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Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [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: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
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Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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Scorcelletti M, Zange J, Böcker J, Sies W, Lau P, Mittag U, Reeves ND, Ireland A, Rittweger J. Associations between long-term exercise participation and lower limb joint and whole-bone geometry in young and older adults. Front Physiol 2023; 14:1150562. [PMID: 37250122 PMCID: PMC10211427 DOI: 10.3389/fphys.2023.1150562] [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: 01/24/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction: Features of lower limb bone geometry are associated with movement kinematics and clinical outcomes including fractures and osteoarthritis. Therefore, it is important to identify their determinants. Lower limb geometry changes dramatically during development, partly due to adaptation to the forces experienced during physical activity. However, the effects of adulthood physical activity on lower limb geometry, and subsequent associations with muscle function are relatively unexplored. Methods: 43 adult males were recruited; 10 young (20-35 years) trained i.e., regional to world-class athletes, 12 young sedentary, 10 older (60-75 years) trained and 11 older sedentary. Skeletal hip and lower limb geometry including acetabular coverage and version angle, total and regional femoral torsion, femoral and tibial lateral and frontal bowing, and frontal plane lower limb alignment were assessed using magnetic resonance imaging. Muscle function was assessed recording peak power and force of jumping and hopping using mechanography. Associations between age, training status and geometry were assessed using multiple linear regression, whilst associations between geometry and muscle function were assessed by linear mixed effects models with adjustment for age and training. Results: Trained individuals had 2° (95% CI:0.6°-3.8°; p = 0.009) higher femoral frontal bowing and older individuals had 2.2° (95% CI:0.8°-3.7°; p = 0.005) greater lateral bowing. An age-by-training interaction indicated 4° (95% CI:1.4°-7.1°; p = 0.005) greater acetabular version angle in younger trained individuals only. Lower limb geometry was not associated with muscle function (p > 0.05). Discussion: The ability to alter skeletal geometry via exercise in adulthood appears limited, especially in epiphyseal regions. Furthermore, lower limb geometry does not appear to be associated with muscle function.
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Affiliation(s)
- Matteo Scorcelletti
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
- Werner Siemens-Endowed Chair for Innovative Implant Development (Fracture Healing), Division of Surgery, Saarland University, Homburg, Germany
| | - Jochen Zange
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Jonas Böcker
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Wolfram Sies
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Patrick Lau
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Uwe Mittag
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Neil D. Reeves
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
| | - Alex Ireland
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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3
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Catapano M, Ahmed M, Breslow RG, Borg-Stein J. The aging athlete. PM R 2022; 14:643-651. [PMID: 35441493 DOI: 10.1002/pmrj.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022]
Abstract
Aging athletes, those 60 years and older, are a growing population of mature, active individuals who value sports and exercise participation throughout their lifespan. Although recommendations for younger and masters athletes have been extrapolated to this population, there remains a paucity of specific guidelines, treatment algorithms, and considerations for aging athletes. The benefits of living an active lifestyle must be weighed against the risks for unique cardiovascular, metabolic, and musculoskeletal injuries requiring diagnostic and therapeutic interventions. In this article, we review the unique cardiovascular and muscular physiology of aging athletes and how it influences the risk of specific medical conditions. We also discuss general prevention and treatment strategies. Finally, we identify areas of future research priorities and emerging treatments.
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Affiliation(s)
- Michael Catapano
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marwa Ahmed
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, Massachusetts, USA.,Division of Sports Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Chen Z, Sherk VD, Sharma-Ghimire P, Bemben MG, Bemben DA. Site-Specific Bone Differences and Energy Status in Male Competitive Runners and Road Cyclists. J Clin Densitom 2022; 25:150-159. [PMID: 34952789 DOI: 10.1016/j.jocd.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022]
Abstract
The interaction between mechanical loading and energy availability on bone health in male endurance athletes merits further investigation. The purpose of this study was to compare bone status in male competitive runners and road cyclists and to investigate the influence of energy availability (EA) on bone mineral density (BMD). 18 competitive runners and 19 road cyclists (20-50 years) participated in this study. Areal BMD and body composition were assessed by dual energy x-ray absorptiometry. Volumetric bone variables at the 4% and 66% tibia sites were assessed by peripheral quantitative computed tomography. Energy availability (EA, 7-day dietary and exercise logs) and resting metabolic rate (RMR, open circuit spirometry) were measured as indicators of energy status. Bone loading history, calcium intake, and training history were assessed by questionnaires. After adjusting for age, runners had significantly greater (p < 0.05) areal BMD (femoral neck, left total hip), Z-scores (total body, hips sites), total bone mineral content and trabecular variables (bone mineral content, volumetric BMD, bone strength index) at tibia 4% site, and total volumetric BMD at tibia 66% site than the cyclists (p ≤ 0.05). At the tibia 66% site, cyclists had significantly greater (p < 0.05) total area, periosteal circumference, endosteal circumference, and strength-strain index than runners. Energy variables were similar for runners and cyclists; however, RMR and RMR ratio (measured RMR/predicted RMR) were significantly lower in cyclists (p < 0.001). In conclusion, there were site-specific differences in hip and tibia bone characteristics between runners and cyclists. RMR was associated with several bone outcomes; however, EA was not related to bone health in runners or to dual energy x-ray absorptiometry bone variables in cyclists.
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Affiliation(s)
- Zhaojing Chen
- Department of Kinesiology, California State University, San Bernardino, CA, USA.
| | - Vanessa D Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Pragya Sharma-Ghimire
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Debra A Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Commentaries on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat? J Appl Physiol (1985) 2021; 131:29-33. [PMID: 34181462 DOI: 10.1152/japplphysiol.00335.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Suominen TH, Alén M, Törmäkangas T, Degens H, Rittweger J, Heinonen A, Suominen H, Korhonen MT. Regular Strength and Sprint Training Counteracts Bone Aging: A 10-Year Follow-Up in Male Masters Athletes. JBMR Plus 2021; 5:e10513. [PMID: 34258508 PMCID: PMC8260815 DOI: 10.1002/jbm4.10513] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/09/2021] [Indexed: 11/06/2022] Open
Abstract
Cross-sectional and interventional studies suggest that high-intensity strength and impact-type training provide a powerful osteogenic stimulus even in old age. However, longitudinal evidence on the ability of high-intensity training to attenuate age-related bone deterioration is currently lacking. This follow-up study assessed the role of continued strength and sprint training on bone aging in 40- to 85-year-old male sprinters (n = 69) with a long-term training background. Peripheral quantitative computed tomography (pQCT)-derived bone structural, strength, and densitometric parameters of the distal tibia and tibia midshaft were assessed at baseline and 10 years later. The groups of well-trained (actively competing, sprint training including strength training ≥2 times/week; n = 36) and less-trained (<2 times/week, no strength training, switched to endurance training; n = 33) athletes were formed according to self-reports at follow-up. Longitudinal changes in bone traits in the two groups were examined using linear mixed models. Over the 10-year period, group-by-time interactions were found for distal tibia total bone mineral content (BMC), trabecular volumetric bone mineral density (vBMD), and compressive strength index, and for mid-tibia cortical cross-sectional area, medullary area, total BMC, and BMC at the anterior and posterior sites (polar mass distribution analysis) (p < 0.05). These interactions reflected maintained (distal tibia) or improved (mid-tibia) bone properties in the well-trained and decreased bone properties in the less-trained athletes over the 10-year period. Depending on the bone variable, the difference in change in favor of the well-trained group ranged from 2% to 5%. The greatest differences were found in distal tibia trabecular vBMD and mid-tibia posterior BMC, which remained significant (p < 0.05) after adjustment for multiple testing. In conclusion, our longitudinal findings indicate that continued strength and sprint training is associated with maintained or even improved tibial properties in middle-aged and older male sprint athletes, suggesting that regular, intensive exercise counteracts bone aging. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Tuuli H Suominen
- Gerontology Research Center, Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Markku Alén
- Department of Medical Rehabilitation, Oulu University Hospital and Center for Life Course Health Research University of Oulu Oulu Finland
| | - Timo Törmäkangas
- Gerontology Research Center, Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Hans Degens
- Department of Life Sciences, Musculoskeletal Science, and Sports Medicine Research Centre Manchester Metropolitan University Manchester UK.,Institute of Sport Science and Innovations Lithuanian Sports University Kaunas Lithuania
| | - Jörn Rittweger
- Institute of Aerospace Medicine German Aerospace Center (DLR) Cologne Germany.,Department of Pediatrics and Adolescent Medicine University of Cologne Cologne Germany
| | - Ari Heinonen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Harri Suominen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Marko T Korhonen
- Gerontology Research Center, Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
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Strasser B, Pesta D, Rittweger J, Burtscher J, Burtscher M. Nutrition for Older Athletes: Focus on Sex-Differences. Nutrients 2021; 13:nu13051409. [PMID: 33922108 PMCID: PMC8143537 DOI: 10.3390/nu13051409] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Regular physical exercise and a healthy diet are major determinants of a healthy lifespan. Although aging is associated with declining endurance performance and muscle function, these components can favorably be modified by regular physical activity and especially by exercise training at all ages in both sexes. In addition, age-related changes in body composition and metabolism, which affect even highly trained masters athletes, can in part be compensated for by higher exercise metabolic efficiency in active individuals. Accordingly, masters athletes are often considered as a role model for healthy aging and their physical capacities are an impressive example of what is possible in aging individuals. In the present review, we first discuss physiological changes, performance and trainability of older athletes with a focus on sex differences. Second, we describe the most important hormonal alterations occurring during aging pertaining regulation of appetite, glucose homeostasis and energy expenditure and the modulatory role of exercise training. The third part highlights nutritional aspects that may support health and physical performance for older athletes. Key nutrition-related concerns include the need for adequate energy and protein intake for preventing low bone and muscle mass and a higher demand for specific nutrients (e.g., vitamin D and probiotics) that may reduce the infection burden in masters athletes. Fourth, we present important research findings on the association between exercise, nutrition and the microbiota, which represents a rapidly developing field in sports nutrition.
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Affiliation(s)
- Barbara Strasser
- Medical Faculty, Sigmund Freud Private University, A-1020 Vienna, Austria
- Correspondence: ; Tel.: +43-(0)1-798-40-98
| | - Dominik Pesta
- Institute of Aerospace Medicine, German Aerospace Center (DLR), D-51147 Cologne, Germany; (D.P.); (J.R.)
- Centre for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, D-50931 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), D-50931 Cologne, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, D-40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD e.V.), D-85764 Neuherberg, Germany
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria;
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), D-51147 Cologne, Germany; (D.P.); (J.R.)
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland;
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria;
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Tanaka H, Tarumi T, Rittweger J. Aging and Physiological Lessons from Master Athletes. Compr Physiol 2019; 10:261-296. [PMID: 31853968 DOI: 10.1002/cphy.c180041] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Sedentary aging is often characterized by physical dysfunction and chronic degenerative diseases. In contrast, masters athletes demonstrate markedly greater physiological function and more favorable levels of risk factors for cardiovascular disease, osteoporosis, frailty, and cognitive dysfunction than their sedentary counterparts. In many cases, age-related deteriorations of physiological functions as well as elevations in risk factors that are typically observed in sedentary adults are substantially attenuated or even absent in masters athletes. Older masters athletes possess greater functional capacity at any given age than their sedentary peers. Impressive profiles of older athletes provide insight into what is possible in human aging and place aging back into the domain of "physiology" rather than under the jurisdiction of "clinical medicine." In addition, these exceptional aging athletes can serve as a role model for the promotion of physical activity at all ages. The study of masters athletes has provided useful insight into the positive example of successful aging. To further establish and propagate masters athletics as a role model for our aging society, future research and action are needed. © 2020 American Physiological Society. Compr Physiol 10:261-296, 2020.
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Affiliation(s)
- Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Takashi Tarumi
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Jörn Rittweger
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Olmedillas H, Gonzalez-Agüero A, Rapún-López M, Gracia-Marco L, Gomez-Cabello A, Pradas de la Fuente F, Moreno LA, Casajús JA, Vicente-Rodríguez G. Bone metabolism markers and vitamin D in adolescent cyclists. Arch Osteoporos 2018; 13:11. [PMID: 29397487 DOI: 10.1007/s11657-018-0415-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/17/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study aimed to describe bone metabolic activity in adolescent competitive cyclists compared to age-matched controls. The main result is that younger subjects present a higher bone turnover than the older ones. Moreover, cyclists under the age of 17 have higher scores on all markers than age-matched controls. PURPOSE The purpose of this study was to describe bone metabolic activity in adolescent competitive cyclists compared to age-matched controls. METHODS Twenty-two male adolescent cyclists between 14 and 20 years (y) and 20 age-matched controls participated in this study. Serum osteocalcin (OC), aminoterminal propeptide of type I procollagen (PINP), and β-isomerized C-telopeptides (β-CTX) were analyzed by electrochemiluminescence immunoassay (ECLIA); plasma 25 hydroxyvitamin D [25(OH)D] was analyzed by enzyme-linked immunosorbent assay (ELISA). RESULTS Analysis of variance revealed no significant differences in bone metabolism markers and vitamin D between cyclists and controls. Cyclists over 17 y had a significantly lower concentration in bone formation and resorption biochemical markers compared to cyclists under 17 y (all P < 0.05). Moreover, controls over 17 y presented lower concentration for PINP (P < 0.05) compared to their peers under 17 y. Comparisons between cyclists and controls under 17 y revealed higher concentrations of OC and PINP (P < 0.05) in cyclists. Group interaction by age was found for OC, PINP, and β-CTX (P < 0.01). Cyclists over 17 y had higher concentrations of [25(OH)D] (P < 0.05) than age-matched controls. CONCLUSIONS The present results support the idea that cycling during adolescence may be associated to a decrease in bone turnover that may affect bone health later in life.
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Affiliation(s)
- Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Campus del Cristo B. Julián Clavería s/n, Asturias, Spain
| | - Alejandro Gonzalez-Agüero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Marta Rapún-López
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, C/Ronda Misericordia, 5, 22001, Huesca, Spain
| | - Luis Gracia-Marco
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alba Gomez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro Universitario de la Defensa, Zaragoza, Spain
| | - Francisco Pradas de la Fuente
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, C/Ronda Misericordia, 5, 22001, Huesca, Spain
| | - Luís A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - José A Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain. .,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
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Bone Structure and Geometric Properties at the Radius and Tibia in Adolescent Endurance-Trained Cyclists. Clin J Sport Med 2017; 27:69-77. [PMID: 26825141 DOI: 10.1097/jsm.0000000000000299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe cortical and trabecular volumetric bone mineral density (vBMD), bone mineral content (BMC), cross-sectional area (CSA), and bone strength indexes (BSIs) in adolescent endurance-trained cyclists (CYC) and compare them with controls (CON). DESIGN Descriptive cohort study. PARTICIPANTS Twenty-five male adolescent CYC and 17 CON. ASSESSMENT OF RISK FACTORS Peripheral quantitative computed tomography was used to evaluate proximal and distal sites of the radius and tibia. MAIN OUTCOME MEASURES Total, trabecular, and cortical BMC, vBMD, and CSA were measured. Also, cortical thickness, endosteal and periosteal circumferences, and different BSIs were calculated. Unadjusted analysis of variance and body weight-adjusted analysis of covariance tests were applied between cyclist and control groups. RESULTS Cyclists were almost 12% lighter than CON (P < 0.05). Unadjusted data showed lower distal total vBMD and proximal cortical BMC and vBMD in cyclists compared with CON at the radius (P < 0.05) and lower distal total and trabecular BMC, vBMD and bone area, proximal total and cortical BMC and vBMD, and cortical bone area at the tibia (P < 0.05). Body weight-adjusted data showed the same differences for distal total vBMD at the radius and total and trabecular BMC and vBMD at the tibia, diaphyseal radius cortical vBMD and tibia total vBMD, cortical BMC and area, and also for tibia cortical thickness and BSI. The rest of differences were no longer detectable and bone area at the distal radius become significantly higher in cyclist compared with CON (P < 0.05). CONCLUSIONS Adolescent CYC in this study showed lower values of BMC and vBMD at determined sites of the radius and tibia than CON, some of these differences were explained in part by their lower body weight. However, even further adjustment, some differences remained, which indicates that further longitudinal studies are needed to better understand if cycling influences these differences.
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Oosthuyse T, McVeigh JA, Micklesfield LK, Meiring RM. Radial and tibial bone indices in athletes participating in different endurance sports: a pQCT study. Eur J Sport Sci 2016; 17:231-240. [PMID: 27537336 DOI: 10.1080/17461391.2016.1219770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low magnitude bone-loading sports may benefit bone structure and strength in the exercised limbs. This study compared peripheral quantitative computed tomography measures of radial and tibial diaphyseal strength (strength-strain index, SSI), structure (total area (ToA) and cortical area (CoA), density (CoD) and thickness (CT), and circumferences), muscle cross-sectional area (MCSA) and strength (one-repetition maximum, 1-RM) in male endurance athletes taking part in (i) non-weight-bearing and non-impact sports: swimmers (SWIM, n = 13) and road cyclists (RC, n = 10), (ii) non-weight-bearing, impact sport: mountain bikers (MB, n = 10), (iii) weight bearing and impact sport: runners (RUN, n = 9). All athlete groups were also compared to sedentary controls (CON, n = 10). Arm MCSA, 1-RM and radial bone size and strength tended to be greater in SWIM than CON and/or RC (ToA, %difference ± 95%CI, SWIM-CON: 14.6% ± 12.7%; SWIM-RC: 12.9% ± 10.7%) but not different to MB and RUN. RUN had bigger tibial CoA than CON, SWIM and RC (CoA, RUN-CON: 12.1% ± 10.7%; RUN-SWIM: 10.9% ± 9.4%; RUN-RC: 15.8% ± 9.5%) without marked changes in tibial strength indices, lower-limb MCSA or 1-RM. Both MB and RC failed to display any difference in tibial indices, lower-limb MCSA and 1-RM compared to CON. In swimmers, the bone structure and strength of the primary exercised limbs, the arms, is greater than controls and road cyclists. Conversely, although runners experience impact and weight-bearing loading, tibial structure is greater without a substantial difference in tibial strength compared to controls and non-impact sports. Failure to observe a difference in tibial indices in MB and RC compared to controls is unexpected.
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Affiliation(s)
- Tanja Oosthuyse
- a Exercise Laboratory, School of Physiology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Joanne A McVeigh
- a Exercise Laboratory, School of Physiology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Lisa K Micklesfield
- b MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Rebecca M Meiring
- a Exercise Laboratory, School of Physiology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
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Mcveigh JA, Meiring R, Cimato A, Micklesfield LK, Oosthuyse T. Radial bone size and strength indices in male road cyclists, mountain bikers and controls. Eur J Sport Sci 2014; 15:332-40. [DOI: 10.1080/17461391.2014.933881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE To observe changes in hip, spine, and tibia bone characteristics in female cyclists over the course of 1 year of training. DESIGN Prospective observational study. SETTING Laboratory. PARTICIPANTS Female cyclists (n = 14) aged 26-41 years with at least 1 year of competition history and intent to compete in 10 or more races in the coming year. ASSESSMENT OF RISK FACTORS Women who train and compete in road cycling as their primary sport. MAIN OUTCOME MEASURES Total body fat-free and fat mass and lumbar spine and proximal femur areal bone mineral density (aBMD) and bone mineral content (BMC) assessments by dual-energy x-ray absorptiometry. Volumetric BMD and BMC of the tibia were measured by peripheral quantitative computed tomography at sites corresponding to 4%, 38%, 66%, and 96% of tibia length. Time points were baseline and after 12 months of training and competition. RESULTS Weight and body composition did not change significantly over 12 months. Total hip aBMD and BMC decreased by -1.4% ± 1.9% and -2.1% ± 2.3% (P < 0.02) and subtrochanter aBMD and BMC decreased by -2.1% ± 2.0% and -3.3% ± 3.7% (P < 0.01). There was a significant decrease in lumbar spine BMC (-1.1% ± 1.9%; P = 0.03). There were no significant bone changes in the tibia (P > 0.11). CONCLUSIONS Bone loss in female cyclists was site specific and similar in magnitude to losses previously reported in male cyclists. Research is needed to understand the mechanisms for bone loss in cyclists.
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Korhonen MT, Heinonen A, Siekkinen J, Isolehto J, Alén M, Kiviranta I, Suominen H. Bone density, structure and strength, and their determinants in aging sprint athletes. Med Sci Sports Exerc 2013; 44:2340-9. [PMID: 22776884 DOI: 10.1249/mss.0b013e318267c954] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study was undertaken to examine bone properties in masters sprinters of different ages and younger reference subjects. In addition, the association of sport-specific ground reaction force, muscle, training, and hormone characteristics with the bone parameters was evaluated in the athletes. METHODS Bone densitometric, structural, and strength parameters were assessed by peripheral quantitative computed tomography at the distal and midtibia in 83 male sprinters (40-85 yr) and 19 physically active referents (31-45 yr). Between-group differences were analyzed by ANCOVA with body mass and height as covariates. RESULTS Bone values were generally greater in athletes than referents, the greatest differences being in bending strength of the tibia shaft as estimated by maximum moment of inertia (Imax). Among athletes, trabecular volumetric bone mineral density of distal tibia was 12% (P < 0.05) lower in the oldest (≥70 yr) versus youngest group, whereas the total bone mineral content, total cross-sectional area, and compressive bone strength index did not differ between the groups. At midtibia, no age group differences were present in the total bone mineral content, total cross-sectional area, cortical wall thickness, cortical volumetric bone mineral density, polar mass distribution, minimum moment of inertia, or maximum moment of inertia. After controlling for age, body mass, and height, most loading-related characteristics, knee extensor muscle thickness, and hormone concentrations correlated with the bone parameters. Multivariate regression models explained 12%-67% (mean, 47.5%) of the variance of the bone parameters. Mechanical power in the eccentric phase of the hopping and body mass were consistently the strongest independent predictors in the models. CONCLUSION The results suggest that regular sprint training has positive (direction-specific) effects on bone strength and structure in middle- and older-aged athletes. Interindividual differences in bone traits seem to be due to combined effects of exercise loading, body size, and hormonal characteristics.
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Affiliation(s)
- Marko T Korhonen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Olmedillas H, González-Agüero A, Moreno LA, Casajus JA, Vicente-Rodríguez G. Cycling and bone health: a systematic review. BMC Med 2012; 10:168. [PMID: 23256921 PMCID: PMC3554602 DOI: 10.1186/1741-7015-10-168] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 12/20/2012] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass. METHODS A scientific literature search on studies discussing bone mass and bone metabolism in cyclists was performed to collect all relevant published material up to April 2012. Descriptive, cross-sectional, longitudinal and interventional studies were all reviewed. Inclusion criteria were met by 31 studies. RESULTS Heterogeneous studies in terms of gender, age, data source, group of comparison, cycling level or modality practiced among others factors showed minor but important differences in results. Despite some controversial results, it has been observed that adult road cyclists participating in regular training have low bone mineral density in key regions (for example, lumbar spine). Conversely, other types of cycling (such as mountain biking), or combination with other sports could reduce this unsafe effect. These results cannot yet be explained by differences in dietary patterns or endocrine factors. CONCLUSIONS From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level.
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Affiliation(s)
- Hugo Olmedillas
- GENUD 'Growth, Exercise, NUtrition and Development' Research Group, Universidad de Zaragoza, Zaragoza, Spain.
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Ducher G, Naughton GA, Lorenzen C. Bone health in cyclists: discrepancies between the axial and peripheral skeletons. Med Sci Sports Exerc 2011; 41:1975; author reply 1976. [PMID: 21606909 DOI: 10.1249/mss.0b013e3181af2764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Olmedillas H, González-Agüero A, Moreno LA, Casajús JA, Vicente-Rodríguez G. Bone related health status in adolescent cyclists. PLoS One 2011; 6:e24841. [PMID: 21980360 PMCID: PMC3184100 DOI: 10.1371/journal.pone.0024841] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 08/19/2011] [Indexed: 11/22/2022] Open
Abstract
Purpose To describe bone status and analyse bone mass in adolescent cyclists. Methods Male road cyclists (n = 22) who had been training for a minimum of 2 years and a maximum of 7 years with a volume of 10 h/w, were compared to age-matched controls (n = 22) involved in recreational sports activities. Subjects were divided in 2 groups based on age: adolescents under 17 yrs (cyclists, n = 11; controls, n = 13) and over 17 yrs (cyclists, n = 11; controls, n = 9). Peak oxygen uptake (VO2max) was measured on a cycloergometer. Whole body, lumbar spine, and hip bone mineral content (BMC), density (BMD) and bone area were assessed using dual x-ray absorptiometry (DXA). Volumetric BMD (vBMD) and bone mineral apparent density (BMAD) were also estimated. Results The BMC of cyclists was lower for the whole body, pelvis, femoral neck and legs; BMD for the pelvis, hip, legs and whole body and legs bone area was lower but higher in the hip area (all, P≤0.05) after adjusting by lean mass and height. The BMC of young cyclists was 10% lower in the leg and 8% higher in the hip area than young controls (P≤0.05). The BMC of cyclists over 17 yrs was 26.5%, 15.8% and 14.4% lower BMC at the pelvis, femoral neck and legs respectively while the BMD was 8.9% to 24.5% lower for the whole body, pelvis, total hip, trochanter, intertrochanter, femoral neck and legs and 17.1% lower the vBMD at the femoral neck (all P≤0.05). Grouped by age interaction was found in both pelvis and hip BMC and BMD and in femoral neck vBMD (all P≤0.05). Conclusion Cycling performed throughout adolescence may negatively affect bone health, then compromising the acquisition of peak bone mass.
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Affiliation(s)
- Hugo Olmedillas
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.
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Abstract
Context: Low bone mineral density (BMD) is a serious public health problem. Osteoporotic fractures are associated with low bone mass, occurring frequently in the hip and spine. Previous studies have demonstrated a positive relationship between BMD and weightbearing exercise but not a similar positive relationship with nonweightbearing exercise. There is concern that cycling, a weight-supported sport, does not benefit bone health. Objective: To systematically review the evidence suggesting that cyclists have impaired bone health at the femoral neck and lumbar spine. Data Sources: Articles in PubMed, Cochrane Library, and CINAHL were identified in December 2009 What is the start date for the search?based on the following terms and combinations: bicycling, bone density, cyclist. Study Selection: Thirteen studies satisfied inclusion criteria: 2 prospective studies (level of evidence 2b) and 11 cross-sectional studies (level of evidence 2c). Data Extraction: Data included sample size, demographics, description of cycling and control criteria, and BMD (g/cm2) at the lumbar spine, femoral neck, and hip. Results: Two prospective studies showed a decrease in femoral neck, total hip, or lumbar spine BMD in cyclists over the study period. Four cross-sectional studies compared cyclists with sedentary controls, and 3 found cyclists’ lumbar spine and femoral neck BMD similar to that of controls, whereas 1 found cyclists’ BMD to be lower than that of controls. Seven cross-sectional studies compared cyclists with active controls: 2 found no differences in femoral neck and lumbar spine BMD between cyclists and controls; 4 found that cyclists had lower lumbar spine BMD than did active controls, including runners; and 1 reported a trend toward lower lumbar spine BMD in cyclists versus controls. Conclusions: There is concerning but inconsistent, limited-quality disease-oriented evidence—primarily from cross-sectional data—indicating that cyclists may be at risk for low bone mass, particularly at the lumbar spine. Additional longitudinal controlled intervention trials are needed.
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Helge EW, Aagaard P, Jakobsen MD, Sundstrup E, Randers MB, Karlsson MK, Krustrup P. Recreational football training decreases risk factors for bone fractures in untrained premenopausal women. Scand J Med Sci Sports 2010; 20 Suppl 1:31-9. [DOI: 10.1111/j.1600-0838.2010.01107.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Penteado VSDR, Castro CHDM, Pinheiro MDM, Santana M, Bertolino S, de Mello MT, Szejnfeld VL. Diet, body composition, and bone mass in well-trained cyclists. J Clin Densitom 2010; 13:43-50. [PMID: 19942468 DOI: 10.1016/j.jocd.2009.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2009] [Revised: 09/07/2009] [Accepted: 09/08/2009] [Indexed: 10/20/2022]
Abstract
Cycling is believed to be associated with low bone mass. In this study, we investigate food intake, body composition, and bone mass in well-trained young adult cyclists compared with those in sedentary controls. Four-day estimated diet records were used to study dietary intake in 31 cyclists and 28 sedentary controls (all male, 24yr old on average), together with maximal oxygen uptake (VO(2max)), body composition, and bone mass measurements (dual-energy X-ray absorptiometry). The VO(2max) values were twice as high as those in the cyclists, whereas no significant difference in bone mass was observed between cyclists and controls. A total of 10 cyclists and 9 controls had low bone mass. Total-body lean mass and appendicular skeletal muscle mass were higher in cyclists (p<0.001), whereas percentage of body fat was lower (p<0.001) compared with that of the controls. Energy and macro- and micronutrient intake was higher in the cyclists than in the controls (p<0.01). Energy consumption was considered adequate in the cyclists, whereas lipid and protein intake was higher than the American College of Sports Medicine recommendation. Lipid consumption negatively correlated with bone mass in the athletes. Our results demonstrate that cycling was associated with greater aerobic conditioning and lean mass without significant association with bone mass compared with sedentary controls.
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Affiliation(s)
| | | | | | - Marcus Santana
- Rheumatology Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
| | - Sheila Bertolino
- Rheumatology Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
| | - Marco Túlio de Mello
- Rheumatology Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
| | - Vera Lúcia Szejnfeld
- Rheumatology Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
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Rittweger J, Gilliver SF, Wilks DC. RESPONSE. Med Sci Sports Exerc 2009. [DOI: 10.1249/mss.0b013e3181af2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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