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Barak MM. Cortical and Trabecular Bone Modeling and Implications for Bone Functional Adaptation in the Mammalian Tibia. Bioengineering (Basel) 2024; 11:514. [PMID: 38790379 PMCID: PMC11118124 DOI: 10.3390/bioengineering11050514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Bone modeling involves the addition of bone material through osteoblast-mediated deposition or the removal of bone material via osteoclast-mediated resorption in response to perceived changes in loads by osteocytes. This process is characterized by the independent occurrence of deposition and resorption, which can take place simultaneously at different locations within the bone due to variations in stress levels across its different regions. The principle of bone functional adaptation states that cortical and trabecular bone tissues will respond to mechanical stimuli by adjusting (i.e., bone modeling) their morphology and architecture to mechanically improve their mechanical function in line with the habitual in vivo loading direction. This principle is relevant to various research areas, such as the development of improved orthopedic implants, preventative medicine for osteopenic elderly patients, and the investigation of locomotion behavior in extinct species. In the present review, the mammalian tibia is used as an example to explore cortical and trabecular bone modeling and to examine its implications for the functional adaptation of bones. Following a short introduction and an exposition on characteristics of mechanical stimuli that influence bone modeling, a detailed critical appraisal of the literature on cortical and trabecular bone modeling and bone functional adaptation is given. By synthesizing key findings from studies involving small mammals (rodents), large mammals, and humans, it is shown that examining both cortical and trabecular bone structures is essential for understanding bone functional adaptation. A combined approach can provide a more comprehensive understanding of this significant physiological phenomenon, as each structure contributes uniquely to the phenomenon.
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Affiliation(s)
- Meir M Barak
- Department of Veterinary Biomedical Sciences, College of Veterinary Medicine, Long Island University, Brookville, NY 11548, USA
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2
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Kikyo N. Circadian Regulation of Bone Remodeling. Int J Mol Sci 2024; 25:4717. [PMID: 38731934 PMCID: PMC11083221 DOI: 10.3390/ijms25094717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Adult bones are continuously remodeled by the balance between bone resorption by osteoclasts and subsequent bone formation by osteoblasts. Many studies have provided molecular evidence that bone remodeling is under the control of circadian rhythms. Circadian fluctuations have been reported in the serum and urine levels of bone turnover markers, such as digested collagen fragments and bone alkaline phosphatase. Additionally, the expressions of over a quarter of all transcripts in bones show circadian rhythmicity, including the genes encoding master transcription factors for osteoblastogenesis and osteoclastogenesis, osteogenic cytokines, and signaling pathway proteins. Serum levels of calcium, phosphate, parathyroid hormone, and calcitonin also display circadian rhythmicity. Finally, osteoblast- and osteoclast-specific knockout mice targeting the core circadian regulator gene Bmal1 show disrupted bone remodeling, although the results have not always been consistent. Despite these studies, however, establishing a direct link between circadian rhythms and bone remodeling in vivo remains a major challenge. It is nearly impossible to repeatedly collect bone materials from human subjects while following circadian changes. In addition, the differences in circadian gene regulation between diurnal humans and nocturnal mice, the main model organism, remain unclear. Filling the knowledge gap in the circadian regulation of bone remodeling could reveal novel regulatory mechanisms underlying many bone disorders including osteoporosis, genetic diseases, and fracture healing. This is also an important question for the basic understanding of how cell differentiation progresses under the influence of cyclically fluctuating environments.
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Affiliation(s)
- Nobuaki Kikyo
- Stem Cell Institute, Minneapolis, MN 55455, USA;
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN 55455, USA
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Costa da Silva RG, Sun TC, Mishra AP, Boyde A, Doube M, Riggs CM. Intracortical remodelling increases in highly loaded bone after exercise cessation. J Anat 2024; 244:424-437. [PMID: 37953410 PMCID: PMC10862154 DOI: 10.1111/joa.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023] Open
Abstract
Resorption within cortices of long bones removes excess mass and damaged tissue and increases during periods of reduced mechanical loading. Returning to high-intensity exercise may place bones at risk of failure due to increased porosity caused by bone resorption. We used point-projection X-ray microscopy images of bone slices from highly loaded (metacarpal, tibia) and minimally loaded (rib) bones from 12 racehorses, 6 that died during a period of high-intensity exercise and 6 that had a period of intense exercise followed by at least 35 days of rest prior to death, and measured intracortical canal cross-sectional area (Ca.Ar) and number (N.Ca) to infer remodelling activity across sites and exercise groups. Large canals that are the consequence of bone resorption (Ca.Ar >0.04 mm2 ) were 1.4× to 18.7× greater in number and area in the third metacarpal bone from rested than exercised animals (p = 0.005-0.008), but were similar in number and area in ribs from rested and exercised animals (p = 0.575-0.688). An intermediate relationship was present in the tibia, and when large canals and smaller canals that result from partial bony infilling (Ca.Ar >0.002 mm2 ) were considered together. The mechanostat may override targeted remodelling during periods of high mechanical load by enhancing bone formation, reducing resorption and suppressing turnover. Both systems may work synergistically in rest periods to remove excess and damaged tissue.
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Affiliation(s)
| | - Tsim Christopher Sun
- Sydney School of Veterinary ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Ambika Prasad Mishra
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
| | - Alan Boyde
- Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Michael Doube
- Department of Infectious Diseases and Public HealthCity University of Hong KongKowloonHong Kong
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Yun C, Kim SH, Kim KM, Yang MH, Byun MR, Kim JH, Kwon D, Pham HTM, Kim HS, Kim JH, Jung YS. Advantages of Using 3D Spheroid Culture Systems in Toxicological and Pharmacological Assessment for Osteogenesis Research. Int J Mol Sci 2024; 25:2512. [PMID: 38473760 DOI: 10.3390/ijms25052512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Bone differentiation is crucial for skeletal development and maintenance. Its dysfunction can cause various pathological conditions such as rickets, osteoporosis, osteogenesis imperfecta, or Paget's disease. Although traditional two-dimensional cell culture systems have contributed significantly to our understanding of bone biology, they fail to replicate the intricate biotic environment of bone tissue. Three-dimensional (3D) spheroid cell cultures have gained widespread popularity for addressing bone defects. This review highlights the advantages of employing 3D culture systems to investigate bone differentiation. It highlights their capacity to mimic the complex in vivo environment and crucial cellular interactions pivotal to bone homeostasis. The exploration of 3D culture models in bone research offers enhanced physiological relevance, improved predictive capabilities, and reduced reliance on animal models, which have contributed to the advancement of safer and more effective strategies for drug development. Studies have highlighted the transformative potential of 3D culture systems for expanding our understanding of bone biology and developing targeted therapeutic interventions for bone-related disorders. This review explores how 3D culture systems have demonstrated promise in unraveling the intricate mechanisms governing bone homeostasis and responses to pharmacological agents.
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Affiliation(s)
- Chawon Yun
- Department of Pharmacy, Research Institute for Drug Development, College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea
| | - Sou Hyun Kim
- Department of Pharmacy, Research Institute for Drug Development, College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea
| | - Kyung Mok Kim
- Department of Pharmacy, Research Institute for Drug Development, College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea
| | - Min Hye Yang
- Department of Pharmacy, Research Institute for Drug Development, College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea
| | - Mi Ran Byun
- College of Pharmacy, Daegu Catholic University, Gyeongsan 38430, Republic of Korea
| | - Joung-Hee Kim
- Department of Medical Beauty Care, Dongguk University Wise, Gyeongju 38066, Republic of Korea
| | - Doyoung Kwon
- Jeju Research Institute of Pharmaceutical Sciences, College of Pharmacy, Jeju National University, Jeju 63243, Republic of Korea
| | - Huyen T M Pham
- Department of Molecular Science and Technology, Ajou University, Suwon 16499, Republic of Korea
| | - Hyo-Sop Kim
- Department of Molecular Science and Technology, Ajou University, Suwon 16499, Republic of Korea
| | - Jae-Ho Kim
- Department of Molecular Science and Technology, Ajou University, Suwon 16499, Republic of Korea
| | - Young-Suk Jung
- Department of Pharmacy, Research Institute for Drug Development, College of Pharmacy, Pusan National University, Busan 46241, Republic of Korea
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Koltun KJ, Sterczala AJ, Sekel NM, Krajewski KT, Martin BJ, Lovalekar M, Connaboy C, Flanagan SD, Wardle SL, O'Leary TJ, Greeves JP, Nindl BC. Effect of acute resistance exercise on bone turnover in young adults before and after concurrent resistance and interval training. Physiol Rep 2024; 12:e15906. [PMID: 38296351 PMCID: PMC10830389 DOI: 10.14814/phy2.15906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 02/05/2024] Open
Abstract
Weight-bearing physical activity can stimulate bone adaptation. This investigation explored the effect of an acute bout of resistance exercise before and after resistance+interval training on circulating biomarkers of bone metabolism and muscle-bone crosstalk. Healthy young male and female participants (n = 21 male, 28 ± 4 years; n = 17 female, 27 ± 5 years) performed a 6 × 10 squat test (75% 1RM) before and after a 12-week resistance+interval training program. Before and after completion of the training program, blood samples were collected at rest, immediately postexercise, and 2 h postexercise. Blood samples were analyzed for βCTX, P1NP, sclerostin, osteocalcin, IGF-1, and irisin. Significant effects of acute exercise (main effect of time) were observed as increases in concentrations of IGF-1, irisin, osteocalcin, and P1NP from rest to postexercise. A sex*time interaction indicated a greater decline in βCTX concentration from rest to 2 h postexercise and a greater increase in sclerostin concentration from rest to immediately postexercise in male compared with female participants. Sex differences (main effect of sex) were also observed for irisin and P1NP concentrations. In summary, changes in concentrations of biochemical markers of bone metabolism and muscle-bone crosstalk were observed in males and females after an acute bout of resistance exercise and following 12 weeks of resistance+interval training.
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Affiliation(s)
- Kristen J. Koltun
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Adam J. Sterczala
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Nicole M. Sekel
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kellen T. Krajewski
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Brian J. Martin
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Mita Lovalekar
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Christopher Connaboy
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Shawn D. Flanagan
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | | | | | - Bradley C. Nindl
- Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory/Warrior Human Performance Research CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
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Schifino AG, Cooley MA, Zhong RX, Heo J, Hoffman DB, Warren GL, Greising SM, Call JA. Tibial bone strength is negatively affected by volumetric muscle loss injury to the adjacent muscle in male mice. J Orthop Res 2024; 42:123-133. [PMID: 37337074 PMCID: PMC10728344 DOI: 10.1002/jor.25643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/15/2023] [Accepted: 06/03/2023] [Indexed: 06/21/2023]
Abstract
This study's objective was to investigate how contractile strength loss associated with a volumetric muscle loss (VML) injury affects the adjacent tibial bone structural and functional properties in male C57BL/6J mice. Mice were randomized into one of two experimental groups: VML-injured mice that were injured at age 12 weeks and aged to 20 weeks (8 weeks postinjury, VML) and 20-week-old age-matched uninjured mice (Uninjured-20). Tibial bone strength, mid-diaphysis cortical geometry, intrinsic material properties, and metaphyseal trabecular bone structure were assessed by three-point bending and microcomputed tomography (µCT). The plantar flexor muscle group (gastrocnemius, soleus, plantaris) was analyzed for its functional capacities, that is, peak-isometric torque and peak-isokinetic power. VML-injured limbs had 25% less peak-isometric torque and 31% less peak-isokinetic power compared to those of Uninjured-20 mice (p < 0.001). Ultimate load, but not stiffness, was significantly less (10%) in tibias of VML-injured limbs compared to those from Uninjured-20 (p = 0.014). µCT analyses showed cortical bone thickness was 6% less in tibias of VML-injured limbs compared to Uninjured-20 (p = 0.001). Importantly, tibial bone cross-section moment of inertia, the primary determinant of bone ultimate load, was 16% smaller in bones of VML-injured limbs compared to bones from Uninjured-20 (p = 0.046). Metaphyseal trabecular bone structure was also altered up to 23% in tibias of VML-injured limbs (p < 0.010). These changes in tibial bone structure and function after a VML injury occur during a natural maturation phase between the age of 12 and 20 weeks, as evidenced by Uninjured-20 mice having greater tibial bone size and strength compared to uninjured-aged 12-week mice.
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Affiliation(s)
| | - Marion A. Cooley
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, August University, Augusta, GA USA
| | - Roger X. Zhong
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA USA
| | - Junwon Heo
- Department of Physiology & Pharmacology, University of Georgia, Athens, GA USA
| | | | - Gordon L. Warren
- Department of Physical Therapy, Georgia State University, Atlanta, GA USA
| | | | - Jarrod A. Call
- Department of Physiology & Pharmacology, University of Georgia, Athens, GA USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA USA
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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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Sekel NM, Hughes JM, Sterczala AJ, Mroz KH, Lovalekar M, Cauley J, Greeves JP, Nindl BC. Utility of HR-pQCT in detecting training-induced changes in healthy adult bone morphology and microstructure. Front Physiol 2023; 14:1266292. [PMID: 37929211 PMCID: PMC10623356 DOI: 10.3389/fphys.2023.1266292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Healthy bone adjusts its traits in an exceptionally coordinated, compensatory process. Recent advancements in skeletal imaging via High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) allows for the in vivo 3-dimensional and longitudinal quantification of bone density, microarchitecture, geometry, and parameters of mechanical strength in response to varying strain stimuli including those resulting from exercise or military training. Further, the voxel size of 61 microns has the potential to capture subtle changes in human bone in as little as 8 weeks. Given the typical time course of bone remodeling, short-term detection of skeletal changes in bone microstructure and morphology is indicative of adaptive bone formation, the deposition of new bone formation, uncoupled from prior resorption, that can occur at mechanistically advantageous regions. This review aims to synthesize existing training-induced HR-pQCT data in three distinct populations of healthy adults excluding disease states, pharmacological intervention and nutritional supplementation. Those included are: 1) military basic or officer training 2) general population and 3) non-osteoporotic aging. This review aims to further identify similarities and contrasts with prior modalities and cumulatively interpret results within the scope of bone functional adaptation.
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Affiliation(s)
- Nicole M. Sekel
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie M. Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Adam J. Sterczala
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kelly H. Mroz
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jane Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Julie P. Greeves
- Army Health and Performance Research, UK Army, Andover, United Kingdom
| | - Bradley C. Nindl
- Neuromuscular Research Laboratory, Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, United States
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Hughes JM, Guerriere KI, Popp KL, Castellani CM, Pasiakos SM. Exercise for optimizing bone health after hormone-induced increases in bone stiffness. Front Endocrinol (Lausanne) 2023; 14:1219454. [PMID: 37790607 PMCID: PMC10544579 DOI: 10.3389/fendo.2023.1219454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/17/2023] [Indexed: 10/05/2023] Open
Abstract
Hormones and mechanical loading co-regulate bone throughout the lifespan. In this review, we posit that times of increased hormonal influence on bone provide opportunities for exercise to optimize bone strength and prevent fragility. Examples include endogenous secretion of growth hormones and sex steroids that modulate adolescent growth and exogenous administration of osteoanabolic drugs like teriparatide, which increase bone stiffness, or its resistance to external forces. We review evidence that after bone stiffness is increased due to hormonal stimuli, mechanoadaptive processes follow. Specifically, exercise provides the mechanical stimulus necessary to offset adaptive bone resorption or promote adaptive bone formation. The collective effects of both decreased bone resorption and increased bone formation optimize bone strength during youth and preserve it later in life. These theoretical constructs provide physiologic foundations for promoting exercise throughout life.
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Affiliation(s)
- Julie M. Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Katelyn I. Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
| | - Kristin L. Popp
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Colleen M. Castellani
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Stefan M. Pasiakos
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, United States
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Heveran CM, Boerckel JD. Osteocyte Remodeling of the Lacunar-Canalicular System: What's in a Name? Curr Osteoporos Rep 2023; 21:11-20. [PMID: 36512204 PMCID: PMC11223162 DOI: 10.1007/s11914-022-00766-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Osteocytes directly modify the bone surrounding the expansive lacunar-canalicular system (LCS) through both resorption and deposition. The existence of this phenomenon is now widely accepted, but is referred to as "osteocyte osteolysis," "LCS remodeling," and "perilacunar remodeling," among other names. The uncertainty in naming this physiological process reflects the many persistent questions about why and how osteocytes interact with local bone matrix. The goal of this review is to examine the purpose and nature of LCS remodeling and its impacts on multiscale bone quality. RECENT FINDINGS While LCS remodeling is clearly important for systemic calcium mobilization, this process may have additional potential drivers and may impact the ability of bone to resist fracture. There is abundant evidence that the osteocyte can resorb and replace bone mineral and does so outside of extreme challenges to mineral homeostasis. The impacts of the osteocyte on organic matrix are less certain, especially regarding whether osteocytes produce osteoid. Though multiple lines of evidence point towards osteocyte production of organic matrix, definitive work is needed. Recent high-resolution imaging studies demonstrate that LCS remodeling influences local material properties. The role of LCS remodeling in the maintenance and deterioration of bone matrix quality in aging and disease are active areas of research. In this review, we highlight current progress in understanding why and how the osteocyte removes and replaces bone tissue and the consequences of these activities to bone quality. We posit that answering these questions is essential for evaluating whether, how, when, and why LCS remodeling may be manipulated for therapeutic benefit in managing bone fragility.
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Affiliation(s)
- C M Heveran
- Department of Mechanical & Industrial Engineering, Montana State University, Bozeman, USA.
| | - J D Boerckel
- Department of Orthopaedic Surgery, Department of Bioengineering, University of Pennsylvania School of Medicine, Philadelphia, USA.
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França CF, Miranda C, Martins FM, Pelet DCS, de Souza Lino AD, Souza MVC, Orsatti FL. Relationship of sarcopenia with bone geometry and mass among postmenopausal women. Menopause 2023; 30:63-69. [PMID: 36576443 DOI: 10.1097/gme.0000000000002097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study was to verify whether sarcopenia and its components are associated with hip areal bone mineral density (aBMD) and geometry in postmenopausal women (PW). METHODS In this cross-sectional study, appendicular bone-free lean mass (aLM) and hip bone mass and geometry were measured using dual-energy x-ray emission absorptiometry (DXA). Muscle power and strength were measured by five times Sit-to-Stand Test (5-STS) and dynamometry, respectively, in 175 PW. Sarcopenia was identified as low aLM plus low muscle strength or low muscle power. Multiple linear regression (covaried by age, smoking, hormonal therapy, and diseases) was used to determine the relationship between sarcopenia and bone geometry and mass. The results are presented as mean differences between groups. RESULTS Dynamometry, five times Sit-to-Stand Test, and aLM indicated positive associations (P < 0.05) with most indicators of bone mass and geometry. Sarcopenia, applying low muscle strength or low muscle power, was negatively associated with femoral neck width (-0.2 mm, P = 0.001), cortical thickness of femoral calcar (-0.6 mm, P = 0.043), subtrochanteric cortical thickness (-1.2 mm, P = 0.002), femoral neck cross-sectional area (-19.5 mm2, P < 0.001), cross-section moment of inertia (-2,244 mm4, P < 0.001), section modulus (-115 mm3, P < 0.001), femoral neck aBMD (-0.1 g/cm2, P = 0.002), upper femoral neck aBMD (-0.1 g/cm2, P = 0.003), lower femoral neck aBMD (-0.1 g/cm2, P = 0.016), and trochanteric aBMD (-0.1 g/cm2, P = 0.035). CONCLUSIONS Thus, muscle mass, strength and power, alone or in combination (ie, sarcopenia), are associated with low aBMD, impaired bone geometry, and, therefore, bone strength in PW. These measures may help identify PW at risk of hip fractures.
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Affiliation(s)
- Caroline F França
- From the Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Laboratory (BioEx), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Camila Miranda
- From the Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Laboratory (BioEx), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fernanda M Martins
- From the Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Laboratory (BioEx), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Danyelle C S Pelet
- From the Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Laboratory (BioEx), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Anderson D de Souza Lino
- From the Applied Physiology, Nutrition and Exercise Research Group (PhyNEr), Exercise Biology Laboratory (BioEx), Health Science Institute, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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12
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Staab JS, Lutz LJ, Foulis SA, Gaffney-Stomberg E, Hughes JM. Load carriage aerobic exercise stimulates a transient rise in biochemical markers of bone formation and resorption. J Appl Physiol (1985) 2023; 134:85-94. [PMID: 36454676 PMCID: PMC9829485 DOI: 10.1152/japplphysiol.00442.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Exercise can be both anabolic and catabolic for bone tissue. The temporal response of both bone formation and resorption following an acute bout of exercise is not well described. We assayed biochemical markers of bone and calcium metabolism for up to 3 days after military-relevant exercise. In randomized order, male (n = 18) and female (n = 2) Soldiers (means ± SD; 21.2 ± 4.1 years) performed a 60-min bout of load carriage (30% body mass; 22.4 ± 3.7 kg) treadmill exercise (EXER) or a resting control trial (REST). Blood samples were collected following provision of a standardized breakfast before (PRE), after (POST) exercise/rest, 1 h, 2 h, and 4 h into recovery. Fasted samples were also collected at 0630 on EXER and REST and for the next three mornings after EXER. Parathyroid hormone and phosphorus were elevated (208% and 128% of PRE, respectively, P < 0.05), and ionized calcium reduced (88% of PRE, P < 0.05) after EXER. N-terminal propeptide of type 1 collagen was elevated at POST (111% of PRE, P < 0.05), and the resorption marker, C-terminal propeptide of type 1 collagen was elevated at 1 h (153% of PRE, P < 0.05). Osteocalcin was higher than PRE at 1 through 4 h post EXER (119%-120% of PRE, P < 0.05). Sclerostin and Dickkopf-related protein-1 were elevated only at POST (132% and 121% of PRE, respectively, P < 0.05) during EXER. Trivial changes in biomarkers during successive recovery days were observed. These results suggest that 60 min of load carriage exercise elicits transient increases in bone formation and resorption that return to pre-exercise concentrations within 24 h post-exercise.NEW & NOTEWORTHY In this study, we demonstrated evidence for increases in both bone formation and resorption in the first 4 h after a bout of load carriage exercise. However, these changes largely disappear by 24 h after exercise. Acute formation and resorption of bone following exercise may reflect distinct physiological mechanoadaptive responses. Future work is needed to identify ways to promote acute post-exercise bone formation and minimize post-exercise resorption to optimize bone adaptation to exercise.
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Affiliation(s)
- Jeffery S Staab
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Laura J Lutz
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Stephen A Foulis
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Erin Gaffney-Stomberg
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Julie M Hughes
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
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13
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Rowbotham SK, Mole CG, Tieppo D, Blaszkowska M, Cordner SM, Blau S. Average thickness of the bones of the human neurocranium: development of reference measurements to assist with blunt force trauma interpretations. Int J Legal Med 2023; 137:195-213. [PMID: 35486199 DOI: 10.1007/s00414-022-02824-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/31/2022] [Indexed: 01/10/2023]
Abstract
The accurate interpretation of a blunt force head injury relies on an understanding of the case circumstances (extrinsic variables) and anatomical details of the individual (intrinsic variables). Whilst it is often possible to account for many of these variables, the intrinsic variable of neurocranial thickness is difficult to account for as data for what constitutes 'normal' thickness is limited. The aim of this study was to investigate the effects of age, sex and ancestry on neurocranial thickness, and develop reference ranges for average neurocranial thickness in the context of those biological variables. Thickness (mm) was measured at 20 points across the frontal, left and right parietals, left and right temporals and occipital bones. Measurements were taken from post-mortem computed tomography scans of 604 individuals. Inferential statistics assessed how age, sex and ancestry affected thickness and descriptive statistics established thickness means. Mean thickness ranged from 2.11 mm (temporal squama) to 19.19 mm (petrous portion). Significant differences were noted in thickness of the frontal and temporal bones when age was considered, all bones when sex was considered and the, right parietal, left and right temporal and occipital bones when ancestry was considered. Furthermore, significant interactions in thickness were seen between age and sex in the frontal bone, ancestry and age in the temporal bone, ancestry and sex in the temporal bone, and age, sex and ancestry in the occipital bone. Given the assorted influence of the biological variables, reference measurement ranges for average thickness incorporated these variables. Such reference measurements allow forensic practitioners to identify when a neurocranial bone is of normal, or abnormal, thickness.
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Affiliation(s)
- Samantha K Rowbotham
- Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia. .,Department of Forensic Medicine, School of Public Health and Preventative Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia.
| | - Calvin G Mole
- Division of Forensic Medicine and Toxicology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa
| | - Diana Tieppo
- Department of Forensic Medicine, School of Public Health and Preventative Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia
| | - Magda Blaszkowska
- Centre for Forensic Anthropology, Faculty of Arts, Business, Law and Education, University of Western Australia, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Stephen M Cordner
- Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventative Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia
| | - Soren Blau
- Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia.,Department of Forensic Medicine, School of Public Health and Preventative Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia
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14
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Nguyen-Khac V, Bonnet-Lebrun A, Skalli W, Adamsbaum C, Linglart A, Wicart P. Changes in adipose bone marrow and bone morphology in X-linked hypophosphatemic rickets. Orthop Traumatol Surg Res 2022; 109:103529. [PMID: 36565743 DOI: 10.1016/j.otsr.2022.103529] [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: 03/03/2022] [Revised: 08/01/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION X-linked hypophosphatemic (XLH) rickets causes significant bone deformities in the lower limbs resulting from a bone mineralization defect. According to Frost's Mechanostat theory, compensatory modeling of the bones takes place during increased mechanical loads. In addition, mechanical stimuli modulate the differentiation of mesenchymal stem cells; common precursors to bone marrow adipocytes and osteoblasts. HYPOTHESIS Bone deformities of the lower limbs lead to increased femoral bone mass and decreased fatty infiltration of the bone marrow (FIBM) in children with XLH rickets compared to a control group. PATIENTS AND METHODS Eleven children (10.3years [6-17]) with XLH rickets and 22 healthy children (10.2years [5-15.5]) underwent lower limb Magnetic Resonance Imaging. A calculation of FIBM was performed at the mid-femur, as well as a calculation of the total bone cross-sectional area (CSA), the cortical CSA, the anteroposterior and mediolateral axes of the femur, bone marrow and the thickness of the femoral cortices. RESULTS Total bone CSA, total cortical CSA and bone marrow CSA were higher in the XLH group than in the control group (p<0.05). The mid-lateral diameters of the femur and bone marrow were more elongated than those of the control group (p<0.001). Only the anterior cortex was thinned in the XLH group (p=0.001), while there was no difference with the control group for the posterior, medial and lateral cortices. The total percentage of FIBM was 72.81% [±3.95] and 77.4% [±5.52] for the XLH and control groups respectively (p<0.001). DISCUSSION The increase in bone mass in the XLH population reflects an adaptation of bone tissue to the bone deformities present in this pathology. The decrease in FIBM indicates a lower risk of osteoporosis in the XLH population and may constitute a new monitoring parameter in this pathology. LEVEL OF STUDY III; Case-control study.
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Affiliation(s)
| | - Aurore Bonnet-Lebrun
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Wafa Skalli
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Catherine Adamsbaum
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Philippe Wicart
- Hospital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvre, 75015 Paris, France
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15
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Guerriere KI, Castellani CM, Popp KL, Bouxsein ML, Hughes JM. Unraveling the physiologic paradoxes that underlie exercise prescription for stress fracture prevention. Exp Biol Med (Maywood) 2022; 247:1833-1839. [PMID: 35983839 PMCID: PMC9679355 DOI: 10.1177/15353702221112108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The effects of exercise on stress fracture risk are paradoxical. Exercise can promote both bone formation and resorption, which in turn, can reduce and increase risk of stress fractures, respectively. We review classic and current literature that suggests that the processes that underlie these responses to exercise are distinct. Bone remodeling involves osteoclastic resorption of fatigue-damaged bone, coupled with subsequent bone deposition to replace the damaged tissue. Bone modeling involves the independent action of osteoblasts and osteoclasts forming or resorbing bone, respectively, on a surface. In the formation mode, modeling results in increased bone stiffness, strength, and resistance to fatigue. Both the remodeling and modeling responses to exercise require significant time for newly deposited bone to fully mineralize. We propose that recognizing these two distinct physiologic pathways and their related time courses reveals the theoretical basis to guide exercise prescription to promote bone health during periods of heightened stress fracture risk. Such guidance may include minimizing rapid increases in the duration of repetitive exercises that may cause fatigue damage accrual, such as long-distance running and marching. Rather, limiting initial exercise characteristics to those known to stimulate bone formation, such as short-duration, moderate-to-high impact, dynamic, and multidirectional activities with rest insertion, may increase the fatigue resistance of bone and consequently minimize stress fracture risk.
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Affiliation(s)
- Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Colleen M Castellani
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Kristin L Popp
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA,Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA,Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Mary L Bouxsein
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA,Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA,Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA 02210, USA,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA,Julie M Hughes.
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16
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Kast S, Shojaa M, Kohl M, von Stengel S, Gosch M, Jakob F, Kerschan-Schindl K, Kladny B, Klöckner N, Lange U, Middeldorf S, Peters S, Schoene D, Sieber C, Thomasius F, Uder M, Kemmler W. Effects of different exercise intensity on bone mineral density in adults: a comparative systematic review and meta-analysis. Osteoporos Int 2022; 33:1643-1657. [PMID: 35304613 PMCID: PMC9499891 DOI: 10.1007/s00198-022-06329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/31/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE The primary objective of the present systematic review and meta-analysis was to determine the effect of differing exercise intensity on (areal) bone mineral density (BMD) at lumbar spine and hip in adults by a comparative meta-analysis. METHODS A systematic review of the literature according to the PRISMA statement included: (a) exercise trials, (b) with ≥two study arms that compared different exercise intensities, (c) intervention ≥6 months, (d) BMD assessments at lumbar spine (LS) or hip. Five electronic databases were scanned without language restrictions up to July 2021. The present analysis of exercise intensity was conducted as a mixed-effect meta-analysis and applied "type of exercise" and "study duration" as moderator in subgroup analyses. Outcome measures were standardized mean differences (SMD) for BMD changes at the LS, and hip. RESULTS Eleven exercise studies with 26 study arms were included. Although the effect of high-intensity exercise was more pronounced on LS-BMD (SMD: 0.19, 95%-CI: 0.61 to -0.23) and hip-ROI (0.17, 0.38 to -0.04), we did not observe significant differences between the groups (LS-BMD: p=0.373 and hip-BMD: p=0.109). We observed a substantial level of heterogeneity between the trials for LS- but not for hip-BMD. Applying "type of exercise" and "study duration" as moderators did not significantly modify the differences between low and high exercise intensity on BMD at LS or hip. CONCLUSION There is insufficient evidence for a superior effect of high-intensity exercise on areal BMD at lumbar spine and hip in people aged 50 years and older. Varying exercise intensity with periods of lower exercise intensity intermitted by higher intensity might be a promising option to address the issue of exercise intensities in intervention studies.
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Affiliation(s)
- S Kast
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - M Shojaa
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Institute of Health Science, Department Population-Based Medicine, University Hospital Tübingen, Tübingen, Germany
| | - M Kohl
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Department of Med. and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - S von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - M Gosch
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Paracelsus Medical University Nürnberg and General Hospital Nürnberg, Nürnberg, Germany
| | - F Jakob
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Bernhard Heine Zentrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - K Kerschan-Schindl
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Austrian Society for Bone and Mineral Research, Vienna, Austria
| | - B Kladny
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Society for Orthopaedics and Trauma, Berlin, Germany
| | - N Klöckner
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Deutsche Rheuma-Liga Bundesverband e.V., Bonn, Germany
| | - U Lange
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Society for Physical and Rehabilitative Medicine, Dresden, Germany
| | - S Middeldorf
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- International Musculoskeletal Pain Society, Berlin, Germany
| | - S Peters
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- German Association for Health-Related Fitness and Exercise Therapy, Hürth-Efferen, Germany
| | - D Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
| | - C Sieber
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- European Geriatric Medicine Society (EuGMS), Institute for Biomedicine of Aging, FAU Erlangen-Nürnberg, Nürnberg, Germany
| | - F Thomasius
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Osteology Umbrella Association Germany, Austria, Switzerland, Frankfurt, Germany
| | - M Uder
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - W Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
- Research and Writing Group on Austria/Germany/Suisse S3 Guideline "Exercise and Fracture Prevention", Bonn, Germany.
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany.
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17
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O'Bryan SJ, Giuliano C, Woessner MN, Vogrin S, Smith C, Duque G, Levinger I. Progressive Resistance Training for Concomitant Increases in Muscle Strength and Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Sports Med 2022; 52:1939-1960. [PMID: 35608815 PMCID: PMC9325860 DOI: 10.1007/s40279-022-01675-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 12/14/2022]
Abstract
Background Older adults experience considerable muscle and bone loss that are closely interconnected. The efficacy of progressive resistance training programs to concurrently reverse/slow the age-related decline in muscle strength and bone mineral density (BMD) in older adults remains unclear. Objectives We aimed to quantify concomitant changes in lower-body muscle strength and BMD in older adults following a progressive resistance training program and to determine how these changes are influenced by mode (resistance only vs. combined resistance and weight-bearing exercises), frequency, volume, load, and program length. Methods MEDLINE/PubMed and Embase databases were searched for articles published in English before 1 June, 2021. Randomized controlled trials reporting changes in leg press or knee extension one repetition maximum and femur/hip or lumbar spine BMD following progressive resistance training in men and/or women ≥ 65 years of age were included. A random-effects meta-analysis and meta-regression determined the effects of resistance training and the individual training characteristics on the percent change (∆%) in muscle strength (standardized mean difference) and BMD (mean difference). The quality of the evidence was assessed using the Cochrane risk-of-bias tool (version 2.0) and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria. Results Seven hundred and eighty studies were identified and 14 were included. Progressive resistance training increased muscle strength (∆ standardized mean difference = 1.1%; 95% confidence interval 0.73, 1.47; p ≤ 0.001) and femur/hip BMD (∆ mean difference = 2.77%; 95% confidence interval 0.44, 5.10; p = 0.02), but not BMD of the lumbar spine (∆ mean difference = 1.60%; 95% confidence interval − 1.44, 4.63; p = 0.30). The certainty for improvement was greater for muscle strength compared with BMD, evidenced by less heterogeneity (I2 = 78.1% vs 98.6%) and a higher overall quality of evidence. No training characteristic significantly affected both outcomes (p > 0.05), although concomitant increases in strength and BMD were favored by higher training frequencies, increases in strength were favored by resistance only and higher volumes, and increases in BMD were favored by combined resistance plus weight-bearing exercises, lower volumes, and higher loads. Conclusions Progressive resistance training programs concomitantly increase lower-limb muscle strength and femur/hip bone mineral density in older adults, with greater certainty for strength improvement. Thus, to maximize the efficacy of progressive resistance training programs to concurrently prevent muscle and bone loss in older adults, it is recommended to incorporate training characteristics more likely to improve BMD. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01675-2.
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Affiliation(s)
- Steven J O'Bryan
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia.
| | - Catherine Giuliano
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
| | - Mary N Woessner
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia.,Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Cassandra Smith
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia.,Institute for Nutrition Research, School of Health and Medical Sciences, Edith Cowan University, Perth, WA, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia.,Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHeS), Victoria University, Footscray Park Campus, Melbourne, VIC, 3134, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia.,Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
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18
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Du J, He Z, Cui J, Li H, Xu M, Zhang S, Zhang S, Yan M, Qu X, Yu Z. Osteocyte Apoptosis Contributes to Cold Exposure-induced Bone Loss. Front Bioeng Biotechnol 2021; 9:733582. [PMID: 34858954 PMCID: PMC8632005 DOI: 10.3389/fbioe.2021.733582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/27/2021] [Indexed: 12/19/2022] Open
Abstract
Emerging evidence indicates that bone mass is regulated by systemic energy balance. Temperature variations have profound effects on energy metabolism in animals, which will affect bone remodeling. But the mechanism remains unclear. 2-month-old C57BL/6J male mice were exposed to cold (4°C) and normal (23°C) temperatures for 28 days and the effects of cold exposure on bone mass was investigated. Micro-computed tomography results showed that bone volume fraction was significantly reduced after 14 days of exposure to cold temperature, and it was recovered after 28 days. Ploton silver staining and immunohistochemical results further revealed that exposure to cold decreased canalicular length, number of E11-and MMP13-positive osteocytes after 14 days, but they returned to the baseline levels after 28 days, different from the normal temperature control group. In addition, change of Caspase-3 indicated that exposure to cold temperature augmented apoptosis of osteocytes. In vitro results confirmed the positive effect of brown adipocytes on osteocyte‘s dendrites and E11 expression. In conclusion, our findings indicate that cold exposure can influence bone mass in a time-dependent manner, with bone mass decreasing and recovering at 2 and 4 weeks respectively. The change of bone mass may be caused by the apoptosis osteocytes. Brown adipocyte tissue could influence bone remodeling through affecting osteocyte.
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Affiliation(s)
- Jingke Du
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zihao He
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, Beijing, China
| | - Junqi Cui
- Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanjun Li
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingming Xu
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuhong Zhang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyan Zhang
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengning Yan
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhifeng Yu
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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19
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Lewis KJ, Cabahug-Zuckerman P, Boorman-Padgett JF, Basta-Pljakic J, Louie J, Stephen S, Spray DC, Thi MM, Seref-Ferlengez Z, Majeska RJ, Weinbaum S, Schaffler MB. Estrogen depletion on In vivo osteocyte calcium signaling responses to mechanical loading. Bone 2021; 152:116072. [PMID: 34171514 PMCID: PMC8316427 DOI: 10.1016/j.bone.2021.116072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/15/2021] [Accepted: 06/20/2021] [Indexed: 11/27/2022]
Abstract
Microstructural adaptation of bone in response to mechanical stimuli is diminished with estrogen deprivation. Here we tested in vivo whether ovariectomy (OVX) alters the acute response of osteocytes, the principal mechanosensory cells of bone, to mechanical loading in mice. We also used super resolution microscopy (Structured Illumination microscopy or SIM) in conjunction with immunohistochemistry to assess changes in the number and organization of "osteocyte mechanosomes" - complexes of Panx1 channels, P2X7 receptors and CaV3 voltage-gated Ca2+ channels clustered around αvβ3 integrin foci on osteocyte processes. Third metatarsals bones of mice expressing an osteocyte-targeted genetically encoded Ca2+ indicator (DMP1-GCaMP3) were cyclically loaded in vivo to strains from 250 to 3000 με and osteocyte intracellular Ca2+ signaling responses were assessed in mid-diaphyses using multiphoton microscopy. The number of Ca2+ signaling osteocytes in control mice increase monotonically with applied strain magnitude for the physiological range of strains. The relationship between the number of Ca2+ signaling osteocytes and loading was unchanged at 2 days post-OVX. However, it was altered markedly at 28 days post-OVX. At loads up to 1000 με, there was a dramatic reduction in number of responding (i.e. Ca2+ signaling) osteocytes; however, at higher strains the numbers of Ca2+ signaling osteocytes were similar to control mice. OVX significantly altered the abundance, make-up and organization of osteocyte mechanosome complexes on dendritic processes. Numbers of αvβ3 foci also staining with either Panx 1, P2X7R or CaV3 declined by nearly half after OVX, pointing to a loss of osteocyte mechanosomes on the dendritic processes with estrogen depletion. At the same time, the areas of the remaining foci that stained for αvβ3 and channel proteins increased significantly, a redistribution of mechanosome components suggesting a potential compensatory response. These results demonstrate that the deleterious effects of estrogen depletion on skeletal mechanical adaptation appear at the level of mechanosensation; osteocytes lose the ability to sense small (physiological) mechanical stimuli. This decline may result at least partly from changes in the structure and organization of osteocyte mechanosomes, which contribute to the distinctive sensitivity of osteocytes (particularly their dendritic processes) to mechanical stimulation.
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Affiliation(s)
- Karl J Lewis
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Pamela Cabahug-Zuckerman
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - James F Boorman-Padgett
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Jelena Basta-Pljakic
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Joyce Louie
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Samuel Stephen
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - David C Spray
- Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Mia M Thi
- Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, United States of America; Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Zeynep Seref-Ferlengez
- Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Robert J Majeska
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Sheldon Weinbaum
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America
| | - Mitchell B Schaffler
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States of America.
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20
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Coulombe JC, Sarazin BA, Mullen Z, Ortega AM, Livingston EW, Bateman TA, Stodieck LS, Lynch ME, Ferguson VL. Microgravity-induced alterations of mouse bones are compartment- and site-specific and vary with age. Bone 2021; 151:116021. [PMID: 34087386 DOI: 10.1016/j.bone.2021.116021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
The age at which astronauts experience microgravity is a critical consideration for skeletal health and similarly has clinical relevance for musculoskeletal disuse on Earth. While astronauts are extensively studied for bone and other physiological changes, rodent studies enable direct evaluation of skeletal changes with microgravity. Yet, mouse spaceflight studies have predominately evaluated tissues from young, growing mice. We evaluated bone microarchitecture in tibiae and femurs from Young (9-week-old) and Mature (32-weeks-old) female, C57BL/6N mice flown in microgravity for ~2 and ~3 weeks, respectively. Microgravity-induced changes were both compartment- and site-specific. Changes were greater in trabecular versus cortical bone in Mature mice exposed to microgravity (-40.0% Tb. BV/TV vs -4.4% Ct. BV/TV), and bone loss was greater in the proximal tibia as compared to the distal femur. Trabecular thickness in Young mice increased by +25.0% on Earth and no significant difference following microgravity. In Mature mice exposed to microgravity, trabecular thickness rapidly decreased (-24.5%) while no change was detected in age-matched mice that were maintained on Earth. Mature mice exposed to microgravity experienced greater bone loss than Young mice with net skeletal growth. Moreover, machine learning classification models confirmed that microgravity exposure-driven decrements in trabecular microarchitecture and cortical structure occurred disproportionately in Mature than in Young mice. Our results suggest that age of disuse onset may have clinical implications in osteoporotic or other at-risk populations on Earth and may contribute to understanding bone loss patterns in astronauts.
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Affiliation(s)
- Jennifer C Coulombe
- Department of Mechanical Engineering, UCB 427, University of Colorado, Boulder, CO 80309, United States of America; BioFrontiers Institute, UCB 596, University of Colorado, Boulder, CO 80309, United States of America
| | - Blayne A Sarazin
- Department of Mechanical Engineering, UCB 427, University of Colorado, Boulder, CO 80309, United States of America
| | - Zachary Mullen
- Laboratory for Interdisciplinary Statistical Analysis, UCB 526, University of Colorado, Boulder, CO 80309, United States of America
| | - Alicia M Ortega
- Department of Mechanical Engineering, UCB 427, University of Colorado, Boulder, CO 80309, United States of America
| | - Eric W Livingston
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, United States of America
| | - Ted A Bateman
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, United States of America
| | - Louis S Stodieck
- Aerospace Engineering Sciences/BioServe Space Technologies, UCB 429, University of Colorado, Boulder, CO 80309, United States of America
| | - Maureen E Lynch
- Department of Mechanical Engineering, UCB 427, University of Colorado, Boulder, CO 80309, United States of America; BioFrontiers Institute, UCB 596, University of Colorado, Boulder, CO 80309, United States of America
| | - Virginia L Ferguson
- Department of Mechanical Engineering, UCB 427, University of Colorado, Boulder, CO 80309, United States of America; BioFrontiers Institute, UCB 596, University of Colorado, Boulder, CO 80309, United States of America; Aerospace Engineering Sciences/BioServe Space Technologies, UCB 429, University of Colorado, Boulder, CO 80309, United States of America.
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21
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Baggaley M, Derrick TR, Vernillo G, Millet GY, Edwards WB. Internal Tibial Forces and Moments During Graded Running. J Biomech Eng 2021; 144:1115052. [PMID: 34318310 DOI: 10.1115/1.4051924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Indexed: 11/08/2022]
Abstract
The stress experienced by the tibia has contributions from the forces and moments acting on the tibia. We sought to quantify the influence of running grade on internal tibial forces and moments. Seventeen participants ran at 3.33 m/s on an instrumented treadmill at 0 deg, ±5 deg, and ±10 deg while motion data were captured. Ankle joint contact force was estimated from an anthropometrically-scaled musculoskeletal model using inverse dynamics-based static optimization. Internal tibial forces and moments were quantified at the distal 1/3rd of the tibia, by ensuring static equilibrium with all applied forces and moments. Downhill running conditions resulted in lower peak internal axial force (range of mean differences: -9% to -16%, p < 0.001), lower peak internal anteroposterior force (-14% to -21%, p < 0.001), and lower peak internal mediolateral force (-14% to -15%, p < 0.001), compared to 0 deg and +5 deg. Furthermore, downhill conditions resulted in lower peak internal mediolateral moment (-11%to -21%, p < 0.001), lower peak internal anteroposterior moment (-13% to -14%, p < 0.001), and lower peak internal torsional moment (-9% to -21%, p < 0.001), compared to 0 deg, +5 deg, and +10 deg. The +10 deg condition resulted in lower peak internal axial force (-7% to -9%, p < 0.001) and lower peak internal mediolateral force (-9%, p = 0.004), compared to 0 deg and +5 deg. These findings suggest that downhill running may be associated with lower tibial stresses than either level or uphill running.
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Affiliation(s)
- Michael Baggaley
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary AB T2N 1N4, Canada
| | - Timothy R Derrick
- Department of Kinesiology, Iowa State University, 0111 L Forker, 534 Wallace Rd, Ames, IA 50011-4008
| | - Gianluca Vernillo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Colombo, 71, Milano 20133, Italy
| | - Guillaume Y Millet
- Univ Lyon, UJM Saint-Etienne, Inter-University Laboratory of Human Movement Biology, 10 rue de la Marandière, Saint Priest en Jarez 42270, France
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary AB T2N 1N4, Canada
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22
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Hughes JM, O'Leary TJ, Koltun KJ, Greeves JP. Promoting adaptive bone formation to prevent stress fractures in military personnel. Eur J Sport Sci 2021; 22:4-15. [PMID: 34269162 DOI: 10.1080/17461391.2021.1949637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Mechanical loading leads to adaptive bone formation - the formation of new bone on existing skeletal surfaces - which increases bone strength and fatigue resistance. The same mechanical loading can also cause microdamage to bone and development of a stress fracture through targeted remodelling. Stress fractures are common in military recruits and cause significant morbidity, lost training time, and discharge from military service. This narrative review proposes strategies to promote adaptive bone formation as a novel approach to mitigate the risk of stress fracture injuries during arduous military training. Exercise that is unaccustomed, dynamic, high-impact, multidirectional, intermittent, and includes extended rest periods to restore bone mechanosensitivity, is most osteogenic. New bone formation can take up to one year to mineralize, and so new exercise training programmes should be initiated well in advance of military activities with high risk of stress fracture. Bone mechanosensitivity is highest in adolescence, before puberty, and so increasing physical activity in youth is likely to protect skeletal health in later life, including for those in the military. Recent data show that adaptive bone formation takes place during initial military training. Adaptive bone formation can also be supported with adequate sleep, vitamin D, calcium, and energy availability. Further evidence on how strategies to promote adaptive bone formation affect stress fracture risk are required. Adaptive bone formation can be optimized with a range of training and nutritional strategies to help create a resilient skeleton, which may protect against stress fracture throughout military service.
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Affiliation(s)
- Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Thomas J O'Leary
- Army Health and Performance Research, Army Headquarters, Andover, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Kristen J Koltun
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PN, USA
| | - Julie P Greeves
- Army Health and Performance Research, Army Headquarters, Andover, UK.,Division of Surgery and Interventional Science, University College London, London, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
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23
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Staab JS, Kolb AL, Tomlinson RE, Pajevic PD, Matheny RW, Hughes JM. Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk. Exp Biol Med (Maywood) 2021; 246:1104-1111. [PMID: 33641442 DOI: 10.1177/1535370221993098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is mounting evidence suggesting that the commonly used analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), may inhibit new bone formation with physical training and increase risk of stress fractures in physically active populations. Stress fractures are thought to occur when bones are subjected to repetitive mechanical loading, which can lead to a cycle of tissue microdamage, repair, and continued mechanical loading until fracture. Adaptive bone formation, particularly on the periosteal surface of long bones, is a concurrent adaptive response of bone to heightened mechanical loading that can improve the fatigue resistance of the skeletal structure, and therefore may play a critical role in offsetting the risk of stress fracture. Reports from animal studies suggest that NSAID administration may suppress this important adaptive response to mechanical loading. These observations have implications for populations such as endurance athletes and military recruits who are at risk of stress fracture and whose use of NSAIDs is widespread. However, results from human trials evaluating exercise and bone adaptation with NSAID consumption have been less conclusive. In this review, we identify knowledge gaps that must be addressed to further support NSAID-related guidelines intended for at-risk populations and individuals.
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Affiliation(s)
- Jeffery S Staab
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Alexander L Kolb
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Ryan E Tomlinson
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | | | - Ronald W Matheny
- Military Operational Medicine Research Program, Fort Detrick, MD 21702, USA
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
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24
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Saers JPP, DeMars LJ, Stephens NB, Jashashvili T, Carlson KJ, Gordon AD, Shaw CN, Ryan TM, Stock JT. Combinations of trabecular and cortical bone properties distinguish various loading modalities between athletes and controls. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 174:434-450. [PMID: 33244746 DOI: 10.1002/ajpa.24176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/06/2020] [Accepted: 11/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Variation in trabecular and cortical bone properties is often used to infer habitual behavior in the past. However, the structures of both types of bone are rarely considered together and may even contradict each other in functional interpretations. We examine trabecular and cortical bone properties in various athletes and sedentary controls to clarify the associations between combinations of cortical and trabecular bone properties and various loading modalities. MATERIALS AND METHODS We compare trabecular and cortical bone properties using peripheral quantitative computed tomography scans of the tibia between groups of 83 male athletes (running, hockey, swimming, cricket) and sedentary controls using Bayesian multilevel models. We quantify midshaft cortical bone rigidity and area (J, CA), midshaft shape index (Imax/Imin), and mean trabecular bone mineral density (BMD) in the distal tibia. RESULTS All groups show unique combinations of biomechanical properties. Cortical bone rigidity is high in sports that involve impact loading (cricket, running, hockey) and low in nonimpact loaded swimmers and controls. Runners have more anteroposteriorly elliptical midshafts compared to other groups. Interestingly, all athletes have greater trabecular BMD compared to controls, but do not differ credibly among each other. DISCUSSION Results suggest that cortical midshaft hypertrophy is associated with impact loading while trabecular BMD is positively associated with both impact and nonimpact loading. Midshaft shape is associated with directionality of loading. Individuals from the different categories overlap substantially, but group means differ credibly, suggesting that nuanced group-level inferences of habitual behavior are possible when combinations of trabecular and cortical bone are analyzed.
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Affiliation(s)
- Jaap P P Saers
- Department of Archaeology, Cambridge University, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
| | - Lily J DeMars
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Nicholas B Stephens
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Tea Jashashvili
- Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Geology and Paleontology, Georgian National Museum, Tbilisi, Georgia
| | - Kristian J Carlson
- Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Evolutionary Studies Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam D Gordon
- Department of Anthropology, University at Albany, SUNY, Albany, New York, USA
| | | | - Timothy M Ryan
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jay T Stock
- Department of Archaeology, Cambridge University, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland.,Department of Anthropology, Western University, London, Ontario, Canada
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