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Grishin NK, De Souza AM, Fairbairn J, Sheel AW, Puterman E, Blydt-Hansen T, Potts JE, Armstrong KR. An 8-Week Virtual Exercise Training Program for Pediatric Solid Organ Transplant Recipients. Pediatr Exerc Sci 2023:1-11. [PMID: 38096811 DOI: 10.1123/pes.2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE Musculoskeletal strength can be impaired in pediatric solid organ transplant recipients. Exercise training programs can be beneficial but in-person delivery can be challenging; virtual exercise programs can alleviate some of these challenges. This feasibility study aimed to deliver an 8-week virtual exercise program in pediatric solid organ transplant recipients. METHOD Program delivery occurred 3 times per week for 30 minutes. An exercise stress test was completed prior to program start. The Bruininks-Oseretsky Test of Motor Proficiency strength subtest and self-report surveys were used to assess musculoskeletal strength, quality of life, fatigue, and physical activity. Contact was maintained through a text messaging platform. Z scores were calculated using standardized normative data. Medians (interquartile range) are reported for all other data. RESULTS Eleven participants completed the program (2 liver, 5 kidney, 4 heart; 58% females; median age = 11.5 [10.3-13.8] y). Six participants attended ≥60% of classes, 5 participants attended <50% of classes. After 8 weeks, strength scores improved (Z score, Pre: -1.0 [-1.65 to -0.60] to Post: -0.2 [-1.30 to 0.40]; P = .007) with no change in other outcome measures. CONCLUSION The virtual exercise program was delivered without technical issues and received positive participant feedback. Engagement and costs need to be considered.
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Affiliation(s)
- Nikol K Grishin
- School of Kinesiology, The University of British Columbia, Vancouver, BC,Canada
| | - Astrid M De Souza
- Children's Heart Center, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia Vancouver, Vancouver, BC,Canada
| | - Julie Fairbairn
- Multi-Organ Transplant Program, British Columbia Children's Hospital, Vancouver, BC,Canada
| | - A William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, BC,Canada
| | - E Puterman
- School of Kinesiology, The University of British Columbia, Vancouver, BC,Canada
| | - Tom Blydt-Hansen
- Multi-Organ Transplant Program, British Columbia Children's Hospital, Vancouver, BC,Canada
- Division of Nephrology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia Vancouver, Vancouver, BC,Canada
| | - James E Potts
- Children's Heart Center, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia Vancouver, Vancouver, BC,Canada
| | - Kathryn R Armstrong
- Children's Heart Center, Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia Vancouver, Vancouver, BC,Canada
- Division of Nephrology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia Vancouver, Vancouver, BC,Canada
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Florence GE, Oosthuyse T, Bosch AN. Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis. J Sports Sci 2023; 41:2063-2076. [PMID: 38305252 DOI: 10.1080/02640414.2024.2312052] [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: 06/21/2022] [Accepted: 01/19/2024] [Indexed: 02/03/2024]
Abstract
Preserving or preventing declines in bone mineral density (BMD) is imperative. As jumping is a high-impact bone-loading action, this meta-analysis evaluated the efficacy of jump training to improve BMD and bone turnover relative to non-jumping controls in men and women > 18 years, following Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. PubMed and COCHRANE Library databases were searched until February 2022. Fifteen articles (19 jumping-trials) met the predetermined search criteria. Eighteen trials were included for BMD data (n = 666 participants). There was a significant small-moderate effect of jumping on femoral neck BMD (%mean difference: 95%CI, +1.50%: 0.83%; 2.17%, p < 0.0001), that remained significant after sub-analysis by age for both younger (+1.81%: 0.98%; 2.65%) and older adults (+1.03%: 0.02%; 2.03%). BMD of total hip (+1.26%: 0.56%; 1.96% vs + 0.06%: -0.96%; 1.08%), and trochanter (+0.84%: 0.20%; 1.48% vs -0.16%: -1.08%; 0.76%) increased significantly with jump training only in younger adults and non-significantly at the lumbar spine (+0.84%: -0.02%; 1.7% vs -0.09%: -0.96%; 0.77%) only in younger but not older adults, respectively. The BMD response to jump training appears to be site-specific, with the highest sensitivity at the femoral neck. No dose-response effect suggests moderate certainty of a gain in femoral neck BMD when performing the median jump-load of 50 jumps four times weekly.
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Affiliation(s)
- Gabriella E Florence
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Tanja Oosthuyse
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrew N Bosch
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Ramirez-Campillo R, Sortwell A, Moran J, Afonso J, Clemente FM, Lloyd RS, Oliver JL, Pedley J, Granacher U. Plyometric-Jump Training Effects on Physical Fitness and Sport-Specific Performance According to Maturity: A Systematic Review with Meta-analysis. SPORTS MEDICINE - OPEN 2023; 9:23. [PMID: 37036542 PMCID: PMC10086091 DOI: 10.1186/s40798-023-00568-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/26/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Among youth, plyometric-jump training (PJT) may provide a safe, accessible, and time-efficient training method. Less is known on PJT effectiveness according to the maturity status. OBJECTIVE This systematic review with meta-analysis set out to analyse the body of peer-reviewed articles assessing the effects of PJT on measures of physical fitness [i.e., maximal dynamic strength; change of direction (COD) speed; linear sprint speed; horizontal and vertical jump performance; reactive strength index] and sport-specific performance (i.e., soccer ball kicking and dribbling velocity) according to the participants' maturity status. METHODS Systematic searches were conducted in three electronic databases using the following inclusion criteria: (i) Population: healthy participants aged < 18 years; (ii) Intervention: PJT program including unilateral and/or bilateral jumps; (iii) Comparator: groups of different maturity status with control groups; (iv) Outcomes: at least one measure of physical fitness and/or sport-specific performance before and after PJT; (v) experimental design with an active or passive control group, and two or more maturity groups exposed to the same PJT. The DerSimonian and Laird random-effects models were used to compute the meta-analysis. The methodological quality of the studies was assessed using the PEDro checklist. GRADE was applied to assess certainty of evidence. RESULTS From 11,028 initially identified studies across three electronic databases, 11 studies were finally eligible to be meta-analysed (n total = 744; seven studies recruited males; four studies recruited females). Three studies were rated as high quality (6 points), and eight studies were of moderate quality (5 points). Seven studies reported the maturity status using age at peak height velocity (PHV; pre-PHV values up to - 2.3; post-PHV up to 2.5). Another four studies used Tanner staging (from Tanner I to V). The training programmes ranged from 4 to 36 weeks, using 1-3 weekly training sessions. When compared to controls, pre-PHV and post-PHV participants obtained small-to-moderate improvements (ES = 0.35 - 0.80, all p < 0.05) in most outcomes (i.e., sport-specific performance; maximal dynamic strength; linear sprint; horizontal jump; reactive strength index) after PJT. The contrast of pre-PHV with post-PHV youth revealed that PJT was similarly effective in both maturity groups, in most outcome measures except for COD speed (in favour of pre-PHV). PJT induces similar physical fitness and sport-specific performance benefits in males and females, with a minimal exercise dosage of 4 weeks (8 intervention sessions), and 92 weekly jumps. Results of this meta-analysis are based on low study heterogeneity, and low to very low certainty of evidence (GRADE analysis) for all outcomes. CONCLUSION Compared to control participants, PJT resulted in improved maximal dynamic strength, linear sprint speed, horizontal jump performance, reactive strength index, and sport-specific performance (i.e., soccer ball kicking and dribbling velocity). These effects seem to occur independently of the maturity status, as both pre-PHV and post-PHV participants achieved similar improvements after PJT interventions for most outcomes. However, several methodological issues (e.g., low sample sizes and the pooling of maturity categories) preclude the attainment of more robust recommendations at the current time. To address this issue, consistency in maturity status reporting strategies must be improved in future studies with the general youth population and youth athletes.
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Affiliation(s)
- Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile
| | - Andrew Sortwell
- School of Nursing, Midwifery, Health Sciences and Physiotherapy, University of Notre Dame Australia, Sydney, Australia
| | - Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, CO43SQ, UK
| | - José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Álvares, 4900-347, Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320, Melgaço, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001, Lisbon, Portugal
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF23 6XD, UK
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF23 6XD, UK
| | - Jason Pedley
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF23 6XD, UK
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg, Germany.
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McCaskie C, Siafarikas A, Cochrane Wilkie J, Sutton V, Chivers P, Hart NH, Murphy MC. The Benefits to Bone Health in Children and Pre-School Children with Additional Exercise Interventions: A Systematic Review and Meta-Analysis. Nutrients 2022; 15:nu15010127. [PMID: 36615785 PMCID: PMC9824212 DOI: 10.3390/nu15010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Determine if exercise interventions, beyond what is already provided to children and preschool children, improve bone health and reduce fracture incidence. DESIGN Systematic review and meta-analysis reported using the PRISMA guidelines. Certainty of evidence was assessed using GRADE recommendations. DATA SOURCES Five electronic databases were searched for records: PUBMED; CINAHL; CENTRAL; SPORTDiscus; Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised, quasi-randomised and non-randomised controlled trials (including cluster-randomised) assessing the impact of additional exercise interventions (e.g., increased physical education classes or specific jumping programs) on bone health in children (6-12 years) and pre-school children (2-5 years) without dietary intervention. RESULTS Thirty-one records representing 16 distinct clinical trials were included. Dual-energy X-ray Absorptiometry (DXA) and/or peripheral Quantitative Computed Tomography (pQCT) were used to quantify bone health. Increased femoral neck bone mineral content in children with additional exercise interventions (n = 790, SMD = 0.55, 95% CI = 0.01 to 1.09) was reported, however this was not significant following sensitivity analysis. Other DXA and pQCT measures, as well as fracture incidence, did not appear to significantly differ over time between intervention and control groups. No studies reported adverse events. Studies failed to report all domains within the TIDieR checklist. All studies were at high risk of bias using the Cochrane RoB Tool 2.0. The certainty of the evidence was very low. CONCLUSIONS The addition of exercise interventions, beyond what is provided to children, does not appear to improve DXA and pQCT measures of bone health. The effect of additional exercise interventions on bone health in pre-school children is largely unknown. Future trials should ensure adherence is clearly reported and controlled for within analysis as well as including reports of adverse events (e.g., apophysitis) that occur due to increased exercise interventions.
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Affiliation(s)
- Callum McCaskie
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Aris Siafarikas
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- School of Medicine and Telethon Kids Institute, University of Western Australia, Crawley, WA 6009, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
| | - Jodie Cochrane Wilkie
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
- Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia
| | - Vanessa Sutton
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Paola Chivers
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
| | - Nicolas H. Hart
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, SA 5042, Australia
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Moore Park, NSW 2007, Australia
| | - Myles C. Murphy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Correspondence:
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McConnell-Nzunga J, Gabel L, Macdonald HM, Rhodes RE, Hofer SM, Naylor PJ, McKay HA. A 4-Yr Mixed Longitudinal Study of Health Behaviors and Fat Mass Accrual during Adolescence and Early Adulthood. Med Sci Sports Exerc 2022; 54:2178-2187. [PMID: 35868009 DOI: 10.1249/mss.0000000000003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Physical activity (PA), sedentary time (SED), and energy intake (EI) are associated with fat mass accrual in children and youth. Previous studies relied primarily on cross-sectional designs and proxy measures of body composition such as body mass index. We aimed to prospectively investigate associations between PA, SED, EI, and total body fat mass accrual using dual-energy x-ray absorptiometry. METHODS This analysis of the mixed longitudinal Healthy Bones III Study included data from 312 participants (138 boys age 9 to 21 yr at baseline). For each participant, we acquired a maximum of four annual total body dual-energy x-ray absorptiometry scans from which we determined fat mass (in kilograms; n = 748 observations). We assessed total PA, moderate-to-vigorous PA (MVPA) and SED with accelerometers (ActiGraph GT1M) and measured EI via 24-h dietary recall. We fit sex-specific multilevel models adjusting for maturity (years from age at peak height velocity (APHV)), weight status, ethnicity, total PA, MVPA, SED, and EI. RESULTS Boys and girls demonstrated divergent trajectories of fat mass accrual; rate of fat mass accrual in girls was four times greater than boys at APHV and increased across adolescence, whereas boys' fat mass plateaued after APHV. In boys, within-person change in MVPA negatively predicted fat mass independent of SED; each annual increase in MVPA of 6 min·d -1 was associated with a 0.21-kg lower fat mass. In girls, between-person average MVPA negatively predicted fat mass accrual independent of SED; greater MVPA of 4 min·d -1 across adolescence was associated with a 0.31-kg lower fat mass. CONCLUSIONS MVPA demonstrates an independent and negative effect on fat mass in boys and girls. Given different trajectories of fat mass accrual and movement behaviors between boys and girls, PA interventions aimed at preventing obesity in youth may benefit from a sex and gendered approach.
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Affiliation(s)
- Jennifer McConnell-Nzunga
- Social Dimensions of Health, University of Victoria, Interdisciplinary Programs, Victoria, BC, CANADA
| | - Leigh Gabel
- Faculty of Kinesiology, University of Calgary, Calgary, AB, CANADA
| | | | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, CANADA
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, CANADA
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Bellver M, Drobnic F, Jovell E, Ferrer-Roca V, Abalos X, Del Rio L, Trilla A. Jumping rope and whole-body vibration program effects on bone values in Olympic artistic swimmers. J Bone Miner Metab 2021; 39:858-867. [PMID: 33839950 DOI: 10.1007/s00774-021-01224-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/18/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Artistic swimming seems not to benefit bone development like other out-of-water physical activities. To increase bone acquisition, artistic swimming should combine water training with weight-bearing impact or strength activities. Artistic swimmers can be a population at risk of developing osteopenia and osteoporosis in later life. The aim of the present study was to evaluate the effects of a training program on bone mineral density (BMD), bone mineral content (BMC) and body composition in an Olympic artistic swimming team. METHODS Sixteen women aged 17-21 years, who train 30 h/week, at the Olympic Training Centre (Barcelona, Spain), were followed up over two seasons. The 1st season involved regular artistic swimming training without specific training to reduce the risk of osteopenia. The exercise intervention, jumping rope and whole-body vibration, was added in the 2nd season. The protocol included 20 min of training 2 days per week, over a 22-week period. Dual energy x-ray absorptiometry measured the bone variables and body composition. The daily diet, medical history and bone turnover markers were evaluated. RESULTS The intervention program increased BMD on lumbar spine (2.10%, p = 0.002), total hip (2.07%, p = 0.001), and femoral neck (2.39%, p = 0.02). Lower limb's fat mass decreased (10.17%, p = 0.038). No significant differences were found for any of the measured anthropometric characteristics between both time points in the 1st season. In conclusions, combined jump rope and vibration should be considered to reduce the risk of bone damage in artistic swimmers.
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Affiliation(s)
- Montse Bellver
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain.
- Consorci Sanitari de Terrassa (CST), Carretera de Torrebonica s/n, 08227, Terrassa, Barcelona, Spain.
- , c/Via Augusta 114, 7º1ª, 08006, Barcelona, Spain.
| | - Franchek Drobnic
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain
- Shenhua Greenland FC, Hunan Highway 2600, Shanghai, China
| | - Esther Jovell
- Consorci Sanitari de Terrassa (CST), Carretera de Torrebonica s/n, 08227, Terrassa, Barcelona, Spain
| | - Ventura Ferrer-Roca
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain
| | - Xavier Abalos
- LCAFE School of Physical Education and Sports Sciences, Sc Wiesbaden 1911 e.v, Wiesbaden, Germany
| | - Luis Del Rio
- CETIR Centre Medic, c/Londres, 6, 08029, Barcelona, Spain
| | - Antoni Trilla
- Hospital Clinic, University of Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain
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7
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Mello JB, Pedretti A, García-Hermoso A, Martins CML, Gaya AR, Duncan MJ, Gaya ACA. Exercise in school Physical Education increase bone mineral content and density: Systematic review and meta-analysis. Eur J Sport Sci 2021; 22:1618-1629. [PMID: 34328066 DOI: 10.1080/17461391.2021.1960426] [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
ABSTRACTThis systematic review and meta-analysis aimed to evaluate the effectiveness of interventions through Physical Education (PE) exercises on bone mineral content (BMC) and density (BMD) of children and adolescents. The research was conducted using the online electronic databases PubMed, Science Direct, Web of Science and Scopus (March 2021). The analysis was restricted to school-based studies that examined the effect of PE interventions on BMC and BMD in schoolchildren (<18 years old). Standardised mean differences (SMD) with 95% confidence interval (CI) and random-effects models were calculated. The heterogeneity and inconsistency of the studies were estimated using Cochran's Q-statistic and I2, respectively. Twenty-two studies with 2,556 participants were selected. PE interventions were associated with a significant increase in BMC (SMD = 1.348; 95% CI, 1.053-1.643) and BMD (SMD = 0.640; 95% CI, 0.417-0.862). Femoral neck subgroup analysis indicate an increase in BMC for boys (SMD = 1.527; 95% CI, 0.990-2.065) and girls (SMD = 1.27; 95% CI, 0.782-1.767), and in BMD for boys (SMD = 0.518; 95% CI, 0.064-0.972) and girls (SMD = 0.817; 95% CI, 0.349-1.284). Finally, increases are reported in the lumbar spine BMC for boys (SMD = 1.860; 95% CI, 1.018-2.700) and girls (SMD = 1.275; 95% CI, 0.782-1.767). This meta-analysis provides insights into the effectiveness of interventions aimed at including physical exercise in PE on bone mass, suggesting that increasing the proportion of curriculum time allocated to PE may improve students' BMD and BMC, especially in the femoral neck and lumbar spine.
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Affiliation(s)
- Júlio B Mello
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Publica de Navarra, Pamplona, Spain.,Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | | | - Anelise R Gaya
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Koshu GRoup Activity, Active Play and Exercise (GRAPE) Study: A Cluster Randomised Controlled Trial Protocol of a School-Based Intervention among Japanese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073351. [PMID: 33805025 PMCID: PMC8036731 DOI: 10.3390/ijerph18073351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/04/2021] [Accepted: 03/17/2021] [Indexed: 12/02/2022]
Abstract
School-based programmes need to be effective, easy for all, easy to perform within a short duration, and inexpensive. However, no studies have reported whether voluntarily and very short-time active play programmes contribute to improved health outcomes. This study aims to describe the GRoup activity, Active Play and Exercise (GRAPE) cluster randomised controlled trial that examined whether active play interventions of very short durations contribute to increasing physical activity (PA) and bone mass among school-aged children. The trial was conducted in 2018 from January to June, and the activity comprised ≥2 children jumping together for approximately 10 s per session, at least five times a day (approximately 1 min/day). School clusters, pair-matched as per school size (total number of children) and region, were randomly allocated to either intervention or wait-list control groups. The primary outcomes comprised objectively measured changes in PA levels (moderate-to-vigorous PA) evaluated using wrist-worn activity trackers from baseline to the one-year follow-up (six-month post-intervention follow-up) and changes in bone mass evaluated using calcaneus quantitative ultrasound parameters. This study could describe the problems and challenges in school-based PA intervention studies and present findings that could make a potentially important contribution to health education and PA promotion.
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Popp KL, Ackerman KE, Rudolph SE, Johannesdottir F, Hughes JM, Tenforde AS, Bredella MA, Xu C, Unnikrishnan G, Reifman J, Bouxsein ML. Changes in Volumetric Bone Mineral Density Over 12 Months After a Tibial Bone Stress Injury Diagnosis: Implications for Return to Sports and Military Duty. Am J Sports Med 2021; 49:226-235. [PMID: 33259223 DOI: 10.1177/0363546520971782] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bone stress injuries (BSIs) occur in up to 20% of runners and military personnel. Typically, after a period of unloading and gradual return to weightbearing activities, athletes return to unrestricted sports participation or military duty approximately 4 to 14 weeks after a BSI diagnosis, depending on the injury location and severity. However, the time course of the recovery of the bone's mechanical competence is not well-characterized, and reinjury rates are high. PURPOSE To assess the bone microarchitecture and volumetric bone mineral density (vBMD) over 12 months after a tibial BSI diagnosis. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS We enrolled 30 female athletes from the local community (aged 18-35 years) with a tibial BSI (grade ≥2 of 4 on magnetic resonance imaging) for this prospective observational study. Participants completed a baseline visit within 3 weeks of the diagnosis. At baseline and 6, 12, 24, and 52 weeks after the BSI diagnosis, we collected high-resolution peripheral quantitative computed tomography scans of the ultradistal tibia (4% of tibial length) of the injured and uninjured legs as well as pain and physical activity assessment findings. RESULTS From baseline to 12 weeks after the diagnosis, total, trabecular, and cortical vBMD declined by 0.58% to 0.94% (P < .05 for all) in the injured leg. Total and trabecular vBMD also declined by 0.61% and 0.67%, respectively, in the uninjured leg (P < .05 for both). At 24 weeks, mean values for all bone parameters were nearly equivalent to baseline values, and by 52 weeks, several mean values had surpassed baseline values. Of the 30 participants, 10 incurred a subsequent BSI during the course of the study, and 1 of these 10 incurred 2 subsequent BSIs. Participants who suffered an additional BSI were younger and had a later age of menarche, a greater incidence of previous fractures, and lower serum parathyroid hormone levels (P < .05 for all). CONCLUSION Bone density declined in both the injured and the uninjured legs and, on average, did not return to baseline for 3 to 6 months after a tibial BSI diagnosis. The observed time to the recovery of baseline vBMD, coupled with the high rate of recurrent BSIs, suggests that improved return-to-sports and military duty guidelines may be in order.
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Affiliation(s)
- Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Kathryn E Ackerman
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sara E Rudolph
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Fjola Johannesdottir
- Harvard Medical School, Boston, Massachusetts, USA.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Adam S Tenforde
- Harvard Medical School, Boston, Massachusetts, USA.,Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Chun Xu
- Biotechnology High Performance Computing Software Applications Institute, Department of Defense, Frederick, Maryland, USA
| | - Ginu Unnikrishnan
- Biotechnology High Performance Computing Software Applications Institute, Department of Defense, Frederick, Maryland, USA
| | - Jaques Reifman
- Biotechnology High Performance Computing Software Applications Institute, Department of Defense, Frederick, Maryland, USA
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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10
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Gil-Cosano JJ, Ubago-Guisado E, Sánchez MJ, Ortega-Acosta MJ, Mateos ME, Benito-Bernal AI, Llorente-Cantarero FJ, Ortega FB, Ruiz JR, Labayen I, Martinez-Vizcaino V, Vlachopoulos D, Arroyo-Morales M, Muñoz-Torres M, Pascual-Gázquez JF, Vicho-González MC, Gracia-Marco L. The effect of an online exercise programme on bone health in paediatric cancer survivors (iBoneFIT): study protocol of a multi-centre randomized controlled trial. BMC Public Health 2020; 20:1520. [PMID: 33032564 PMCID: PMC7545891 DOI: 10.1186/s12889-020-09607-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. METHODS A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health. DISCUSSION Whether a simple, feasible and short in duration exercise programme can improve bone health has not been examined in paediatric cancer survivors. This article describes the design, rationale and methods of a study intended to test the effect of a rigorous online exercise programme on bone health in paediatric cancer survivors. If successful, the iBoneFIT study will contribute to decrease chronic health conditions in this population and will have a positive impact in the society. TRIAL REGISTRATION Prospectively registered in isrctn.com: isrctn61195625 . Registered 2 April 2020.
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Affiliation(s)
- Jose J Gil-Cosano
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071, Granada, Spain
| | - Esther Ubago-Guisado
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071, Granada, Spain
| | - Maria J Sánchez
- Andalusian School of Health (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Maria J Ortega-Acosta
- Servicio de Pediatría y Oncohematología Pediátricas, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Maria E Mateos
- Pediatric Oncology Unit, Department of Pediatrics, Reina Sofia University Hospital, Córdoba, Spain
- Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Córdoba, Spain
| | | | - Francisco J Llorente-Cantarero
- Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Córdoba, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Specific Didactics, Faculty of Education, University of Córdoba, 14071, Córdoba, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071, Granada, Spain
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071, Granada, Spain
| | - Idoia Labayen
- Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Navarra's Health Research Institute (IdiSNA), Department of Health Sciences, Public University of Navarra, Calle Tajonar 22, 31006, Pamplona, Navarra, Spain
| | - Vicente Martinez-Vizcaino
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Manuel Arroyo-Morales
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012, Granada, Spain
- Department of Physiotherapy, University of Granada, E-18016, Granada, Spain
- "Cuídate" Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016, Granada, Spain
| | - Manuel Muñoz-Torres
- Bone Metabolic Unit, Endocrinology and Nutrition Division, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Granada, Spain
- CIBERFES, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Universidad de Granada, Granada, Spain
| | - Juan F Pascual-Gázquez
- Servicio de Pediatría y Oncohematología Pediátricas, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Maria C Vicho-González
- Pediatric Oncology Unit, Department of Pediatrics, Reina Sofia University Hospital, Córdoba, Spain
| | - Luis Gracia-Marco
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071, Granada, Spain.
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11
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Sedentariness and Physical Activity during School Recess Are Associated with VO 2Peak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134733. [PMID: 32630222 PMCID: PMC7369719 DOI: 10.3390/ijerph17134733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/17/2022]
Abstract
Recess time (RT) is a main component of school-based activities, and could contribute up to 40% of the physical activity (PA) recommended in the health guidelines. The main goal was to analyze the association between accelerometer-measured PA and sedentary time during RT with cardiorespiratory fitness (CRF). A total of 146 children and adolescents, aged 8-19 years, were recruited from six schools. PA levels were measured with GT3X accelerometers over 7 days. CRF was measured using a portable breath-by-breath gas analyzer. A general linear model (GML) was conducted to analyze the association between PA intensities and CRF during RT. Additionally, a logistic binary regression was used to evaluate the risk of unhealthy CRF among different categories of PA and sedentary time. Participants classified as healthy showed higher PA levels during RT than those classed as unhealthy. GML analysis showed that sedentary time during RT was significantly associated with VO2Peak. Finally, individuals who were sedentary for more than 15 min during RT presented 97.7% lower odds of having unhealthy CRF (adjusted Odds Ratio = 0.023, 95% CI -0.002 to 0.263). Our data suggest an association between recess sedentary time and unhealthy CRF. Thus, school-aged children and adolescents must be empowered to perform PA during RT to prevent the deleterious effects of sedentary time on CRF.
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12
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Kato T, Tomioka T, Yamashita T, Yamamoto H, Sugajima Y, Ohnishi N. Nordic Walking Increases Distal Radius Bone Mineral Content in Young Women. J Sports Sci Med 2020; 19:237-244. [PMID: 32390716 PMCID: PMC7196759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/15/2020] [Indexed: 06/11/2023]
Abstract
Unlike the lumbar spine and femur, the radius does not bear a gravitational mechanical compression load during daily activities. The distal radius is a common fracture site, but few studies have addressed the effects of exercise on fracture risk. The aim of this study was to determine the effects of the pole push-off movement of Nordic walking (NW) on the bone mineral content (BMC) and areal bone mineral density (aBMD) of the distal radius and the muscle cross-sectional area (CSA) at the mid-humeral and mid-femoral levels. The participants were allocated to two groups: an NW group and a control group. The NW group walked at least 30 min with NW poles three times a week for six months. There were no significant changes in muscle CSA at the mid-humeral or mid-femoral levels between or within groups. There were also no significant changes in BMC or aBMD at 1/3 and 1/6 of the distance from the distal end of the radius in either group. However, the BMC and aBMD at 1/10 of the distance from the distal end of the radius were significantly increased by NW. The NW pole push-off movement provided effective loading to increase the osteogenic response in the ultra-distal radius. The ground reaction forces transmitted through the poles to the radius stimulated bone formation, particularly in the ultra-distal radius.
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Affiliation(s)
- Takeru Kato
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
- Suzuka University of Medical Science, Faculty of Health Sciences, Department of Clinical Nutrition, Suzuka, Mie, Japan
| | - Toru Tomioka
- Meijo University, Faculty of Foreign Studies, Nagoya, Aichi, Japan
| | - Takenori Yamashita
- Suzuka University of Medical Science, Faculty of Health Sciences, Department of Clinical Radiation, Suzuka, Mie, Japan
| | - Hidehiro Yamamoto
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
| | - Yasuhiro Sugajima
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
| | - Norikazu Ohnishi
- Mie Prefectural College of Nursing, Faculty of Nursing, Tsu, Mie, Japan
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13
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Cronholm F, Lindgren E, Rosengren BE, Dencker M, Karlsson C, Karlsson MK. Daily School Physical Activity from Before to After Puberty Improves Bone Mass and a Musculoskeletal Composite Risk Score for Fracture. Sports (Basel) 2020; 8:E40. [PMID: 32231105 PMCID: PMC7240745 DOI: 10.3390/sports8040040] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 01/29/2023] Open
Abstract
This 7.5-year prospective controlled exercise intervention study assessed if daily school physical activity (PA), from before to after puberty, improved musculoskeletal traits. There were 63 boys and 34 girls in the intervention group (40 min PA/day), and 26 boys and 17 girls in the control group (60 min PA/week). We measured musculoskeletal traits at the start and end of the study. The overall musculoskeletal effect of PA was also estimated by a composite score (mean Z-score of the lumbar spine bone mineral content (BMC), bone area (BA), total body lean mass (TBLM), calcaneal ultrasound (speed of sound (SOS)), and muscle strength (knee flexion peak torque)). We used analyses of covariance (ANCOVA) for group comparisons. Compared to the gender-matched control group, intervention boys reached higher gains in BMC, BA, muscle strength, as well as in the composite score, and intervention girls higher gains in BMC, BA, SOS, as well as in the composite score (all p < 0.05, respectively). Our small sample study indicates that a daily school-based PA intervention program from Tanner stage 1 to 5 in both sexes is associated with greater bone mineral accrual, greater gain in bone size, and a greater gain in a musculoskeletal composite score for fractures.
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Affiliation(s)
- Felix Cronholm
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden; (F.C.); (E.L.); (B.E.R.); (C.K.)
| | - Erik Lindgren
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden; (F.C.); (E.L.); (B.E.R.); (C.K.)
| | - Björn E. Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden; (F.C.); (E.L.); (B.E.R.); (C.K.)
| | - Magnus Dencker
- Department of Physiology and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden;
| | - Caroline Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden; (F.C.); (E.L.); (B.E.R.); (C.K.)
| | - Magnus K. Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skane University Hospital, Lund University, SE-205 02 Malmo, Sweden; (F.C.); (E.L.); (B.E.R.); (C.K.)
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14
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How Physical Activity across the Lifespan Can Reduce the Impact of Bone Ageing: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061862. [PMID: 32183049 PMCID: PMC7143872 DOI: 10.3390/ijerph17061862] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 02/07/2023]
Abstract
Bone remodeling is a lifelong process, due to the balanced activity of the osteoblasts (OBs), the bone-forming cells, and osteoclasts (OCs), the bone-resorbing cells. This equilibrium is mainly regulated by the WNT-ß-cathenin pathway and the RANK-RANKL/OPG system, respectively. Bone ageing is a process which normally occurs during life due to the imbalance between bone formation and bone resorption, potentially leading to osteoporosis. Bone loss associated with bone ageing is determined by oxidative stress, the result of the increasing production of reactive oxygen species (ROS). The promotion of physical exercise during growth increases the chances of accruing bone and delaying the onset of osteoporosis. Several studies demonstrate that physical exercise is associated with higher bone mineral density and lower fracture incidence, and the resulting bone mineral gain is maintained with ageing, despite a reduction of physical activity in adulthood. The benefits of exercise are widely recognized, thus physical activity is considered the best non-pharmacologic treatment for pathologies such as osteoporosis, obesity, diabetes and cardiovascular disease. We reviewed the physiological mechanisms which control bone remodeling, the effects of physical activity on bone health, and studies on the impact of exercise in reducing bone ageing.
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15
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Vazou S, Webster CA, Stewart G, Candal P, Egan CA, Pennell A, Russ LB. A Systematic Review and Qualitative Synthesis Resulting in a Typology of Elementary Classroom Movement Integration Interventions. SPORTS MEDICINE-OPEN 2020; 6:1. [PMID: 31907711 PMCID: PMC6944721 DOI: 10.1186/s40798-019-0218-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
Abstract
Background/Objective Movement integration (MI) involves infusing physical activity into normal classroom time. A wide range of MI interventions have succeeded in increasing children’s participation in physical activity. However, no previous research has attempted to unpack the various MI intervention approaches. Therefore, this study aimed to systematically review, qualitatively analyze, and develop a typology of MI interventions conducted in primary/elementary school settings. Subjects/Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to identify published MI interventions. Irrelevant records were removed first by title, then by abstract, and finally by full texts of articles, resulting in 72 studies being retained for qualitative analysis. A deductive approach, using previous MI research as an a priori analytic framework, alongside inductive techniques were used to analyze the data. Results Four types of MI interventions were identified and labeled based on their design: student-driven, teacher-driven, researcher-teacher collaboration, and researcher-driven. Each type was further refined based on the MI strategies (movement breaks, active lessons, other: opening activity, transitions, reward, awareness), the level of intrapersonal and institutional support (training, resources), and the delivery (dose, intensity, type, fidelity). Nearly half of the interventions were researcher-driven, which may undermine the sustainability of MI as a routine practice by teachers in schools. An imbalance is evident on the MI strategies, with transitions, opening and awareness activities, and rewards being limitedly studied. Delivery should be further examined with a strong focus on reporting fidelity. Conclusions There are distinct approaches that are most often employed to promote the use of MI and these approaches may often lack a minimum standard for reporting MI intervention details. This typology may be useful to effectively translate the evidence into practice in real-life settings to better understand and study MI interventions.
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Affiliation(s)
- Spyridoula Vazou
- Department of Kinesiology, Iowa State University, 534 Wallace Road, Ames, IA, 50011, USA.
| | - Collin A Webster
- Department of Physical Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
| | - Gregory Stewart
- Department of Physical Education and Exercise Science, Methodist University, 5400 Ramsey Street, Fayetteville, NC, 28311, USA
| | - Priscila Candal
- Department of Kinesiology, Iowa State University, 534 Wallace Road, Ames, IA, 50011, USA
| | - Cate A Egan
- Department of Movement Studies, University of Idaho, 875 Perimeter Drive, Moscow, ID, 83844, USA
| | - Adam Pennell
- Natural Science Division, Pepperdine University, Malibu, CA, USA
| | - Laura B Russ
- Department of Physical Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
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16
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McConnell-Nzunga J, Naylor PJ, Macdonald HM, Rhodes RE, Hofer SM, McKay HA. Body fat accrual trajectories for a sample of Asian-Canadian and Caucasian-Canadian children and youth: A longitudinal DXA-based study. Pediatr Obes 2020; 15:e12570. [PMID: 31385453 DOI: 10.1111/ijpo.12570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/14/2019] [Accepted: 07/05/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body fat accrual trajectories can be used to monitor trends in body fat mass and identify potential health risks. Currently, no body fat percent (BF%) centile distance and velocity curves exist for Canadian youth. OBJECTIVES To develop sex-specific and ethnic-specific BF% centile distance and velocity curves for White and Asian-Canadian youth. METHODS We utilized 4734 observations from 944 participants (female = 487; Asian = 532) to create sex-specific BF% velocity curves for age 10 to 18 years and sex-specific and ethnic-specific BF% percentile distance curves for ages 9 to 18 years for White and Asian children. BF% was derived from whole body DXA scans. RESULTS BF% centile distance curves for Asian and White girls were similar. BF% at most centiles plateaued around age 16 for Asian but not for White boys. Velocity curves for boys declined from age 11 to 13 years and then increased until age 18 years. For girls from 10 to 15 years, velocity curves converged towards the 50th centile then remained flat from 16 to 18 years. CONCLUSIONS BF% distance and velocity centiles can be used to identify when an individual veers from an average BF% accrual trajectory. In future, these curves may be used to investigate differences in fat mass and accrual across Canada.
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Affiliation(s)
- Jennifer McConnell-Nzunga
- Social Dimensions of Health, University of Victoria, Interdisciplinary Programs, Victoria, BC, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada.,Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Scott M Hofer
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Centre, Vancouver, BC, Canada.,Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
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17
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Popp KL, Turkington V, Hughes JM, Xu C, Unnikrishnan G, Reifman J, Bouxsein ML. Skeletal loading score is associated with bone microarchitecture in young adults. Bone 2019; 127:360-366. [PMID: 31265923 DOI: 10.1016/j.bone.2019.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Physical activity that involves high strain magnitudes and high rates of loading is reported to be most effective in eliciting an osteogenic bone response. Whether a history of participation in osteogenic activities during youth, as well as current participation in osteogenic activities, contributes to young adult bone microarchitecture and strength is unknown. PURPOSE We determined the association between a new skeletal loading (SkL) score reflecting physical activity from age 11 to adulthood, the bone specific physical activity questionnaire (BPAQ) and bone microarchitecture in young Black and White men and women. METHODS We conducted a cross-sectional study of young ([mean ± SD] 23.7 ± 3.3 years) Black (n = 51 women, n = 31 men) and White (n = 50 women, n = 49 men) adults. Microarchitecture and estimated bone strength (by micro-finite element analysis) were assessed at the ultradistal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT). Physical activity questionnaires were administered and a SkL score was derived based on ground reaction force, rate of loading, frequency, duration, and life period of participation per activity from age 11 onwards. BPAQ score was also calculated. We used multiple linear regression to determine associations between both SkL score and BPAQ score and bone outcomes, adjusting for age, height, weight, sex, and race. RESULTS We found that SkL score, which accounts for current and historical physical activity, was significantly associated with most cortical bone parameters at the tibia including area, area fraction, porosity, thickness, and tissue mineral density (R2 = 0.27-0.55, all p < 0.01). Further, trabecular thickness, separation, number, and bone mineral density (R2 = 0.22-0.32, all p < 0.01), as well as stiffness and failure load (R2 = 0.63-0.65, all p < 0.01), were associated with the SkL score. The BPAQ was also significantly associated with most bone parameters, but to a lesser degree than SkL score. CONCLUSION These findings suggest that among young adults, greater amounts of osteogenic physical activity, as assessed by the SkL score and BPAQ are associated with improved bone microarchitecture and strength. With the potential to predict bone parameters in young adults, these scores may ultimately serve to identify those most vulnerable to fracture.
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Affiliation(s)
- Kristin L Popp
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA; Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02155, USA.
| | - Victoria Turkington
- Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA
| | - 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, USA
| | - 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, USA
| | - 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, USA
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02155, USA; Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, and Department of Orthopedic Surgery, Harvard Medical School, One Overland Street, Boston, MA 02215, USA
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18
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Williams CA, Gracia-Marco L. A 9-Month Jumping Intervention to Improve Bone Geometry in Adolescent Male Athletes. Med Sci Sports Exerc 2019; 50:2544-2554. [PMID: 30067592 DOI: 10.1249/mss.0000000000001719] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Sports have different effects on bone development and effective interventions to improve bone health of adolescent athletes are needed. The purpose of the study was to investigate the effect of a 9-month jumping intervention on bone geometry and metabolism in adolescent male athletes. METHODS Ninety-three adolescent (14.1 yr old) male swimmers (SWI), footballers (FOO), and cyclists (CYC) were randomized to intervention and sport (INT-SWI = 19, INT-FOO = 15, and INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, and CON-CYC = 12) groups. Cross-sectional area, cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck were assessed using hip structural analysis and trabecular texture of the lumbar spine using trabecular bone score. Bone mineral content (BMC) at femoral neck and lumbar spine was assessed using dual-energy x-ray absorptiometry. Serum N-terminal propeptide of procollagen type I, isomer of the carboxy-terminal telopeptide of type 1 collagen, total serum calcium, and 25-hydroxyvitamin D were analyzed. RESULTS INT-CYC acquired significantly higher lumbar spine BMC (4.6%) and femoral neck BMC (9.8%) than CON-CYC. INT-CYC acquired significantly higher cross-sectional area (11.0%), CSMI (10.1%), and trabecular bone score (4.4%) than CON-CYC. INT-SWI acquired significantly higher femoral neck BMC (6.0%) and CSMI (10.9%) than CON-SWI. There were no significant differences between INT-FOO and CON-FOO in any bone outcomes. N-terminal propeptide of procollagen type I significantly decreased in CON-SWI, INT-FOO, CON-FOO, and CON-CYC. Carboxy-terminal telopeptide of type 1 collagen significantly decreased in CON-SWI and CON-CYC. The 25-hydroxyvitamin D significantly increased in INT-CYC, CON-CYC, INT-FOO, and CON-FOO. CONCLUSIONS A 9-month jumping intervention improved bone outcomes in adolescent swimmers and cyclists, but not in footballers. This intervention might be used by sports clubs to improve bone health of adolescent athletes.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM.,IGOID Research Group, University of Castilla-La Mancha, Toledo, SPAIN
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM.,Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, SPAIN.,PROFITH Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, SPAIN
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19
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Pagnotti GM, Styner M, Uzer G, Patel VS, Wright LE, Ness KK, Guise TA, Rubin J, Rubin CT. Combating osteoporosis and obesity with exercise: leveraging cell mechanosensitivity. Nat Rev Endocrinol 2019; 15:339-355. [PMID: 30814687 PMCID: PMC6520125 DOI: 10.1038/s41574-019-0170-1] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis, a condition of skeletal decline that undermines quality of life, is treated with pharmacological interventions that are associated with poor adherence and adverse effects. Complicating efforts to improve clinical outcomes, the incidence of obesity is increasing, predisposing the population to a range of musculoskeletal complications and metabolic disorders. Pharmacological management of obesity has yet to deliver notable reductions in weight and debilitating complications are rarely avoided. By contrast, exercise shows promise as a non-invasive and non-pharmacological method of regulating both osteoporosis and obesity. The principal components of exercise - mechanical signals - promote bone and muscle anabolism while limiting formation and expansion of fat mass. Mechanical regulation of bone and marrow fat might be achieved by regulating functions of differentiated cells in the skeletal tissue while biasing lineage selection of their common progenitors - mesenchymal stem cells. An inverse relationship between adipocyte versus osteoblast fate selection from stem cells is implicated in clinical conditions such as childhood obesity and increased marrow adiposity in type 2 diabetes mellitus, as well as contributing to skeletal frailty. Understanding how exercise-induced mechanical signals can be used to improve bone quality while decreasing fat mass and metabolic dysfunction should lead to new strategies to treat chronic diseases such as osteoporosis and obesity.
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Affiliation(s)
- Gabriel M Pagnotti
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Maya Styner
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gunes Uzer
- College of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Vihitaben S Patel
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Laura E Wright
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Theresa A Guise
- School of Medicine, Division of Endocrinology, Indiana University, Indianapolis, IN, USA
| | - Janet Rubin
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
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20
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LeMoult J, Humphreys KL, King LS, Colich NL, Price AN, Ordaz SJ, Gotlib IH. Associations Among Early Life Stress, Rumination, Symptoms of Psychopathology, and Sex in Youth in the Early Stages of Puberty: a Moderated Mediation Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:199-207. [PMID: 29774495 PMCID: PMC6604804 DOI: 10.1007/s10802-018-0430-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Despite the high prevalence and substantial costs of early life stress (ELS), the mechanisms through which ELS confers risk for psychopathology are poorly understood, particularly among youth who are in an earlier stage of the transition through puberty. We sought to advance our understanding of the link between ELS and psychopathology by testing whether rumination mediates the relation between ELS and symptoms of psychopathology in youth in the early stages of puberty, and whether sex moderates this mediation. We assessed levels of ELS, both brooding and reflection subtypes of rumination, and internalizing and externalizing symptoms in 170 youth in the early stages of puberty (56% girls) ages 9-13 years. Brooding, but not reflection, mediated the relation between ELS and both internalizing and externalizing symptoms. Importantly, however, sex moderated the relation among ELS, brooding, and symptoms. Specifically, brooding mediated the relation between ELS and both internalizing and externalizing symptoms for girls, but not for boys. Findings support the formulation that brooding is a mechanism linking ELS to multiple forms of behavioral and emotional problems exclusively in girls in the early stages of puberty.
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Affiliation(s)
- Joelle LeMoult
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | | | - Lucy S King
- Stanford University, Bldg. 420, Jordan Hall, Stanford, CA, 94305, USA
| | - Natalie L Colich
- Stanford University, Bldg. 420, Jordan Hall, Stanford, CA, 94305, USA
| | | | - Sarah J Ordaz
- Stanford University, Bldg. 420, Jordan Hall, Stanford, CA, 94305, USA
| | - Ian H Gotlib
- Stanford University, Bldg. 420, Jordan Hall, Stanford, CA, 94305, USA
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21
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Taylor SL, Noonan RJ, Knowles ZR, Owen MB, Fairclough SJ. Process evaluation of a pilot multi-component physical activity intervention - active schools: Skelmersdale. BMC Public Health 2018; 18:1383. [PMID: 30563488 PMCID: PMC6299621 DOI: 10.1186/s12889-018-6272-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools have been identified as key environments to promote child physical activity (PA). Implementation of multi-component PA interventions within schools is advocated but research has showed that they may not always be effective at increasing child PA. Results of the Active Schools: Skelmersdale (AS:Sk) multi-component pilot intervention indicated no significant positive change to child PA levels. Process evaluations can provide information on which aspects of an intervention were delivered and how. Therefore, the purpose of this study was to use a combination of methods to elicit child and teacher perceptions regarding the feasibility and acceptability of the AS:Sk intervention, alongside systematic researcher observations. The overarching study aim was to understand how schools implemented the AS:Sk intervention, with a specific focus on the frequency of intervention component implementation, and how the components were incorporated into the school day. METHODS The study generated five data sets. Data elicited from 18 participating children via a write draw, show and tell task included, frequency counts of most enjoyable intervention components, drawings, and verbatim data. Teacher verbatim data was collected from 3 interviews, and 18 researcher observations were recorded using field notes. The data sources were pooled to produce the themes presented in the results section. RESULTS The combination of data sources revealed four themes and 16 sub-themes. Implementation methods: how and when the components were implemented in schools. Child engagement: enjoyment and positive behaviour. Facilitators: peer influence, teacher influence, staggered implementation, incentives, rewards, challenges and competition, flexibility and adaptability, child ownership, routine. Barriers: time within an intense curriculum, space, sustaining child interest, parental support, school policies. CONCLUSIONS This study revealed that teachers believed classroom based activities were most feasible and acceptable due to the reduced implementation barriers of sufficient time and space. In contrast, children reported that the activities outside of the classroom were preferred. Future school-based PA interventions should aim to achieve a balance between routine PA at a set time and PA that is flexible and adaptable. Further process evaluations of multi-component school-based PA interventions are warranted to develop the limited evidence base.
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Affiliation(s)
- Sarah L Taylor
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK.
| | - Robert J Noonan
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
| | - Zoe R Knowles
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 2AT, UK
| | - Michael B Owen
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
| | - Stuart J Fairclough
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK.,Department of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
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22
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Houghton KM, Macdonald HM, McKay HA, Guzman J, Duffy C, Tucker L. Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2018; 16:67. [PMID: 30348221 PMCID: PMC6198360 DOI: 10.1186/s12969-018-0283-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/10/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Arthritis in childhood can be associated with muscle weakness around affected joints, low bone mass and low bone strength. Exercise is recognized as an important part of management of children with juvenile idiopathic arthritis (JIA) but the exercise prescription to best promote bone and muscle health is unknown. We therefore aimed to: 1. assess feasibility and safety of a 6-month home- and group-based exercise program for children with JIA; 2. estimate the effect of program participation on bone mass and strength, muscle function and clinical outcomes and 3. determine if any positive changes in bone and muscle outcomes are maintained 6 months later. METHODS We recruited 24 children with JIA who were part of the Linking Exercise, Physical Activity and Pathophysiology in Childhood Arthritis (LEAP) study to participate in a 6-month home-based exercise program involving jumping and handgrip exercises, resistance training and one group exercise session per month. We assessed lumbar spine bone mass (dual energy X-ray absorptiometry), distal tibia and radius bone microarchitecture and strength (high-resolution peripheral quantitative computed tomography), muscle function (jumping mechanography, dynamometry) and clinical outcomes (joint assessment, function, health-related quality of life) at baseline, 6- and 12-months. Adherence was assessed using weekly activity logs. RESULTS Thirteen children completed the 6-month intervention. Participants reported 9 adverse events and post-exercise pain was rare (0.4%). Fatigue improved, but there were no other sustained improvements in muscle, bone or clinical outcomes. Adherence to the exercise program was low (47%) and decreased over time. CONCLUSION Children with JIA safely participated in a home-based exercise program designed to enhance muscle and bone strength. Fatigue improved, which may in turn facilitate physical activity participation. Prescribed exercise posed adherence challenges and efforts are needed to address facilitators and barriers to participation in and adherence to exercise programs among children with JIA. TRIAL REGISTRATION Data of the children with JIA are from the LEAP study (Canadian Institutes of Health Research (CIHR; GRANT# 107535 ). http://www.leapjia.com/.
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Affiliation(s)
- Kristin M. Houghton
- 0000 0001 0684 7788grid.414137.4Division of Rheumatology, K4-123 ACB, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, University of British Columbia, Vancouver, BC Canada
| | - Heather M. Macdonald
- 0000 0001 2288 9830grid.17091.3eDepartment of Family Practice, University of British Columbia, Vancouver, BC Canada ,0000 0004 0384 4428grid.417243.7Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC Canada
| | - Heather A. McKay
- 0000 0001 2288 9830grid.17091.3eDepartment of Family Practice, University of British Columbia, Vancouver, BC Canada ,0000 0004 0384 4428grid.417243.7Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Orthopaedics, University of British Columbia, Vancouver, BC Canada
| | - Jaime Guzman
- 0000 0001 0684 7788grid.414137.4Division of Rheumatology, K4-123 ACB, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, University of British Columbia, Vancouver, BC Canada
| | - Ciarán Duffy
- 0000 0000 9402 6172grid.414148.cDivision of Rheumatology, Department of Pediatrics, Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | - Lori Tucker
- 0000 0001 0684 7788grid.414137.4Division of Rheumatology, K4-123 ACB, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, University of British Columbia, Vancouver, BC Canada
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23
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Vlachopoulos D. The impact of different loading sports and a jumping intervention on bone health in adolescent males: the PRO-BONE study. Br J Sports Med 2018; 53:1255-1256. [PMID: 30341091 DOI: 10.1136/bjsports-2018-099767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2018] [Indexed: 11/04/2022]
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24
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Pomeroy E, Mushrif-Tripathy V, Kulkarni B, Kinra S, Stock JT, Cole TJ, Shirley MK, Wells JCK. Estimating body mass and composition from proximal femur dimensions using dual energy x-ray absorptiometry. ARCHAEOLOGICAL AND ANTHROPOLOGICAL SCIENCES 2018; 11:2167-2179. [PMID: 31565085 PMCID: PMC6743672 DOI: 10.1007/s12520-018-0665-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/04/2018] [Indexed: 06/10/2023]
Abstract
Body mass prediction from the skeleton most commonly employs femoral head diameter (FHD). However, theoretical predictions and empirical data suggest the relationship between mass and FHD is strongest in young adults, that bone dimensions reflect lean mass better than body or fat mass and that other femoral measurements may be superior. Here, we generate prediction equations for body mass and its components using femoral head, neck and proximal shaft diameters and body composition data derived from dual-energy x-ray absorptiometry (DXA) scans of young adults (n = 155, 77 females and 78 males, mean age 22.7 ± 1.3 years) from the Andhra Pradesh Children and Parents Study, Hyderabad, India. Sex-specific regression of log-transformed data on femoral measurements predicted lean mass with smaller standard errors of estimate (SEEs) than body mass (12-14% and 16-17% respectively), while none of the femoral measurements were significant predictors of fat mass. Subtrochanteric mediolateral shaft diameter gave lower SEEs for lean mass in both sexes and for body mass in males than FHD, while FHD was a better predictor of body mass in women. Our results provide further evidence that lean mass is more closely related to proximal femur dimensions than body or fat mass and that proximal shaft diameter is a better predictor than FHD of lean but not always body mass. The mechanisms underlying these relationships have implications for selecting the most appropriate measurement and reference sample for estimating body or lean mass, which also depend on the question under investigation.
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Affiliation(s)
- Emma Pomeroy
- School of Natural Sciences and Psychology, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF UK
| | | | | | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jay T. Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, UK
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child Health, UCL, London, UK
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25
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Nguyen VH. School-based exercise interventions effectively increase bone mineralization in children and adolescents. Osteoporos Sarcopenia 2018; 4:39-46. [PMID: 30775541 PMCID: PMC6362970 DOI: 10.1016/j.afos.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/09/2018] [Accepted: 05/28/2018] [Indexed: 11/30/2022] Open
Abstract
Osteoporosis and fragility fractures have become major global public health concerns, and they can be prevented by maximizing peak bone mass during childhood and adolescence with weight-bearing physical activity, which can result in stronger and healthier bones that significantly decrease the risk of osteoporosis and fragility fractures in adulthood and the elderly years. From a public health perspective, implementing weight-bearing physical activity for children and adolescents is best achieved with school-based exercise interventions, and a review of school-based exercise interventions was conducted to determine their effectiveness in increasing bone mineral density (BMD) and/or bone mineral content (BMC). Seventeen studies were reviewed, all school-based exercise interventions utilized jumping exercises, and 15 of the 17 studies found at least one significant increase in measures of BMD and/or BMC for the total body, and/or at the hip, vertebrae, and/or wrist. One study that found no significant differences did report significant increases in bone structural strength, and the other study with no significant differences had exercises that measured and reported the lowest ground reaction forces (GRFs) of only 2–3 times body weight (BW), whereas the other studies that showed significant increase(s) in BMD and/or BMC had exercise with measured and reported GRFs ranging from 3.5 × to 8.8 × BW. School-based exercise interventions are time- and cost-efficient and effective in increasing BMD and/or BMC in children and adolescents, but must incorporate high-intensity exercise, such as high-impact jumping of sufficient GRFs, in order to significantly increase bone mineralization for osteoporosis and fragility fracture prevention later in life.
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Affiliation(s)
- Vu H Nguyen
- Public Health Program, Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO, USA
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26
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Gabel L, Macdonald HM, Nettlefold LA, McKay HA. Sex-, Ethnic-, and Age-Specific Centile Curves for pQCT- and HR-pQCT-Derived Measures of Bone Structure and Strength in Adolescents and Young Adults. J Bone Miner Res 2018; 33:987-1000. [PMID: 29394462 DOI: 10.1002/jbmr.3399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/18/2018] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
Abstract
There are presently no adolescent centile curves for bone parameters at the tibial midshaft using peripheral quantitative computed tomography (pQCT) or at the distal radius and tibia using high-resolution pQCT (HR-pQCT). Thus, we aimed to develop sex-, ethnic-, site-, and age-specific centile curves for pQCT and HR-pQCT-derived bone outcomes for youth and young adults aged 10 to 21 years. We acquired pQCT scans (XCT3000 or XCT2000) at the tibial midshaft (50% site) and HR-pQCT scans (XtremeCT) at the distal radius (7% site) and tibia (8% site) in a convenience sample of participants in the mixed-longitudinal University of British Columbia Healthy Bones III Study. We scanned 778 10- to 21-year-olds annually for a maximum of 11 years using pQCT (413 girls, 56% Asian; 365 boys, 54% Asian; n = 3160 observations) and 349 10- to 21-year-olds annually for a maximum of 4 years using HR-pQCT (189 girls, 51% Asian; 165 boys, 50% Asian; n = 1090 observations). For pQCT, we report cortical bone mineral density (BMD), total bone cross-sectional area, and polar strength-strain index. For HR-pQCT, we report standard measures (total BMD, trabecular number, thickness, and bone volume fraction) and automated segmentation measures (total bone cross-sectional area, cortical BMD, porosity, and thickness). We applied finite element analysis to estimate failure load. We applied the lamda, mu, sigma (LMS) method using LMS ChartMaker Light (version 2.5, The Institute of Child Health, London, UK) to construct LMS tables and centile plots. We report sex- and age-specific centiles (3rd, 10th, 25th, 50th, 75th, and 97th) for whites and Asians for pQCT bone parameters at the tibial midshaft and HR-pQCT bone parameters at the distal radius and tibia. These centile curves might be used by clinicians and scientists to interpret values or better understand trajectories of bone parameters in clinical populations, those from different geographic regions or of different ethnic origins. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay A Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
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27
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Evaluation of a Pilot School-Based Physical Activity Clustered Randomised Controlled Trial-Active Schools: Skelmersdale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051011. [PMID: 29772839 PMCID: PMC5982050 DOI: 10.3390/ijerph15051011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 12/12/2022]
Abstract
Schools are key environments in which physical activity (PA) can be promoted. Various strategies and opportunities should be used to engage children in PA within schools. The aim of this study was to evaluate the effectiveness of the multi-component Active Schools: Skelmersdale (AS:Sk) pilot intervention on children's PA and sedentary time (ST). The AS:Sk intervention was implemented for eight weeks in four schools with three control schools continuing normal practice. It consisted of eight components: active breaks, bounce at the bell, 'Born To Move' videos, Daily Mile or 100 Mile Club, playground activity challenge cards, physical education teacher training, newsletters, and activity homework. Child-level measures were collected at baseline and follow-up, including objectively measured PA. After accounting for confounding variables, the intervention had a significant effect on school day ST which was significantly less for the intervention children by 9 min per day compared to the control group. The AS:Sk pilot intervention was effective in reducing school day ST but significant changes in PA were negligible. To increase the efficacy of the current and future school-based interventions, authors should focus on implementation and process evaluations to better understand how schools are implementing intervention components.
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28
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Zhang T, Gao J, Fang J, Gong H. Multiscale investigation on the effects of additional weight bearing in combination with low-magnitude high-frequency vibration on bone quality of growing female rats. J Bone Miner Metab 2018; 36:157-169. [PMID: 28293780 DOI: 10.1007/s00774-017-0827-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 02/15/2017] [Indexed: 11/29/2022]
Abstract
This study aimed to explore the effects of additional weight bearing in combination with low-magnitude high-frequency vibration (LMHFV; 45 Hz, 0.3 g) on bone quality. One hundred twenty rats were randomly divided into ten groups; namely, sedentary (SED), additional weight bearing in which the rat wears a backpack whose weight is x% of the body weight (WBx; x = 5, 12, 19, 26), basic vibration (V), and additional weight bearing in combination with LMHFV in which the rat wears a backpack whose weight is x% of the body weight (Vx; x = 5, 12, 19, 26). The experiment was conducted for 12 weeks, 7 days per week, and 15 min per day. A three-point bending mechanical test, micro computed tomography, and a nanoindentation test were used. Serum samples were analyzed chemically. Failure load in V19 rats was significantly lower than that in SED rats (P < 0.05). Vx (x = 5, 12, 19, 26) rats showed poor microarchitectures. The content of tartrate-resistant acid phosphatase 5b was significantly higher in Vx (x = 5, 12, 19, 26) rats than that in SED rats (P < 0.05). V26 rats demonstrated comparatively better nanomechanical properties of materials than the other vibrational groups. Additional weight bearing in combination with LMHFV negatively affected the macromechanical properties and microarchitecture of bone. Heavy additional weight bearing, such as 26% of body weight, in combination with LMHFV was able to improve the nanomechanical properties of growing bone material compared with LMHFV. A combined mechanical stimulation was used, which may provide useful information to understand the mechanism of this mechanical stimulation on bone.
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Affiliation(s)
- Tianlong Zhang
- Department of Engineering Mechanics, Jilin University, Changchun, 130022, People's Republic of China
| | - Jiazi Gao
- Department of Engineering Mechanics, Jilin University, Changchun, 130022, People's Republic of China
| | - Juan Fang
- Department of Engineering Mechanics, Jilin University, Changchun, 130022, People's Republic of China
| | - He Gong
- Department of Engineering Mechanics, Jilin University, Changchun, 130022, People's Republic of China.
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29
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Williams CA, Gracia-Marco L. The effect of a high-impact jumping intervention on bone mass, bone stiffness and fitness parameters in adolescent athletes. Arch Osteoporos 2018; 13:128. [PMID: 30446875 PMCID: PMC6244891 DOI: 10.1007/s11657-018-0543-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study demonstrates that a 9-month jumping intervention can improve bone mass gains and physical fitness performance in adolescent males participating in non-osteogenic sports, such as swimming and cycling. PURPOSE To examine the effect of a jumping intervention on bone mass, bone stiffness and fitness parameters in adolescents involved in different sports. METHODS Ninety-three adolescent male swimmers (SWI), footballers (FOO) and cyclists (CYC) were randomised to intervention (INT) and sport (INT-SWI = 19, INT-FOO = 15, INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, CON-CYC = 12) groups. The 9-month jumping intervention consisted of 3 levels (12 weeks each) of 20 repetitions per set of counter movement jumps (CMJ) using adjustable weight vests (level 1 = 20 CMJ jumps/set, 0 kg, 3 sets/day, 3 times/week; level 2 = 20 CMJ jumps/set, 2 kg, 4 sets/day, 3 times/week; level 3 = 20 CMJ jumps/set, 5 kg, 4 sets/day, 4 times/week). Total body bone mineral content (BMC) at total body less head (TBLH) was measured using dual-energy X-ray absorptiometry and bone stiffness using quantitative ultrasound. Fitness was assessed using the 20-m shuttle run (20mSRT), CMJ and standing long jump (SLJ) tests. RESULTS INT-SWI had significantly higher increase in BMC legs and bone stiffness compared to CON-SWI (4.2-12.7%). INT-CYC had significantly higher increase in BMC at TBLH and legs and bone stiffness compared to CON-CYC (5.0-12.3%). There were no significant differences between INT-FOO and CON-FOO in any bone outcomes (0.9-3.9%). The increase in CMJ performance was significantly higher in INT-SWI (3.1 cm) and INT-CYC (3.2 cm) compared to CON-SWI and CON-CYC groups, respectively. CONCLUSIONS A 9-month jumping intervention can improve bone mass, bone stiffness and muscular fitness in adolescent males participating in non-osteogenic sports, such as swimming and cycling. CLINICAL TRIAL REGISTRATION ISRCTN17982776.
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Affiliation(s)
- Dimitris Vlachopoulos
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Alan R. Barker
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Esther Ubago-Guisado
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2194 2329grid.8048.4IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Craig A. Williams
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Luis Gracia-Marco
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2152 8769grid.11205.37Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain ,0000000121678994grid.4489.1PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Ekström A, Östenberg AH, Björklund G, Alricsson M. The effects of introducing Tabata interval training and stability exercises to school children as a school-based intervention program. Int J Adolesc Med Health 2017; 31:ijamh-2017-0043. [PMID: 29168957 DOI: 10.1515/ijamh-2017-0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Background Physical activities during leisure time as well as school hours have changed over the past few years, with adolescents being less physically active and adopting a sedentary lifestyle. Objective The overall objective of this mixed-methods study was to evaluate the feasibility of introducing a 4-min Tabata interval training into a lower secondary school context. A further aim was to evaluate the possible effects on: coordination, balance, and strength. Methods The study was conducted as an intervention study with a mixed-method approach. Forty-three children, aged 7-9 years, participated in the intervention group. Additionally, 13 children were recruited as a control group. The intervention itself was delivered by the teachers and was performed for 4-min every day in a classroom setting. All participants performed physical tests before and after the intervention period to evaluate the Tabata training. After the completion of the 6-week Tabata interval training, the four teachers were interviewed. Results The push-ups (p = 0.004), kneeling push-ups (p = 0.03), and standing long jump (p = 0.01) improved in the intervention group after 6 weeks. No differences were observed between the genders. The teachers experienced that it worked well to integrate the Tabata interval training in the classroom setting. Conclusion After 6 weeks, a school-based Tabata intervention program improved physical performance. The teachers saw no obstacles in including the Tabata intervention program in a classroom setting and pointed out several positive aspects such as an increased energy level and development in the children's movement patterns.
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Affiliation(s)
- Annika Ekström
- Department of Sports Science, Linnaeus University, Kalmar/Växjö, Sweden
| | | | - Glenn Björklund
- The Swedish Sports Confederation, Stockholm, Sweden
- Swedish Winter Sport Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Marie Alricsson
- Department of Sports Science, Linnaeus University, Kalmar/Växjö, Sweden
- Swedish Winter Sport Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Abstract
PURPOSE We examined the influence of vigorous physical activity (VPA) bout frequency on bone strength accrual across adolescence, independent of total volume of VPA. METHODS We measured VPA (6 metabolic equivalents; total volume and bout frequency <5 min in duration) annually using waist-worn accelerometers (ActiGraph GT1M) in 309 adolescents (9-20 y at baseline: 99, <13 y; 126, 13-18 y; 84, >18 y) over a maximum of 4 years. We applied finite element analysis to high-resolution peripheral quantitative computed tomography scans of the distal tibia (8% site) to estimate bone strength (failure load; F.Load, Newtons). We fit a mixed effects model with maturity offset (years from age at peak height velocity) as a random effect and sex, ethnicity, tibia length, lean body mass, and VPA (volume and bout frequency) as fixed effects. RESULTS VPA volume and bout frequency were positively associated with F.Load across adolescence; however, VPA volume did not predict F.Load once VPA bout frequency was included in the model. Participants in the upper quartile of VPA bout frequency (∼33 bouts per day) had 10% (500 N) greater F.Load across adolescence compared with participants in the lowest quartile (∼9 bouts per day; P = .012). Each additional daily bout of VPA was associated with 21 N greater F.Load, independent of total volume of VPA. CONCLUSION Frequent VPA should be promoted for optimal bone strength accrual.
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Abstract
PURPOSE The goal of the current work is to challenge the enduring notion that prepuberty is the optimum timing for maximum bone response to exercise in childhood and to present the evidence that early puberty is a more potently receptive period. METHOD The relevant literature is reviewed and the causes of the misconception are addressed in detail. RESULTS Contrary to prevailing opinion, ample evidence exists to suggest that the peripubertal years represent the developmental period during which bone is likely to respond most robustly to exercise intervention. CONCLUSION Public health initiatives that target bone-specific exercise interventions during the pubertal years are likely to be the most effective strategy to harness the increased receptiveness of the growing skeleton to mechanical loading.
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Gabel L, Macdonald HM, Nettlefold L, McKay HA. Physical Activity, Sedentary Time, and Bone Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT study. J Bone Miner Res 2017; 32:1525-1536. [PMID: 28326606 DOI: 10.1002/jbmr.3115] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 11/08/2022]
Abstract
Bone strength is influenced by bone geometry, density, and bone microarchitecture, which adapt to increased mechanical loads during growth. Physical activity (PA) is essential for optimal bone strength accrual; however, less is known about how sedentary time influences bone strength and its determinants. Thus, our aim was to investigate the prospective associations between PA, sedentary time, and bone strength and its determinants during adolescence. We used HR-pQCT at distal tibia (8% site) and radius (7% site) in 173 girls and 136 boys (aged 9 to 20 years at baseline). We conducted a maximum of four annual measurements at the tibia (n = 785 observations) and radius (n = 582 observations). We assessed moderate-to-vigorous PA (MVPA) and sedentary time with accelerometers (ActiGraph GT1M). We aligned participants on maturity (years from age at peak height velocity) and fit a mixed-effects model adjusting for maturity, sex, ethnicity, leg muscle power, lean mass, limb length, dietary calcium, and MVPA in sedentary time models. MVPA was a positive independent predictor of bone strength (failure load [F.Load]) and bone volume fraction (BV/TV) at the tibia and radius, total area (Tt.Ar) and cortical porosity (Ct.Po) at the tibia, and negative predictor of load-to-strength ratio at the radius. Sedentary time was a negative independent predictor of Tt.Ar at both sites and Ct.Po at the tibia and a positive predictor of cortical thickness (Ct.Th), trabecular thickness (Tb.Th), and cortical bone mineral density (Ct.BMD) at the tibia. Bone parameters demonstrated maturity-specific associations with MVPA and sedentary time, whereby associations were strongest during early and mid-puberty. Our findings support the importance of PA for bone strength accrual and its determinants across adolescent growth and provide new evidence of a detrimental association of sedentary time with bone geometry but positive associations with microarchitecture. This study highlights maturity-specific relationships of bone strength and its determinants with loading and unloading. Future studies should evaluate the dose-response relationship and whether associations persist into adulthood. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
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Okubo R, Sanada LS, Castania VA, Louzada MJQ, de Paula FJA, Maffulli N, Shimano AC. Jumping exercise preserves bone mineral density and mechanical properties in osteopenic ovariectomized rats even following established osteopenia. Osteoporos Int 2017; 28:1461-1471. [PMID: 28124728 DOI: 10.1007/s00198-017-3905-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/02/2017] [Indexed: 10/20/2022]
Abstract
UNLABELLED The effects of jump training on bone structure before and after ovariectomy-induced osteopenia in rats were investigated. Jumping exercise induced favorable changes in bone mineral density, bone mechanical properties, and bone formation/resorption markers. This exercise is effective to prevent bone loss after ovariectomy even when osteopenia is already established. INTRODUCTION The present study investigated the effects of jump training on bone structure before and after ovariectomy-induced osteopenia in 80 10-week-old Wistar rats. METHODS Forty rats (prevention program) were randomly allocated to one of four equal groups (n = 10): sham-operated sedentary (SHAM-SEDp), ovariectomized (OVX) sedentary (OVX-SEDp), sham-operated exercised (SHAM-EXp), and OVX exercised (OVX-EXp). SHAM-EXp and OVX-EXp animals began training 3 days after surgery. Another 40 rats (treatment program) were randomly allocated into another four groups (n = 10): sham-operated sedentary (SHAM-SEDt), OVX sedentary (OVX-SEDt), sham-operated exercised (SHAM-EXt), and OVX exercised (OVX-EXt). SHAM-EXt and OVX-EXt animals began training 60 days after surgery. The rats in the exercised groups jumped 20 times/day, 5 days/week, to a height of 40 cm for 12 weeks. At the end of the experimental period, serum osteocalcin, follicle-stimulating hormone (FSH) dosage, dual X-ray absorptiometry (DXA), histomorphometry, and biomechanical tests were analyzed. RESULTS The OVX groups showed higher values of FSH and body weight (p < 0.05). DXA showed that jump training significantly increased bone mineral density of the femur and fifth lumbar vertebra (p < 0.05). The stiffness of the left femur and fifth lumbar vertebra in the exercised groups was greater than that of the sedentary groups (p < 0.05). Ovariectomy induced significant difference in bone volume (BV/TV, percent), trabecular separation (Tb.Sp, micrometer), and trabecular number (Tb.N, per millimeter) (p < 0.05) compared to sham operation. Jump training in the OVX group induced significant differences in BV/TV, Tb.Sp, and Tb.N and decreased osteoblast number per bone perimeter (p < 0.05) compared with OVX nontraining, in the prevention groups. Osteocalcin dosage showed higher values in the exercised groups (p < 0.05). CONCLUSIONS Jumping exercise induced favorable changes in bone mineral density, bone mechanical properties, and bone formation/resorption markers. Jump training is effective to prevent bone loss after ovariectomy even when osteopenia is already established.
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Affiliation(s)
- R Okubo
- Department of Physiotherapy, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil.
| | - L S Sanada
- Department of Physiotherapy, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - V A Castania
- Department of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, School of Medicine of Ribeirao Preto, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| | - M J Q Louzada
- Department of Animal Support, Production and Health, School of Veterinary Medicine, Sao Paulo State University, Araçatuba, São Paulo, Brazil
| | - F J A de Paula
- Department of Internal Medicine, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - N Maffulli
- Faculty of Medicine and Surgery, Department of Musculoskeletal Disorders, University of Salerno, Salerno, Italy
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, England, E1 4DG, UK
| | - A C Shimano
- Department of Biomechanics, Medicine and Rehabilitation of Locomotor Apparatus, School of Medicine of Ribeirao Preto, University of Sao Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
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Gómez-Bruton A, Matute-Llorente Á, González-Agüero A, Casajús JA, Vicente-Rodríguez G. Plyometric exercise and bone health in children and adolescents: a systematic review. World J Pediatr 2017; 13:112-121. [PMID: 28101776 DOI: 10.1007/s12519-016-0076-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 12/18/2015] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many jumping interventions have been performed in children and adolescents in order to improve bone-related variables and thus, ensure a healthy bone development during these periods and later in life. This systematic review aims to summarize and update present knowledge regarding the effects that jumping interventions may have on bone mass, structure and metabolism in order to ascertain the efficacy and durability (duration of the effects caused by the intervention) of the interventions. DATA SOURCES Identification of studies was performed by searching in the database MEDLINE/PubMed and SportDiscus. Additional studies were identified by contacting clinical experts and searching bibliographies and abstracts. Search terms included "bone and bones", "jump*", "weight-bearing", "resistance training" and "school intervention". The search was conducted up to October 2014. Only studies that had performed a specific jumping intervention in under 18-year olds and had measured bone mass were included. Independent extraction of articles was done by 2 authors using predefined data fields. RESULTS A total of 26 studies were included in this review. Twenty-four studies found positive results as subjects included in the intervention groups showed higher bone mineral density, bone mineral content and bone structure improvements than controls. Only two studies found no effects on bone mass after a 10-week and 9-month intervention. Moreover, those studies that evaluated the durability of the effects found that some of the increases in the intervention groups were maintained after several years. CONCLUSIONS Jumping interventions during childhood and adolescence improve bone mineral content, density and structural properties without side effects. These type of interventions should be therefore implemented when possible in order to increase bone mass in early stages of life, which may have a direct preventive effect on bone diseases like osteoporosis later in life.
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Affiliation(s)
- Alejandro Gómez-Bruton
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2a planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
| | - Ángel Matute-Llorente
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2a planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
| | - Alejandro González-Agüero
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2a planta, Zaragoza, Spain
| | - José A Casajús
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2a planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
| | - Germán Vicente-Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2a planta, Zaragoza, Spain. .,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.
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Gabel L, Macdonald HM, McKay HA. Sex Differences and Growth-Related Adaptations in Bone Microarchitecture, Geometry, Density, and Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT Study. J Bone Miner Res 2017; 32:250-263. [PMID: 27556581 PMCID: PMC5233447 DOI: 10.1002/jbmr.2982] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/10/2016] [Accepted: 08/22/2016] [Indexed: 11/09/2022]
Abstract
Sex differences in bone strength and fracture risk are well documented. However, we know little about bone strength accrual during growth and adaptations in bone microstructure, density, and geometry that accompany gains in bone strength. Thus, our objectives were to (1) describe growth related adaptations in bone microarchitecture, geometry, density, and strength at the distal tibia and radius in boys and girls; and (2) compare differences in adaptations in bone microarchitecture, geometry, density, and strength between boys and girls. We used HR-pQCT at the distal tibia (8% site) and radius (7% site) in 184 boys and 209 girls (9 to 20 years old at baseline). We aligned boys and girls on a common maturational landmark (age at peak height velocity [APHV]) and fit a mixed effects model to these longitudinal data. Importantly, boys showed 28% to 63% greater estimated bone strength across 12 years of longitudinal growth. Boys showed 28% to 80% more porous cortices compared with girls at both sites across all biological ages, except at the radius at 9 years post-APHV. However, cortical density was similar between boys and girls at all ages at both sites, except at 9 years post-APHV at the tibia when girls' values were 2% greater than boys'. Boys showed 13% to 48% greater cortical and total bone area across growth. Load-to-strength ratio was 26% to 27% lower in boys at all ages, indicating lower risk of distal forearm fracture compared with girls. Contrary to previous HR-pQCT studies that did not align boys and girls at the same biological age, we did not observe sex differences in Ct.BMD. Boys' superior bone size and strength compared with girls may confer them a protective advantage. However, boys' consistently more porous cortices may contribute to their higher fracture incidence during adolescence. Large prospective studies using HR-pQCT that target boys and girls who have sustained a fracture are needed to verify this. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M. Macdonald
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Heather A. McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Department of Family Practice, University of British Columbia, Vancouver, Canada
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Martin SPK, Bachrach LK, Golden NH. Controlled Pilot Study of High-Impact Low-Frequency Exercise on Bone Loss and Vital-Sign Stabilization in Adolescents With Eating Disorders. J Adolesc Health 2017; 60:33-37. [PMID: 27836532 DOI: 10.1016/j.jadohealth.2016.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/13/2016] [Accepted: 08/15/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Adolescents with anorexia nervosa (AN) face an increased lifetime risk of bone fragility. This randomized controlled study examined the efficacy and safety of a high-impact activity program on markers of bone turnover and stabilization of vital signs (VSS). METHODS Forty-one hospitalized adolescents with AN were randomly assigned to routine care or routine care plus 20 jumps twice daily. Bone markers were measured at baseline days 1-3 (T1), days 4-6 (T2), and days 7-9 (T3). The primary outcome was change in bone-specific alkaline phosphatase (BSAP) at T3 adjusted for BSAP and % median body mass index at T1. Secondary outcomes were serum N-telopeptide (NTX) and osteocalcin at T3. Safety was determined by comparing weight gain, time to VSS and length of stay for each group. RESULTS BSAP, NTX, or osteocalcin did not differ between groups at baseline or at T3. BSAP and NTX at T3 were not associated with group of enrollment or % median body mass index. VSS was significantly reduced in the intervention group compared with the control group (11.6 ± 5.7 days vs. 17 ± 10.5 days, p = .049). There was no significant difference in weight gain or length of stay between groups. CONCLUSIONS Twice-daily jumping activity failed to influence markers of bone turnover in adolescents with AN but was well tolerated, shortened time to vital-sign stabilization and did not slow weight gain.
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Affiliation(s)
- Susanne P K Martin
- Division of Adolescent Medicine, Stanford University School of Medicine, Palo Alto, California.
| | - Laura K Bachrach
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Palo Alto, California
| | - Neville H Golden
- Division of Adolescent Medicine, Stanford University School of Medicine, Palo Alto, California
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Abstract
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population. Postmenopausal osteoporosis, resulting from oestrogen deficiency, is the most common type of osteoporosis. Oestrogen deficiency results in an increase in bone turnover owing to effects on all types of bone cells. The imbalance in bone formation and resorption has effects on trabecular bone (loss of connectivity) and cortical bone (cortical thinning and porosity). Osteoporosis is diagnosed using bone density measurements of the lumbar spine and proximal femur. Preventive strategies to improve bone health include diet, exercise and abstaining from smoking. Fractures may be prevented by reducing falls in high-risk populations. Several drugs are licensed to reduce fracture risk by slowing down bone resorption (such as bisphosphonates and denosumab) or by stimulating bone formation (such as teriparatide). Improved understanding of the cellular basis for osteoporosis has resulted in new drugs targeted to key pathways, which are under development.
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Drummy C, Murtagh EM, McKee DP, Breslin G, Davison GW, Murphy MH. The effect of a classroom activity break on physical activity levels and adiposity in primary school children. J Paediatr Child Health 2016; 52:745-9. [PMID: 27168479 DOI: 10.1111/jpc.13182] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 11/09/2015] [Accepted: 02/20/2016] [Indexed: 11/29/2022]
Abstract
AIM Despite recognition that regular physical activity is essential for good health, many children do not accumulate sufficient daily physical activity. The aim of this study was to examine the effect of a classroom-based activity break on accelerometer-determined moderate-to-vigorous intensity physical activity (MVPA) and adiposity in primary school children. METHODS One hundred twenty children from seven primary schools in Northern Ireland participated in the study. In each school, one class of children was randomly assigned to an intervention group and another class to a control group. Teachers of the intervention classes led a 5-min activity break three times per day for 12 weeks. Accelerometer-determined MVPA, height, weight and four skinfolds were measured at baseline and post-intervention. RESULTS Compared with the control group, the intervention group significantly increased weekday MVPA (+9.5 min) from baseline to post-intervention. There were no significant changes in BMI; however, an increase in sum-of-skinfolds of the intervention group was observed. CONCLUSIONS Classroom-based activity breaks led by the teacher are successful in increasing children's physical activity levels. The programme shows a positive step in improving overall physical activity levels and contributing to the goal of 60 min daily MVPA.
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Affiliation(s)
- Clare Drummy
- Sport and Exercise Science Research Institute, University of Ulster, Belfast, United Kingdom
| | - Elaine M Murtagh
- Department of Arts Education and Physical Education, Mary Immaculate College, University of Limerick, Limerick, Ireland
| | - David P McKee
- Department of Health and Physical Education, Stranmillis University College, Belfast, United Kingdom
| | - Gavin Breslin
- Sport and Exercise Science Research Institute, University of Ulster, Belfast, United Kingdom
| | - Gareth W Davison
- Sport and Exercise Science Research Institute, University of Ulster, Belfast, United Kingdom
| | - Marie H Murphy
- Sport and Exercise Science Research Institute, University of Ulster, Belfast, United Kingdom
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Ghazal N, Al-Shaar L, Maalouf J, Nabulsi M, Arabi A, Choucair M, Tamim H, Mahfoud Z, El-Hajj Fuleihan G. Persistent Effect of Vitamin D Supplementation on Musculoskeletal Parameters in Adolescents One Year After Trial Completion. J Bone Miner Res 2016; 31:1473-80. [PMID: 26841085 DOI: 10.1002/jbmr.2802] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/19/2016] [Accepted: 01/31/2016] [Indexed: 11/11/2022]
Abstract
We showed a beneficial effect of vitamin D supplementation on musculoskeletal parameters in adolescent girls in a 1-year, randomized, double-blinded placebo-controlled trial (RCT). Our objective for this study was to investigate the residual effect of vitamin D supplementation on bone mineral content (BMC), bone mineral density (BMD), at the lumbar spine and hip, lean mass, and height, 1 year after trial completion. We performed post hoc analyses in 167 adolescents, 86 girls and 81 boys, age 13.9 ± 2 years, who received vitamin D or placebo during the trial, and continued into the follow-up trial. Musculoskeletal parameters were measured at baseline, 12 months (intervention), and 24 months (follow-up). ANOVA and t tests were used to compare results between the placebo group and the merged vitamin D arms (200 or 2000 IU/day), by gender. Baseline characteristics were comparable between treatment groups at entry into the extension. Girls who had received vitamin D during the trial, had significantly larger hip BMC increments compared to those assigned to placebo, at 24 months compared to study entry, but not 24 compared to 12 months, which persisted in adjusted analyses. There were no significant differences in bone mass changes between treatment groups in boys, at 24 months compared to 12 months or to baseline. The beneficial effect of vitamin D supplementation on hip bone mass, achieved in girls during the trial, persisted 1 year after trial completion. These net cumulative increments, 1 year after discontinuation of supplementation, may have important implications on optimizing peak bone mass accretion in adolescent girls. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Nisrine Ghazal
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Laila Al-Shaar
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon.,Scholars in Health Research Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joyce Maalouf
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Calcium Metabolism and Osteoporosis Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mona Nabulsi
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Asma Arabi
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mahmoud Choucair
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon
| | | | - Ghada El-Hajj Fuleihan
- American University of Beirut Medical Center (AUB-MC), Beirut, Lebanon.,Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon.,Scholars in Health Research Program, American University of Beirut Medical Center, Beirut, Lebanon.,Calcium Metabolism and Osteoporosis Program, American University of Beirut Medical Center, Beirut, Lebanon
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Faigenbaum AD. State of the Art Reviews: Resistance Training for Children and Adolescents. Am J Lifestyle Med 2016. [DOI: 10.1177/1559827606296814] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although much of what we understand about the stimulus of resistance exercise has been gained by exploring the responses of adults to various training protocols, research into the effects of resistance exercise on children and adolescents has increased over the past decade. Despite outdated concerns that resistance training was ineffective or unsafe for youth, research increasingly suggests that resistance training can be a safe and effective method of exercise for children and adolescents provided that appropriate training guidelines are followed. In addition to enhancing motor skills and sports performance, regular participation in a youth resistance training program has the potential to positively influence several measurable indices of health. It helps strengthen bone, facilitate weight control, enhance psychosocial well-being, and improve one's cardiovascular risk profile. Furthermore, a stronger musculoskeletal system will enable boys and girls to perform life's daily activities with more energy and vigor and may increase a young athlete's resistance to sports-related injuries. Along with other types of physical activity, a properly designed youth resistance training program can offer observable health value to children and adolescents when appropriately prescribed and supervised.
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Affiliation(s)
- Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08628-0718,
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42
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Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O'Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 2016; 27:1281-1386. [PMID: 26856587 PMCID: PMC4791473 DOI: 10.1007/s00198-015-3440-3] [Citation(s) in RCA: 722] [Impact Index Per Article: 90.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/10/2015] [Indexed: 12/21/2022]
Abstract
Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. [Table: see text] Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.
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Affiliation(s)
- C M Weaver
- Department of Nutritional Sciences, Women's Global Health Institute, Purdue University, 700 W. State Street, West Lafayette, IN, 47907, USA
| | - C M Gordon
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital, 3333 Burnet Avenue, MLC 4000, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
| | - K F Janz
- Departments of Health and Human Physiology and Epidemiology, University of Iowa, 130 E FH, Iowa City, IA, 52242, USA
| | - H J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA
| | - J M Lappe
- Schools of Nursing and Medicine, Creighton University, 601 N. 30th Street, Omaha, NE, 68131, USA
| | - R Lewis
- Department of Foods and Nutrition, University of Georgia, Dawson Hall, Athens, GA, 30602, USA
| | - M O'Karma
- The Children's Hospital of Philadelphia Research Institute, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
| | - T C Wallace
- Department of Nutrition and Food Studies, George Mason University, MS 1 F8, 10340 Democracy Lane, Fairfax, VA, 22030, USA.
- National Osteoporosis Foundation, 1150 17th Street NW, Suite 850, Washington, DC, 20036, USA.
- National Osteoporosis Foundation, 251 18th Street South, Suite 630, Arlington, VA, 22202, USA.
| | - B S Zemel
- University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
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Hubbard K, Economos CD, Bakun P, Boulos R, Chui K, Mueller MP, Smith K, Sacheck J. Disparities in moderate-to-vigorous physical activity among girls and overweight and obese schoolchildren during school- and out-of-school time. Int J Behav Nutr Phys Act 2016; 13:39. [PMID: 27000400 PMCID: PMC4802912 DOI: 10.1186/s12966-016-0358-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 03/02/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Increasing physical activity (PA) during the school day and out-of-school time are critical strategies for preventing childhood obesity and improving overall health. The purpose of the present investigation was to examine schoolchildren's volume and type of PA during school-time and out-of-school, compared to national recommendations and differences by sex and weight status. METHODS This cross-sectional analysis included 517 3(rd)-5(th) grade schoolchildren from 13 New England elementary schools (October 2013-January 2014). Demographics were collected by parent questionnaire. Measured height and weight were used to categorize child weight status. Accelerometer data were collected over 7 days. PA was coded as total activity counts and minutes of sedentary, light, and moderate-to-vigorous physical activity (SED, LPA, MVPA) during 1) school, 2) weekday out-of-school, 3) weekend, and 4) total daily time. Multivariable mixed models were used to examine associations between sex and weight status and total counts, SED, LPA, and MVPA, controlling for demographics, wear-time, and clustering within schools. RESULTS 453 participants (60.5% girls; mean age 9.1 years; 30.5% overweight/obese) had valid accelerometer wear time (≥3 days, ≥ 10 h/day). Few children achieved 60 min total daily (15.0%) or school-time (8.0 %) MVPA recommendations. For all time-of-day categories, girls achieved fewer MVPA minutes than boys (p < .0001), and overweight/obese participants achieved fewer MVPA minutes than normal/underweight participants (p = 0.05). Minutes of LPA declined by grade-level (p < .05) and were lower in girls than boys during school-time only (p < .05). CONCLUSION Disparities in MVPA by sex and weight status across school and out-of-school time highlight the need for programs with equitable reach.
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Affiliation(s)
- Kristie Hubbard
- />Tufts University School of Medicine, Public Health and Community Medicine, 145 Harrison Avenue, Boston, MA 02111 USA
| | - Christina D. Economos
- />ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Peter Bakun
- />ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Rebecca Boulos
- />University of New England, School of Community and Population Health, 11 Hills Beach Rd, Biddeford, ME 04005 USA
| | - Kenneth Chui
- />Tufts University School of Medicine, Public Health and Community Medicine, 145 Harrison Avenue, Boston, MA 02111 USA
| | - Megan P. Mueller
- />Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Katie Smith
- />ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Jennifer Sacheck
- />Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
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Yanagihara GR, Paiva AG, Gasparini GA, Macedo AP, Frighetto PD, Volpon JB, Shimano AC. High-impact exercise in rats prior to and during suspension can prevent bone loss. Braz J Med Biol Res 2016; 49:S0100-879X2016000300605. [PMID: 26840705 PMCID: PMC4763823 DOI: 10.1590/1414-431x20155086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/16/2015] [Indexed: 11/22/2022] Open
Abstract
High-impact exercise has been considered an important method for treating bone loss in osteopenic experimental models. In this study, we investigated the effects of osteopenia caused by inactivity in femora and tibiae of rats subjected to jump training using the rat tail suspension model. Eight-week-old female Wistar rats were divided into five groups (n=10 each group): jump training for 2 weeks before suspension and training during 3 weeks of suspension; jump training for 2 weeks before suspension; jump training only during suspension; suspension without any training; and a control group. The exercise protocol consisted of 20 jumps/day, 5 days/week, with a jump height of 40 cm. The bone mineral density of the femora and tibiae was measured by double energy X-ray absorptiometry and the same bones were evaluated by mechanical tests. Bone microarchitecture was evaluated by scanning electron microscopy. One-way ANOVA was used to compare groups. Significance was determined as P<0.05. Regarding bone mineral density, mechanical properties and bone microarchitecture, the beneficial effects were greater in the bones of animals subjected to pre-suspension training and subsequently to training during suspension, compared with the bones of animals subjected to pre-suspension training or to training during suspension. Our results indicate that a period of high impact exercise prior to tail suspension in rats can prevent the installation of osteopenia if there is also training during the tail suspension.
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Affiliation(s)
- G R Yanagihara
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A G Paiva
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - G A Gasparini
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A P Macedo
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P D Frighetto
- Instituto Federal de Educação, Ciência e Tecnologia de São Paulo, São Paulo, SP, Brasil
| | - J B Volpon
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A C Shimano
- Laboratório de Bioengenharia, Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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45
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Daly RM, Ducher G, Hill B, Telford RM, Eser P, Naughton G, Seibel MJ, Telford RD. Effects of a Specialist-Led, School Physical Education Program on Bone Mass, Structure, and Strength in Primary School Children: A 4-Year Cluster Randomized Controlled Trial. J Bone Miner Res 2016; 31:289-98. [PMID: 26260216 DOI: 10.1002/jbmr.2688] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/09/2022]
Abstract
This 4-year cluster randomized controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 years) from grade 2 in 29 primary schools investigated the effects of a specialist-taught physical education (PE) program on bone strength and body composition. All children received 150 min/week of common practice (CP) PE from general classroom teachers but in 13 schools 100 min/week of CP PE was replaced by specialized-led PE (SPE) by teachers who emphasized more vigorous exercise/games combined with static and dynamic postural activities involving muscle strength. Outcome measures assessed in grades 2, 4, and 6 included: total body bone mineral content (BMC), lean mass (LM), and fat mass (FM) by DXA, and radius and tibia (4% and 66% sites) bone structure, volumetric density and strength, and muscle cross-sectional area (CSA) by pQCT. After 4-years, gains in total body BMC, FM, and muscle CSA were similar between the groups in both sexes, but girls in the SPE group experienced a greater gain in total body LM (mean 1.0 kg; 95% CI, 0.2 to 1.9 kg). Compared to CP, girls in the SPE group also had greater gains in cortical area (CoA) and cortical thickness (CoTh) at the mid-tibia (CoA, 5.0% [95% CI, 0.2% to 1.9%]; CoTh, 7.5% [95% CI, 2.4% to 12.6%]) and mid-radius (CoA, 9.3% [95% CI, 3.5% to 15.1%]; CoTh, 14.4% [95% CI, 6.1% to 22.7%]), whereas SPE boys had a 5.2% (95% CI, 0.4% to 10.0%) greater gain in mid-tibia CoTh. These benefits were due to reduced endocortical expansion. There were no significant benefits of SPE on total bone area, cortical density or bone strength at the mid-shaft sites, nor any appreciable effects at the distal skeletal sites. This study indicates that a specialist-led school-based PE program improves cortical bone structure, due to reduced endocortical expansion. This finding challenges the notion that periosteal apposition is the predominant response of bone to loading during the prepubertal and early-pubertal period.
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Affiliation(s)
- Robin M Daly
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
| | - Gaele Ducher
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
| | - Briony Hill
- School of Psychology, Deakin University, Melbourne, Australia
| | - Rohan M Telford
- Centre for Research and Action in Public Health, Department of Health, University of Canberra, Canberra, Australia
| | - Prisca Eser
- Swiss Cardiovascular Centre Bern, University Hospital (Inselspital), Bern, Switzerland
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, The University of Sydney, Sydney, Australia
| | - Richard D Telford
- UC Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
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Gabel L, Nettlefold L, Brasher PM, Moore SA, Ahamed Y, Macdonald HM, McKay HA. Reexamining the Surfaces of Bone in Boys and Girls During Adolescent Growth: A 12-Year Mixed Longitudinal pQCT Study. J Bone Miner Res 2015; 30:2158-67. [PMID: 26058373 PMCID: PMC5059154 DOI: 10.1002/jbmr.2570] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 06/01/2015] [Accepted: 06/04/2015] [Indexed: 11/09/2022]
Abstract
We revisit Stanley Garn's theory related to sex differences in endocortical and periosteal apposition during adolescence using a 12-year mixed longitudinal study design. We used peripheral quantitative computed tomography to examine bone parameters in 230 participants (110 boys, 120 girls; aged 11.0 years at baseline). We assessed total (Tt.Ar, mm(2)), cortical (Ct.Ar, mm(2)), and medullary canal area (Me.Ar, mm(2)), Ct.Ar/Tt.Ar, cortical bone mineral density (Ct.BMD, mg/cm(3)), and polar strength-strain index (SSIp , mm(3)) at the tibial midshaft (50% site). We used annual measures of height and chronological age to identify age at peak height velocity (APHV) for each participant. We compared annual accrual rates of bone parameters between boys and girls, aligned on APHV using a linear mixed effects model. At APHV, boys demonstrated greater Tt.Ar (ratio = 1.27; 95% confidence interval [CI] 1.21, 1.32), Ct.Ar (1.24 [1.18, 1.30]), Me.Ar (1.31 [1.22, 1.40]), and SSIp (1.36 [1.28, 1.45]) and less Ct.Ar/Tt.Ar (0.98 [0.96, 1.00]) and Ct.BMD (0.97 [0.96, 0.97]) compared with girls. Boys and girls demonstrated periosteal bone formation and net bone loss at the endocortical surface. Compared with girls, boys demonstrated greater annual accrual rates pre-APHV for Tt.Ar (1.18 [1.02, 1.34]) and Me.Ar (1.34 [1.11, 1.57]), lower annual accrual rates pre-APHV for Ct.Ar/Tt.Ar (0.56 [0.29, 0.83]) and Ct.BMD (-0.07 [-0.17, 0.04]), and similar annual accrual rates pre-APHV for Ct.Ar (1.10 [0.94, 1.26]) and SSIp (1.14 [0.98, 1.30]). Post-APHV, boys demonstrated similar annual accrual rates for Ct.Ar/Tt.Ar (1.01 [0.71, 1.31]) and greater annual accrual rates for all other bone parameters compared with girls (ratio = 1.23 to 2.63; 95% CI 1.11 to 3.45). Our findings support those of Garn and others of accelerated periosteal apposition during adolescence, more evident in boys than girls. However, our findings challenge the notion of greater endocortical apposition in girls, suggesting instead that girls experience diminished endocortical resorption compared with boys.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Penelope M Brasher
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Sarah A Moore
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Yasmin Ahamed
- Centre of Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Heather M Macdonald
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Abstract
BACKGROUND Periods of growth are thought to be the best time to increase bone mineral content, bone area, and areal bone mineral density (aBMD) through increased loading owing to high rates of bone modeling and remodeling. However, questions remain regarding whether a benefit of exercise is seen at all bone sites, is dependent on pubertal status or sex of the child, or whether other factors such as diet modify the response to exercise. QUESTIONS/PURPOSES We asked: (1) Does bone-loading exercise in childhood consistently increase bone mineral content, bone area, or aBMD? (2) Do effects of exercise differ depending on pubertal status or sex? (3) Does calcium intake modify the bone response to exercise? METHODS A literature search identified 22 unique trials for inclusion in this meta-analysis of the effect of exercise on bone changes by bone site, pubertal status, and sex. Sample sizes ranged from 16 to 410 subjects 3 to 18 years old with length of intervention ranging from 3 to 36 months. Fifteen of 22 trials were randomized (child randomized in nine, classroom/school randomized in six) and seven were observational trials. Ten trials were Level 2 and 11 were Level 3 based on the Oxford Centre for Evidence-Based Medicine criteria. Random effects models tested the difference (intervention mean effect-control mean effect) in percent change in bone mineral content, bone area, and aBMD. Meta-regression was used to identify sources of heterogeneity and funnel plots were used to assess publication bias. RESULTS Children assigned to exercise had greater mean percent changes in bone mineral content and aBMD than children assigned to the control groups. Mean differences (95% CI) in bone mineral content percent change between intervention and control groups at total body (0.8; 95% CI, 0.3-1.3; p = 0.003), femoral neck (1.5; 95% CI, 0.5-2.5; p = 0.003), and spine (1.7; 95% CI, 0.4-3.1; p = 0.01) were significant with no differences in bone area (all p > 0.05). There were greater percent changes in aBMD in intervention than control groups at the femoral neck (0.6; 95% CI, 0.2-1.1; p = 0.006) and spine (1.2; 95% CI, 0.6-1.8; p < 0.001). Benefit of exercise was limited to children who were prepubertal (bone mineral content: total body [0.9; 95% CI, 0.2-1.7; p = 0.01], femoral neck [1.8; 95% CI, 0.0-3.5; p = 0.047], spine [3.7; 95% CI, 0.8-6.6; p = 0.01], and aBMD: femoral neck [0.6; 95% CI, -0.1-1.2; p = 0.07], spine [1.5; 95% CI, 0.7-2.3; p < 0.001]), with no differences among children who were pubertal (all p > 0.05). Changes in aBMD did not differ by sex (all p > 0.05), although the number of studies providing male-specific results was small (six of 22 eligible studies included boys). There was significant heterogeneity in bone mineral content and bone area for which a source could not be identified. Heterogeneity in spine aBMD was reduced by including calcium intake and intervention length as covariates. Three trials designed to determine whether calcium intake modified the bone response to exercise all reported a greater effect of exercise on leg bone mineral content in children randomized to receive supplemental calcium than those receiving placebo. CONCLUSIONS Exercise interventions during childhood led to 0.6% to 1.7% greater annual increase in bone accrual, with effects predominantly among children who were prepubertal. If this effect were to persist into adulthood, it would have substantial implications for osteoporosis prevention. It is important to identify sources of heterogeneity among studies to determine factors that might influence the bone response to increased exercise during growth. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Bonny Specker
- />EA Martin Program, South Dakota State University, SWC Box 506, Brookings, SD 57007 USA
| | - Natalie W. Thiex
- />Biology and Microbiology Department, South Dakota State University, Brookings, SD USA
| | - Ramu G. Sudhagoni
- />Master of Public Health Program, School of Health Sciences, University of South Dakota, Vermillion, SD USA
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48
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Kato T, Niwa M, Yamashita T, Matumoto M, Umemura Y. Past sporting activity during growth induces greater bone mineral content and enhances bone geometry in young men and women. J Bone Miner Metab 2015; 33:569-76. [PMID: 25224129 DOI: 10.1007/s00774-014-0620-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/08/2014] [Indexed: 11/30/2022]
Abstract
We aimed to determine the effect of past sporting activity on bone mineral content (BMC), areal bone mineral density (aBMD) in the lumbar spine and proximal femur, and bone geometry of the mid femur in young men and women. We assessed 142 subjects, comprising 79 young men (21.2 ± 0.8 years) and 63 premenopausal young women (21.4 ± 0.6 years). The subjects were classified into three groups, two on the basis of the age of starting to participate in sport [elementary school starters (6-12 years), junior high school to university starters (13-22 years)], and the third group had no participation in sport. We measured BMC and aBMD by dual-energy X-ray absorptiometry (DXA) in the lumbar spine and proximal femur, and bone geometric characteristics of the mid femur by magnetic resonance imaging (MRI), and calculated the osteogenic index (OI) of previous sporting activity. The OI correlated significantly with many MRI-determined measures of bone geometry; DXA-measured BMC and aBMD were effective indicators of previous sporting activity in both sexes. The female elementary school starters had significantly greater femoral mid-diaphyseal perimeters (vs the no-sport group), bone cross-sectional area (vs the 13-22-year-old starters and the no-sport group), and maximum and minimum second moment of area at the mid-diaphysis point of the femur (vs the no-sport group). The OI is a proven practicable and useful index. DXA- and MRI-determined geometric characteristics showed that high-impact, weight-bearing exercise before and in early puberty induces greater total proximal femur BMC and enhances femoral mid-diaphyseal size and shape, and that these benefits persisted in young adult women.
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Affiliation(s)
- Takeru Kato
- Department of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science, Kishioka, 1001-1, Suzuka, 510-0293, Japan,
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Wallace IJ, Pagnotti GM, Rubin-Sigler J, Naeher M, Copes LE, Judex S, Rubin CT, Demes B. Focal enhancement of the skeleton to exercise correlates with responsivity of bone marrow mesenchymal stem cells rather than peak external forces. ACTA ACUST UNITED AC 2015; 218:3002-9. [PMID: 26232415 DOI: 10.1242/jeb.118729] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 07/20/2015] [Indexed: 01/06/2023]
Abstract
Force magnitudes have been suggested to drive the structural response of bone to exercise. As importantly, the degree to which any given bone can adapt to functional challenges may be enabled, or constrained, by regional variation in the capacity of marrow progenitors to differentiate into bone-forming cells. Here, we investigate the relationship between bone adaptation and mesenchymal stem cell (MSC) responsivity in growing mice subject to exercise. First, using a force plate, we show that peak external forces generated by forelimbs during quadrupedal locomotion are significantly higher than hindlimb forces. Second, by subjecting mice to treadmill running and then measuring bone structure with μCT, we show that skeletal effects of exercise are site-specific but not defined by load magnitudes. Specifically, in the forelimb, where external forces generated by running were highest, exercise failed to augment diaphyseal structure in either the humerus or radius, nor did it affect humeral trabecular structure. In contrast, in the ulna, femur and tibia, exercise led to significant enhancements of diaphyseal bone areas and moments of area. Trabecular structure was also enhanced by running in the femur and tibia. Finally, using flow cytometry, we show that marrow-derived MSCs in the femur are more responsive to exercise-induced loads than humeral cells, such that running significantly lowered MSC populations only in the femur. Together, these data suggest that the ability of the progenitor population to differentiate toward osteoblastogenesis may correlate better with bone structural adaptation than peak external forces caused by exercise.
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Affiliation(s)
- Ian J Wallace
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Gabriel M Pagnotti
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jasper Rubin-Sigler
- Department of Anatomical Sciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - Matthew Naeher
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Lynn E Copes
- Department of Medical Sciences, Quinnipiac University, Hamden, CT 06518, USA
| | - Stefan Judex
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Brigitte Demes
- Department of Anatomical Sciences, Stony Brook University, Stony Brook, NY 11794, USA
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Ireland A, Degens H, Ganse B, Maden-Wilkinson TM, Wilks DC, Rittweger J. Greater tibial bone strength in male tennis players than controls in the absence of greater muscle output. J Orthop Translat 2015; 3:142-151. [PMID: 30035051 PMCID: PMC5982387 DOI: 10.1016/j.jot.2015.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/17/2015] [Accepted: 04/29/2015] [Indexed: 11/28/2022] Open
Abstract
Background/Objective The greatest forces experienced by bones result from muscular contractions—muscles produce most force in high-velocity eccentric contractions. Bouncing movements, e.g., sprinting or hopping—where such contractions occur—are highly beneficial for lower limb bones. However, there is a growing body of evidence that torsional stresses are highly osteogenic. Sports in which frequent quick turning occurs—hence large torsional stresses can be expected—e.g., tennis, may also improve bone strength even in the absence of large ground reaction and muscle forces. Methods To investigate the relative effects of bouncing and turning movements on bones, we recruited 47 older men (mean age 62.4 ± 12.9 years). They were competitive sprinters (representing exposure to bouncing movement), competitive tennis players (turning movements), and inactive controls. Peripheral quantitative computed tomography scans of tibial diaphysis at 66% distal–proximal length were taken; muscle sizes from peripheral quantitative computed tomography and countermovement jump performance were also examined. Results Bone strength of tennis players was clearly greater than that of controls (23% greater bone mass; p < 0.001) and similar to that in sprinters. Tennis players' jump relative power and height were 15% and 25% lower than those of sprinters (p < 0.05) and similar to control values, being 2% greater and 6% lower, respectively (p > 0.5). Material eccentricity analysis suggests that torsional stresses may be a significant adaptive stimulus to tibial bone. Conclusion Results suggest that sports with quick turning movements are highly osteogenic, even in the absence of greater muscular output. This may be related to the large torsional stresses produced during turning movements.
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Affiliation(s)
- Alex Ireland
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Bergita Ganse
- Institute of Aerospace Medicine, German Aerospace Centre, Cologne, Germany
| | | | - Desiree Christin Wilks
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Centre, Cologne, Germany
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