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Amato A, Proia P, Alioto A, Rossi C, Pagliaro A, Ragonese P, Schirò G, Salemi G, Caldarella R, Vasto S, Nowak R, Kostrzewa-Nowak D, Musumeci G, Baldassano S. High-intensity interval training improves bone remodeling, lipid profile, and physical function in multiple sclerosis patients. Sci Rep 2024; 14:16195. [PMID: 39003295 PMCID: PMC11246443 DOI: 10.1038/s41598-024-66448-5] [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: 01/25/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease due to an autoimmune chronic inflammatory response, yet the etiology is currently not completely understood. It is already known that physical activity plays an essential role in improving quality of life, especially in neuropathological conditions. The study was aimed to investigate the possible benefits of high-intensity interval training (HIIT) in bone and lipid metabolism markers, and neuromotor abilities in MS patients. 130 participants were recruited; 16 subjects with MS met the inclusion criteria and were included in the data analysis. The patients were randomly assigned to two groups: a Control group (CG) (34.88 ± 4.45 yrs) that didn't perform any physical activity and the Exercise group (EG) (36.20 ± 7.80 yrs) that performed HIIT protocol. The training program was conducted remotely by a kinesiologist. It was performed three times a week for 8 weeks. At the beginning (T0) and the end of the study (T1) physical function tests, bone remodelling markers, and lipid markers analyses were performed. After 8 weeks of training the wall squat (s) (T0 = 27.18 ± 4.21; T1 = 41.68 ± 5.38, p ≤ 0.01) and Time Up and Go test (s) (T0 = 7.65 ± 0.43; T1 = 6.34 ± 0.38 p ≤ 0.01) performances improved; lipid markers analysis showed a decrease in Total (mg/dl) (T0 = 187.22 ± 15.73; T1 = 173.44 ± 13.03, p ≤ 0.05) and LDL (mg/dl) (T0 = 108 ± 21.08; T1 = 95.02 ± 17.99, p < 0.05) cholesterol levels. Additionally, the levels of osteocalcin (µg/L), a marker of bone formation increased (T0 = 20.88 ± 4.22; T1 = 23.66 ± 6.24, p < 0.05), 25-OH Vitamin D (µg/L) improved after 8 weeks (T0 = 21.11 ± 7.11; T1 = 27.66 ± 7.59, p < 0.05). HIIT had an effect on lower limb strength and gait control, improved bone formation, and lipid management, in MS patients.
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Affiliation(s)
- Alessandra Amato
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia No 97, 95123, Catania, Italy
| | - Patrizia Proia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy.
| | - Anna Alioto
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Carlo Rossi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Andrea Pagliaro
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Salemi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Rosalia Caldarella
- Department of Laboratory Medicine, "P. Giaccone" University Hospital, University of Palermo, 90127, Palermo, Italy
| | - Sonya Vasto
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128, Palermo, Italy
| | - Robert Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St, 70-240, Szczecin, Poland
- Department of Pathology, Pomeranian Medical University in Szczecin, 1 Unii Lubelskiej St, 71-242, Szczecin, Poland
| | - Dorota Kostrzewa-Nowak
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. Al, 70-111, Szczecin, Poland
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia No 97, 95123, Catania, Italy
| | - Sara Baldassano
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128, Palermo, Italy
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Azami P, Ashraf A, Yousefi O, Hosseinpour A, Nasiri A. Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls. BMC Sports Sci Med Rehabil 2024; 16:104. [PMID: 38711058 DOI: 10.1186/s13102-024-00896-4] [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: 08/28/2023] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE This present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness. METHODS Professional athletes aged 20 to 40 years with a history of treadmill running (minimum 75 min per week for the past three months or more) and age-, sex-, and body mass index (BMI)-matched healthy controls were recruited. Demographics and clinical features of participants were recorded. Athletes were divided into subgroup 1 with less than 12 months of treadmill running and subgroup 2 with 12 months or more of treadmill running. Distal femoral cartilage thicknesses were measured at the midpoints of the right medial condyle (RMC), right intercondylar area (RIA), right lateral condyle (RLC), left medial condyle (LMC), left intercondylar area (LIA), and left lateral condyle (LLC) via ultrasonography. RESULT A total of 72 athletes (mean age: 29.6 ± 6.6 years) and 72 controls (mean age: 31.9 ± 6.7 years) were enrolled. Athletes had significantly thinner cartilages in the RLC (2.21 ± 0.38 vs. 2.39 ± 0.31 cm, p = 0.002), LLC (2.28 ± 0.37 vs. 2.46 ± 0.35 cm, p = 0.004), and LMC (2.28 ± 0.42 vs. 2.42 ± 0.36 cm, p = 0.039) compared with the control group. Furthermore, cartilage thickness was significantly thinner in subgroup 2 athletes compared with the control group in the RLC (2.13 ± 0.34 vs. 2.39 ± 0.31 cm, p = 0.001), LLC (2.22 ± 0.31 vs. 2.46 ± 0.35 cm, p = 0.005), and LMC (2.21 ± 0.46 vs. 2.42 ± 0.36 cm, p = 0.027); however, subgroup 1 athletes did not have such differences. There was a weak negative correlation between total months of treadmill running and cartilage thickness in the RLC (r = - 0.0236, p = 0.046) and LLC (r = - 0.0233, p = 0.049). No significant correlation was found between the distal femoral cartilage thickness at different sites and the patients' demographic features, including age, BMI, speed and incline of treadmill running, and minutes of running per session and week (p > 0.05). CONCLUSION Compared with healthy controls, professional athletes with a history of long-term high-intensity treadmill running had thinner femoral cartilages. The duration (months) of treadmill running was weakly negatively correlated with distal femoral cartilage thickness. Longitudinal studies with prolonged follow-ups are needed to clarify how treadmill running affects femoral cartilage thickness in athletes.
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Affiliation(s)
- Pouria Azami
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ashraf
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Aref Nasiri
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
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Zhou H, Chen L, Su H, Chen G, Tong P. Risk of low bone mineral density in patients with haemophilia: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:52. [PMID: 38212803 PMCID: PMC10782745 DOI: 10.1186/s13018-023-04499-6] [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: 07/14/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Patients with haemophilia (PWH) may have lower bone mineral density (BMD). The risk of low BMD in PWH has not been comprehensively analysed. This study aimed to examine the risk of low BMD and changes in BMD in PWH. METHODS A comprehensive systematic search was performed in 4 databases: PubMed, Embase, Web of Science, and Cochrane Library. The last search was carried out on 11 December 2022. Review Manager 5.4 and Stata 16 were used for meta-analysis. Odds ratios were calculated by the incidence of low BMD between the haemophilia and control groups in each study. A meta-analysis of the odds ratios for each study was performed to estimate pooled odds ratios. Fixed effects models or random effects models were used to assess outcomes. Heterogeneity was evaluated using Higgins' I2. Subgroup analysis and sensitivity analysis were performed to interpret the potential source of heterogeneity. A funnel plot, Egger's regression test, and the trim-and-fill method were used to assess publication bias. RESULTS 19 of 793 studies, published between 2004 and 2022, that were identified by search strategy were included in this meta-analysis. The risk for low BMD was approximately four times higher compared to controls. PWH have significantly lower lumbar spine, femoral neck, and total hip BMD. Subgroup analysis showed that the risk of low BMD did not increase significantly in developed countries. Very low heterogeneity was observed in the meta-analysis of the risk of low BMD. The result from Egger's regression test suggested that there may be publication bias. However, the meta-analysis results did not alter after the trim-and-fill correction and the findings were robust. CONCLUSION Haemophilia was associated with an increased risk of low BMD. However, the risk of low BMD did not increase significantly in developed countries. And BMD was reduced in PWH, regardless of age, region, or economic ability. For PWH, our concerns should extend beyond bleeding and osteoarthritis to encompass BMD starting at a young age.
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Affiliation(s)
- Haojing Zhou
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Lei Chen
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Hai Su
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Guoqian Chen
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang Province, China.
| | - Peijian Tong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang Province, China.
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Beaver LM, Prati M, Gilman KE, Luo T, Shay NF, Branscum AJ, Turner RT, Iwaniec UT. Diet composition influences the effect of high fat diets on bone in growing male mice. Bone 2023; 176:116888. [PMID: 37652285 DOI: 10.1016/j.bone.2023.116888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/26/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
The effect of diet-induced obesity on bone in rodents is variable, with bone mass increases, decreases, and no impact reported. The goal of this study was to evaluate whether the composition of obesogenic diet may influence bone independent of its effect on body weight. As proof-of-principle, we used a mouse model to compare the skeletal effects of a commonly used high fat 'Western' diet and a modified high fat diet. The modified high fat diet included ground English walnut and was isocaloric for macronutrients, but differed in fatty acid composition and contained nutrients (e.g. polyphenols) not present in the standard 'Western' diet. Eight-week-old mice were randomized into 1 of 3 dietary treatments (n = 8/group): (1) low fat control diet (LF; 10 % kcal fat); (2) high fat 'Western' diet (HF; 46 % kcal fat as soybean oil and lard); or (3) modified high fat diet supplemented with ground walnuts (HF + walnut; 46 % kcal fat as soybean oil, lard, and walnut) and maintained on their respective diets for 9 weeks. Bone response in femur was then evaluated using dual energy x-ray absorptiometry, microcomputed tomography, and histomorphometry. Consumption of both obesogenic diets resulted in increased weight gain but differed in impact on bone and bone marrow adiposity in distal femur metaphysis. Mice consuming the high fat 'Western' diet exhibited a tendency for lower cancellous bone volume fraction and connectivity density, and had lower osteoblast-lined bone perimeter (an index of bone formation) and higher bone marrow adiposity than low fat controls. Mice fed the modified high fat diet did not differ from mice fed control (low fat) diet in cancellous bone microarchitecture, or osteoblast-lined bone perimeter, and exhibited lower bone marrow adiposity compared to mice fed the 'Western' diet. This proof-of-principal study demonstrates that two obesogenic diets, similar in macronutrient distribution and induction of weight gain, can have different effects on cancellous bone in distal femur metaphysis. Because the composition of the diets used to induce obesity in rodents does not recapitulate a common human diet, our finding challenges the translatability of rodent studies evaluating the impact of diet-induced obesity on bone.
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Affiliation(s)
- Laura M Beaver
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA; Linus Pauling Institute, Oregon State University, Corvallis, OR, USA
| | - Maud Prati
- Food Science and Technology, Oregon State University, Corvallis, OR, USA
| | - Kristy E Gilman
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Ting Luo
- Food Science and Technology, Oregon State University, Corvallis, OR, USA
| | - Neil F Shay
- Food Science and Technology, Oregon State University, Corvallis, OR, USA
| | - Adam J Branscum
- Biostatistics Program, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Russell T Turner
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA; Center for Healthy Aging Research, Oregon State University, Corvallis, OR, USA
| | - Urszula T Iwaniec
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA; Center for Healthy Aging Research, Oregon State University, Corvallis, OR, USA.
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Moon RJ, Citeroni NL, Aihie RR, Harvey NC. Early Life Programming of Skeletal Health. Curr Osteoporos Rep 2023; 21:433-446. [PMID: 37335525 PMCID: PMC10393901 DOI: 10.1007/s11914-023-00800-y] [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: 06/02/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Increasing bone mineral accrual during childhood might delay the onset of osteoporosis. We discuss the scientific evidence for early life approaches to optimising skeletal health. RECENT FINDINGS There is an ever-growing body of evidence from observational studies suggesting associations between early life exposures, particularly during foetal development, and bone mineral density (BMD). The findings of such studies are often heterogeneous, and for some exposures, for example, maternal smoking and alcohol intake in pregnancy or age at conception, intervention studies are not feasible. The most frequently studied exposures in intervention studies are calcium or vitamin D supplementation in pregnancy, which overall suggest positive effects on offspring childhood BMD. Maternal calcium and/or vitamin D supplementation during pregnancy appear to have positive effects on offspring BMD during early childhood, but further long-term follow-up is required to demonstrate persistence of the effect into later life.
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Affiliation(s)
- Rebecca J. Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Natasha L. Citeroni
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | | | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Moreau NG, Friel KM, Fuchs RK, Dayanidhi S, Sukal-Moulton T, Grant-Beuttler M, Peterson MD, Stevenson RD, Duff SV. Lifelong Fitness in Ambulatory Children and Adolescents with Cerebral Palsy I: Key Ingredients for Bone and Muscle Health. Behav Sci (Basel) 2023; 13:539. [PMID: 37503986 PMCID: PMC10376586 DOI: 10.3390/bs13070539] [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: 04/11/2023] [Revised: 06/10/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
Physical activity of a sufficient amount and intensity is essential to health and the prevention of a sedentary lifestyle in all children as they transition into adolescence and adulthood. While fostering a fit lifestyle in all children can be challenging, it may be even more so for those with cerebral palsy (CP). Evidence suggests that bone and muscle health can improve with targeted exercise programs for children with CP. Yet, it is not clear how musculoskeletal improvements are sustained into adulthood. In this perspective, we introduce key ingredients and guidelines to promote bone and muscle health in ambulatory children with CP (GMFCS I-III), which could lay the foundation for sustained fitness and musculoskeletal health as they transition from childhood to adolescence and adulthood. First, one must consider crucial characteristics of the skeletal and muscular systems as well as key factors to augment bone and muscle integrity. Second, to build a better foundation, we must consider critical time periods and essential ingredients for programming. Finally, to foster the sustainability of a fit lifestyle, we must encourage commitment and self-initiated action while ensuring the attainment of skill acquisition and function. Thus, the overall objective of this perspective paper is to guide exercise programming and community implementation to truly alter lifelong fitness in persons with CP.
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Affiliation(s)
- Noelle G. Moreau
- Department of Physical Therapy, School of Allied Health Professions, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Kathleen M. Friel
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, NY 10605, USA;
| | - Robyn K. Fuchs
- Division of Biomedical Science, College of Osteopathic Medicine, Marian University, Indianapolis, IN 46222, USA;
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA;
| | - Marybeth Grant-Beuttler
- Department of Physical Therapy, Oregon Institute of Technology, Klamath Falls, OR 97601, USA;
| | - Mark D. Peterson
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Richard D. Stevenson
- Division of Neurodevelopmental and Behavioral Pediatrics, Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA;
| | - Susan V. Duff
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA 92618, USA;
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Elbeltagi R, Al-Beltagi M, Saeed NK, Alhawamdeh R. Play therapy in children with autism: Its role, implications, and limitations. World J Clin Pediatr 2023; 12:1-22. [PMID: 36685315 PMCID: PMC9850869 DOI: 10.5409/wjcp.v12.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 01/03/2023] Open
Abstract
Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities, problem-solving, manual dexterity, sharing, decision-making, and working in a group. Play affects all the brain's areas, structures, and functions. Children with autism have adaptive behavior, adaptive response, and social interaction limitations. This review explores the different applications of play therapy in helping children with autism disorder. Play is usually significantly impaired in children with autism. Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels. The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development. Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways. It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words. Play therapy also helps those children to experience feeling out various interaction styles. Every child with autism is unique and responds differently. Therefore, different types of intervention, like play therapy, could fit the differences in children with autism. Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others. This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way. Despite weak evidence, play therapy still has potential benefits for patients and their families.
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Affiliation(s)
- Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Bahrain
| | - Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Dr. Sulaiman Al-Habib Medical Group, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain
- Pathology Department, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Bahrain
| | - Rawan Alhawamdeh
- Pediatrics Research and Development Department, Genomics Creativity and Play Center, Manama 0000, Bahrain
- School of Continuing Education, Masters in Psychology, Harvard University, Cambridge, MA 02138, United States
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Strässle M, Grossmann J, Eppenberger P, Faas A, Jerkovic I, Floris J, Öhrström L, Akgül G, Aldakak L, Rühli F, Bender N, Staub K. Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces. PeerJ 2023; 11:e15205. [PMID: 37041974 PMCID: PMC10083003 DOI: 10.7717/peerj.15205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/19/2023] [Indexed: 04/13/2023] Open
Abstract
Background Quantitative Ultrasound (QUS) methods have been widely used to assess estimated bone density. This study aimed to assess changes in estimated bone density in association with changes in body composition, physical activity, and anthropometry. Methods We examined changes in anthropometry, body composition, and physical activity associated with changes in estimated bone mineral density (measured using quantitative ultrasound with a heel ultrasound device indicating broadband ultrasound attenuation BUA and speed of sound SOS) in a follow-up sample of n = 73 young men at the beginning and again 18 weeks later at the end of basic military training. Results At the end of the basic training, the subjects were on average significantly heavier (+1.0%), slightly taller (+0.5%) and had a higher fat mass (+6.6%) and grip strength (+8.6%). A significant decrease in mean physical activity (-49.5%) and mean estimated bone density calculated with BUA (-7.5%) was observed in the paired t-test. The results of the multivariable linear regressions (backward selection) show that changes in skeletal muscle mass (delta = 2nd measurement minus 1st measurement) have negative and body weight (delta) have positive association with the speed of sound SOS (delta), while fat mass (delta) and physical activity (delta) had the strongest negative associations with estimated bone mineral density (delta). In particular, we found a negative association between fat mass (delta) and estimated bone mineral density (delta, estimated with BUA). Conclusion Our study suggests that estimated bone density from the calcaneus can change within a few months even in young and mostly healthy individuals, depending upon physical activity levels and other co-factors. Further studies including other troop types as control groups as well as on women should follow in order to investigate this public health relevant topic in more depth. To what extent the estimated bone density measurement with quantitative ultrasound is clinically relevant needs to be investigated in further studies.
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Affiliation(s)
- Michael Strässle
- Kantonsspital St. Gallen, St. Gallen, Switzerland
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Medical Faculty, University of Zürich, Zurich, Switzerland
| | - Jonas Grossmann
- Functional Genomics Center Zurich, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Patrick Eppenberger
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | | | | | - Joël Floris
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Lena Öhrström
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Gülfirde Akgül
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Lafi Aldakak
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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McCaskie C, Siafarikas A, Cochrane Wilkie J, Sutton V, Chivers P, Hart NH, Murphy MC. The Benefits to Bone Health in Children and Pre-School Children with Additional Exercise Interventions: A Systematic Review and Meta-Analysis. Nutrients 2022; 15:nu15010127. [PMID: 36615785 PMCID: PMC9824212 DOI: 10.3390/nu15010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Determine if exercise interventions, beyond what is already provided to children and preschool children, improve bone health and reduce fracture incidence. DESIGN Systematic review and meta-analysis reported using the PRISMA guidelines. Certainty of evidence was assessed using GRADE recommendations. DATA SOURCES Five electronic databases were searched for records: PUBMED; CINAHL; CENTRAL; SPORTDiscus; Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised, quasi-randomised and non-randomised controlled trials (including cluster-randomised) assessing the impact of additional exercise interventions (e.g., increased physical education classes or specific jumping programs) on bone health in children (6-12 years) and pre-school children (2-5 years) without dietary intervention. RESULTS Thirty-one records representing 16 distinct clinical trials were included. Dual-energy X-ray Absorptiometry (DXA) and/or peripheral Quantitative Computed Tomography (pQCT) were used to quantify bone health. Increased femoral neck bone mineral content in children with additional exercise interventions (n = 790, SMD = 0.55, 95% CI = 0.01 to 1.09) was reported, however this was not significant following sensitivity analysis. Other DXA and pQCT measures, as well as fracture incidence, did not appear to significantly differ over time between intervention and control groups. No studies reported adverse events. Studies failed to report all domains within the TIDieR checklist. All studies were at high risk of bias using the Cochrane RoB Tool 2.0. The certainty of the evidence was very low. CONCLUSIONS The addition of exercise interventions, beyond what is provided to children, does not appear to improve DXA and pQCT measures of bone health. The effect of additional exercise interventions on bone health in pre-school children is largely unknown. Future trials should ensure adherence is clearly reported and controlled for within analysis as well as including reports of adverse events (e.g., apophysitis) that occur due to increased exercise interventions.
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Affiliation(s)
- Callum McCaskie
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Aris Siafarikas
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Department of Endocrinology and Diabetes, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- School of Medicine and Telethon Kids Institute, University of Western Australia, Crawley, WA 6009, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
| | - Jodie Cochrane Wilkie
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
- Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia
| | - Vanessa Sutton
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Paola Chivers
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
| | - Nicolas H. Hart
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Western Australian Bone Research Collaboration, Fremantle, WA 6160, Australia
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, Adelaide, SA 5042, Australia
- School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Moore Park, NSW 2007, Australia
| | - Myles C. Murphy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
- Correspondence:
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Adolescent Bone Advantages 3 Years After Resistance Training Trial. Pediatr Exerc Sci 2022; 35:61-69. [PMID: 36150707 DOI: 10.1123/pes.2022-0011] [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: 01/16/2022] [Revised: 07/30/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE We assessed maintenance of skeletal advantages 3 years after completion of a 2-year, school-based, controlled exercise trial in adolescent girls. METHOD Middle-school girls participated in a resistance training program embedded in physical education classes. Effort groups (low-effort group [LO] and high-effort group [HI]) were identified; the control group (CON) participated in standard physical education at a separate school. Baseline and follow-up (FU) assessments at 6, 18, and 54 (FU3) months included densitometry, anthropometry, and questionnaires assessing physical maturity and nonintervention organized physical activity. Linear mixed effects models were fit to evaluate bone outcomes across all FU time points for CON versus LO/HI. RESULTS Sixty-eight girls (23 CON/25 HI/20 LO) were 11.6 (0.3) years at baseline. Bone parameters did not differ at baseline, except femoral neck bone mineral density (LO < HI/CON, P < .05). Forty-seven participants provided FU3 assessment: 17 CON/16 HI/14 LO. After adjusting for height, gynecologic age, baseline bone, and organized physical activity, bone gains across all time points were greater for HI versus CON for legs bone mineral content, femoral neck bone mineral content/bone mineral density, and third lumbar vertebra bone mineral content/bone mineral density (P ≤ .05). At FU3, bone values were greater for HI versus CON at subhead, legs, femoral neck, and third lumbar vertebra (P < .03). CONCLUSION Adolescent girls who exerted high effort in a school-based resistance training program demonstrated significant skeletal benefits 3 years after program completion.
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Friedman MA, Kohn DH. Calcium and phosphorus supplemented diet increases bone volume after thirty days of high speed treadmill exercise in adult mice. Sci Rep 2022; 12:14616. [PMID: 36028525 PMCID: PMC9418142 DOI: 10.1038/s41598-022-19016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Weight-bearing exercise increases bone mass and strength. Increasing bone loading frequency during exercise can strengthen bone. Combining exercise with a calcium- and phosphorus-supplemented diet increases cortical area more than exercise alone in mice. Thus, we hypothesized that combining high-speed treadmill exercise while feeding mice a mineral-supplemented diet would lead to greater cortical area than high-speed exercise on a standard diet and low-speed exercise on a supplemented diet. Fifteen-week old male C57BL/6 mice were assigned to seven groups—(1) baseline, (2) non-exercise fed a control diet, (3) non-exercise fed a supplemented diet, (4) low-speed exercise fed a control diet, (5) low-speed exercise fed a supplemented diet, (6) high-speed exercise fed a control diet, and (7) high-speed exercise fed a supplemented diet. Mice exercised thirty days for 20 min/day at 12 m/min or 20 m/min. Tibiae were assessed by micro-CT and 4-point bending. Cortical area fraction and trabecular bone volume fraction (BV/TV) were significantly increased by the supplemented diet. High-speed exercised mice had significantly lower body weight, with no detrimental effects to bone health. Increasing running speed can decrease body weight while maintaining the benefits of exercise and nutrition on bone health. Running can lower body weight without harming bone health.
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Affiliation(s)
- Michael A Friedman
- The University of Michigan, 1011 N University Ave., Ann Arbor, MI, 48109, USA
| | - David H Kohn
- The University of Michigan, 1011 N University Ave., Ann Arbor, MI, 48109, USA.
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12
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Peak Loads Associated With High-Impact Physical Activities in Children. Pediatr Exerc Sci 2022; 34:148-151. [PMID: 35158323 DOI: 10.1123/pes.2021-0013] [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: 01/22/2021] [Revised: 12/06/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022]
Abstract
UNLABELLED Physical activities involving impact loading are important for improving bone strength and mineral density in children. There is little research quantifying impact loads associated with various high-impact activities. PURPOSE Examine the magnitude of peak ground reaction forces (pGRF) across different jumping activities in children. METHODS Eight children between 8 and 12 years (9.63 [1.49] y; 1.42 [0.08] m; 33.69 [4.81] kg), performed 5 trials of a broad jump, countermovement jump, jumping jack, leap jump, and drop jump on a force plate. The pGRF were determined during the landing phase of each activity and expressed in units of body weight (BW). A repeated-measures analysis of variance was employed to assess differences in pGRF across activities. RESULTS Drop jump exhibited the greatest pGRF (3.09 [0.46] BW) in comparison with the vertical jumping jack (2.56 [0.21] BW; P < .001) and countermovement jump (2.45 [0.22] BW; P = .001), as well as the horizontal broad jump (2.25 [0.2] BW; P = .003), and leap jump (2.01 [0.1] BW; P = .002). CONCLUSION Peak loads between 2 and 3.1 BW were exhibited across each jump activity, which is moderate compared with magnitudes in most jump interventions seeking to improve bone health. All conditions except drop jump exhibited loading <3 BW, suggesting these activities may not produce sufficient loads to improve bone outcomes.
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13
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Characteristics of Interventions to Improve Bone Health in Children With Cerebral Palsy: A Systematic Review. Pediatr Phys Ther 2022; 34:163-170. [PMID: 35385446 DOI: 10.1097/pep.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE A systematic review evaluated exercise parameters and ages that produced the most improvement in bone among individuals with cerebral palsy (CP) ages 3 to 21 years. METHODS PubMed, Scopus, Ebscohost, and Web of Science identified potential articles. Covidence was used to identify eligible citations and assess bias. The osteogenic index (OI) was used to evaluate intervention parameters. RESULTS The database search identified 312 citations. Twelve full-text articles were included. A 1-hour calisthenic exercise program performed 2 to 3 times a week for 8 months targeting each body region had the highest effect size and a substantial OI. Most of the interventions reviewed had low OIs. Activities of longer duration and greater intensity had greater OIs and prepubertal age-enhanced treatment effects. CONCLUSION Bone interventions for individuals with CP have low OIs, and principles of mechanostat theory should be applied to exercise dosing.
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Huerta Ojeda Á, Barahona-Fuentes G, Galdames Maliqueo S. Effects of a period without mandatory physical training on maximum oxygen uptake and anthropometric parameters in naval cadets. PLoS One 2021; 16:e0251516. [PMID: 34077447 PMCID: PMC8171865 DOI: 10.1371/journal.pone.0251516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/27/2021] [Indexed: 11/28/2022] Open
Abstract
The effects of a period without physical training on the civilian population are well established. However, no studies show the effects of a period without mandatory physical training on maximum oxygen uptake (VO2 max) and anthropometric parameters in naval cadets. This study aimed to investigate changes in VO2 max and anthropometric parameters after 12 weeks without mandatory physical training in naval cadets. The sample was 38 healthy and physically active naval cadets. The measured variables, including VO2 max and anthropometric parameters, were evaluated through the 12-minute race test (12MRT) and the somatotype. Both variables had a separation of 12 weeks without mandatory physical training. A t-test for related samples was used to evidence changes between the test and post-test; effect size was calculated through Cohen’s d-test. Distance in 12MRT and VO2 max showed significant decreases at the end of 12 weeks without mandatory physical training (p < 0.001). Likewise, the tricipital skinfold thickness and the endomorphic component showed significant increases (p < 0.05). 12 weeks without mandatory physical training significantly reduces the VO2 max in naval cadets. Simultaneously, the same period without physical training increases both the tricipital skinfold thickness and the endomorphic component in this population.
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Affiliation(s)
- Álvaro Huerta Ojeda
- Grupo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Escuela de Educación Física, Universidad de Las Américas, sede Viña del Mar, Chile
- * E-mail:
| | - Guillermo Barahona-Fuentes
- Grupo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Escuela de Educación Física, Universidad de Las Américas, sede Viña del Mar, Chile
| | - Sergio Galdames Maliqueo
- Grupo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Escuela de Educación Física, Universidad de Las Américas, sede Viña del Mar, Chile
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Abstract
Bone mass is a key determinant of osteoporosis and fragility fractures. Epidemiologic studies have shown that a 10% increase in peak bone mass (PBM) at the population level reduces the risk of fracture later in life by 50%. Low PBM is possibly due to the bone loss caused by various conditions or processes that occur during adolescence and young adulthood. Race, gender, and family history (genetics) are responsible for the majority of PBM, but other factors, such as physical activity, calcium and vitamin D intake, weight, smoking and alcohol consumption, socioeconomic status, age at menarche, and other secondary causes (diseases and medications), play important roles in PBM gain during childhood and adolescence. Hence, the optimization of lifestyle factors that affect PBM and bone strength is an important strategy to maximize PBM among adolescents and young people, and thus to reduce the low bone mass or osteoporosis risk in later life. This review aims to summarize the available evidence for the common but important factors that influence bone mass gain during growth and development and discuss the advances of developing high PBM.
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Affiliation(s)
- Xiaowei Zhu
- Disease & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, 310024, China
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Houfeng Zheng
- Disease & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, 310024, China.
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, 310024, China.
- School of Life Sciences, Fudan University, Shanghai, 200433, China.
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Weare-Regales N, Hudey SN, Lockey RF. Practical Guidance for Prevention and Management of Glucocorticoid-Induced Osteoporosis for the Allergist/Immunologist. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:1841-1850. [PMID: 33444813 DOI: 10.1016/j.jaip.2020.12.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/27/2022]
Abstract
Osteoporosis is a silent disorder with dire consequences, and glucocorticoid use remains the most common iatrogenic cause illustrated by the fact that 30% to 50% of subjects on such long-term therapy experience fractures (Oimomi M, Nakamichi T, Ohara T, Sakai M, Igaki N, Hata F, et al. Fructose-related glycation. Diabetes Res Clin Pract 1989;7:137-9; Reid IR. Glucocorticoid osteoporosis--mechanisms and management. Eur J Endocrinol 1997;137:209-17). By directly affecting bone quality while actively used, glucocorticoids increase the risk of fracture that is independent of a subject's bone density status at the time (Weinstein RS. True strength. J Bone Miner Res 2000;15:621-5). A large number of subjects seen in an allergy and immunology clinic have asthma, chronic rhinosinusitis, or other chronic inflammatory diseases, necessitating the use of these medications and placing them at higher risk for this disease. Data on the effects of both oral and inhaled glucocorticoids on fracture risk are presented. This review concretizes the importance of osteoporosis, its pathophysiology, and provides practical guidelines to prevent and treat it. Management recommendations are tailored to 2 different age groups. The first group consists of children, adolescents, and adults 40 years or younger with a focus on attaining peak bone mass. The second group consists of adults 40 years or older where the use of imaging modalities and Fracture Risk Assessment Tool scores helps triage subjects into fracture risk categories. Those at moderate to high risk require bone-sparing medications. Universal preventive measures for both groups are reviewed. Complicated and severe cases may need additional expertise by an endocrinologist or rheumatologist.
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Affiliation(s)
- Natalia Weare-Regales
- Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, University of South Florida, Morsani College of Medicine and James A. Haley Veterans' Hospital, Tampa, Fla
| | - Stephanie N Hudey
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Fla.
| | - Richard F Lockey
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Fla
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Abstract
PURPOSE Individuals with cerebral palsy (CP), ambulatory or not, have less bone strength and density than their peers. Aging individuals with CP are at a higher risk for nontraumatic fractures, progressive deformity, pain, and spinal stenosis. Critical periods for skeletal formation are during prepuberty and adolescence. Applying mechanostat theory to exercise design for individuals with CP may be beneficial. METHODS Principles of mechanostat theory, particularly the osteogenic index, is applied to guide the design of exercise programs based on varying levels of physical capacity. RESULTS Recommendations are made for optimizing dosing of a variety of interventions for improving bone health among individuals with CP based on mechanostat theory with specific type, number of repetitions, and frequency. CONCLUSIONS Researchers and clinicians are called to action to consider the role of exercise throughout the lifespan for all individuals with CP, regardless of level of severity.
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18
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Formalioni A, Veiga RSD, Tuchtenhagen AX, Cabistany LD, Del Vecchio FB. AUTONOMIC, CARDIOVASCULAR & PHYSIOLOGICAL RESPONSES IN STRENGTH TRAINING PROTOCOLS. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202604222948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction Strength training is a recurrent practice among several publics and the topic of several studies, yet there is a shortage of previous studies that analyzed these parameters in the same subjects in training sessions involving volume, interval and different repetitions maximum ranges. Objective The study was aimed at measuring and comparing the acute effect of different ST (strength training) protocols on HR (heart rate), HRV (heart rate variability), [LAC] (lactate concentration), [CK] (creatine kinase) and SPE (subjective perceived exertion). Methods Eleven individuals with previous experience were recruited and in three sessions they performed three different training models, namely: high load (4 sets at 90% of 1RM, 180s rest between sets), medium load (3 sets at 75% of 1 RM, 90s rest between sets), and low load (2 sets at 50% of 1 RM, 45s rest between sets) in free squat, bench press, deadlift and bent-over row exercises. Results There was no difference in CK between low load (resistance) and medium load (hypertrophy) (p = 0.60), between resistance and high load (strength) (p = 0.84), and between hypertrophy and strength (p = 0.91), while there was higher lactate accumulation in training with medium and low loads in comparison to training with high loads (p <0.001). Conclusion It can be noted that workouts with high loads, few repetitions and longer intervals (maximum strength) generate lower blood lactate concentrations and SPE values when compared to training with lower loads and shorter intervals (resistance training and hypertrophy). Additionally, when evaluating autonomic and cardiovascular variables, it would appear that manipulating the percentage of 1RM and the interval time does not generate significant changes in HRV, blood pressure (BP) and HR when the repetitions are executed until failure. Level of evidence II; Prospective comparative study.
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19
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Lee JY, Finlayson C, Olson-Kennedy J, Garofalo R, Chan YM, Glidden DV, Rosenthal SM. Low Bone Mineral Density in Early Pubertal Transgender/Gender Diverse Youth: Findings From the Trans Youth Care Study. J Endocr Soc 2020; 4:bvaa065. [PMID: 32832823 PMCID: PMC7433770 DOI: 10.1210/jendso/bvaa065] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022] Open
Abstract
Context Transgender youth may initiate GnRH agonists (GnRHa) to suppress puberty, a critical period for bone-mass accrual. Low bone mineral density (BMD) has been reported in late-pubertal transgender girls before gender-affirming therapy, but little is known about BMD in early-pubertal transgender youth. Objective To describe BMD in early-pubertal transgender youth. Design Cross-sectional analysis of the prospective, observational, longitudinal Trans Youth Care Study cohort. Setting Four multidisciplinary academic pediatric gender centers in the United States. Participants Early-pubertal transgender youth initiating GnRHa. Main Outcome Measures Areal and volumetric BMD Z-scores. Results Designated males at birth (DMAB) had below-average BMD Z-scores when compared with male reference standards, and designated females at birth (DFAB) had below-average BMD Z-scores when compared with female reference standards except at hip sites. At least 1 BMD Z-score was < -2 in 30% of DMAB and 13% of DFAB. Youth with low BMD scored lower on the Physical Activity Questionnaire for Older Children than youth with normal BMD, 2.32 ± 0.71 vs. 2.76 ± 0.61 (P = 0.01). There were no significant deficiencies in vitamin D, but dietary calcium intake was suboptimal in all youth. Conclusions In early-pubertal transgender youth, BMD was lower than reference standards for sex designated at birth. This lower BMD may be explained, in part, by suboptimal calcium intake and decreased physical activity–potential targets for intervention. Our results suggest a potential need for assessment of BMD in prepubertal gender-diverse youth and continued monitoring of BMD throughout the pubertal period of gender-affirming therapy.
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Affiliation(s)
- Janet Y Lee
- Division of Pediatric Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, California.,Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Courtney Finlayson
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Johanna Olson-Kennedy
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Robert Garofalo
- Division of Adolescent Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Yee-Ming Chan
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Stephen M Rosenthal
- Division of Pediatric Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, California
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Del Vecchio FB, Coswig VS, Cabistany LD, Orcy RB, Gentil P. Effects of exercise cessation on adipose tissue physiological markers related to fat regain: A systematic review. SAGE Open Med 2020; 8:2050312120936956. [PMID: 32655863 PMCID: PMC7331762 DOI: 10.1177/2050312120936956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
Tissues usually super compensate during the period that follow physical exercise. Although this is widely accepted for muscle and glycogen, the compensatory effect is not usually applied to fat tissues. Notwithstanding, evidence for this has been present since the 1970s when it was first suggested that the increased lipogenic activity in response to training might be an adaptation that enables to restore an energy reserve that can be used in times of need. In this context, the present review aimed to summarize information about the effect of detraining on fat metabolism and the physiological responses associated with fat regain. A systematic search on PubMed and Scielo was performed using "training cessation," "detraining," "exercise detraining," and "exercise cessation" combined with "fat tissue," "adipose tissue," "adipose metabolism," and "fat metabolism," as descriptors. From 377 results, 25 were included in this review, 12 humans and 13 rodents, resulting in a sample of 6772 humans and 613 animals. The analysis provided evidence for fat super compensation, as well as differences in humans and rodents, among different protocols and possible mechanisms for fat gain after exercise cessation. In summary, exercise cessation appears to increase the ability of the adipose tissue to store energy. However, caution should be taken, especially regarding conclusions based on investigations on humans, considering the multiple factors that could affect fat metabolism.
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Affiliation(s)
| | | | - Leo Dutra Cabistany
- Superior School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Rafael Bueno Orcy
- Superior School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, GO, Brazil
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Mustafy T, Londono I, Moldovan F, Villemure I. Isolated Cyclic Loading During Adolescence Improves Tibial Bone Microstructure and Strength at Adulthood. JBMR Plus 2020; 4:e10349. [PMID: 32258967 PMCID: PMC7117850 DOI: 10.1002/jbm4.10349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 12/21/2022] Open
Abstract
Bone is a unique living tissue, which responds to the mechanical stimuli regularly imposed on it. Adolescence facilitates a favorable condition for the skeleton that enables the exercise to positively influence bone architecture and overall strength. However, it is still dubious for how long the skeletal benefits gained in adolescence is preserved at adulthood. The current study aims to use a rat model to investigate the effects of in vivo low- (LI), medium- (MI), and high- (HI) intensity cyclic loadings applied during puberty on longitudinal bone development, morphometry, and biomechanics during adolescence as well as at adulthood. Forty-two young (4-week-old) male rats were randomized into control, sham, LI, MI, and HI groups. After a 5 day/week for 8 weeks cyclic loading regime applied on the right tibia, loaded rats underwent a subsequent 41-week, normal cage activity period. Right tibias were removed at 52 weeks of age, and a comprehensive assessment was performed using μCT, mechanical testing, and finite element analysis. HI and MI groups exhibited reduced body weight and food intake at the end of the loading period compared with shams, but these effects disappeared afterward. HI cyclic loading increased BMD, bone volume fraction, trabecular thickness, trabecular number, and decreased trabecular spacing after loading. All loading-induced benefits, except BMD, persisted until the end of the normal cage activity period. Moreover, HI loading induced enhanced bone area, periosteal perimeter, and moment of inertia, which remained up to the 52nd week. After the normal cage activity at adulthood, the HI group showed increased ultimate force and stress, stiffness, postyield displacement and energy, and toughness compared with the sham group. Overall, our findings suggest that even though both trabecular and cortical bone drifted through age-related changes during aging, HI cyclic loading performed during adolescence can render lifelong benefits in bone microstructure and biomechanics. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Tanvir Mustafy
- Department of Mechanical EngineeringÉcole Polytechnique of MontréalMontréalQuébecCanada
- Department of PediatricsSainte‐Justine University Hospital CenterMontréalQuébecCanada
| | - Irène Londono
- Department of PediatricsSainte‐Justine University Hospital CenterMontréalQuébecCanada
| | - Florina Moldovan
- Department of PediatricsSainte‐Justine University Hospital CenterMontréalQuébecCanada
- Department of Stomatology, Faculty of DentistryUniversité de MontréalMontréalQuébecCanada
| | - Isabelle Villemure
- Department of Mechanical EngineeringÉcole Polytechnique of MontréalMontréalQuébecCanada
- Department of PediatricsSainte‐Justine University Hospital CenterMontréalQuébecCanada
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Bodnyk KA, Kuchynsky KS, Balgemann M, Stephens B, Hart RT. The long-term residual effects of low-magnitude mechanical stimulation therapy on skeletal health. J Biol Eng 2020; 14:9. [PMID: 32190111 PMCID: PMC7073014 DOI: 10.1186/s13036-020-0232-x] [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: 10/12/2019] [Accepted: 03/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Low-magnitude mechanical stimulation (LMMS) may improve skeletal health. The objective of this research was to investigate the long-term residual effects of LMMS on bone health. 10-week old female mice were given LMMS for 8 weeks; SHAM did not receive LMMS. Some groups remained on study for an additional 8 or 16 weeks post treatment (N = 17). Results Epiphyseal trabecular mineralizing surface to bone surface ratio (MS/BS) and bone formation rate (BFR/BS) were significantly greater in the LMMS group compared to the SHAM group at 8 weeks by 92 and 128% respectively. Mineral apposition rate (MAR) was significantly greater in the LMMS group 16 weeks post treatment by 14%. Metaphyseal trabecular bone mineral density (BMD) increased by 18%, bone volume tissue volume ratio (BV/TV) increased by 37%, and trabecular thickness (Tb.Th.) increased by 10% with LMMS at 8 weeks post treatment. Significant effects 16 weeks post treatment were maintained for BV/TV and Tb.Th. The middle-cortical region bone volume (BV) increased by 4% and cortical thickness increased by 3% with 8-week LMMS. Conclusions LMMS improves bone morphological parameters immediately after and in some cases long-term post LMMS. Results from this work will be helpful in developing treatment strategies to increase bone health in younger individuals.
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Affiliation(s)
- Kyle A Bodnyk
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH 43210 USA
| | - Kyle S Kuchynsky
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH 43210 USA
| | - Megan Balgemann
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH 43210 USA
| | - Brooke Stephens
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH 43210 USA
| | - Richard T Hart
- Department of Biomedical Engineering, The Ohio State University, 1080 Carmack Rd, Columbus, OH 43210 USA
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Lanhers C, Courteix D, Valente-Dos-Santos J, Ferry B, Gracia-Marco L, Pereira B, Borda IM, Lespessailles E, Duclos M. Gonadal hormones may predict structural bone fragility in elite female soccer player. J Sports Sci 2020; 38:827-837. [PMID: 32149566 DOI: 10.1080/02640414.2020.1735982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose: This study determined the impact of menstrual status on bone tissue in elite post-pubertal female soccer players over an entire season.Methods: Fifty-one elite female soccer players participated. At baseline, forty-one were assigned to the low hormonal androgenic profile (low-HAPL) and 10 to the high hormonal androgenic profile (high-HAPL).Results: An 8-month training program led to increased bone mineral density content (p<0.05). The low-HAPL athletes improved the Narrow neck average cortical thickness (ACT) by 1.4% and reduced the corresponding Buckling ratio (BR) by 2.6%, thus decreasing the fracture risk (p<0.05). The high-HAPL athletes decreased the Narrow neck ACT by 5.4% and increased the BR by 2.6%, increasing fracture risk (p<0.05). Differences were assigned as being "very likely beneficial" for the low-HAPL athletes, supported by very large (d=3.41) and large (d=1.58) effect sizes for the Narrow neck ACT and BR, respectively.Conclusion: A season of soccer training has induced bone geometry improvements in adolescent females. Bone health parameters improved in the two clusters. However, high-HAPL athletes decreased its resistance to loading compare to low-HAPL athletes. Even if female players do not present clinical symptoms related to their hormonal status, sport medicine physicians should pay attention to their structural bone fragility.
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Affiliation(s)
- Charlotte Lanhers
- Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.,Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.,Unité De Nutrition Humaine (UNH), Université Clermont Auvergne, INRA, Clermont-Ferrand, France
| | - Daniel Courteix
- Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), University Clermont Auvergne, Clermont-Ferrand, France
| | - João Valente-Dos-Santos
- Research Unity for Sport and Physical Activity (CIDAF, UID/DTP/04213/2016), University of Coimbra, Coimbra, Portugal.,FCT, Foundation for Science and Technology, Portuguese Foundation for Science and Technology (SFRH/BPD/100470/2014), Lisbon, Portugal.,Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Faculty of Physical Education and Sport, Lusófona University of Humanities and Technologies, Lisbon, Portugal
| | - Beatrice Ferry
- I3MTO, University of Orléans, Orléans, France.,Rheumatology, CHR Orléans, Orléans, France
| | - Luis Gracia-Marco
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Universidad De Zaragoza, Zaragoza, Spain.,PROmoting FITness and Health through Physical Activity (PROFITH) Research Group, Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - Bruno Pereira
- Department of Clinical Research and Innovation (DRCI), University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Ileana Monica Borda
- Clinical Rehabilitation Hospital, University of Medicine and Pharmacy "Luliu Hatieganu", Cluj-Napoca, Romania
| | - Eric Lespessailles
- I3MTO, University of Orléans, Orléans, France.,Rheumatology, CHR Orléans, Orléans, France
| | - Martine Duclos
- Sport Medicine and Functional Explorations, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.,Unité De Nutrition Humaine (UNH), Université Clermont Auvergne, INRA, Clermont-Ferrand, France
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Fallowfield JL, Leiper RG, Shaw AM, Whittamore DR, Lanham-New SA, Allsopp AJ, Kluzek S, Arden NK, Sanchez-Santos MT. Risk of Injury in Royal Air Force Training: Does Sex Really Matter? Mil Med 2020; 185:170-177. [PMID: 30137495 DOI: 10.1093/milmed/usy177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/01/2018] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Musculoskeletal injuries are common during military and other occupational physical training programs. Employers have a duty of care to reduce employees' injury risk, where females tend to be at greater risk than males. However, quantification of principle co-factors influencing the sex-injury association, and their relative importance, remain poorly defined. Injury risk co-factors were investigated during Royal Air Force (RAF) recruit training to inform the strategic prioritization of mitigation strategies. MATERIAL AND METHODS A cohort of 1,193 (males n = 990 (83%); females n = 203 (17%)) recruits, undertaking Phase-1 military training, were prospectively monitored for injury occurrence. The primary independent variable was sex, and potential confounders (fitness, smoking, anthropometric measures, education attainment) were assessed pre-training. Generalized linear models were used to assess associations between sex and injury. RESULTS In total, 31% of recruits (28% males; 49% females) presented at least one injury during training. Females had a two-fold greater unadjusted risk of injury during training than males (RR = 1.77; 95% CI 1.49-2.10). After anthropometric, lifestyle and education measures were included in the model, the excess risk decreased by 34%, but the associations continued to be statistically significant. In contrast, when aerobic fitness was adjusted, an inverse association was identified; the injury risk was 40% lower in females compared with males (RR = 0.59; 95% CI: 0.42-0.83). CONCLUSIONS Physical fitness was the most important confounder with respect to differences in males' and females' injury risk, rather than sex alone. Mitigation to reduce this risk should, therefore, focus upon physical training, complemented by healthy lifestyle interventions.
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Affiliation(s)
- Joanne L Fallowfield
- Environmental Medicine and Sciences Division, Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire PO12 2DL, UK
| | - Rachel G Leiper
- Regional Medical Centre, RAF Halton, Aylesbury, Bucks HP22 5PG, UK
| | - Anneliese M Shaw
- Environmental Medicine and Sciences Division, Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire PO12 2DL, UK
| | - David R Whittamore
- Nutritional Sciences Department, Faculty of Health and Medical Sciences, University of Surrey, Guilford, Surrey GU2 7XH, UK
| | - Susan A Lanham-New
- Nutritional Sciences Department, Faculty of Health and Medical Sciences, University of Surrey, Guilford, Surrey GU2 7XH, UK
| | - Adrian J Allsopp
- Environmental Medicine and Sciences Division, Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire PO12 2DL, UK
| | - Stefan Kluzek
- Arthritis Research UK Sports, Exercise and Osteoarthritis Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK
| | - Nigel K Arden
- Arthritis Research UK Sports, Exercise and Osteoarthritis Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.,MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO17 1BJ, UK.,Sydney Medical School, Edward Ford Building A27, The University of Sydney, NSW 2006, Australia
| | - Maria T Sanchez-Santos
- Arthritis Research UK Sports, Exercise and Osteoarthritis Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK
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Abstract
PURPOSE OF REVIEW The goal of this review is to highlight the deficits in muscle and bone in children with cerebral palsy (CP), discuss the muscle-bone relationship in the CP population, and identify muscle-based intervention strategies that may stimulate an improvement in their bone development. RECENT FINDINGS The latest research suggests that muscle and bone are both severely underdeveloped and weak in children with CP, even in ambulatory children with mild forms of the disorder. The small and low-performing muscles and limited participation in physical activity are likely the major contributors to the poor bone development in children with CP. However, the muscle-bone relationship may be complicated by other factors, such as a high degree of fat and collagen infiltration of muscle, atypical muscle activation, and muscle spasticity. Muscle-based interventions, such as resistance training, vibration, and nutritional supplementation, have the potential to improve bone development in children with CP, especially if they are initiated before puberty. Studies are needed to identify the muscle-related factors with the greatest influence on bone development in children with CP. Identifying treatment strategies that capitalize on the relationship between muscle and bone, while also improving balance, coordination, and physical activity participation, is an important step toward increasing bone strength and minimizing fractures in children with CP.
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Affiliation(s)
- Christopher M Modlesky
- Department of Kinesiology, University of Georgia, 330 River Road, Room 353, Athens, GA, 30602, USA.
| | - Chuan Zhang
- Department of Kinesiology, University of Georgia, 330 River Road, Room 353, Athens, GA, 30602, USA
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26
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Maggio ABR, Martin X, Steiger C, Tabard-Fougère A, Dayer R, Delhumeau C, Ceroni D. Do teenagers return to normal physical activity levels after limb fractures? A longitudinal, accelerometry-based, activity monitoring study. J Child Orthop 2019; 13:575-581. [PMID: 31908674 PMCID: PMC6924123 DOI: 10.1302/1863-2548.13.190082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study aimed to elucidate whether levels of physical activity (PA) return to normal after bone healing or whether long-term behavioural changes in PA are to be expected in children and teenagers who have sustained limb fractures. METHODS In all, 100 children and teenagers with a first episode of limb fracture and 100 sex- and age-matched healthy controls (CTRL) were recruited for a prospective study. PA in limb fracture patients was assessed at 18-month follow-up using accelerometer measurements, and values were compared with those of CTRL. Time spent in PA at different levels of intensity was determined for each participant and expressed in minutes and as a percentage of total validly measured time. RESULTS Mean levels of PA at different levels of intensity by previously injured children and teenagers were similar than CTRL (42 sets of paired data). However, time spent in moderate-to-vigorous PA (MVPA) was lower than 60 minutes among limb-fracture patients at 18-month follow-up. CONCLUSION The amount of skeletal loading in children and teenagers returns to normal values by 18 months after limb fracture. Even if time spent in MVPA is not significantly lower in children and teenagers with limb fractures, it no longer reached the international recommendations for school-aged children (MVPA > 60 minutes), which may be interpreted as a lifestyle modification or a behavioural change to avoid new trauma. LEVEL OF EVIDENCE II.
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Affiliation(s)
- A. B. R. Maggio
- Health and movement consultation, Pediatric Cardiology Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - X. Martin
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland,Clinical Epidemiology Service, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - C. Steiger
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - A. Tabard-Fougère
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland,Correspondence should be sent to A. Tabard-Fougère, Pediatric Orthopedic Unit, Department of Child and Adolescent, Children’s Hospital, 6 Rue Willy Donzé, 1211 Geneva 14 / Switzerland. E-mail:
| | - R. Dayer
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - C. Delhumeau
- Clinical Epidemiology Service, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - D. Ceroni
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
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27
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Ward RC, Janz KF, Letuchy EM, Peterson C, Levy SM. Contribution of High School Sport Participation to Young Adult Bone Strength. Med Sci Sports Exerc 2019; 51:1064-1072. [PMID: 30557192 DOI: 10.1249/mss.0000000000001870] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Nearly 8 million American adolescents participate in sports. Participation declines in young adulthood. PURPOSE This study assessed longitudinal effects of high school sport participation and muscle power on young adult bone strength. METHODS Two hundred twenty-eight young adults from the Iowa Bone Development Study completed an interscholastic sport participation questionnaire. Current physical activity (PA) behaviors were assessed via questionnaire. Dual x-ray absorptiometry assessed hip areal bone mineral density and was used with hip structure analysis to estimate femoral neck section modulus and hip cross-sectional area. Peripheral quantitative computed tomography provided strength-strain index and bone strength index at 38% and 4% midshaft tibial sites, respectively. Vertical jump estimated muscle power at 17 yr. Sex-specific multiple linear regression predicted young adult bone outcomes based on sport participation groups. Mediation analysis analyzed the effects of muscle power on relationships between sport participation and bone strength. RESULTS At follow-up, males participating in any interscholastic sport had greater bone strength than males who did not participate in sport. The explained variability in bone outcomes was 2% to 16%. Females who participated in sports requiring muscle power had greater bone strength than females who did not participate in sports or females who participated in nonpower sports (explained variability was 4%-10%). Muscle power mediated 24.7% to 41% of the effect of sport participation on bone outcomes in males and 19.4% to 30% in females. CONCLUSIONS Former male interscholastic sport participants and female interscholastic power sport participants have stronger bones than peers even when adjusting for current PA. Muscle power did not fully explain differences in all bone outcomes, suggesting that sport participation has additional bone health benefits.
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Affiliation(s)
- Ryan C Ward
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
| | - Kathleen F Janz
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
| | - Elena M Letuchy
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Clayton Peterson
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
| | - Steven M Levy
- Department of Preventative and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA
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28
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Popp KL, Turkington V, Hughes JM, Xu C, Unnikrishnan G, Reifman J, Bouxsein ML. Skeletal loading score is associated with bone microarchitecture in young adults. Bone 2019; 127:360-366. [PMID: 31265923 DOI: 10.1016/j.bone.2019.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED Physical activity that involves high strain magnitudes and high rates of loading is reported to be most effective in eliciting an osteogenic bone response. Whether a history of participation in osteogenic activities during youth, as well as current participation in osteogenic activities, contributes to young adult bone microarchitecture and strength is unknown. PURPOSE We determined the association between a new skeletal loading (SkL) score reflecting physical activity from age 11 to adulthood, the bone specific physical activity questionnaire (BPAQ) and bone microarchitecture in young Black and White men and women. METHODS We conducted a cross-sectional study of young ([mean ± SD] 23.7 ± 3.3 years) Black (n = 51 women, n = 31 men) and White (n = 50 women, n = 49 men) adults. Microarchitecture and estimated bone strength (by micro-finite element analysis) were assessed at the ultradistal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT). Physical activity questionnaires were administered and a SkL score was derived based on ground reaction force, rate of loading, frequency, duration, and life period of participation per activity from age 11 onwards. BPAQ score was also calculated. We used multiple linear regression to determine associations between both SkL score and BPAQ score and bone outcomes, adjusting for age, height, weight, sex, and race. RESULTS We found that SkL score, which accounts for current and historical physical activity, was significantly associated with most cortical bone parameters at the tibia including area, area fraction, porosity, thickness, and tissue mineral density (R2 = 0.27-0.55, all p < 0.01). Further, trabecular thickness, separation, number, and bone mineral density (R2 = 0.22-0.32, all p < 0.01), as well as stiffness and failure load (R2 = 0.63-0.65, all p < 0.01), were associated with the SkL score. The BPAQ was also significantly associated with most bone parameters, but to a lesser degree than SkL score. CONCLUSION These findings suggest that among young adults, greater amounts of osteogenic physical activity, as assessed by the SkL score and BPAQ are associated with improved bone microarchitecture and strength. With the potential to predict bone parameters in young adults, these scores may ultimately serve to identify those most vulnerable to fracture.
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Affiliation(s)
- Kristin L Popp
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA; Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02155, USA.
| | - Victoria Turkington
- Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA
| | - Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA 01760, USA
| | - Chun Xu
- Department of Defense, Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, USA
| | - Ginu Unnikrishnan
- Department of Defense, Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, USA
| | - Jaques Reifman
- Department of Defense, Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advance Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, MD 21702, USA
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02155, USA; Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, and Department of Orthopedic Surgery, Harvard Medical School, One Overland Street, Boston, MA 02215, USA
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29
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Avila JAD, Avila RAD, Gonçalves EM, Guerra Junior G. Influence of physical training on bone mineral density in healthy young adults: a systematic review. ACTA ACUST UNITED AC 2019; 65:1102-1106. [PMID: 31531609 DOI: 10.1590/1806-9282.65.8.1102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/13/2019] [Indexed: 11/22/2022]
Affiliation(s)
- Josiel Almeida de Avila
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
| | - Rafael Almeida de Avila
- Faculdade de Ciências Médicas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brasil
| | - Ezequiel Moreira Gonçalves
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
| | - Gil Guerra Junior
- Laboratório de Crescimento e Desenvolvimento (LabCreD), Centro de Investigação em Pediatria (CIPED), Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (UNICAMP), Campinhas, SP, Brasil
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30
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Hervás G, Ruiz-Litago F, Irazusta J, Irazusta A, Sanz B, Gil-Goikouria J, Fraile-Bermudez AB, Pérez-Rodrigo C, Zarrazquin I. Bone Health and Its Relationship with Impact Loading and the Continuity of Physical Activity throughout School Periods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2834. [PMID: 31398885 PMCID: PMC6719051 DOI: 10.3390/ijerph16162834] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 11/16/2022]
Abstract
Bone is influenced by physical activity (PA) throughout life, but childhood and adolescence provide a key opportunity to maximize peak bone mass. Thus, it is important to identify the relationship between PA practiced in childhood and young adulthood to design a promotion plan for bone health. The purpose of this study was to analyze the relationship between different impact-loading PAs (and their continuity throughout school periods from childhood to young adulthood) and bone stiffness index (SI). In this cross-sectional study, which was conducted on 145 university students aged 18-21 years, bone measurements were measured by quantitative ultrasonometry (QUS), and PA information was recalled using a self-administered questionnaire. Associations between the SI and the impact of PA performed during secondary school (p = 0.027), high school (p = 0.002), and university (p = 0.016) periods were observed. The continuity of PA over a longer period of time was related to a higher SI (p = 0.007). Those who practiced PA throughout all school periods had a higher SI than those who practiced during primary school only (p = 0.038) or through primary and secondary schools (p = 0.009). These results suggest that impact-loading PA practiced during different school periods is related to higher values of the SI. Therefore, continuous PA from an early age may be an important contributing factor to achieving and maintaining adequate bone health.
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Affiliation(s)
- Gotzone Hervás
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain.
| | - Fatima Ruiz-Litago
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Jon Irazusta
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Amaia Irazusta
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Begoña Sanz
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Javier Gil-Goikouria
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Ana Belen Fraile-Bermudez
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Carmen Pérez-Rodrigo
- Department of Physigology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Idoia Zarrazquin
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
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31
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Kao KT, Denker M, Zacharin M, Wong SC. Pubertal abnormalities in adolescents with chronic disease. Best Pract Res Clin Endocrinol Metab 2019; 33:101275. [PMID: 31047817 DOI: 10.1016/j.beem.2019.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pubertal disorders in the context of chronic disease especially in those with chronic inflammatory disorders or those requiring prolonged periods of treatment with glucocorticoid are common reasons for referral to the paediatric endocrine clinic. Disorders of puberty are also common in adolescents with disability requiring management by paediatric endocrinologists. In these adolescents, impaired skeletal development is also observed and this can be associated with fragility fractures. Chronic inflammation, glucocorticoid and sub-optimal nutrition all impact on the hypothalamic-pituitary gonadal axis, and can also impact on skeletal development locally by their effects on the growth plate and bone. Addressing pubertal disorders is important to ensure adolescents with chronic disease are matched with their peers, promote adequate bone mass accrual and linear growth. Careful discussion with primary clinicians, the young person and the family is needed when instituting endocrine therapies to address puberty and manage bone health.
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Affiliation(s)
- K T Kao
- Department of Endocrinology, Royal Children's Hospital, Melbourne, Australia; Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, United Kingdom
| | - M Denker
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, United Kingdom
| | - M Zacharin
- Department of Endocrinology, Royal Children's Hospital, Melbourne, Australia
| | - S C Wong
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, United Kingdom.
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Tamme R, Jürimäe J, Mäestu E, Remmel L, Purge P, Mengel E, Tillmann V. Physical Activity in Puberty is Associated with Total Body and Femoral Neck Bone Mineral Characteristics in Males at 18 Years of Age. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E203. [PMID: 31126164 PMCID: PMC6572272 DOI: 10.3390/medicina55050203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 01/12/2023]
Abstract
Background and objectives: Studies indicate that genetic and lifestyle factors influence optimal bone development. Adaptations in bone mineral characteristics related to physical activity (PA) are most often observed in pre- and peri-puberty. Longitudinal associations between bone mineral accrual and objectively measured PA in puberty are poorly understood. The present study aims to investigate whether pubertal PA at different intensities is related to bone mineral characteristics in individuals at 18 years of age. Materials and Methods: Anthropometrics, pubertal stage, bone age and PA by accelerometer were measured in 88 boys at the mean age of 12.1 (T1), 13.1 (T2), 14.0 (T3) and 18.0 years (T4). Different bone mineral parameters were measured by dual-energy X-ray at T4. Stepwise multiple regression analysis was performed to determine the effect of bone age, body mass and PA characteristics on measured bone mineral parameters at 18 years of age. Results: Total PA in puberty together with mean pubertal body mass predicted 35.5% of total body (TB) bone mineral density (BMD), 43.0% of TB less head (LH) bone mineral content (BMC) and 48.1% of BMC/height in individuals at 18 years of age. Vigorous PA and body mass in puberty predicted 43.2% of femoral neck (FN) BMD; bone age at T1, vigorous PA and body mass in puberty predicted 47.3% of FN BMC at 18 years of age. No associations between pubertal PA levels and lumbar spine bone mineral characteristics in individuals at 18 years of age were found. Conclusions: Physical activity in puberty has a significant impact on bone mineral characteristics in individuals at 18 years of age, with total PA being a significant predictor of TB BMD and TB LH BMC as well as BMC/height, whereas vigorous PA is a significant predictor of FN BMD and FN BMC.
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Affiliation(s)
- Reeli Tamme
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia.
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Priit Purge
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Eva Mengel
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
| | - Vallo Tillmann
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia.
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
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Ubago-Guisado E, Vlachopoulos D, Barker AR, Christoffersen T, Metcalf B, Gracia-Marco L. Effect of maturational timing on bone health in male adolescent athletes engaged in different sports: The PRO-BONE study. J Sci Med Sport 2019; 22:253-258. [DOI: 10.1016/j.jsams.2018.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 08/03/2018] [Accepted: 08/12/2018] [Indexed: 01/18/2023]
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Marin-Puyalto J, Mäestu J, Gomez-Cabello A, Lätt E, Remmel L, Purge P, Casajús JA, Vicente-Rodríguez G, Jürimäe J. Vigorous physical activity patterns affect bone growth during early puberty in boys. Osteoporos Int 2018; 29:2693-2701. [PMID: 30334092 DOI: 10.1007/s00198-018-4731-2] [Citation(s) in RCA: 8] [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: 05/09/2018] [Accepted: 10/03/2018] [Indexed: 01/26/2023]
Abstract
UNLABELLED This study aims to analyze the impact of participation in vigorous physical activity as it can promote a healthy bone development. Adolescents who increased their participation in vigorous physical activity showed higher improvements in bone parameters compared to those who did not, which highlights the relevance of vigorous physical activity engagement. INTRODUCTION The main purpose of the study was to analyze the effects of different patterns of vigorous physical activity (VPA) on bone development. METHODS One-week accelerometry registers and dual-energy X-ray absorptiometry scans at the whole body, hip, and lumbar spine of 140 healthy male adolescents (11-13 years, at baseline) were performed twice with a 1-year interval between measurements. Four patterns of VPA evolution ("low-low," "low-high," "high-low," and "high-high") and three patterns of bone growth ("optimal," "mean," and "reduced") were defined according to the median participation in VPA and a cluster analysis of the longitudinal changes in BMC and BMD in all sites measured, respectively. Bone mineral parameters were adjusted for skeletal age and body weight prior to statistical comparison among groups. RESULTS Participants in the "low-high" group had greater adjusted BMD increases at both the femoral neck and lumbar spine when compared to the "low-low" group (estimated mean (95% CI) 0.066 (0.047-0.085) vs. 0.034 (0.021-0.047) g/cm2 and 0.074 (0.054-0.093) vs. 0.049 (0.035-0.062) g/cm2 respectively, both p < 0.05). Femoral neck BMD adjusted increase was also different between the "high-high" and the "high-low" groups (0.053 (0.041-0.066) vs. 0.030 (0.011-0.049) g/cm2, p < 0.05). Additionally, a higher percentage of "optimal" growth was found in the "low-high" group than in the "low-low" and "high-low" categories (36.3, 12.5 and 13.6% respectively, p < 0.05). CONCLUSIONS Engaging in VPA as well as maintaining high levels of VPA during puberty is associated with greater gains in bone mass, which can have an impact in future bone health.
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Affiliation(s)
- J Marin-Puyalto
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Zaragoza, Spain
| | - J Mäestu
- Institute of Sport Pedagogy and Coaching Sciences, Centre of Behavioral, Social and Health Sciences, University of Tartu, Tartu, Estonia
| | - A Gomez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
| | - E Lätt
- Institute of Sport Pedagogy and Coaching Sciences, Centre of Behavioral, Social and Health Sciences, University of Tartu, Tartu, Estonia
| | - L Remmel
- Institute of Sport Pedagogy and Coaching Sciences, Centre of Behavioral, Social and Health Sciences, University of Tartu, Tartu, Estonia
| | - P Purge
- Institute of Sport Pedagogy and Coaching Sciences, Centre of Behavioral, Social and Health Sciences, University of Tartu, Tartu, Estonia
| | - J A Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- Faculty of Health Sciences (FCS), Department of Physiatry and Nursing, Universidad de Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain
| | - G Vicente-Rodríguez
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.
- Faculty of Health Sciences (FCS), Department of Physiatry and Nursing, Universidad de Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
| | - J Jürimäe
- Institute of Sport Pedagogy and Coaching Sciences, Centre of Behavioral, Social and Health Sciences, University of Tartu, Tartu, Estonia
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Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther 2018; 23:170-180. [PMID: 30503353 DOI: 10.1016/j.bjpt.2018.11.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Osteoporosis and related fragility fractures are a global public health problem in which pharmaceutical agents targeting bone mineral density (BMD) are the first line of treatment. However, pharmaceuticals have no effect on improving other key fracture risk factors, including low muscle strength, power and functional capacity, all of which are associated with an increased risk for falls and fracture, independent of BMD. Targeted exercise training is the only strategy that can simultaneously improve multiple skeletal and fall-related risk factors, but it must be appropriately prescribed and tailored to the desired outcome(s) and the specified target group. OBJECTIVES In this review, we provide an overview of the general principles of training and specific loading characteristics underlying current exercise guidelines for the prevention of osteoporosis, and an update on the latest scientific evidence with regard to the type and dose of exercise shown to positively influence bone mass, structure and strength and reduce fracture risk in postmenopausal women.
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Combined mineral-supplemented diet and exercise increases bone mass and strength after eight weeks and maintains increases after eight weeks detraining in adult mice. PLoS One 2018; 13:e0204470. [PMID: 30240447 PMCID: PMC6150513 DOI: 10.1371/journal.pone.0204470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/07/2018] [Indexed: 11/19/2022] Open
Abstract
Exercise has long-lasting benefits to bone mass and structural strength even after cessation. Combining exercise with a calcium- and phosphorus-supplemented diet increases cortical bone mineral content (BMC), area, and yield force more than exercise alone in adult mice. These increases could also be maintained after stopping exercise if the modified diet is maintained. It was hypothesized that combining exercise with a mineral-supplemented diet would lead to greater cortical BMC, area, and yield force immediately after a lengthy exercise program and after an equally long period of non-exercise (detraining) in adult mice. Male, 16-week old C57Bl/6 mice were assigned to 9 weight-matched groups–a baseline group, exercise and non-exercise groups fed a control or mineral-supplemented diet for 8 weeks, exercise + detraining and non-exercise groups fed a control or mineral-supplemented diet for 16 weeks. Exercise + detraining consisted of 8 weeks of exercise followed by 8 weeks without exercise. The daily exercise program consisted of running on a treadmill at 12 m/min, 30 min/day. After 8 weeks, mice fed the supplemented diet had greater tibial cortical BMC and area, trabecular bone volume/tissue volume (BV/TV), bone mineral density (vBMD), yield force, and ultimate force than mice fed the control diet. Exercise increased cortical BMC and area only when coupled with the supplemented diet. After 16 weeks, both exercised and non-exercised mice fed the supplemented diet maintained greater tibial cortical BMC and area, trabecular BV/TV, vBMD, yield force, and ultimate force than mice fed the control diet. Combining exercise with a mineral-supplemented diet leads to greater bone mass and structural strength than exercise alone. These benefits remain after an equally long period of detraining. Long-term use of dietary mineral supplements may help increase and maintain bone mass with aging in adult mice.
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Nguyen VH. School-based exercise interventions effectively increase bone mineralization in children and adolescents. Osteoporos Sarcopenia 2018; 4:39-46. [PMID: 30775541 PMCID: PMC6362970 DOI: 10.1016/j.afos.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/09/2018] [Accepted: 05/28/2018] [Indexed: 11/30/2022] Open
Abstract
Osteoporosis and fragility fractures have become major global public health concerns, and they can be prevented by maximizing peak bone mass during childhood and adolescence with weight-bearing physical activity, which can result in stronger and healthier bones that significantly decrease the risk of osteoporosis and fragility fractures in adulthood and the elderly years. From a public health perspective, implementing weight-bearing physical activity for children and adolescents is best achieved with school-based exercise interventions, and a review of school-based exercise interventions was conducted to determine their effectiveness in increasing bone mineral density (BMD) and/or bone mineral content (BMC). Seventeen studies were reviewed, all school-based exercise interventions utilized jumping exercises, and 15 of the 17 studies found at least one significant increase in measures of BMD and/or BMC for the total body, and/or at the hip, vertebrae, and/or wrist. One study that found no significant differences did report significant increases in bone structural strength, and the other study with no significant differences had exercises that measured and reported the lowest ground reaction forces (GRFs) of only 2–3 times body weight (BW), whereas the other studies that showed significant increase(s) in BMD and/or BMC had exercise with measured and reported GRFs ranging from 3.5 × to 8.8 × BW. School-based exercise interventions are time- and cost-efficient and effective in increasing BMD and/or BMC in children and adolescents, but must incorporate high-intensity exercise, such as high-impact jumping of sufficient GRFs, in order to significantly increase bone mineralization for osteoporosis and fragility fracture prevention later in life.
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Affiliation(s)
- Vu H Nguyen
- Public Health Program, Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO, USA
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Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical Activity and Exercise on Women's Bone Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E878. [PMID: 29710770 PMCID: PMC5981917 DOI: 10.3390/ijerph15050878] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022]
Abstract
In 2011 over 1.7 million people were hospitalized because of a fragility fracture, and direct costs associated with osteoporosis treatment exceeded 70 billion dollars in the United States. Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor in determining fragility fracture risk later in life. Physical activity is a widely accessible, low cost, and highly modifiable contributor to bone health. Exercise is especially effective during adolescence, a time period when nearly 50% of peak adult bone mass is gained. Here, we review the evidence linking exercise and physical activity to bone health in women. Bone structure and quality will be discussed, especially in the context of clinical diagnosis of osteoporosis. We review the mechanisms governing bone metabolism in the context of physical activity and exercise. Questions such as, when during life is exercise most effective, and what specific types of exercises improve bone health, are addressed. Finally, we discuss some emerging areas of research on this topic, and summarize areas of need and opportunity.
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Affiliation(s)
- Karen L Troy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Megan E Mancuso
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Tiffiny A Butler
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
| | - Joshua E Johnson
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA 01545 USA.
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Karpiński M, Popko J, Maresz K, Badmaev V, Stohs SJ. Roles of Vitamins D and K, Nutrition, and Lifestyle in Low-Energy Bone Fractures in Children and Young Adults. J Am Coll Nutr 2018; 36:399-412. [PMID: 28686548 DOI: 10.1080/07315724.2017.1307791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The research on skeletal system health in children and young adults, while recognizing the important role of calcium and vitamin D, goes beyond these nutritional standards. This review focuses on the role of vitamin K in combination with vitamin D and other factors in bone health. The current understanding is that maintaining bone health and prevention of low-energy fractures in any pediatric population includes nutritional factors combined with an active lifestyle. Calcium, vitamin D, and vitamin K supplementation contribute independently and collectively to bone health. The beneficial role of vitamin K, particularly vitamin K2 as menaquinone-7 (MK-7), in bone and cardiovascular health is reasonably well supported scientifically, with several preclinical, epidemiological, and clinical studies published over the last decade. Osteocalcin and matrix-Gla (glutamate-containing) protein (MGP) exemplify vitamin K-dependent proteins involved in building bone matrix and keeping calcium from accumulating in the arterial walls, respectively. An important part of the mechanism of vitamin K involves carboxylation and posttranslational activation of the family of vitamin K-dependent proteins, which prevent expression of pro-inflammatory factors and support improvement in bone mineral concentration, bone mineral density, and the quality of bone matrix. Understanding the combined approach to a healthy skeletal system in children and young adults, including the roles of vitamins D and K, calcium, healthy diet, and exercise, is particularly important in view of reports of subclinical insufficiency of vitamins D and K in otherwise healthy pediatric populations with low-energy bone fractures.
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Affiliation(s)
- Michał Karpiński
- a Department of Pediatric Orthopedics and Traumatology Medical University of Bialystok , Bialystok , Poland
| | - Janusz Popko
- b Medical Institute of the State College of Computer Science and Business Administration , Łomża , Poland
| | | | | | - Sidney J Stohs
- e Creighton University Medical Center , Omaha , Nebraska
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Atalla M, Pinto AJ, Mielke GI, Baciuk EP, Benatti FB, Gualano B. Tackling Youth Inactivity and Sedentary Behavior in an Entire Latin America City. Front Pediatr 2018; 6:298. [PMID: 30370264 PMCID: PMC6194316 DOI: 10.3389/fped.2018.00298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/24/2018] [Indexed: 01/26/2023] Open
Abstract
Real-world interventions are fundamental to bridge the research-practice gap in healthy lifestyle promotion. This study aimed to assess the impact of a 7-month, intensive, city-wide intervention ("Life of Health") on tackling youth inactivity and sedentary behavior in an entire Latin-American city (Jaguariuna, Brazil). For youth, a program focused on tackling inactivity/sedentary behavior was delivered at every school (n = 18). Plausibility assessments (pre-to-post design) were performed with 3,592 youth (out of 8,300 individuals at school age in the city) to test the effectiveness of the intervention. Primary outcomes were physical activity and sedentary behavior. Secondary outcome was BMI z-score. Physical activity did not change (0; 95%CI:-2.7-2.8 min/day; p = 0.976), although physically inactive sub-group increased physical activity levels (11.2; 95%CI:8.8-13.6 min/day; p < 0.001). Weekday television and videogame time decreased, whereas computer time increased. Participants with overweight and obesity decreased BMI z-score (-0.08; 95%CI:-0.11-0.05; p < 0.001; -0.15; 95%CI:-0.19-0.11; p < 0.001). This intervention was not able to change the proportion of physical inactivity and sedentary behavior in youth at a city level. Nonetheless, physically inactive individuals increased PA levels and participants with overweight and obesity experienced a reduction in BMI z-score, evidencing the relevance of the intervention. Education-based lifestyle programs should be supplemented with environmental changes to better tackle inactivity/sedentary behavior in the real-world.
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Affiliation(s)
| | - Ana Jessica Pinto
- Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Gregore Iven Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Fabiana Braga Benatti
- Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Bruno Gualano
- Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Williams CA, Gracia-Marco L. The effect of a high-impact jumping intervention on bone mass, bone stiffness and fitness parameters in adolescent athletes. Arch Osteoporos 2018; 13:128. [PMID: 30446875 PMCID: PMC6244891 DOI: 10.1007/s11657-018-0543-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study demonstrates that a 9-month jumping intervention can improve bone mass gains and physical fitness performance in adolescent males participating in non-osteogenic sports, such as swimming and cycling. PURPOSE To examine the effect of a jumping intervention on bone mass, bone stiffness and fitness parameters in adolescents involved in different sports. METHODS Ninety-three adolescent male swimmers (SWI), footballers (FOO) and cyclists (CYC) were randomised to intervention (INT) and sport (INT-SWI = 19, INT-FOO = 15, INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, CON-CYC = 12) groups. The 9-month jumping intervention consisted of 3 levels (12 weeks each) of 20 repetitions per set of counter movement jumps (CMJ) using adjustable weight vests (level 1 = 20 CMJ jumps/set, 0 kg, 3 sets/day, 3 times/week; level 2 = 20 CMJ jumps/set, 2 kg, 4 sets/day, 3 times/week; level 3 = 20 CMJ jumps/set, 5 kg, 4 sets/day, 4 times/week). Total body bone mineral content (BMC) at total body less head (TBLH) was measured using dual-energy X-ray absorptiometry and bone stiffness using quantitative ultrasound. Fitness was assessed using the 20-m shuttle run (20mSRT), CMJ and standing long jump (SLJ) tests. RESULTS INT-SWI had significantly higher increase in BMC legs and bone stiffness compared to CON-SWI (4.2-12.7%). INT-CYC had significantly higher increase in BMC at TBLH and legs and bone stiffness compared to CON-CYC (5.0-12.3%). There were no significant differences between INT-FOO and CON-FOO in any bone outcomes (0.9-3.9%). The increase in CMJ performance was significantly higher in INT-SWI (3.1 cm) and INT-CYC (3.2 cm) compared to CON-SWI and CON-CYC groups, respectively. CONCLUSIONS A 9-month jumping intervention can improve bone mass, bone stiffness and muscular fitness in adolescent males participating in non-osteogenic sports, such as swimming and cycling. CLINICAL TRIAL REGISTRATION ISRCTN17982776.
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Affiliation(s)
- Dimitris Vlachopoulos
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Alan R. Barker
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Esther Ubago-Guisado
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2194 2329grid.8048.4IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Craig A. Williams
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Luis Gracia-Marco
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2152 8769grid.11205.37Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain ,0000000121678994grid.4489.1PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Abstract
PURPOSE To determine the 12-month maintenance of a 9-month, thrice-weekly, 10-minute high-intensity exercise program, delivered in schools, on bone and other health-related performance variables in prepubertal children. METHODS All participants (N = 311) of the CAPO kids trial (testing times T1-T2) were contacted to undergo retesting (T3) of all original measures-including weight, standing and sitting height, calcaneal broadband ultrasound attenuation (Achilles, GE), and stiffness index (Achilles, GE)-waist circumference, resting heart rate, blood pressure, vertical jump, and aerobic capacity. Maturity was determined by estimating age of peak height velocity using sex-specific regression equations. RESULTS A total of 240 children [12.3 (0.6) y old] were included in the current study (77% of initial follow-up sample at T2). Between the T2 and T3 time points, both exercise (EX) group and control (CON) group increased broadband ultrasound attenuation (EX: 5.6%, P ≤ .001; CON: 6.5%, P ≤ .001), stiffness index (EX: 7.3%, P ≤ .001; CON: 5.2%, P ≤ .001), vertical jump (EX: 5.9%, P ≤ .001; CON: 6.3%, P ≤ .001), estimated maximal oxygen consumption (EX: 13.3%, P ≤ .001; CON: 12.1%, P ≤ .001), and reduced waist circumference (EX: -5.2%, P ≤ .001; CON: -5.6%, P ≤ .001), with no between-group differences in the magnitude of those changes. No differences were detected in absolute values between groups at T3. CONCLUSION Although the statistically significant differences observed between groups following the intervention were no longer significant 1 year after withdrawal of the intervention, the between-group similarities in growth trajectories of those parameters could suggest that some benefit of the intervention for bone health, waist circumference, and physical performance endured.
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Structural Strength Benefits Observed at the Hip of Premenarcheal Gymnasts Are Maintained Into Young Adulthood 10 Years After Retirement From the Sport. Pediatr Exerc Sci 2017; 29:476-485. [PMID: 28661717 DOI: 10.1123/pes.2017-0039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Premenarcheal female gymnasts have been consistently found to have greater bone mass and structural advantages. However, little is known about whether these structural advantages are maintained after the loading stimulus is removed. Therefore, the purpose of this study was to investigate the structural properties at the hip after long-term retirement from gymnastics. METHODS Structural properties were derived from dual-energy X-ray absorptiometry scans using the hip structural analysis program for the same 24 gymnasts and 21 nongymnasts both in adolescence (8-15 y) and adulthood (22-30 y). Structural measures were obtained at the narrow neck, intertrochanter, and femoral shaft and included cross-sectional area, section modulus, and buckling ratio. Multivariate analysis of covariance was used to assess differences between groups in bone measures while controlling for size, age, maturity, and physical activity. RESULTS Gymnasts were found to have structural advantages at the narrow neck in adolescence (16% greater cross-sectional area, 17% greater section modulus, and 25% lower buckling ratio) and 14 years later (13% greater cross-sectional area and 26% lower buckling ratio). Benefits were also found at the intertrochanter and femoral shaft sites in adolescence and adulthood. CONCLUSION Ten years after retirement from gymnastics, former gymnasts' maintained significantly better hip bone structure than females who did not participate in gymnastics during growth.
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Fatouros IG, Knapp KM, Williams CA, Gracia-Marco L. Longitudinal Adaptations of Bone Mass, Geometry, and Metabolism in Adolescent Male Athletes: The PRO-BONE Study. J Bone Miner Res 2017; 32:2269-2277. [PMID: 28685886 DOI: 10.1002/jbmr.3206] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/24/2017] [Accepted: 06/26/2017] [Indexed: 11/09/2022]
Abstract
Adolescence is a crucial period for bone development, and exercise can enhance bone acquisition during this period of life. However, it is not known how the different loading sports practiced can affect bone acquisition in adolescent male athletes. Therefore, the purpose of the present study was to determine the 1-year longitudinal bone acquisition among adolescent males involved in osteogenic (football) and non-osteogenic (swimming and cycling) sports and to compare with active controls. A total of 116 adolescent males aged 12 to 14 years at baseline were followed for 1 year: 37 swimmers, 37 footballers, 28 cyclists, and 14 active controls. Bone mineral content (BMC) was assessed using dual-energy X-ray absorptiometry (DXA); cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck was assessed using hip structural analysis (HSA); and bone texture of the lumbar spine was assessed using trabecular bone score (TBS). Serum N-terminal propeptide of procollagen type I (PINP), isomer of the Carboxi-terminal telopeptide of type 1 collagen (CTX-I), total serum calcium, and 25 hydroxyvitamin D [25(OH)D] were analyzed. Footballers had significantly higher adjusted BMC at the lumbar spine (7.0%) and femoral neck (5.0%) compared with cyclists, and significantly greater BMC at the lumbar spine (6.9%) compared with swimmers. Footballers presented significantly greater TBS (4.3%) compared with swimmers, and greater CSMI (10.2%), CSA (7.1%), Z (8.9%) and TBS (4.2%) compared with cyclists. No differences were noted between cyclists and swimmers, both groups had similar bone acquisition compared with controls. PINP was significantly higher in footballers and controls compared with cyclists and swimmers (3.3% to 6.0%), and 25(OH)D was significantly higher in footballers and cyclists compared with swimmers and controls (9.9% to 13.1%). These findings suggest that bone acquisition is higher in adolescent male footballers compared with swimmers and cyclists at the femoral neck and lumbar spine sites of the skeleton. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK.,IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Ioannis G Fatouros
- Department of Kinesiology, Institute for Research and Technology, Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | | | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK.,Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain
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Abstract
PURPOSE The goal of the current work is to challenge the enduring notion that prepuberty is the optimum timing for maximum bone response to exercise in childhood and to present the evidence that early puberty is a more potently receptive period. METHOD The relevant literature is reviewed and the causes of the misconception are addressed in detail. RESULTS Contrary to prevailing opinion, ample evidence exists to suggest that the peripubertal years represent the developmental period during which bone is likely to respond most robustly to exercise intervention. CONCLUSION Public health initiatives that target bone-specific exercise interventions during the pubertal years are likely to be the most effective strategy to harness the increased receptiveness of the growing skeleton to mechanical loading.
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Resilient, Responsive, and Healthy Developing Bones: The Good News About Exercise and Bone in Children and Youth. Pediatr Exerc Sci 2017; 29:437-439. [PMID: 29019441 DOI: 10.1123/pes.2017-0205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Morphological and Microstructural Alterations of the Articular Cartilage and Bones during Treadmill Exercises with Different Additional Weight-Bearing Levels. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:8696921. [PMID: 29065659 PMCID: PMC5525086 DOI: 10.1155/2017/8696921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 11/18/2022]
Abstract
The aim of this study was to investigate the morphological and microstructural alterations of the articular cartilage and bones during treadmill exercises with different exercise intensities. Sixty 5-week-old female rats were randomly divided into 10 groups: five additional weight-bearing groups (WBx) and five additional weight-bearing with treadmill exercise groups (EBx), which were subjected to additional weight bearing of x% (x = 0, 5, 12, 19, and 26) of the corresponding body weight of each rat for 15 min/day. After 8 weeks of experiment, the rats were humanely sacrificed and their bilateral intact knee joints were harvested. Morphological analysis of the cartilages and microcomputed tomography evaluation of bones were subsequently performed. Results showed that increased additional weight bearing may lead to cartilage damage. No significant difference was observed among the subchondral cortical thicknesses of the groups. The microstructure of subchondral trabecular bone of 12% and 19% additional weight-bearing groups was significantly improved; however, the WB26 and EB26 groups showed low bone mineral density and bone volume fraction as well as high structure model index. In conclusion, effects of treadmill exercise on joints may be associated with different additional weight-bearing levels, and exercise intensities during joint growth and maturation should be selected reasonably.
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Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiol Rev 2017; 97:1351-1402. [PMID: 28814614 PMCID: PMC6347102 DOI: 10.1152/physrev.00019.2016] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022] Open
Abstract
This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.
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Affiliation(s)
- Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Christian K Roberts
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - John P Thyfault
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Gregory N Ruegsegger
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Ryan G Toedebusch
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Ortega FB, Krustrup P, Metcalf B, Castro Pinero J, Ruiz JR, Knapp KM, Williams CA, Moreno LA, Gracia-Marco L. The effect of 12-month participation in osteogenic and non-osteogenic sports on bone development in adolescent male athletes. The PRO-BONE study. J Sci Med Sport 2017; 21:404-409. [PMID: 28886923 DOI: 10.1016/j.jsams.2017.08.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/24/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development. DESIGN A 12-month study was conducted in adolescent males involved in football, swimming and cycling and compared with an active control group. METHODS 116 adolescent males (13.1±0.1years at baseline): 37 footballers, 37 swimmers, 28 cyclists and 14 active controls were followed for 12 months. Bone mineral content (BMC) was measured by dual-energy X-ray absorptiometry, and bone stiffness was measured by quantitative ultrasound. Bone outcomes at 12 months were adjusted for baseline bone status, age, height, lean mass and moderate to vigorous physical activity. RESULTS Footballers had higher improvement in adjusted BMC at the total body, total hip, shaft, Ward's triangle, legs and bone stiffness compared to cyclists (6.3-8.0%). Footballers had significantly higher adjusted BMC at total body, shaft and legs compared to swimmers (5.4-5.6%). There was no significant difference between swimmers and cyclists for any bone outcomes. Swimming and cycling participation resulted in non-significant lower bone development at most sites of the skeleton compared to controls (-4.3 to -0.6%). CONCLUSIONS Football participation induces significantly greater improvements in BMC and bone stiffness over 12 months compared to cycling and swimming. CLINICAL TRIAL REGISTRATION ISRCTN17982776.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; IGOID Research Group, University of Castilla-La Mancha, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - Peter Krustrup
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Brad Metcalf
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Jose Castro Pinero
- GALENO Research Group, Department of Physical Education, School of Education, University of Cadiz, Spain
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | | | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Spain
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain; Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Spain.
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50
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Physical activity for paediatric rheumatic diseases: standing up against old paradigms. Nat Rev Rheumatol 2017; 13:368-379. [DOI: 10.1038/nrrheum.2017.75] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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