after the eight-week intervention. Sclerostin, not PTH, was a significant positive correlate and predictor in all ROTC models for estimated bone strength at the fracture prone 38% tibial site. Both groups decreased total body and regional fat mass and ROTC increased aerobic capacity (all p≤0.05). CONCLUSIONS All bone, body composition, and performance measures either improved or were maintained in response to ROTC training and sclerostin should be further investigated as a potential early indicator of changes in estimated tibial bone strength in military cohorts.
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Affiliation(s)
- Breanne S Baker
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1100 Virginia Ave, Columbia, MO 65212, Office: 573-882-3038, , Twitter @DrBreeBaker-Also affiliated with the Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Samuel R Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, 78539. -Also affiliated with the Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Christopher D Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071, Twitter @ChrisBlack_PhD
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
| | - Debra A Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73071
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Yang CB, Hsu CH, Huang CN, Tsao TH. The influence of low-impact dance intervention on bone metabolism, cognition, and function fitness of old women. J Women Aging 2021; 34:438-448. [PMID: 34224342 DOI: 10.1080/08952841.2021.1942766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined the low-impact dance intervention on the markers of bone metabolism, cognitive function, and functional fitness of postmenopausal women. Senior women were randomized into low-impact dance (LG) or control group (CG). Three dance sessions weekly were scheduled in the LG for 16 weeks. The markers of bone metabolism, bone composition, Stroop test, and functional fitness were assessed at pre- and post-intervention. The marker of bone formation, some of cognitive function and functional fitness were improved in the LG. The low-impact dance intervention benefited the marker of bone formation, parts of cognitive function and functional fitness.
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Affiliation(s)
- Chung Bing Yang
- Department of Physical Education and Kinesiology, National Dong Hwa University, Hualien, Taiwan
| | - Chin Hsing Hsu
- Department of Recreational Sports and Health Promotion, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Chih Neng Huang
- Physical Education Office, National Taiwan Ocean University, Keelung, Taiwan
| | - Te Hung Tsao
- Center for Exercise and Health EducationNational Sun Yat-Sen University, Kaohsiung, Taiwan
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Ng CA, McMillan LB, Humbert L, Ebeling PR, Scott D. Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density. Osteoporos Int 2021; 32:893-905. [PMID: 33159533 DOI: 10.1007/s00198-020-05723-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/29/2020] [Indexed: 12/01/2022]
Abstract
UNLABELLED The feasibility and efficacy of home-based, impact exercise are unclear. This pilot impact exercise intervention was feasible and safe, and improved bone health and physical function in postmenopausal women with low bone density. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk. INTRODUCTION The feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact exercise intervention in postmenopausal women with low BMD. METHODS Fifty community-dwelling postmenopausal women with BMD T-scores < - 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical performance was assessed by repeated chair stand time and stair climb time. RESULTS Forty-four women (mean ± SD age 64.5 ± 7.5 years) completed the intervention, with adherence of 85.3 ± 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 ± 3.76% (p = 0.048). Trabecular volumetric BMD (vBMD) increased at the total hip (2.27 ± 7.03%; p = 0.038) and femoral neck increased (3.20 ± 5.39%; p < 0.001). Distal tibia total vBMD increased by 0.32 ± 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 ± 1.54% (p = 0.034). Chair stand and stair climb time improved by 2.34 ± 1.88 s (p < 0.001) and 0.27 ± 0.49 s (p < 0.001), respectively. CONCLUSION A 16-week home-based, impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk in older populations.
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Affiliation(s)
- C-A Ng
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - L B McMillan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - L Humbert
- Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - D Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Department of Medicine at Western Health, The University of Melbourne, Sunshine, Victoria, Australia
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Wherry SJ, Miller RM, Jeong SH, Beavers KM. The Ability of Exercise to Mitigate Caloric Restriction-Induced Bone Loss in Older Adults: A Structured Review of RCTs and Narrative Review of Exercise-Induced Changes in Bone Biomarkers. Nutrients 2021; 13:1250. [PMID: 33920153 PMCID: PMC8070587 DOI: 10.3390/nu13041250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Despite the adverse metabolic and functional consequences of obesity, caloric restriction- (CR) induced weight loss is often contra-indicated in older adults with obesity due to the accompanying loss of areal bone mineral density (aBMD) and subsequent increased risk of fracture. Several studies show a positive effect of exercise on aBMD among weight-stable older adults; however, data on the ability of exercise to mitigate bone loss secondary to CR are surprisingly equivocal. The purpose of this review is to provide a focused update of the randomized controlled trial literature assessing the efficacy of exercise as a countermeasure to CR-induced bone loss among older adults. Secondarily, we present data demonstrating the occurrence of exercise-induced changes in bone biomarkers, offering insight into why exercise is not more effective than observed in mitigating CR-induced bone loss.
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Affiliation(s)
- Sarah J. Wherry
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Aurora, CO 80045, USA
| | - Ryan M. Miller
- Department of Internal Medicine, Sections on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Sarah H. Jeong
- Z. Smith Reynolds Library, Wake Forest University, Winston-Salem, NC 27109, USA;
| | - Kristen M. Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA
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20
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Troy KL, Mancuso ME, Johnson JE, Butler TA, Ngo BH, Schnitzer TJ. Dominant and nondominant distal radius microstructure: Predictors of asymmetry and effects of a unilateral mechanical loading intervention. Bone Rep 2021; 14:101012. [PMID: 33786342 PMCID: PMC7994725 DOI: 10.1016/j.bonr.2021.101012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 11/15/2022] Open
Abstract
Most information about distal radius microstructure is based on the non-dominant forearm, with little known about the factors that contribute to bilateral asymmetries in the general population, or what factors may influence bilateral changes over time. Here, we analyzed bilateral high resolution peripheral quantitative computed tomography (HRpQCT) data collected over a 12-month period as part of a clinical trial that prescribed a well-controlled, compressive loading task to the nondominant forearm. Baseline data from 102 women age 21–40, and longitudinal data from 66 women who completed the 12-month trial, were examined to determine factors responsible for side-to-side asymmetries in bone structure and change in structure over time. Cross-sectionally, the dominant radius had 2.4%–2.7% larger cross-sectional area, trabecular area, and bone mineral content than the nondominant radius, but no other differences were noted. Those who more strongly favored their dominant arm had significantly more, thinner, closely spaced trabecular struts in their dominant versus nondominant radius. Individuals assigned to a loading intervention had significant bilateral gains in total bone mineral density (2.0% and 1.2% in the nondominant versus dominant sides), and unilateral gains in the nondominant (loaded) cortical area (3.1%), thickness (3.0%), bone mineral density (1.7%) and inner trabecular density (1.3%). Each of these gains were significantly predicted by loading dose, a metric that included bone strain, number of cycles, and strain rate. Within individuals, change was negatively associated with age, meaning that women closer to age 40 experienced less of a gain in bone versus those closer to age 21. We believe that dominant/nondominant asymmetries in bone structure reflect differences in habitual loads during growth and past ability to adapt, while response to loading reflects current individual physiologic capacity to adapt. We examined relationships between physical activity, handedness, demographics, and asymmetries in distal radius structure. Trabecular and cross-sectional area were 2.4-2.7% larger in the dominant side. We examined factors that predicted 12-month change after a unilateral loading intervention on the nondominant side. The intervention caused unilateral (nondominant) increases in most variables, which scaled with loading dose. The results also suggest that greater dietary calcium is associated with endosteal bone apposition following loading.
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Affiliation(s)
- Karen L Troy
- Department of Biomedical Engienering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| | - Megan E Mancuso
- Department of Biomedical Engienering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| | - Joshua E Johnson
- Orthopaedic Biomechanics Laboratory, Dept. of Orthopaedic Surgery, University of Iowa, Iowa City, IA, United States of America
| | - Tiffiny A Butler
- Department of Biomedical Engienering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| | - Bao Han Ngo
- Massachusetts Academy of Math and Science, Worcester, MA, United States of America
| | - Thomas J Schnitzer
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States of America
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21
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Hiam D, Landen S, Jacques M, Voisin S, Alvarez-Romero J, Byrnes E, Chubb P, Levinger I, Eynon N. Osteocalcin and its forms respond similarly to exercise in males and females. Bone 2021; 144:115818. [PMID: 33338665 DOI: 10.1016/j.bone.2020.115818] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/09/2020] [Accepted: 12/13/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Acute exercise increases osteocalcin (OC), a marker of bone turnover, and in particular the undercarboxylated form (ucOC). Males and females differ in baseline levels of total OC and it is thought the hormonal milieu may be driving these differences. Males and females adapt differently to the same exercise intervention, however it is unclear whether the exercise effects on OC are also sex-specific. We tested whether the responses of OC and its forms to acute High Intensity Interval Exercise (HIIE) and High Intensity Interval Training (HIIT) differed between males and females. Secondly, we examined whether sex hormones vary with OC forms within sexes to understand if these are driving factor in any potential sex differences. METHODS Total OC (tOC), undercarboxylated OC (ucOC), and carboxylated OC (cOC) were measured in serum of 96 healthy participants from the Gene SMART cohort (74 males and 22 females) at rest, immediately after, and 3 h after a single bout of HIIE, and at rest, 48 h after completing a four week HIIT intervention. Baseline testosterone and estradiol were also measured for a subset of the cohort (Males = 38, Females = 20). Linear mixed models were used to a) uncover the sex-specific effects of acute exercise and short-term training on OC forms and b) to examine whether the sex hormones were associated with OC levels. RESULTS At baseline, males had higher levels of tOC, cOC, and ucOC than females (q < 0.01). In both sexes tOC, and ucOC increased to the same extent after acute HIIE. At baseline, in males only, higher testosterone was associated with higher ucOC (β = 3.37; q < 0.046). Finally, tOC and ucOC did not change following 4 weeks of HIIT. CONCLUSION/DISCUSSION While there were no long-term changes in OC and its forms. tOC and ucOC were transiently enhanced after a bout of HIIE similarly in both sexes. This may be important in metabolic signalling in skeletal muscle and bone suggesting that regular exercise is needed to maintain these benefits. Overall, these data suggest that the sex differences in exercise adaptations do not extend to the bone turnover marker, OC.
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Affiliation(s)
- D Hiam
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - S Landen
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - M Jacques
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - S Voisin
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - J Alvarez-Romero
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia
| | - E Byrnes
- PathWest Laboratory Medicine, QEII Medical Centre, Perth, Australia
| | - P Chubb
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, Australia
| | - I Levinger
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - N Eynon
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
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22
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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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23
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Dolan E, Varley I, Ackerman KE, Pereira RMR, Elliott-Sale KJ, Sale C. The Bone Metabolic Response to Exercise and Nutrition. Exerc Sport Sci Rev 2020; 48:49-58. [PMID: 31913188 DOI: 10.1249/jes.0000000000000215] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone (re)modeling markers can help determine how the bone responds to different types, intensities, and durations of exercise. They also might help predict those at risk of bone injury. We synthesized evidence on the acute and chronic bone metabolic responses to exercise, along with how nutritional factors can moderate this response. Recommendations to optimize future research efforts are made.
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Affiliation(s)
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Kathryn E Ackerman
- Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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24
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Abstract
INTRODUCTION Bone has conventionally been considered to be a passive organ that only receives external control, but according to recent findings, it has become clear that bone is an endocrine organ that actively regulates systemic metabolism through osteocalcin (OC). METHODS We focus on the relationship between the brain and bone and summarize the effects of OC on cognitive function as well as the association between OC and improved cognitive function through exercise. RESULTS The findings suggest that the decrease in OC produced by bone is responsible for the decrease in cognitive function associated with aging. Furthermore, positive effect of improving cognitive function can generally be recognized in exercise interventions conducted for healthy elderly people and those with MCI, and moderate exercise is particularly effective for dementia prevention. CONCLUSION The improving bone health with aging may exert beneficial effects on cognition.
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Affiliation(s)
- Misa Nakamura
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Masakazu Imaoka
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan.,Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
| | - Masatoshi Takeda
- Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Osaka, Japan
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25
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Fakhri F, Habibi A, Ghanbarzadeh M, Ranjbar R. Effect of Four Weeks Plyometric Training with and without Blood Flow Restriction on Serum Bone Formation and Degeneration Markers in Inactive Girls. MEDICAL LABORATORY JOURNAL 2020. [DOI: 10.29252/mlj.14.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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26
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Lambert C, Beck BR, Harding AT, Watson SL, Weeks BK. Regional changes in indices of bone strength of upper and lower limbs in response to high-intensity impact loading or high-intensity resistance training. Bone 2020; 132:115192. [PMID: 31846824 DOI: 10.1016/j.bone.2019.115192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/22/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Abstract
It is well known that the bone response to physical activity is highly dependent on the nature of the loads imposed. Despite this, few direct comparisons of the effect of impact-style loading and resistance training on bone have been made. We therefore aimed to compare the effects of 10-month, twice-weekly, high-impact loading and 10-month, twice-weekly, high-intensity resistance training on indices of bone strength of both the upper and lower limbs of young adult women. Physically inactive, otherwise healthy, young adult women (18-30 years) with below average bone mass (T-score ≤ 0) were recruited as part of the OPTIMA-Ex trial. Testing included DXA- and pQCT-derived measures of bone mass and indices of bone strength and QUS-derived measures of bone quality of the dominant (D) and non-dominant (ND) upper (radius) and lower limbs (femoral neck, tibia, calcaneus). The present study examined those participants who completed the impact training (IT; n = 10) and resistance training (RT; n = 12) arms of the trial. Age differed between groups at baseline (IT = 23.2 ± 3.8 years, RT = 20.5 ± 1.8 years; p = 0.042). Compliance with the training programs did not differ (IT = 61.4 ± 15.1%, RT = 66.4 ± 11.2%, p = 0.381). Age and baseline differences in bone outcomes served as covariates for repeated measures and univariate ANCOVA conducted for dependent variables and percent change respectively. IT improved distal pQCT-derived bone mineral density (BMD) of the upper limb (ND radius: total BMD = 8.55 ± 2.26% versus 1.50 ± 2.04%, p = 0.040 and trabecular BMD = 1.86 ± 0.90% versus -1.30 ± 0.81%, p = 0.029) and lower limb (ND tibia trabecular BMD = 1.22 ± 0.55% versus -0.82 ± 0.50%, p = 0.017), more than RT. IT also improved upper limb bone strength index (BSI) (ND radius total BSI = 15.35 ± 2.83% versus 2.67 ± 2.55, p = 0.005) and lower limb BSI (D tibia total BSI = 5.16 ± 1.13% versus 0.37 ± 1.02%, p = 0.008; D tibia trabecular BSI = 3.93 ± 1.76% versus -2.84 ± 1.59, p = 0.014, ND tibia trabecular BSI = 3.57 ± 1.63% versus -3.15 ± 1.48%, p = 0.009) more than RT. Conversely, RT improved DXA-derived cortical volumetric BMD at the femoral neck more than IT (3.68 ± 1.99% versus -4.14 ± 2.20%, p = 0.021). Results suggest that IT and RT provide differing site-specific effects in both the upper and lower limbs, with superior bone responses observed at the distal segment from IT, while RT appeared to have greater effect on the shaft of the bone, on indices of bone-strength in young adult women.
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Affiliation(s)
- Conor Lambert
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia; The Bone Clinic, Brisbane, Queensland, Australia
| | - Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Steven L Watson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Benjamin K Weeks
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
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RANKL/RANK/OPG Pathway: A Mechanism Involved in Exercise-Induced Bone Remodeling. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6910312. [PMID: 32149122 PMCID: PMC7053481 DOI: 10.1155/2020/6910312] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 01/06/2020] [Indexed: 12/21/2022]
Abstract
Bones as an alive organ consist of about 70% mineral and 30% organic component. About 200 million people are suffering from osteopenia and osteoporosis around the world. There are multiple ways of protecting bone from endogenous and exogenous risk factors. Planned physical activity is another useful way for protecting bone health. It has been investigated that arranged exercise would effectively regulate bone metabolism. Until now, a number of systems have discovered how exercise could help bone health. Previous studies reported different mechanisms of the effect of exercise on bone health by modulation of bone remodeling. However, the regulation of RANKL/RANK/OPG pathway in exercise and physical performance as one of the most important remodeling systems is not considered comprehensive in previous evidence. Therefore, the aim of this review is to clarify exercise influence on bone modeling and remodeling, with a concentration on its role in regulating RANKL/RANK/OPG pathway.
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Honda A, Kon M, Matsubayashi T, Suzuki Y. Short-Term Intermittent Hypoxic Resistance Training Does Not Impair Osteogenic Response in Sea Level Residents. High Alt Med Biol 2020; 21:160-166. [PMID: 32013568 DOI: 10.1089/ham.2019.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Osteogenic responses induced by training under hypoxia remain unclear. We aimed to investigate whether intermittent hypoxic resistance training affects osteogenic responses. Materials and Methods: Sixteen male participants underwent resistance training under normoxia (NRT; n = 7) or hypoxia (HRT; O2 = 14.4%, n = 9), twice a week for 8 weeks. The HRT group exercised and rested for 30 minutes under hypoxia, with total hypoxic exposure time in one session of ∼60 minutes. At pre- and postexperiment, bone mineral density (BMD) of the whole body and right proximal femur was measured. At the first and last training sessions, bone alkaline phosphatase (BAP), osteocalcin (OC), cross-linked N-telopeptide of type I collagen (NTx), type I collagen cross-linked C-telopeptide (ICTP), interleukin-6 (IL-6), and blood lactate (La) concentration were analyzed at rest and postexercise. Results: BMD did not change with training and hypoxia. Although BAP, OC, and ICTP levels at rest significantly increased with training (p < 0.01, 0.05, and 0.05, respectively), they did not change with hypoxia. NTx and IL-6 did not change. Additionally, changing patterns of bone markers and La induced by a single bout of exercise were similar among groups in both training sessions. Conclusions: Short-term resistance training enhanced overall bone metabolism, regardless of the oxygen level. Hypoxia has no effects on osteogenic responses.
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Affiliation(s)
- Akiko Honda
- Department of Health and Sport Sciences, School of Health Sciences, Asahi University, Mizuho, Japan
| | - Michihiro Kon
- School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Takeo Matsubayashi
- Department of Sports Sciences, Japan Institute of Sports Sciences, Kita-ku, Japan
| | - Yasuhiro Suzuki
- Department of Sports Sciences, Japan Institute of Sports Sciences, Kita-ku, Japan
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29
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Avila JAD, Avila RAD, Gonçalves EM, Guerra Junior G. Influence of physical training on bone mineral density in healthy young adults: a systematic review. ACTA ACUST UNITED AC 2019; 65:1102-1106. [PMID: 31531609 DOI: 10.1590/1806-9282.65.8.1102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/13/2019] [Indexed: 11/22/2022]
Affiliation(s)
- Josiel Almeida de Avila
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
| | - Rafael Almeida de Avila
- Faculdade de Ciências Médicas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Ezequiel Moreira Gonçalves
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
| | - Gil Guerra Junior
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
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30
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de Avila JA, Melloni MAS, Pascoa MA, Cirolini VX, Barbeta CJDO, de Avila RA, Gonçalves EM, Guerra-Junior G. Effect of 7 Months of Physical Training and Military Routine on the Bone Mass of Young Adults. Mil Med 2019; 184:e353-e359. [PMID: 30793203 DOI: 10.1093/milmed/usz001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Physical activity (PA) has a great influence on bone mineral density (BMD) and bone mineral content (BMC), however longitudinal studies that seek to relate bone mass to physical activity are scarce and have a small sample size. The aim of this study was to evaluate and compare the effect of 7 months of military physical training (MPT), impact sports (IS), and swimming in the bone mass of young military adults. MATERIALS AND METHODS A prospective study was conducted with 213 military school students (male and aged 19.2 ± 1.2 years) divided into three groups: MPT (n = 144), IS (n = 56), and Swimming (n = 13). Dual-energy X-ray absorptiometry was used to determine body composition (percentage of fat, fat mass, and fat-free mass) and bone mass (BMD, BMD Z-Score, total BMC, arm BMC, leg BMC, and trunk BMC), at the beginning of the military service and after 7 months of training. RESULTS It was observed a significant increase in BMD, BMD Z-Score, total BMC and BMC of all segments analyzed for all groups (p < 0.01). There was a significantly greater variation in BMD of the IS group in relation to the MPT group (p < 0.01), and in the arm BMC of the MPT group in relation to the IS group (p < 0.05). CONCLUSION After 7 months of training, there were significant increases in BMC and BMD of all the groups evaluated. The bone response was associated with the muscular group used in the physical exercise and the IS group showed greater gain in BMD.
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Affiliation(s)
- Josiel Almeida de Avila
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Mauro Augusto Schreiter Melloni
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Mauro Alexandre Pascoa
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Vagner Xavier Cirolini
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Camila Justino de Oliveira Barbeta
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Rafael Almeida de Avila
- Faculty of Medical Sciences, Federal University of Santa Maria (UFSM), 1000 Roraima Avenue, Cidade Universitária, Camobi, 97105-900 - Santa Maria, Rio Grande do Sul, Brazil
| | - Ezequiel Moreira Gonçalves
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
| | - Gil Guerra-Junior
- Growth and Body Composition Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo Rue, Cidade Universitária Zeferino Vaz, 13083-887 - Campinas, São Paulo, Brazil
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Koundourakis NE, Androulakis N, Dermitzaki E, Venihaki M, Margioris AN. Effect of a 6-week supervised detraining period on bone metabolism markers and their association with ergometrics and components of the hypothalamic-pituitary-gonadal (HPG) axis in professional male soccer players. J Bone Miner Metab 2019; 37:512-519. [PMID: 30187272 DOI: 10.1007/s00774-018-0947-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 08/07/2018] [Indexed: 01/12/2023]
Abstract
The aim of this study was to examine the effect of a supervised 6-week detraining period on bone metabolism markers, and their association with ergometrics, and components of the hypothalamic-pituitary-gonadal (HPG) axis in elite male professional soccer players. Sixty-seven soccer players (mean age ± SD 23.4 ± 5.2 years) that were following a supervised training program participated in this study. Players were tested twice: immediately after the conclusion of the competition period, and following the detraining period, for the determination of bone-turnover rates, ergometrics, and components of the HPG-axis. The detraining period resulted in significant reduction in osteocalcin [OC] (p < 0.001), C-terminal propeptide of collagen type-I [CICP] (p = 0.002), and bone-alkaline-phosphatase [b-ALP] (p < 0.001) values, while C-terminal telopeptide [CTX] was increased (p < 0.001). No significant relationships were apparent between bone biomarkers and body weight, body-fat %, total testosterone, free testosterone, estradiol, follicle-stimulating hormone, and luteinizing hormone in both experimental sessions (p > 0.05). Similarly, despite the deterioration in ergometrics after detraining (all p < 0.001), no significant correlations were evident (p > 0.05) between bone biomarkers and maximal oxygen consumption, squat jump, countermovement jump, and 20 m sprint performance, and also between % change of bone biomarkers and ergometrics, apart from a weak relationship (p = 0.041) between OC and VO2max of questionable value. Our results suggest that the 6-week soccer off-season detraining period in our study negatively affected bone physiology as reflected by the suppression of bone-formation rate and a parallel induction of bone resorption. The cause of this acute alteration of bone-turnover rates is not related to the examined components of the HPG-axis, although parallels is not associated with the changes in ergometrics.
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Affiliation(s)
- Nikolaos E Koundourakis
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | - Nikolaos Androulakis
- Department of Hematology Laboratory, University Hospital, Heraklion, Crete, Greece
| | - Eirini Dermitzaki
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Maria Venihaki
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Andrew N Margioris
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
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Chien KY, Chang WG, Sanders ME, Chen CH, Wu WC, Chen WC. Effects of land vs water jump exercise: Implications for exercise design targeting bone health. Scand J Med Sci Sports 2019; 29:826-834. [PMID: 30779462 DOI: 10.1111/sms.13410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE To quantify ground reaction force (GRF), osteogenic index (OI), muscle activity, and blood lactate levels during continuous jumping performed in water and on land. METHODS Thirteen post-menopausal women (59.5 ± 6.8 years) performed two bouts of jumping, on land (LND) and in water at a depth of 1 m (WEX). Each 10-minute, 40-second bout consisted of 2 consecutive sets of squat, lunge, jumping jax, countermovement, and single legged jumps as intervals: 10 seconds maximal effort and 60 seconds recovery at 50% of heart rate reserve (HRR). Pre- and post-exercise lower extremity rate of perceived exertion (RPE) was recorded, and 10-µL earlobe blood samples were collected to assess lactate concentration. During exercise, data were collected for electromyography, GRF, and heart rate. Total GRF (TGRF) and total muscular activity (TMA) during each 10 seconds of jumping were measured. OI for one bout of continued jumps was determined by averaging GRF·ln (number of jumps + 1). RESULTS There were no differences between WEX and LND for percent HRR and RPE. TGRF, OI, TMA, and lactate concentration on LND jumps were significantly higher than WEX. CONCLUSION At similar cardiorespiratory and RPE levels, the lower impact loading of 10 minutes 40 seconds of interval continuous jumping exercise in 1-m depth was less osteogenic than on land. However, one daily bout of water jumping, 5 days per week resulted in a similar OI as 3 days of jumping on land. WEX might substitute or provide an adjunct to LND exercise to promote bone health.
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Affiliation(s)
- Kuei-Yu Chien
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Wei-Gang Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan, Taiwan
| | - Mary E Sanders
- School of Medicine & Community Health Sciences, University of Nevada, Reno, Nevada
| | - Chia-Hsin Chen
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan, Taiwan
| | - Wan-Chun Wu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Wan-Chin Chen
- Graduate Institute of Sports Equipment Technology, University of Taipei, Taipei, Taiwan
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Buskermolen J, van der Meijden K, Furrer R, Mons DJ, van Essen HW, Heijboer AC, Lips P, Jaspers RT, Bravenboer N. Effects of different training modalities on phosphate homeostasis and local vitamin D metabolism in rat bone. PeerJ 2019; 7:e6184. [PMID: 30697476 PMCID: PMC6348094 DOI: 10.7717/peerj.6184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/29/2018] [Indexed: 01/31/2023] Open
Abstract
Objectives Mechanical loading may be an important factor in the regulation of bone derived hormones involved in phosphate homeostasis. This study investigated the effects of peak power and endurance training on expression levels of fibroblast growth factor 23 (FGF23) and 1α-hydroxylase (CYP27b1) in bone. Methods Thirty-eight rats were assigned to six weeks of training in four groups: peak power (PT), endurance (ET), PT followed by ET (PET) or no training (control). In cortical bone, FGF23 was quantified using immunohistochemistry. mRNA expression levels of proteins involved in phosphate and vitamin D homeostasis were quantified in cortical bone and kidney. C-terminal FGF23, 25-hydroxyvitamin D3, parathyroid hormone (PTH), calcium and phosphate concentrations were measured in plasma or serum. Results Neither FGF23 mRNA and protein expression levels in cortical bone nor FGF23 plasma concentrations differed between the groups. In cortical bone, mRNA expression levels of sclerostin (SOST), dental matrix protein 1 (DMP1), phosphate-regulating gene with homologies to endopeptidases on the X chromosome (PHEX) and matrix extracellular phosphoglycoprotein (MEPE) were lower after PT compared to ET and PET. Expression levels of CYP27b1 and vitamin D receptor (VDR) in tibial bone were decreased after PT compared to ET. In kidney, no differences between groups were observed for mRNA expression levels of CYP27b1, 24-hydroxylase (CYP24), VDR, NaPi-IIa cotransporter (NPT2a) and NaPi-IIc cotransporter (NPT2c). Serum PTH concentrations were higher after PT compared to controls. Conclusion After six weeks, none of the training modalities induced changes in FGF23 expression levels. However, PT might have caused changes in local phosphate regulation within bone compared to ET and PET. CYP27b1 and VDR expression in bone was reduced after PT compared to ET, suggesting high intensity peak power training in this rat model is associated with decreased vitamin D signalling in bone.
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Affiliation(s)
- Joost Buskermolen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Karen van der Meijden
- Department of Internal Medicine/Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Regula Furrer
- Laboratory for Myology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Dirk-Jan Mons
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Huib W van Essen
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Lips
- Department of Internal Medicine/Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Richard T Jaspers
- Laboratory for Myology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Nathalie Bravenboer
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
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The effects of concurrent training (aerobic-resistance) and milk consumption on some markers of bone mineral density in women with osteoporosis. BMC WOMENS HEALTH 2018; 18:202. [PMID: 30558600 PMCID: PMC6296016 DOI: 10.1186/s12905-018-0694-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 11/27/2018] [Indexed: 01/10/2023]
Abstract
Background Osteoporosis is a skeletal metabolic disorder characterized by low bone mineral density (BMD) and reduced bone strength leading to higher bone fractures risk. The present study attempted to investigate the effects of concurrent training (aerobic-resistance) and milk consumption on some markers of BMD in women with osteoporosis. Methods For this purpose, forty women diagnosed with osteoporosis within an age range of 30-45 years were divided into four groups of ten including concurrent training-milk, concurrent training, milk consumption and control group. The concurrent exercises were performed in ten weeks with three sessions in each week including aerobic training (running at 55–75% of maximum heart rate) and resistance training (4 move in a circle performed two times with 10 repetition maximum (RM)). Milk consumption was two times of 250 ml per day in ten weeks. Before and after treatment, BMDs in the hip and lumbar spine area were estimated with Dual-energy X-ray absorptiometry (DEXA) device and 5 cc blood was taken from a vein in the arm to determine the blood levels of 25-hydroxyvitamin D (25OH-D) and alkaline phosphatase (ALP). Results Based on the results, blood levels 25OH-D and ALP significantly increased in concurrent training-milk, concurrent training and milk group with higher increase in concurrent training-milk group (P < 0.05). Furthermore, the right and left hip BMD in concurrent training-milk and concurrent training groups increased significantly with higher increase in concurrent training-milk group (p < 0.05). Also, lumbar spine BMD increased significantly in concurrent training-milk and concurrent training (p < 0.05). Conclusions It seems that combination of concurrent training and milk consumption has more efficient impacts on the BMD of young women diagnosed with osteoporosis compared to the milk or concurrent training groups alone. This treatment can be used as an effective way to improve BMD in young women with diagnosed osteoporosis.
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Montgomery G, Abt G, Dobson C, Smith T, Evans W, Ditroilo M. The mechanical loading and muscle activation of four common exercises used in osteoporosis prevention for early postmenopausal women. J Electromyogr Kinesiol 2018; 44:124-131. [PMID: 30611015 DOI: 10.1016/j.jelekin.2018.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022] Open
Abstract
High impact exercise can reduce postmenopausal bone loss, however stimulus frequency (loading cycles per second) can affect osteogenesis. We aimed to examine the effect of stimulus frequency on the mechanical loading of four common osteoporosis prevention exercises, measuring body acceleration and muscle activation with accelerometry and electromyography (EMG), respectively. Fourteen early postmenopausal women completed randomised countermovement jumps (CMJ), box-drops (BD), heel-drops (HD) and stamp (STP) exercises for continuous and intermittent stimulus frequencies. Sacrum accelerometry and surface electromyography (EMG) of four muscles were recorded. CMJ (mean ± SD: 10.7 ± 4.8 g & 10.0 ± 5.0 g), BD (9.6 ± 4.1 g & 9.5 ± 4.0 g) and HD (7.3 ± 3.8 g & 8.6 ± 4.4 g) conditions generated greater peak acceleration than STP (3.5 ± 1.4 g & 3.6 ± 1.7 g) across continuous and intermittent trials. CMJ and BD generated greater acceleration gradients than STP across continuous and intermittent trials. CMJ generated greater rectus femoris EMG than all other exercises, CMJ and BD generated greater semitendinosus and tibialis anterior EMG than HD across continuous and intermittent trials. CMJ and BD provide greater peak acceleration than STP and remain similar during different stimulus frequencies. CMJ, BD and HD may exceed STP in maintaining postmenopausal bone health.
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Affiliation(s)
- G Montgomery
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK.
| | - G Abt
- School of Life Sciences, The University of Hull, Hull, UK
| | - C Dobson
- School of Engineering and Computer Science, The University of Hull, Hull, UK
| | - T Smith
- Faculty of Education, Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - W Evans
- University of Sunderland, Faculty of Applied Sciences, Department of Sport and Exercise Sciences, Sunderland, UK
| | - M Ditroilo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Duplanty AA, Levitt DE, Hill DW, McFarlin BK, DiMarco NM, Vingren JL. Resistance Training Is Associated With Higher Bone Mineral Density Among Young Adult Male Distance Runners Independent of Physiological Factors. J Strength Cond Res 2018; 32:1594-1600. [PMID: 29470364 DOI: 10.1519/jsc.0000000000002504] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Duplanty, AA, Levitt, DE, Hill, DW, McFarlin, BK, DiMarco, NM, and Vingren, JL. Resistance training is associated with higher bone mineral density among young adult male distance runners independent of physiological factors. J Strength Cond Res 32(6): 1594-1600, 2018-Low bone mineral density (BMD) in male distance runners is common and could be modulated by a host of biomarkers involved in the dynamic balance of bone tissue. In contrast, resistance training can increase BMD; however, the efficacy of resistance training in protecting BMD in distance runners has not been elucidated. The aim of this study was to investigate the relationship between resistance training, testosterone and bone metabolism biomarker concentrations, and BMD in young adult male distance runners. Twenty-five apparently healthy men (23-32 years; mean ± SD: 25.9 ± 2.9 years; 1.77 ± 0.04 m; 75.4 ± 8.5 kg) were categorized into 1 of 3 groups: untrained control participants (CON; n = 8); nonresistance-trained runners (NRT; n = 8); or resistance-trained runners (RT; n = 9). Blood was collected and analyzed for concentrations of free and total testosterone and 14 bone metabolism biomarkers. Bone mineral density was assessed using dual-energy X-ray absorptiometry. At all measured sites, BMD was greater (p ≤ 0.05) for RT compared with NRT and CON. Vitamin D concentration was greater (p ≤ 0.05) in RT and NRT compared with CON. Concentrations of testosterone and remaining bone biomarkers did not differ between groups (p > 0.05). Resistance-trained runners had greater BMD than nonresistance-trained runners and untrained peers. This difference did not seem to be modulated by biomarkers that contribute to bone formation or resorption, indicating that differences in BMD are associated with habitual load-bearing exercise using external resistance. Runners should perform resistance exercise at least once per week because this is associated with greater BMD.
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Affiliation(s)
- Anthony A Duplanty
- Department of Kinesiology, Texas Woman's University, Denton, Texas.,Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas.,Department of Biological Sciences, University of North Texas, Denton, Texas
| | - Danielle E Levitt
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas.,Department of Biological Sciences, University of North Texas, Denton, Texas
| | - David W Hill
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas
| | - Brian K McFarlin
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas.,Department of Biological Sciences, University of North Texas, Denton, Texas
| | - Nancy M DiMarco
- Institute for Women's Health, Texas Woman's University, Denton, Texas
| | - Jakob L Vingren
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas.,Department of Biological Sciences, University of North Texas, Denton, Texas
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Hughes JM, Gaffney-Stomberg E, Guerriere KI, Taylor KM, Popp KL, Xu C, Unnikrishnan G, Staab JS, Matheny RW, McClung JP, Reifman J, Bouxsein ML. Changes in tibial bone microarchitecture in female recruits in response to 8 weeks of U.S. Army Basic Combat Training. Bone 2018; 113:9-16. [PMID: 29709620 DOI: 10.1016/j.bone.2018.04.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/19/2018] [Accepted: 04/23/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND U.S. Army Basic Combat Training (BCT) is a physically-demanding program at the start of military service. Whereas animal studies have shown that increased mechanical loading rapidly alters bone structure, there is limited evidence of changes in bone density and structure in humans exposed to a brief period of unaccustomed physical activity. PURPOSE We aimed to characterize changes in tibial bone density and microarchitecture and serum-based biochemical markers of bone metabolism in female recruits as a result of 8 weeks of BCT. METHODS We collected high-resolution peripheral quantitative computed tomographic images of the distal tibial metaphysis and diaphysis (4% and 30% of tibia length from the distal growth plate, respectively) and serum markers of bone metabolism before and after BCT. Linear mixed models were used to estimate the mean difference for each outcome from pre- to post-BCT, while controlling for race/ethnicity, age, and body mass index. RESULTS 91 female BCT recruits volunteered and completed this observational study (age = 21.5 ± 3.3 yrs). At the distal tibial metaphysis, cortical thickness, trabecular thickness, trabecular number, bone volume/total volume, and total and trabecular volumetric bone density (vBMD) increased significantly by 1-2% (all p < 0.05) over the BCT period, whereas trabecular separation, cortical tissue mineral density (TMD), and cortical vBMD decreased significantly by 0.3-1.0% (all p < 0.05). At the tibial diaphysis, cortical vBMD and cortical TMD decreased significantly (both -0.7%, p < 0.001). Bone strength, estimated by micro finite element analysis, increased by 2.5% and 0.7% at the distal tibial metaphysis and diaphysis, respectively (both p < 0.05). Among the biochemical markers of bone metabolism, sclerostin decreased (-5.7%), whereas bone alkaline phosphatase, C-telopeptide cross-links of type 1 collagen, tartrate-resistance acid phosphatase, and 25(OH)D increased by 10-28% (all p < 0.05). CONCLUSION BCT leads to improvements in trabecular bone microarchitecture and increases in serum bone formation markers indicative of new bone formation, as well as increases in serum bone resorption markers and decreases in cortical vBMD consistent with intracortical remodeling. Together, these results demonstrate specific changes in trabecular and cortical bone density and microarchitecture following 8 weeks of unaccustomed physical activity in women.
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Affiliation(s)
- Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States.
| | - Erin Gaffney-Stomberg
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States
| | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States
| | - Kathryn M Taylor
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States
| | - Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Chun Xu
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, United States
| | - Ginu Unnikrishnan
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, United States
| | - Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States
| | - Ronald W Matheny
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, 01760, United States
| | - James P McClung
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, United States
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, United States
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02215, United States
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Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical Activity and Exercise on Women's Bone Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E878. [PMID: 29710770 PMCID: PMC5981917 DOI: 10.3390/ijerph15050878] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022]
Abstract
In 2011 over 1.7 million people were hospitalized because of a fragility fracture, and direct costs associated with osteoporosis treatment exceeded 70 billion dollars in the United States. Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor in determining fragility fracture risk later in life. Physical activity is a widely accessible, low cost, and highly modifiable contributor to bone health. Exercise is especially effective during adolescence, a time period when nearly 50% of peak adult bone mass is gained. Here, we review the evidence linking exercise and physical activity to bone health in women. Bone structure and quality will be discussed, especially in the context of clinical diagnosis of osteoporosis. We review the mechanisms governing bone metabolism in the context of physical activity and exercise. Questions such as, when during life is exercise most effective, and what specific types of exercises improve bone health, are addressed. Finally, we discuss some emerging areas of research on this topic, and summarize areas of need and opportunity.
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Affiliation(s)
- Karen L Troy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Megan E Mancuso
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Tiffiny A Butler
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Joshua E Johnson
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
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DuPont WH, Kraemer WJ, Nindl BC, Lee EC, Fragala MS, Hatfield DL, Caldwell LK, Post EM, Beeler MK, Volek JS, Maresh CM. The effects of different exercise training modalities on plasma proenkephalin Peptide F in women. Peptides 2017; 91:26-32. [PMID: 28263851 DOI: 10.1016/j.peptides.2017.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/13/2017] [Accepted: 02/16/2017] [Indexed: 12/16/2022]
Abstract
Due to the important interactions of proenkephalin fragments (e.g., proenkephalin [107-140] Peptide F) to enhance activation of immune cells and potentially combat pain associated with exercise-induced muscle tissue damage, we examined the differential plasma responses of Peptide F to different exercise training programs. Participants were tested pre-training (T1), and after 8 weeks (T2) of training. Fifty-nine healthy women were matched and then randomly assigned to one of four groups: heavy resistance strength training (STR, n=18), high intensity endurance training (END, n=14), combined strength and endurance training (CMB, n=17), or control (CON, n=10). Blood was collected using a cannula inserted into a superficial vein in the antecubital fossa with samples collected at rest and immediately after an acute bout of 6 X 10 RM in a squat resistance exercise before training and after training. Prior to any training, no significant differences were observed for any of the groups before or after acute exercise. With training, significant (P≤0.95) elevations were observed with acute exercise in each of the exercise training groups and this effect was significantly greater in the CMB group. These data indicate that in untrained women exercise training will not change resting of plasma Peptide F concentrations unless both forms of exercise are performed but will result in significant increases in the immediate post-exercise responses. Such findings appear to indicate adrenal medullary adaptations opioid production significantly altered with exercise training.
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Affiliation(s)
- William H DuPont
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States.
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Elaine C Lee
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | | | - Disa L Hatfield
- Department of Kinesiology, University of Rhode Island, Kingston, RI, United States
| | - Lydia K Caldwell
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Emily M Post
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Matthew K Beeler
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Jeff S Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Carl M Maresh
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
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Xiao C. Reply to: Comment on "Effects of Elastic Resistance Band Exercise on Postural Balance, Estrogen, Bone Metabolism Index, and Muscle Strength of Perimenopausal Period Women". J Am Geriatr Soc 2017; 65:881-882. [PMID: 28152159 DOI: 10.1111/jgs.14749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chunmei Xiao
- Department of Health Promotion and Physical Education, Beijing Institute of Graphic Communication, Beijing, China
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Wen HJ, Huang TH, Li TL, Chong PN, Ang BS. Effects of short-term step aerobics exercise on bone metabolism and functional fitness in postmenopausal women with low bone mass. Osteoporos Int 2017; 28:539-547. [PMID: 27613719 DOI: 10.1007/s00198-016-3759-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 08/25/2016] [Indexed: 01/22/2023]
Abstract
UNLABELLED Measurement of bone turnover markers is an alternative way to determine the effects of exercise on bone health. A 10-week group-based step aerobics exercise significantly improved functional fitness in postmenopausal women with low bone mass, and showed a positive trend in reducing resorption activity via bone turnover markers. INTRODUCTION The major goal of this study was to determine the effects of short-term group-based step aerobics (GBSA) exercise on the bone metabolism, bone mineral density (BMD), and functional fitness of postmenopausal women (PMW) with low bone mass. METHODS Forty-eight PMW (aged 58.2 ± 3.5 years) with low bone mass (lumbar spine BMD T-score of -2.00 ± 0.67) were recruited and randomly assigned to an exercise group (EG) or to a control group (CG). Participants from the EG attended a progressive 10-week GBSA exercise at an intensity of 75-85 % of heart rate reserve, 90 min per session, and three sessions per week. Serum bone metabolic markers (C-terminal telopeptide of type 1 collagen [CTX] and osteocalcin), BMD, and functional fitness components were measured before and after the training program. Mixed-models repeated measures method was used to compare differences between the groups (α = 0.05). RESULTS After the 10-week intervention period, there was no significant exercise program by time interaction for CTX; however, the percent change for CTX was significantly different between the groups (EG = -13.1 ± 24.4 % vs. CG = 11.0 ± 51.5 %, P < 0.05). While there was no significant change of osteocalcin in both groups. As expected, there was no significant change of BMD in both groups. In addition, the functional fitness components in the EG were significantly improved, as demonstrated by substantial enhancement in both lower- and upper-limb muscular strength and cardiovascular endurance (P < 0.05). CONCLUSION The current short-term GBSA exercise benefited to bone metabolism and general health by significantly reduced bone resorption activity and improved functional fitness in PMW with low bone mass. This suggested GBSA could be adopted as a form of group-based exercise for senior community.
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Affiliation(s)
- H J Wen
- Center of Physical Education, Tzu Chi University, No. 701, Sec. 3, Zhongyang Rd., Hualien, 970, Taiwan.
| | - T H Huang
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, No. 1, Daxue Rd., East District, Tainan City, 701, Taiwan
| | - T L Li
- Department of Sport Promotion, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Guishan District, Taoyuan City, 333, Taiwan
| | - P N Chong
- Department of Radiology, Tzu Chi Hospital, No. 707, Sec. 3, Zhongyang Rd., Hualien City, 970, Taiwan
| | - B S Ang
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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Verniba D, Vescovi JD, Hood DA, Gage WH. The analysis of knee joint loading during drop landing from different heights and under different instruction sets in healthy males. SPORTS MEDICINE-OPEN 2017; 3:6. [PMID: 28101732 PMCID: PMC5243232 DOI: 10.1186/s40798-016-0072-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 12/20/2016] [Indexed: 11/29/2022]
Abstract
Background Mechanical loading during exercise has been shown to promote tissue remodeling. Safe and accessible exercise may be beneficial to populations at risk of diminished bone and joint health. We examined the effect of drop height and instruction on knee loading during a drop-landing task and proposed a task that makes use of drop heights that may be appropriate for rehabilitation purposes and functional in daily life to examine transient knee joint loads. Methods Twenty males (22.0 ± 2.8 years) performed drop landings from 22 cm (low) and 44 cm (high) heights, each under three instructions: “land naturally” (natural), “softly” (soft), and “stiffly” (stiff). Knee compression force and external flexion moment were estimated using three-dimensional inverse dynamics and normalized to body mass. Results Peak knee compression force was larger (p < 0.001) for high (17.8 ± 0.63 N/kg) than low (14.8 ± 0.61 N/kg) heights. There was an increase (p < 0.001) in the knee compression force across soft (11.8 ± 0.40 N/kg), natural (17.0 ± 0.62 N/kg), and stiff (20.2 ± 0.67 N/kg) instructions. Peak knee flexion moment in high-natural (2.12 ± 0.08 Nm/kg) was larger (p < 0.001) than in high-soft (1.88 ± 0.08 Nm/kg), but lower than in high-stiff (2.23 ± 0.08 Nm/kg). No differences in peak knee flexion moment were observed across instructions for the low height. Conclusions We propose a drop-landing task that creates a scalable increase in knee compression loading. The absence of increased knee flexion moment with drop from the low height, compared to high, suggests that individuals could perform the task without incremental risk of knee injury. This task could be used in future studies to examine the effect of acute bouts of mechanical loading on bone and cartilage metabolism.
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Affiliation(s)
- Dmitry Verniba
- Orthopaedic Neuromechanics Laboratory, Sherman Health Science Research Centre, York University, Toronto, Ontario, Canada. .,Muscle Health Research Centre, York University, Toronto, Ontario, Canada. .,School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
| | - Jason D Vescovi
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - David A Hood
- Muscle Health Research Centre, York University, Toronto, Ontario, Canada.,School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - William H Gage
- Orthopaedic Neuromechanics Laboratory, Sherman Health Science Research Centre, York University, Toronto, Ontario, Canada.,Muscle Health Research Centre, York University, Toronto, Ontario, Canada.,School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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Bordbar MR, Haghpanah S, Dabbaghmanesh MH, Omrani GR, Saki F. Bone mineral density in children with acute leukemia and its associated factors in Iran: a case-control study. Arch Osteoporos 2016; 11:36. [PMID: 27785744 DOI: 10.1007/s11657-016-0290-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/18/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED Acute leukemia is the most common malignancy in children. We showed that low bone mass is prevalent among children with leukemia, especially in femur. Serum calcium, exercise, chemotherapy protocol, and radiotherapy are the main contributing factors. We suggest that early diagnosis and treatment of this problem could improve bone health in them. INTRODUCTION Acute leukemia is the most common malignancy in children and has been reported to be associated with low bone mass. Due to lack of sufficient data about the bone mineral density of children with leukemia in the Middle East, and inconsistencies between possible associated factors contributing to decreasing bone density in these children, we aimed to conduct a case-control study in Iran. MATERIALS AND METHODS This case-control study was conducted on 60 children with acute leukemia and 60 age- and sex-matched healthy controls. Anthropometric data, sun exposure, puberty, physical activity, and mineral biochemical parameters were assessed. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). Data analysis was done by SPSS software v. 21. RESULTS Serum calcium was higher in the control group (P = 0.012) while serum phosphorous, alkaline phosphatase, and serum 25(OH)D3 were higher in children with leukemia with P values of 0.04, 0.002, and 0.036, respectively. Sun exposure and physical activity were more in healthy controls (P values <0.001 and 0.003, respectively). Prevalence of vitamin D deficiency in case and control groups was 57.8 and 79.4 %, respectively. This prevalence was higher in healthy controls (P value = 0.007). Both lumbar and femoral neck bone mineral apparent density (BMAD) were higher in the control group (P value <0.001). Serum calcium, physical activity, and radiotherapy were the most relevant factors associated with lumbar BMAD. Femoral neck BMAD was associated with chemotherapy protocol. CONCLUSION Low bone mass for chronological age is prevalent among children with leukemia, especially in the femoral neck. Serum calcium, physical activity, chemotherapy protocol, and radiotherapy are the main contributing factors.
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Affiliation(s)
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Forough Saki
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Yuan Y, Chen X, Zhang L, Wu J, Guo J, Zou D, Chen B, Sun Z, Shen C, Zou J. The roles of exercise in bone remodeling and in prevention and treatment of osteoporosis. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2016; 122:122-130. [DOI: 10.1016/j.pbiomolbio.2015.11.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 12/23/2022]
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Mustian KM, Cole CL, Lin PJ, Asare M, Fung C, Janelsins MC, Kamen CS, Peppone LJ, Magnuson A. Exercise Recommendations for the Management of Symptoms Clusters Resulting From Cancer and Cancer Treatments. Semin Oncol Nurs 2016; 32:383-393. [PMID: 27776835 DOI: 10.1016/j.soncn.2016.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To review existing exercise guidelines for cancer patients and survivors for the management of symptom clusters. DATA SOURCES Review of PubMed literature and published exercise guidelines. CONCLUSION Cancer and its treatments are responsible for a copious number of incapacitating symptoms that markedly impair quality of life. The exercise oncology literature provides consistent support for the safety and efficacy of exercise interventions in managing cancer- and treatment-related symptoms, as well as improving quality of life in cancer patients and survivors. IMPLICATIONS FOR NURSING PRACTICE Effective management of symptoms enhances recovery, resumption of normal life activities and quality of life for patients and survivors. Exercise is a safe, appropriate, and effective therapeutic option before, during, and after the completion of treatment for alleviating symptoms and symptom clusters.
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Kim JE, Moon H, Jin HM. The effects of exercise training and type of exercise training on changes in bone mineral denstiy in Korean postmenopausal women: a systematic review. J Exerc Nutrition Biochem 2016; 20:7-15. [PMID: 27757382 PMCID: PMC5067416 DOI: 10.20463/jenb.2016.09.20.3.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/22/2022] Open
Abstract
[Purpose] To systematically review the effects of exercise training and the type of exercise training on changes in bone mineral density (BMD) in Korean postmenopausal women. [Methods] Korean studies Information Service System (KISS) and PubMed were searched and 17 randomized control trials were selected. Changes in BMD of lumbar spine (LS), femur neck (FN), Ward’s triangle (WT), and trochanter (Tro) were chosen as major outcomes. [Results] Exercise training increased BMD of LS, FN, WT, and Tro. According to the type of exercise training, combined exercise training (aerobic + resistance) showed improvements in BMD of LS, FN, WT, and Tro. However, aerobic exercise training alone and resistance exercise training alone showed inconsistent results. [Conclusion] Exercise training can improve the BMD of LS, FN, WT, and Tro in Korean postmenopausal women. The type of exercise training may be a crucial factor for maintaining or improving bone health of this population.
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Affiliation(s)
- Jung Eun Kim
- Department of Nutrition Science, Purdue University, West Lafayette, IN USA
| | - Hwasil Moon
- Division of Kinesiology & Sport Studies, Ewha Womans University, Seoul Republic of Korea
| | - Haeng Mi Jin
- Department of Sport Rehabilitation, The Graduate School of Alternative Medicine, Kyonggi University, Seoul Republic of Korea
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Abd El-Kader SM, Al-Jiffri OH, Ashmawy EM, Gaowgzeh RAM. Treadmill walking exercise modulates bone mineral status and inflammatory cytokines in obese asthmatic patients with long term intake of corticosteroids. Afr Health Sci 2016; 16:798-808. [PMID: 27917214 DOI: 10.4314/ahs.v16i3.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Obesity and asthma are an important public health problem in Saudi Arabia. An increasing body of data supports the hypothesis that obesity is a risk factor for asthma. Asthma appears to be associated with low bone mineral density (BMD) due to long-term use of corticosteroids. Studies recently showed that weight bearing exercise training can increase mineral bone density, reduce weight and improve metabolic control. OBJECTIVE The present study aimed to measure the effects of treadmill walking exercises on bone mineral status and inflammatory cytokines in obese asthmatic patients treated with long term intake of corticosteroids. METHODS Eighty obese asthmatic patients of both sexes, their age ranged from 41 to 53 years. Subjects were divided into two equal groups: training group (group A) received aerobic exercise training on treadmill for six months in addition to the medical treatment where, the control group (group B) received only the medical treatment. RESULTS The results of this study indicated a significant increase in BMD of the lumbar spine & the radius, serum calcium and high density lipoprotein cholesterol (HDL-c) & significant reduction in parathyroid hormone, leptin, tumor necrosis factor- alpha(TNF-α), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), low density lipoprotein cholesterol (LDL-c), triglycerides (TG) and body mass index (BMI) in group (A), while these changes were not significant in group (B).Also; there was a significant difference between both groups at the end of the study. CONCLUSION Treadmill walking exercise training is an effective treatment policy to improve bone mineral status and modulates inflammatory cytokines and blood lipids profile in obese asthmatic patients with long term intake of corticosteroids.
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Affiliation(s)
- Shehab M Abd El-Kader
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama H Al-Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eman M Ashmawy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Riziq Allah M Gaowgzeh
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Izard RM, Fraser WD, Negus C, Sale C, Greeves JP. Increased density and periosteal expansion of the tibia in young adult men following short-term arduous training. Bone 2016; 88:13-19. [PMID: 27046087 DOI: 10.1016/j.bone.2016.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 03/23/2016] [Accepted: 03/28/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Few human studies have reported early structural adaptations of bone to weight-bearing exercise, which provide a greater contribution to improved bone strength than increased density. This prospective study examined site- and regional-specific adaptations of the tibia during arduous training in a cohort of male military (infantry) recruits to better understand how bone responds in vivo to mechanical loading. METHODS Tibial bone density and geometry were measured in 90 British Army male recruits (ages 21±3years, height: 1.78±0.06m, body mass: 73.9±9.8kg) in weeks 1 (Baseline) and 10 of initial military training. Scans were performed at the 4%, 14%, 38% and 66% sites, measured from the distal end plate, using pQCT (XCT2000L, Stratec Pforzheim, Germany). Customised software (BAMPack, L-3 ATI) was used to examine whole bone cross-section and regional sectors. T-tests determined significant differences between time points (P<0.05). RESULTS Bone density of trabecular and cortical compartments increased significantly at all measured sites. Bone geometry (cortical area and thickness) and bone strength (i, MMi and BSI) at the diaphyseal sites (38 and 66%) were also significantly higher in week 10. Regional changes in density and geometry were largely observed in the anterior, medial-anterior and anterior-posterior sectors. Calf muscle density and area (66% site) increased significantly at week 10 (P<0.01). CONCLUSIONS In vivo mechanical loading improves bone strength of the human tibia by increased density and periosteal expansion, which varies by site and region of the bone. These changes may occur in response to the nature and distribution of forces originating from bending, torsional and shear stresses of military training. These improvements are observed early in training when the osteogenic stimulus is sufficient, which may be close to the fracture threshold in some individuals.
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Affiliation(s)
| | | | - Charles Negus
- L-3 ATI, Simulation, Engineering, and Testing, San Diego, CA, USA
| | - Craig Sale
- Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, UK
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Hespanhol Junior LC, Pillay JD, van Mechelen W, Verhagen E. Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults. Sports Med 2016; 45:1455-68. [PMID: 26178328 PMCID: PMC4579257 DOI: 10.1007/s40279-015-0359-y] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health. Objective The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults. Data Sources Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication. Study Selection Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18–65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups. Study Appraisal and Synthesis Methods Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes. Results After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60–90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1–2.5], body fat by 2.7 % (95 % CI 5.1–0.2), resting heart rate by 6.7 min−1 (95 % CI 10.3–3.0) and triglycerides by 16.9 mg dl−1 (95 % CI 28.1–5.6). Also, running significantly increased maximal oxygen uptake (VO2max) by 7.1 ml min−1 kg−1 (95 % CI 5.0–9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl−1 (95 % CI 1.2–5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training. Limitations It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis. Conclusions Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs. Electronic supplementary material The online version of this article (doi:10.1007/s40279-015-0359-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luiz Carlos Hespanhol Junior
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Julian David Pillay
- Department of Basic Medical Sciences, Durban University of Technology, PO Box 1334, Durban, 4001, South Africa.
| | - Willem van Mechelen
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Evert Verhagen
- Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Alghadir AH, Gabr SA, Al-Eisa ES, Alghadir MH. Correlation between bone mineral density and serum trace elements in response to supervised aerobic training in older adults. Clin Interv Aging 2016; 11:265-73. [PMID: 27013870 PMCID: PMC4778779 DOI: 10.2147/cia.s100566] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Life style and physical activity play a pivotal role in prevention and treatment of osteoporosis. The mechanism for better bone metabolism and improvement of physical disorders is not clear yet. Trace minerals such as Ca, Mn, Cu, and Zn are essential precursors for most vital biological process, especially those of bone health. Objective The main target of this study was evaluating the effective role of supervised aerobic exercise for 1 hour/day, 3 days/week for 12 weeks in the functions of trace elements in bone health through measuring bone mineral density (BMD), osteoporosis (T-score), bone markers, and trace element concentrations in healthy subjects aged 30–60 years with age average of 41.2±4.9. Methods A total of 100 healthy subjects (47 males, 53 females; age range 30–60 years) were recruited for this study. Based on dual-energy x-ray absorptiometry (DEXA) scan analysis, the participants were classified into three groups: normal (n=30), osteopenic (n=40), and osteoporotic (n=30). Following, 12 weeks of moderate aerobic exercise, bone-specific alkaline phosphatase (BAP), BMD, T-score, and trace elements such as Ca, Mn, Cu, and Zn were assessed at baseline and post-intervention. Results Significant improvement in serum BAP level, T-score, and BMD were observed in all participants following 12 weeks of moderate exercise. Participants with osteopenia and osteoporosis showed significant increase in serum Ca and Mn, along with decrease in serum Cu and Zn levels following 12 weeks of aerobic training. In control group, the improvements in serum trace elements and body mass index were significantly linked with the enhancement in the levels of BAP, BMD hip, and BMD spine. These results supported the preventive effects of moderate exercise in healthy subjects against osteoporosis. In both sexes, the changes in serum trace elements significantly correlated (P<0.05) with the improvement in BAP, BMD hip, BMD spine, and body mass index in all groups. Conclusion The observed changes in the levels of Ca, Mn, Cu, and Zn were shown to be positively correlated with improved bone mass density among control and osteoporosis subjects of both sexes. These results demonstrate that aerobic exercise of moderate intensity might protect bone and cartilage by regulation of body trace elements which are involved in the biosynthesis of bone matrix structures and inhibition of bone resorption process via a proposed anti-free radical mechanism.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia; Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Einas S Al-Eisa
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Muaz H Alghadir
- Department of Orthopedics, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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