Adolescent female handball players present greater bone mass content than soccer players: A cross-sectional study

Team sports practice and bone health: A systematic review and meta- analysis

The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators "AND", "OR", "NOT": (``men'' OR ``man'' OR ``women'' OR ``woman'') AND (``bone mineral density'' OR ``BMD'' OR ``bone mineral content'' OR ``BMC'' OR ``peak bone mass'' OR ``mechanical loading'' OR ``osteoporosis'' OR ``bone geometry'' OR ``bone resistance'') AND (``team sport'' OR ``sport'' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players''). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.

Comparison of bone mineral density between female amateur triathletes and nonathletes: A cross-sectional study

PURPOSE

Physical inactivity is considered an important risk factor for osteoporosis, however, some athletes performing extremely high training volumes can also develop bone mass loss. Moreover, the effect of total body mass or body surface area on bone mineral density remains controversial. Therefore, the aim of this study was to compare the absolute bone mineral density and bone mineral density adjusted to body surface area between amateur triathletes and nonactive women.

METHODS

Forty-two healthy women (23 amateur triathletes and 19 nonactive individuals) were evaluated for body composition using a dual-energy X-ray absorptiometry system.

RESULTS

Compared to nonactive women, amateur triathletes exhibited lower body mass index (p < 0.001), lower bone mineral density (p < 0.001), and body surface area (p < 0.001). However, bone mineral density adjusted by body surface area in the triathletes was higher than in the nonactive women (p = 0.03).

CONCLUSION

These findings showed that amateur triathles presented lower absolute bone mineral density, but higher bone mineral density adjusted to body surface area. Future studies are recommended to identify if the higher bone mineral density adjusted to body surface area are associated with a lower bone fragility.

Comparison of Knee Muscular Strength Balance among Pre- and Post-Puberty Adolescent Swimmers: A Cross-Sectional Pilot Study

Muscular weakness and strength imbalance between the thigh muscles are considered risk factors for knee injuries. Hormonal changes, characteristic of puberty, strongly affect muscle strength; however, it is unknown whether they affect muscular strength balance. The present study aimed to compare knee flexor strength, knee extensor strength, and strength balance ratio, called the conventional ratio (CR), between prepubertal and postpubertal swimmers of both sexes. A total of 56 boys and 22 girls aged between 10 and 20 years participated in the study. Peak torque, CR, and body composition were measured using an isokinetic dynamometer and dual-energy X-ray absorptiometry, respectively. The postpubertal boys group presented significantly higher fat-free mass (p < 0.001) and lower fat mass (p = 0.001) than the prepubertal group. There were no significant differences among the female swimmers. Peak torque for both flexor and extensor muscles was significantly greater in postpubertal male (p < 0.001, both) and female swimmers (p < 0.001 and p = 0.001, respectively) than in prepubertal swimmers. The CR did not differ between the pre- and postpubertal groups. However, the mean CR values were lower than the literature recommendations, which brings attention to a higher risk of knee injuries.

Reference values for bone mass in young athletes: a cross-sectional study in São Paulo, Brazil

Reference values for bone mass in young athletes need to be used for screening purposes, and country/regional reference values should be used to improve precision of comparisons. The aim of the present study was to develop reference values for bone health variables in Brazilian young athletes. The bone mass content (BMC), bone mass density (BMD), and total body less head (TBLH) BMD using dual-energy X-ray absorptiometry were measured in 702 young athletes (327 men and 375 women) aged 8.5-18.5 years, divided into 5 groups, according to their age: group 1 (8.5-10.5 years), group 2 (10.6-12.5 years), group 3 (12.6-14.5 years), group 4 (14.6-16.5 years), and group 5 (16.6-18.5 years). Comparisons between the sexes and ages were performed and age-sex-smoothed reference values were constructed. Male athletes presented high BMC and BMD than female athletes in age groups 3, 4, and 5 (p < 0.005) and high TBLH BMD than female athletes in age groups 4 and 5 (p < 0.005). Reference values, including the percentiles are presented for the bone health variables of each sex and age group. The age-, sex-, and ethnic-specific reference data for bone variables presented in this study enabled more precise reference data for young Brazilian athletes. These data may assist in monitoring changes during an athletes' growth and different phases of athletic training.