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Murray AA, Erlandson MC. Tibial cortical and trabecular variables together can pinpoint the timing of impact loading relative to menarche in premenopausal females. Am J Hum Biol 2021; 34:e23711. [PMID: 34878660 DOI: 10.1002/ajhb.23711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/29/2021] [Accepted: 11/26/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Though relationships between limb bone structure and mechanical loading have provided fantastic opportunities for understanding the lives of prehistoric adults, the lives of children remain poorly understood. Our aim was to determine whether or not adult tibial skeletal variables retain information about childhood/adolescent loading, through assessing relationships between cortical and trabecular bone variables and the timing of impact loading relative to menarche in premenopausal adult females. METHODS Peripheral quantitative computed tomography was used to quantify geometric and densitometric variables from the proximal tibial diaphysis (66% location) and distal epiphysis (4% location) among 81 nulliparous young adult female controls and athletes aged 19-33 years grouped according to intensity of impact loading both pre- and post-menarche: (1) Low:Low (Controls); (2) High:Low; (3) High:High; (4) Moderate:Moderate; (5) Low:Moderate. ANCOVA was used to compare properties among the groups adjusted for age, stature, and body mass. RESULTS Significant increases in diaphyseal total cross-sectional area and strength-strain index were documented among groups with any pre-menarcheal impact loading relative to groups with none, regardless of post-menarcheal loading history (p < .01). In contrast, significantly elevated distal trabecular volumetric bone mineral density was only documented among groups with recent post-menarcheal loading relative to groups with none, regardless of pre-menarcheal impact loading history (p < .01). CONCLUSIONS The consideration of diaphyseal cortical bone geometric and epiphyseal trabecular bone densitometric variables together within the tibia can identify variation in pre-menarcheal and post-menarcheal impact loading histories among premenopausal adult females.
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Affiliation(s)
- Alison A Murray
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
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Esteban-García P, Jiménez-Díaz JF, Abián-Vicén J, Bravo-Sánchez A, Rubio-Arias JÁ. Effect of 12 Weeks Core Training on Core Muscle Performance in Rhythmic Gymnastics. BIOLOGY 2021; 10:biology10111210. [PMID: 34827203 PMCID: PMC8615256 DOI: 10.3390/biology10111210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/18/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Rhythmic gymnastics performance is characterized by technical elements involving flexibility, aerobic capacity and strength. Increased core strength in rhythmic gymnastics could lead to improved sporting performance. OBJECTIVE The aim of this study was to analyze the effect of 12 weeks of core muscle training on core muscle performance in rhythmic gymnasts. METHODS A randomized controlled study involving 24 rhythmic gymnastics was conducted. Participants were randomly assigned to a control group (CG; n = 12; age 13.50 ± 3.17 years) or a training group (TG; n = 12; age 14.41 ± 2.35 years). Body composition, isometric strength of trunk, core endurance and core muscle electromyographic activity were measured (EMG) after 12 weeks of core training. Independent sample t-tests were carried out to compare baseline values between groups. A two-way repeated-measures analysis of variance (ANOVA) (time × group) was applied. RESULTS The TG improved body composition, trunk lean mass (mean differences MD = -0.31; p = 0.040), lean mass (MD = 0.43; p = 0.037) and bone mass (MD = -0.06; p < 0.001) after training. Core training increased isometric strength of trunk, flexion test (MD = -21.53; p = 0.019) and extension test (MD = 22.7; p = 0.049), as well as the prone bridge core endurance test (MD = -11.27; p = 0.040). The EMG values also increased in the TG in prone bridge for front trunk (MD = -58.58; p = 0.026). CONCLUSIONS Core strength training leads to improvements in body composition, as well as improvements in trunk strength and increases in muscle electromyographic activity. These improvements could therefore improve performance during competitive rhythmic gymnastics exercises.
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Affiliation(s)
- Paula Esteban-García
- Performance and Sport Rehabilitation Laboratory, PerlaSport Group, Faculty of Physical Activity and Sport Science, University of Castilla la Mancha, 45071 Toledo, Spain; (J.F.J.-D.); (J.A.-V.); (A.B.-S.)
- Correspondence:
| | - José Fernando Jiménez-Díaz
- Performance and Sport Rehabilitation Laboratory, PerlaSport Group, Faculty of Physical Activity and Sport Science, University of Castilla la Mancha, 45071 Toledo, Spain; (J.F.J.-D.); (J.A.-V.); (A.B.-S.)
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, PerlaSport Group, Faculty of Physical Activity and Sport Science, University of Castilla la Mancha, 45071 Toledo, Spain; (J.F.J.-D.); (J.A.-V.); (A.B.-S.)
| | - Alfredo Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, PerlaSport Group, Faculty of Physical Activity and Sport Science, University of Castilla la Mancha, 45071 Toledo, Spain; (J.F.J.-D.); (J.A.-V.); (A.B.-S.)
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Kovač M, Sember V, Pajek M. IMPLEMENTATION OF THE GYMNASTICS CURRICULUM IN THE FIRST THREE-YEAR CYCLE OF THE PRIMARY SCHOOL IN SLOVENIA. SCIENCE OF GYMNASTICS JOURNAL 2020. [DOI: 10.52165/sgj.12.3.299-312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Throughout the world, gymnastics is an essential part of physical education (PE) curricula, especially in the first years of schooling. In this period, PE is taught by the general teachers (GTs) with low levels of experience about how to teach gymnastics. Our study aimed to find out how GTs complied with the prescribed gymnastics curriculum contents. The sample included 90 GTs from 21 primary schools from Ljubljana, the capital of Slovenia. A self-administered questionnaire was designed to examine the opinions of GTs about some factors of importance and implementation of gymnastics contents on a five-level Likert scale. A one-way ANOVA, Tukey post hoc test, and Mann-Whitney U test were used in the data processing. GTs allocated more time to those contents of the PE curriculum that rank higher regarding the importance of child development and are easier to teach. They spent only 16.93 lessons on gymnastics per academic year, ranked gymnastics at fourth place (out of 7) regarding its importance for children's development, and gymnastics seemed to be the most challenging content to teach. Within gymnastic content, the least implemented elements were those mentioned as the most difficult to learn for children (acrobatics, hang and support, and vaults). GTs believed that teaching methods (4.29) were less important for successful gymnastics performance than children’s motor efficiency (4.73) and self-activity (4.57). The outcomes of this study may aid in the future updating of GT education study programmes and designing a creative system of continuous professional development.
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Colombo A, Stephens NB, Tsegai ZJ, Bettuzzi M, Morigi MP, Belcastro MG, Hublin JJ. Trabecular Analysis of the Distal Radial Metaphysis during the Acquisition of Crawling and Bipedal Walking in Childhood: A Preliminary Study. ACTA ACUST UNITED AC 2019. [DOI: 10.3166/bmsap-2018-0041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In modern day populations, children following a normal pattern of development acquire independent bipedal locomotion between the ages of 9 and 18 months. Variability in the timing of this psychomotor developmental milestone depends on various factors, including cultural influences. It is well known that trabecular bone adapts to changes in biomechanical loading and that this can be influenced by alternative locomotor modes, such as crawling, which may be adopted before the acquisition of bipedal locomotion. With the onset of crawling, increased loading of the distal metaphysis of the radius, a component of the wrist, may lead to changes in trabecular bone architecture. To test this hypothesis, eight distal metaphyses of the radius of nonpathological children aged 0 to 3 years from the Bologna collection of identified skeletons were μCT-scanned at a resolution of 10.7 μm. The microarchitectural parameters of the trabecular bone (trabecular bone volume fraction, trabecular thickness, trabecular spacing, and trabecular ellipsoid factor) were quantified for the entire metaphysis and 3D morphometric maps of the distribution of the bone volume fraction were generated. Analysis of these microarchitectural parameters and the 3D morphometric maps show changes in the trabecular bone structure between 6 and 15 months, the period during which both crawling and bipedalism are acquired. This preliminary study analyzed the trabecular structure of the growing radius in three dimensions for the first time, and suggests that ontogenetic changes in the trabecular structure of the radial metaphysis may be related to changes in the biomechanical loading of the wrist during early locomotor transitions, i.e. the onset of crawling. Moreover, microarchitectural analysis could supply important information on the developmental timing of locomotor transitions, which would facilitate interpretations of locomotor development in past populations.
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5
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Health Effects of Wrist-Loading Sports During Youth: A Systematic Literature Review. J Phys Act Health 2018; 15:708-720. [PMID: 29741447 DOI: 10.1123/jpah.2017-0328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The benefits and risks of performing popular wrist-loading sports at a young age have not been investigated systematically. We aimed to evaluate positive and negative long-term wrist-related health effects of sports performance requiring repetitive wrist loading during youth. METHODS Six databases were searched for cohort and cross-sectional studies. Three investigators selected studies evaluating quantitatively measured health effects of upper extremities in athletes practicing wrist-loading sports (gymnastics, tennis, volleyball, field hockey, rowing, and judo) for minimally 4 months before the age of 18. RESULTS A total of 23 studies with 5 outcome measures, nearly all of moderate to good quality, were eligible for inclusion. Bone mineral density and bone mineral content were higher in athletes compared with controls and in tennis players' dominant arm. Mixed results were found for ulnar variance in gymnasts. Handgrip strength was greater in tennis players' dominant arm and in experienced gymnasts. CONCLUSIONS Wrist-loading sports performance during youth can promote bone strength in wrists and dominant handgrip strength, but evidence on the lasting of these effects and on prevalence of wrist joint degeneration in former young athletes is limited. For better counseling of young athletes and their parents, future studies with increased comparability are essential, for which recommendations are provided.
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Tan VP, Macdonald HM, Gabel L, McKay HA. Physical activity, but not sedentary time, influences bone strength in late adolescence. Arch Osteoporos 2018; 13:31. [PMID: 29556801 DOI: 10.1007/s11657-018-0441-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 02/28/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Physical activity is essential for optimal bone strength accrual, but we know little about interactions between physical activity, sedentary time, and bone outcomes in older adolescents. Physical activity (by accelerometer and self-report) positively predicted bone strength and the distal and midshaft tibia in 15-year-old boys and girls. Lean body mass mediated the relationship between physical activity and bone strength in adolescents. PURPOSE To examine the influence of physical activity (PA) and sedentary time on bone strength, structure, and density in older adolescents. METHODS We used peripheral quantitative computed tomography to estimate bone strength at the distal tibia (8% site; bone strength index, BSI) and tibial midshaft (50% site; polar strength strain index, SSIp) in adolescent boys (n = 86; 15.3 ± 0.4 years) and girls (n = 106; 15.3 ± 0.4 years). Using accelerometers (GT1M, Actigraph), we measured moderate-to-vigorous PA (MVPAAccel), vigorous PA (VPAAccel), and sedentary time in addition to self-reported MVPA (MVPAPAQ-A) and impact PA (ImpactPAPAQ-A). We examined relations between PA and sedentary time and bone outcomes, adjusting for ethnicity, maturity, tibial length, and total body lean mass. RESULTS At the distal tibia, MVPAAccel and VPAAccel positively predicted BSI (explained 6-7% of the variance, p < 0.05). After adjusting for lean mass, only VPAAccel explained residual variance in BSI. At the tibial midshaft, MVPAAccel, but not VPAAccel, positively predicted SSIp (explained 3% of the variance, p = 0.01). Lean mass attenuated this association. MVPAPAQ-A and ImpactPAPAQ-A also positively predicted BSI and SSIp (explained 2-4% of the variance, p < 0.05), but only ImpactPAPAQ-A explained residual variance in BSI after accounting for lean mass. Sedentary time did not independently predict bone strength at either site. CONCLUSION Greater tibial bone strength in active adolescents is mediated, in part, by lean mass. Despite spending most of their day in sedentary pursuits, adolescents' bone strength was not negatively influenced by sedentary time.
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Affiliation(s)
- Vina Ps Tan
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Heather M Macdonald
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Leigh Gabel
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Heather A McKay
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada. .,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada. .,Department of Orthopedics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Legerlotz K. The Effects of Resistance Training on Health of Children and Adolescents With Disabilities. Am J Lifestyle Med 2018; 14:382-396. [PMID: 33281519 DOI: 10.1177/1559827618759640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/16/2018] [Accepted: 01/26/2018] [Indexed: 11/15/2022] Open
Abstract
Many parents still hesitate to encourage their children to participate in resistance training programs. This is unfortunate since recent research shows that resistance training can positively affect children's health. This narrative review aims to present an overview of the health-associated effects resistance training can provide particularly in children and adolescents with disabilities by describing its effects on muscle strength, physical function, mental health, self-concept, obesity, and injury prevention. To illustrate the variety of possible fields of application, the effects of resistance training in children and adolescents suffering from Charcot-Marie-Tooth disease, cerebral palsy, Down syndrome, Ehlers-Danlos syndrome, joint hypermobility, juvenile idiopathic arthritis, obesity, and spina bifida are discussed. Although randomized controlled trials with a sufficiently large sample size are rare, the research presented in this review indicates that this mode of training might be a potent tool to improve mental and physical health by improving muscle strength, body composition, self-concept or functionality, reducing pain or injury risk, and strengthening bone or tendons even in the most vulnerable groups of children with physical or mental disability. Furthermore, it has to be emphasized that compared with other types of treatment resistance training is considered to be without adverse effects.
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Affiliation(s)
- Kirsten Legerlotz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Germany
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8
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Erlandson MC, Hounjet S, Treen T, Lanovaz JL. Upper and lower limb loading during weight-bearing activity in children: reaction forces and influence of body weight. J Sports Sci 2017; 36:1640-1647. [PMID: 29199897 DOI: 10.1080/02640414.2017.1407438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Weight bearing (WB) activity is important for healthy skeletal development. The magnitude of loading during WB activities, especially upper limb impacts, has yet to be quantified in children. This study quantifies ground reaction forces (GRF) experienced by children performing WB activities and examines the contribution of body weight (BW) to GRF. Fifty children, aged 8-12 were recruited (34 males). GRF were measured using force plates during 20 upper and lower limb activities (such as landing on the feet and hands). Sex differences in GRF and associations between peak force and BW were examined using independent sample t-tests and linear regressions (p < 0.05), respectively. Lower limb GRF varied from 2-6x BW with no significant sex differences. GRF during upper limb activities varied from 1/3-1.7x BW with males experiencing significantly greater GRF for 25% of activities. BW was significantly associated with peak force in almost all activities; however, GRF variation explained by BW was wide-ranging across activities and not dependent on limb or activity type (static vs dynamic). Therefore, factors other than BW, such as technique, may be important in determining forces experienced by children performing WB activity and should be considered when choosing activities for WB activity interventions.
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Affiliation(s)
- M C Erlandson
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Canada
| | - S Hounjet
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Canada
| | - T Treen
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Canada
| | - J L Lanovaz
- a College of Kinesiology , University of Saskatchewan , Saskatoon , Canada
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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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Abstract
PURPOSE To synthesize existing literatures on the impact of gymnastics participation on the skeletal health of young male gymnasts. METHODS Following a systematic search, 12 studies were included in this review. Quality of included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE modified) criteria. RESULTS Assessment of skeletal health varied between and within imaging modality protocols. Gymnasts had higher total bone content, greater total and trabecular bone density, larger bone size, a thicker cortex, and higher estimates of bone strength than controls. Recreational studies reported no difference in height or weight between gymnasts and controls; however, elite gymnasts were shorter and lighter than nongymnasts. STROBE scores ranged from 65% to 95%. CONCLUSION Gymnastics participation may be beneficial to the bone health of young males as gymnasts had higher bone density and bone mineral content, larger bones, and greater estimates of bone strength than controls.
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11
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Barbour-Tuck E, Erlandson M, Muhajarine N, Foulds H, Baxter-Jones A. Longitudinal patterns in BMI and percent total body fat from peak height velocity through emerging adulthood into young adulthood. Am J Hum Biol 2017; 30. [PMID: 28901657 DOI: 10.1002/ajhb.23056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/17/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Emerging adulthood, a potential critical period, is an understudied period of fat mass accrual. The aim of this study was to describe patterns of fat mass accrual, and weight status, from adolescence, through emerging adulthood, into young adulthood. METHODS One-hundred-eighteen participants (59 male) were measured repeatedly for 20 years. Annual measures of height, weight, and body composition (DXA) were taken. Calculated measures included: peak height velocity (PHV), biological age (BA; years from PHV), body mass index (BMI), and percent total body fat (%TBF). Weight status groupings (normal NW, and overweight/obese OWO) were created using age and sex specific BMI and %TBF cut-offs. Analysis included t-tests and logistic regression. RESULTS BMI and %TBF increased significantly until 8 years post PHV (P < .05), plateaued for 7 years (P > .05), and then began increasing again (P < .05). At PHV, 9% of males and 14% of females were OWO rising to 65% and 32% respectively 15 years post PHV. OWO status at PHV did not predict OWO status in early adulthood (P > .05). CONCLUSIONS During emerging adulthood, the prevalence of OWO increased. Being NW at PHV was not protective against being overweight in young adulthood. Emerging adulthood appears to be a potential critical period for fat accrual and warrants further attention.
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Affiliation(s)
- Erin Barbour-Tuck
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marta Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Heather Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Adam Baxter-Jones
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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12
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Gabel L, Macdonald HM, Nettlefold L, McKay HA. Physical Activity, Sedentary Time, and Bone Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT study. J Bone Miner Res 2017; 32:1525-1536. [PMID: 28326606 DOI: 10.1002/jbmr.3115] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 11/08/2022]
Abstract
Bone strength is influenced by bone geometry, density, and bone microarchitecture, which adapt to increased mechanical loads during growth. Physical activity (PA) is essential for optimal bone strength accrual; however, less is known about how sedentary time influences bone strength and its determinants. Thus, our aim was to investigate the prospective associations between PA, sedentary time, and bone strength and its determinants during adolescence. We used HR-pQCT at distal tibia (8% site) and radius (7% site) in 173 girls and 136 boys (aged 9 to 20 years at baseline). We conducted a maximum of four annual measurements at the tibia (n = 785 observations) and radius (n = 582 observations). We assessed moderate-to-vigorous PA (MVPA) and sedentary time with accelerometers (ActiGraph GT1M). We aligned participants on maturity (years from age at peak height velocity) and fit a mixed-effects model adjusting for maturity, sex, ethnicity, leg muscle power, lean mass, limb length, dietary calcium, and MVPA in sedentary time models. MVPA was a positive independent predictor of bone strength (failure load [F.Load]) and bone volume fraction (BV/TV) at the tibia and radius, total area (Tt.Ar) and cortical porosity (Ct.Po) at the tibia, and negative predictor of load-to-strength ratio at the radius. Sedentary time was a negative independent predictor of Tt.Ar at both sites and Ct.Po at the tibia and a positive predictor of cortical thickness (Ct.Th), trabecular thickness (Tb.Th), and cortical bone mineral density (Ct.BMD) at the tibia. Bone parameters demonstrated maturity-specific associations with MVPA and sedentary time, whereby associations were strongest during early and mid-puberty. Our findings support the importance of PA for bone strength accrual and its determinants across adolescent growth and provide new evidence of a detrimental association of sedentary time with bone geometry but positive associations with microarchitecture. This study highlights maturity-specific relationships of bone strength and its determinants with loading and unloading. Future studies should evaluate the dose-response relationship and whether associations persist into adulthood. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
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Guerra MRV, Estelles JRD, Abdouni YA, Falcochio DF, Rosa JRP, Catani LH. FREQUENCY OF WRIST GROWTH PLATE INJURY IN YOUNG GYMNASTS AT A TRAINING CENTER. ACTA ORTOPEDICA BRASILEIRA 2016; 24:204-207. [PMID: 28243175 PMCID: PMC5035693 DOI: 10.1590/1413-785220162404157422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To assess the frequency of physeal injuries and wrist pain in young competitive gymnasts according to their training characteristics. Methods: This is a cross-sectional study (January-June 2015) of a male gymnastics team in São Paulo, SP, Brazil. Nineteen gymnasts, mean age 13.3 years, were evaluated in three ways: a questionnaire, physical examination and radiographs. Results: On average, they trained since 6 years-old and during hours per week. Eighty-two percent had wrist pain and 65% had wrist physeal injury. The pain was worse in practitioners of (82%) and soil (17%) exercises. A greater frequency of physeal injury was found in those with more years of training and higher weekly working hours, wrist pain was more frequent in those with higher weekly working hours, and a decreased range of motion was observed in those with physeal injury, results statistically significant. Conclusions: We found that 65% of gymnasts had wrist physeal injury and 82% had wrist pain. There were statistically significant relationships between physeal injury and years of training, physeal injury and weekly working hours, pain and weekly working hours, and physeal injury and range of motion. Level of Evidence IV, Case Series.
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14
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MOORE SARAHA, MCKAY HEATHERA, MACDONALD HEATHER, NETTLEFOLD LINDSAY, BAXTER-JONES ADAMDG, CAMERON NOËL, BRASHER PENELOPEMA. Enhancing a Somatic Maturity Prediction Model. Med Sci Sports Exerc 2015; 47:1755-64. [DOI: 10.1249/mss.0000000000000588] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Jackowski SA, Baxter-Jones ADG, Gruodyte-Raciene R, Kontulainen SA, Erlandson MC. A longitudinal study of bone area, content, density, and strength development at the radius and tibia in children 4-12 years of age exposed to recreational gymnastics. Osteoporos Int 2015; 26:1677-90. [PMID: 25740207 DOI: 10.1007/s00198-015-3041-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 01/14/2015] [Indexed: 12/01/2022]
Abstract
UNLABELLED This study investigated the long-term relationship between the exposure to childhood recreational gymnastics and bone measures and bone strength parameters at the radius and tibia. It was observed that individuals exposed to recreational gymnastics had significantly greater total bone content and area at the distal radius. No differences were observed at the tibia. INTRODUCTION This study investigated the relationship between exposure to early childhood recreational gymnastics with bone measures and bone strength development at the radius and tibia. METHODS One hundred twenty seven children (59 male, 68 female) involved in either recreational gymnastics (gymnasts) or other recreational sports (non-gymnasts) between 4 and 6 years of age were recruited. Peripheral quantitative computed tomography (pQCT) scans of their distal and shaft sites of the forearm and leg were obtained over 3 years, covering the ages of 4-12 years at study completion. Multilevel random effects models were constructed to assess differences in the development of bone measures and bone strength measures between those exposed and not exposed to gymnastics while controlling for age, limb length, weight, physical activity, muscle area, sex, and hours of training. RESULTS Once age, limb length, weight, muscle area, physical activity, sex, and hours of training effects were controlled, it was observed that individuals exposed to recreational gymnastics had significantly greater total bone area (18.0 ± 7.5 mm(2)) and total bone content (6.0 ± 3.0 mg/mm) at the distal radius (p < 0.05). This represents an 8-21 % benefit in ToA and 8-15 % benefit to ToC from 4 to 12 years of age. Exposure to recreational gymnastics had no significant effect on bone measures at the radius shaft or at the tibia (p > 0.05). CONCLUSIONS Exposure to early life recreational gymnastics provides skeletal benefits to distal radius bone content and area. Thus, childhood recreational gymnastics exposure may be advantageous to bone development at the wrist.
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Affiliation(s)
- S A Jackowski
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
| | - A D G Baxter-Jones
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada.
| | | | - S A Kontulainen
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
| | - M C Erlandson
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
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The Influence of Organized Physical Activity (Including Gymnastics) on Young Adult Skeletal Traits: Is Maturity Phase Important? Pediatr Exerc Sci 2015; 27:285-96. [PMID: 25386845 PMCID: PMC4428999 DOI: 10.1123/pes.2014-0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We prospectively evaluated adolescent organized physical activity (PA) as a factor in adult female bone traits. Annual DXA scans accompanied semiannual records of anthropometry, maturity, and PA for 42 participants in this preliminary analysis (criteria: appropriately timed DXA scans at ~1 year premenarche [predictor] and ~5 years postmenarche [dependent variable]). Regression analysis evaluated total adolescent interscan PA and PA over 3 maturity subphases as predictors of young adult bone outcomes: 1) bone mineral content (BMC), geometry, and strength indices at nondominant distal radius and femoral neck; 2) subhead BMC; 3) lumbar spine BMC. Analyses accounted for baseline gynecological age (years pre- or postmenarche), baseline bone status, adult body size and interscan body size change. Gymnastics training was evaluated as a potentially independent predictor, but did not improve models for any outcomes (p > .07). Premenarcheal bone traits were strong predictors of most adult outcomes (semipartial r2 = .21-0.59, p ≤ .001). Adult 1/3 radius and subhead BMC were predicted by both total PA and PA 1-3 years postmenarche (p < .03). PA 3-5 years postmenarche predicted femoral narrow neck width, endosteal diameter, and buckling ratio (p < .05). Thus, participation in organized physical activity programs throughout middle and high school may reduce lifetime fracture risk in females.
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Tan VPS, Macdonald HM, Kim S, Nettlefold L, Gabel L, Ashe MC, McKay HA. Influence of physical activity on bone strength in children and adolescents: a systematic review and narrative synthesis. J Bone Miner Res 2014; 29:2161-81. [PMID: 24737388 DOI: 10.1002/jbmr.2254] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 04/04/2014] [Accepted: 04/09/2014] [Indexed: 11/08/2022]
Abstract
A preponderance of evidence from systematic reviews supports the effectiveness of weight-bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone strength. Thus, our systematic review extended the scope of the previous review by including all PA intervention and observational studies, including organized sports participation studies, with child or adolescent bone strength as the main outcome. We also sought to discern the skeletal elements (eg, mass, structure, density) that accompanied significant bone strength changes. Our electronic-database, forward, and reference searches yielded 14 intervention and 23 observational studies that met our inclusion criteria. We used the Effective Public Health Practice Project (EPHPP) tool to assess the quality of studies. Due to heterogeneity across studies, we adopted a narrative synthesis for our analysis and found that bone strength adaptations to PA were related to maturity level, sex, and study quality. Three (of five) weight-bearing PA intervention studies with a strong rating reported significantly greater gains in bone strength for the intervention group (3% to 4%) compared with only three significant (of nine) moderate intervention studies. Changes in bone structure (eg, bone cross-sectional area, cortical thickness, alone or in combination) rather than bone mass most often accompanied significant bone strength outcomes. Prepuberty and peripuberty may be the most opportune time for boys and girls to enhance bone strength through PA, although this finding is tempered by the few available studies in more mature groups. Despite the central role that muscle plays in bones' response to loading, few studies discerned the specific contribution of muscle function (or surrogates) to bone strength. Although not the focus of the current review, this seems an important consideration for future studies.
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Affiliation(s)
- Vina P S Tan
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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Abstract
This article discusses how participation in recreational gymnastics can improve the skeletal health of young girls in terms of gaining bone mass, strength, and density. Additionally, the article investigates negative skeletal adaptations, such as overuse injuries and the effects of rigorous training on growth and maturity.
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Affiliation(s)
- Alexa Knorr
- Alexa Knorr is a pediatric nurse practitioner in New York, NY
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Adams JE, Engelke K, Zemel BS, Ward KA. Quantitative computer tomography in children and adolescents: the 2013 ISCD Pediatric Official Positions. J Clin Densitom 2014; 17:258-74. [PMID: 24792821 DOI: 10.1016/j.jocd.2014.01.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/14/2014] [Indexed: 12/24/2022]
Abstract
In 2007, International Society of Clinical Densitometry Pediatric Positions Task Forces reviewed the evidence for the clinical application of peripheral quantitative computed tomography (pQCT) in children and adolescents. At that time, numerous limitations regarding the clinical application of pQCT were identified, although its use as a research modality for investigation of bone strength was highlighted. The present report provides an updated review of evidence for the clinical application of pQCT, as well as additional reviews of whole body QCT scans of the central and peripheral skeletons, and high-resolution pQCT in children. Although these techniques remain in the domain of research, this report summarizes the recent literature and evidence of the clinical applicability and offers general recommendations regarding the use of these modalities in pediatric bone health assessment.
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Affiliation(s)
- Judith E Adams
- Department of Clinical Radiology, The Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, England, UK.
| | - Klaus Engelke
- Institute of Medical Physics, University of Erlangen, Erlangen, Germany and Synarc A/S, Germany
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kate A Ward
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
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Gruodyte-Raciene R, Erlandson MC, Jackowski SA, Baxter-Jones AD. Structural strength development at the proximal femur in 4- to 10-year-old precompetitive gymnasts: a 4-year longitudinal hip structural analysis study. J Bone Miner Res 2013; 28:2592-600. [PMID: 23722912 DOI: 10.1002/jbmr.1986] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/25/2013] [Accepted: 05/02/2013] [Indexed: 11/08/2022]
Abstract
Gymnastics, a high-impact weight-bearing physical activity, has been shown to be highly osteogenic. Previously in this cohort, bone mass development (bone mineral content accrual [BMC]) was shown to be positively associated with low-level (recreational) gymnastics exposure (1 to 2 hours per week); however, BMC is only one single component of bone strength. Bone strength is influenced not only by bone mineralization but also bone geometry, bone architecture, and the imposing loads on the bone. The aim of this study was to investigate whether low-level gymnastics training influenced the estimated structural geometry development at the proximal femur. A total of 165 children (92 gymnasts and 73 non-gymnasts) between the ages of 4 and 6 years were recruited into this study and assessed annually for 4 years. During the 4 years, 64 gymnasts withdrew from the sport and were reclassified as ex-gymnasts. A dual-energy X-ray absorptiometry (DXA) image of each child's hip was obtained. Values of cross-sectional area (CSA), section modulus (Z), and cortical thickness (CT) at the narrow neck (NN), intertrochanter (IT), and shaft (S) were estimated using the hip structural analysis (HSA) program. Multilevel random-effects models were constructed and used to develop bone structural strength development trajectories (estimate ± SEE). Once the confounders of body size and lifestyle were controlled, it was found that gymnasts had 6% greater NN CSA than non-gymnasts controls (0.09 ± 0.03 cm(2) , p < 0.05), 7% greater NN Z (0.04 ± 0.01 cm(3) , p < 0.05), 5% greater IT CSA (0.11 ± 0.04 cm(3) , p < 0.05), 6% greater IT Z (0.07 ± 0.03 cm(3) , p < 0.05), and 3% greater S CSA (0.06 ± 0.03 cm(3) , p < 0.05). These results suggest that early exposure to low-level gymnastics participation confers benefits related to geometric and bone architecture properties during childhood and, if maintained, may improve bone health in adolescence and adulthood.
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Affiliation(s)
- Rita Gruodyte-Raciene
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada; Lithuanian Sports University, Kaunas, Lithuania
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Kontulainen SA, Kawalilak CE, Johnston JD, Bailey DA. Prevention of Osteoporosis and Bone Fragility. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613487664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The importance of optimal bone growth in childhood and adolescence has been recognized as one of the key strategies in osteoporotic fracture prevention. Low birth size, poor childhood growth, and low peak bone mass at the cessation of growth have been linked to the later risk of osteoporosis and hip fracture. Formerly, the focus was merely on maximizing bone mineral accrual because a high peak bone mineral mass may prevent attainment of a critical “fracture threshold” associated with age-related bone loss and osteoporosis. More recently, the focus has shifted away from bone mineral accrual—as measured by dual-energy X-ray absorptiometry (DXA)—toward the optimization of bone strength. This is partly because of the advances in bone imaging that have enabled estimation of bone strength beyond bone mass. In this review, we briefly describe long-bone growth and structural development and our abilities to assess bone properties by medical imaging tools. In addition, we summarize the evidence of factors contributing to skeletal growth, bone fragility, and the development of strong, healthy bones.
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Affiliation(s)
- Saija Annukka Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - Chantal Elizabeth Kawalilak
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - James Duncan Johnston
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - Donald Alexander Bailey
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
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Frank AW, Labas MC, Johnston JD, Kontulainen SA. Site-specific variance in radius and tibia bone strength as determined by muscle size and body mass. Physiother Can 2013; 64:292-301. [PMID: 23729966 DOI: 10.3138/ptc.2010-40bh] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To investigate the predictive ability of muscle cross-sectional area (MCSA) and body mass on bone mineral content, compressive bone strength index (BSIc), and the polar stress-strain index (SSIp) of the forearms and lower legs of middle-aged adults. METHODS A total of 53 healthy adults (37 male, 16 female; mean age 50.4; SD 2.1 y) were scanned with peripheral quantitative computed tomography (pQCT) to measure radius and tibia total and cortical bone mineral content, BSIc, SSIp, and forearm and lower-leg MCSA (BSIc: 4% distal; SSIp and MCSA at 65% and 66% radius and tibia shaft sites, respectively). Multiple regression models adjusted for sex and height were used to assess the relative variance in radius or tibia bone outcomes predicted by body mass and/or forearm or lower-leg MCSA. RESULTS Forearm MCSA independently predicted total bone-mineral content, BSIc, and SSIp in radius (r partial=0.59, 0.56, 0.42). Body mass was a negative predictor of radius BSIc (r partial=-0.32) and did not predict other radius outcomes when both body mass and MCSA were forced in the models. In the lower leg shaft, MCSA, and body mass predicted bone content and strength similarly when independently added to the models with sex and height. CONCLUSIONS Forearm MCSA was a dominant predictor of radius bone content and estimated strength. In the tibia, both body mass and lower-leg MCSA contributed to predicting bone content and estimated strength.
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23
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Erlandson MC, Kontulainen SA, Chilibeck PD, Arnold CM, Faulkner RA, Baxter-Jones ADG. Former premenarcheal gymnasts exhibit site-specific skeletal benefits in adulthood after long-term retirement. J Bone Miner Res 2012; 27:2298-305. [PMID: 22714629 DOI: 10.1002/jbmr.1689] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Young female gymnasts have greater bone strength compared to controls; although possibly due to selection into gymnastics, it is thought that their loading activity during growth increases their bone mass, influencing both bone geometry and architecture. If such bone mass and geometric adaptations are maintained, this may potentially decrease the risk of osteoporosis and risk of fracture later in life. However, there is limited evidence of the persisting benefit of gymnastic exercise during growth on adult bone geometric parameters. Therefore, the purpose of this study was to determine whether adult bone geometry, volumetric density, and estimated strength were greater in retired gymnasts compared to controls, 10 years after retirement from the sport. Bone geometric and densitometric parameters, measured by peripheral quantitative computed tomography (pQCT) at the radius and tibia, were compared between 25 retired female gymnasts and 22 controls, age range 22 to 30 years, by multivariate analysis of covariance (covariates: age, height, and muscle cross-sectional area). Retired gymnasts had significantly greater adjusted total and trabecular area (16%), total and trabecular bone mineral content (BMC) (18% and 22%, respectively), and estimated strength (21%) at the distal radius (p < 0.05) than controls. Adjusted total and cortical area and BMC, medullary area, and estimated strength were also significantly greater (13% to 46%) in retired gymnasts at the 30% and 65% radial shaft sites (p < 0.05). At the distal tibia, retired gymnasts had 12% to 13% greater total and trabecular BMC and volumetric bone mineral density as well as 21% greater estimated strength; total and cortical BMC and estimated strength were also greater at the tibial shaft (8%, 11%, and 10%, respectively) (p < 0.05). Former female gymnasts have significantly better geometric and densitometric properties, as well as estimated strength, at the radius and tibia 10 years after retirement from gymnastics compared to females who did not participate in gymnastics in childhood and adolescence.
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Affiliation(s)
- Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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24
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Burt LA, Greene DA, Ducher G, Naughton GA. Skeletal adaptations associated with pre-pubertal gymnastics participation as determined by DXA and pQCT: a systematic review and meta-analysis. J Sci Med Sport 2012; 16:231-9. [PMID: 22951266 DOI: 10.1016/j.jsams.2012.07.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/20/2012] [Accepted: 07/27/2012] [Indexed: 11/26/2022]
Abstract
UNLABELLED Participation in gymnastics prior to puberty offers an intriguing and unique model, particularly in girls. The individuality comes from both upper and lower limbs being exposed to high mechanical loading through year long intensive training programs, initiated at a young age. Studying this unique model and the associated changes in musculoskeletal health during growth is an area of specific interest. Previous reviews on gymnastics participation and bone health have been broad; and not limited to a particular maturation period, such as pre-puberty. OBJECTIVES To determine the difference in skeletal health between pre-pubertal girls participating in gymnastics compared with non-gymnasts. DESIGN Meta-analysis. METHODS Following a systematic search, 17 studies were included in this meta-analysis. All studies used dual-energy X-ray absorptiometry to assess bone mineral density and bone mineral content. In addition, two studies included peripheral quantitative computed tomography. RESULTS Following the implementation of a random effects model, gymnasts were found to have greater bone properties than non-gymnasts. The largest difference in bone health between gymnasts and non-gymnasts was observed in peripheral quantitative computed tomography-derived volumetric bone mineral density at the distal radius (d=1.06). CONCLUSIONS Participation in gymnastics during pre-pubertal growth was associated with skeletal health benefits, particularly to the upper body.
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Affiliation(s)
- Lauren A Burt
- Centre of Physical Activity Across the Lifespan, Australian Catholic University, Australia.
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Dowthwaite JN, Rosenbaum PF, Scerpella TA. Site-specific advantages in skeletal geometry and strength at the proximal femur and forearm in young female gymnasts. Bone 2012; 50:1173-83. [PMID: 22342799 PMCID: PMC3340420 DOI: 10.1016/j.bone.2012.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/15/2012] [Accepted: 01/20/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE We evaluated site-specific skeletal adaptation to loading during growth, comparing radius (RAD) and femoral neck (FN) DXA scans in young female gymnasts (GYM) and non-gymnasts (NON). METHODS Subjects from an ongoing longitudinal study (8-26yr old) underwent annual DXA scans (proximal femur, forearm, total body) and anthropometry, completing maturity and physical activity questionnaires. This cross-sectional analysis used the most recent data meeting the following criteria: gynecological age ≤2.5yr post-menarche; and GYM annual mean gymnastic exposure ≥5.0h/wk in the prior year. Bone geometric and strength indices were derived from scans for 173 subjects (8-17yr old) via hip structural analysis (femoral narrow neck, NN) and similar radius formulae (1/3 and Ultradistal (UD)). Maturity was coded as M1 (Tanner I breast), M2 (pre-menarche, ≥Tanner II breast) or M3 (post-menarche). ANOVA and chi square compared descriptive data. Two factor ANCOVA adjusted for age, height, total body non-bone lean mass and percent body fat; significance was tested for main effects and interactions between gymnastic exposure and maturity. RESULTS At the distal radius, GYM means were significantly greater than NON means for all variables (p<0.05). At the proximal femur, GYM exhibited narrower periosteal and endosteal dimensions, but greater indices of cortical thickness, BMC, aBMD and section modulus, with lower buckling ratio (p<0.05). However, significant interactions between maturity and loading were detected for the following: 1) FN bone mineral content (BMC) and NN buckling ratio (GYM BMC advantages only in M1 and M3; for BMC and buckling ratio, M1 advantages were greatest); 2) 1/3 radius BMC, width, endosteal diameter, cortical cross-sectional area, and section modulus (GYM advantages primarily post-menarche); and 3) UD radius BMC and axial compressive strength (GYM advantages were larger with greater maturity, greatest post-menarche). CONCLUSIONS Maturity-specific comparisons suggested site-specific skeletal adaptation to loading during growth, with greater advantages at the radius versus the proximal femur. At the radius, GYM advantages included greater bone width, cortical cross-sectional area and cortical thickness; in contrast, at the femoral neck, GYM bone tissue cross-sectional area and cortical thickness were greater, but bone width was narrower than in NON. Future longitudinal analyses will evaluate putative maturity-specific differences.
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Affiliation(s)
- Jodi N. Dowthwaite
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-9981; Fax: 001-315-464-6638,
| | - Paula F. Rosenbaum
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-4430; Fax: 001-315-464-4429,
| | - Tamara A. Scerpella
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, U.S.A. Phone: 001-315-464-9981; Fax: 001-315-464-6638,
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Burt LA, Naughton GA, Greene DA, Courteix D, Ducher G. Non-elite gymnastics participation is associated with greater bone strength, muscle size, and function in pre- and early pubertal girls. Osteoporos Int 2012; 23:1277-86. [PMID: 21660556 DOI: 10.1007/s00198-011-1677-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 05/11/2011] [Indexed: 11/26/2022]
Abstract
UNLABELLED Recent reports indicate an increase in forearm fractures in children. Bone geometric properties are an important determinant of bone strength and therefore fracture risk. Participation in non-elite gymnastics appears to contribute to improving young girls' musculoskeletal health, more specifically in the upper body. INTRODUCTION The primary aim of this study was to determine the association between non-elite gymnastics participation and upper limb bone mass, geometry, and strength in addition to muscle size and function in young girls. METHODS Eighty-eight pre- and early pubertal girls (30 high-training gymnasts [HGYM, 6-16 hr/ wk], 29 low-training gymnasts [LGYM, 1-5 h r/wk] and 29 non-gymnasts [NONGYM]), aged 6-11 years were recruited. Upper limb lean mass, BMD and BMC were derived from a whole body DXA scan. Forearm volumetric BMD, bone geometry, estimated strength, and muscle CSA were determined using peripheral QCT. Upper body muscle function was investigated with muscle strength, explosive power, and muscle endurance tasks. RESULTS HGYM showed greater forearm bone strength compared with NGYM, as well as greater arm lean mass, BMC, and muscle function (+5% to +103%, p < 0.05). LGYM displayed greater arm lean mass, BMC, muscle power, and endurance than NGYM (+4% to +46%, p < 0.05); however, the difference in bone strength did not reach significance. Estimated fracture risk at the distal radius, which accounted for body weight, was lower in both groups of gymnasts. Compared with NONGYM, HGYM tended to show larger skeletal differences than LGYM; yet, the two groups of gymnasts only differed for arm lean mass and muscle CSA. CONCLUSION Non-elite gymnastics participation was associated with musculoskeletal benefits in upper limb bone geometry, strength and muscle function. Differences between the two gymnastic groups emerged for arm lean mass and muscle CSA, but not for bone strength.
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Affiliation(s)
- L A Burt
- Centre of Physical Activity Across the Lifespan, Australian Catholic University, Locked Bag 2002, 2135 Strathfield, NSW, Australia.
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Erlandson MC, Kontulainen SA, Chilibeck PD, Arnold CM, Faulkner RA, Baxter-Jones ADG. Higher premenarcheal bone mass in elite gymnasts is maintained into young adulthood after long-term retirement from sport: a 14-year follow-up. J Bone Miner Res 2012; 27:104-10. [PMID: 21956460 DOI: 10.1002/jbmr.514] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 08/08/2011] [Accepted: 08/29/2011] [Indexed: 11/11/2022]
Abstract
Sports that impact-load the skeleton during childhood and adolescence increase determinants of bone strength such as bone mineral content and density; however, it is unclear if this benefit is maintained after retirement from the sport. The purpose of this study was to assess whether the previously reported higher bone mass in a group of premenarcheal gymnasts was still apparent 10 years after the cessation of participation and withdrawal of the gymnastics loading stimulus. In 1995, 30 gymnasts 8 to 15 years of age were measured and compared with 30 age-matched nongymnasts. Twenty-five former gymnasts and 22 nongymnasts were measured again 14 years later (2009 to 2010). Gymnasts had been retired from gymnastics training and competition for an average of 10 years. Total body (TB), lumbar spine (LS), and femoral neck (FN) bone mineral content (BMC) was assessed at both measurement occasions by dual-energy X-ray absorptiometry (DXA). Multivariate analysis of covariance (MANCOVA) was used to compare former gymnasts' and nongymnasts' BMC while controlling for differences in body size and maturation (covariates: age, height, weight, and years from menarche [1995] or age at menarche [2009 to 2010]). Premenarcheal gymnasts (measured in 1995) had significantly greater size-adjusted TB, LS, and FN BMC (p < 0.05) (15%, 17%, and 12%, respectively) than nongymnasts. Ten years after retirement, gymnasts had maintained similar size-adjusted TB, LS, and FN BMC differences (p < 0.05) (13%, 19%, and 13%, respectively) when compared with nongymnasts. Bone mass benefits in premenarcheal gymnasts were still apparent even after long-term (10 years) removal of the gymnastics loading stimulus.
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Affiliation(s)
- Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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Maïmoun L, Coste O, Mariano-Goulart D, Galtier F, Mura T, Philibert P, Briot K, Paris F, Sultan C. In peripubertal girls, artistic gymnastics improves areal bone mineral density and femoral bone geometry without affecting serum OPG/RANKL levels. Osteoporos Int 2011; 22:3055-66. [PMID: 21359671 DOI: 10.1007/s00198-011-1541-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 12/20/2010] [Indexed: 11/30/2022]
Abstract
UNLABELLED Peripubertal artistic gymnasts display elevated areal bone mineral density at various bone sites, despite delayed menarche and a high frequency of menstrual disorders, factors that may compromise bone health. The concomitant improvement in femoral bone geometry and strength suggested that this type of physical activity might have favourable clinical impact. INTRODUCTION The purpose of this study is to evaluate the effect of artistic gymnastics (GYM) on areal bone mineral density (aBMD), femoral bone geometry and bone markers and its relationship with the osteoprotegerin (OPG)/rank-ligand (RANKL) system in peripubertal girls. METHODS Forty-six girls (age 10-17.2 years) were recruited for this study: 23 elite athletes in the GYM group (training 12-30 h/week, age at start of training 5.3 years) and 23 age-matched (± 6 months; leisure physical activity ≤ 3 h/week) controls (CON). The aBMD at whole body, total proximal femur, lumbar spine, mid-radius and skull was determined using dual-X-ray absorptiometry. Hip structural analysis (HSA software) was applied at the femur to evaluate cross-sectional area (CSA, cm(2)), cross-sectional moment of inertia (CSMI, cm(4)), and the section modulus (Z, cm(3)) and buckling ratio at neck, intertrochanteric region and shaft. Markers of bone turnover and OPG/RANKL levels were also analysed. RESULTS GYM had higher (5.5-16.4%) non-adjusted aBMD and adjusted aBMD for age, fat-free soft tissue and fat mass at all bone sites, skull excepted and the difference increased with age. In the three femoral regions adjusted for body weight and height, CSA (12.5-18%), CSMI (14-18%), Z (15.5-18.6%) and mean cortical thickness (13.6-21%) were higher in GYM than CON, while the buckling ratio (21-27.1%) was lower. Bone markers decreased with age in both groups and GYM presented higher values than CON only in the postmenarchal period. A similar increase in RANKL with age without OPG variation was observed for both groups. CONCLUSION GYM is associated not only with an increase in aBMD but also an improvement in bone geometry associated with an increase in bone remodelling. These adaptations seem to be independent of the OPG/RANKL system.
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Affiliation(s)
- L Maïmoun
- Service d'Hormonologie, Hôpital Lapeyronie, CHU Montpellier et UMI, Montpellier, France
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Erlandson MC, Kontulainen SA, Chilibeck PD, Arnold CM, Baxter-Jones ADG. Bone mineral accrual in 4- to 10-year-old precompetitive, recreational gymnasts: a 4-year longitudinal study. J Bone Miner Res 2011; 26:1313-20. [PMID: 21308773 DOI: 10.1002/jbmr.338] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Competitive female gymnasts have greater bone mineral measures than nongymnasts. However, less is known about the effect of recreational and/or precompetitive gymnastics participation on bone development. The purpose of this study was to investigate whether the differences previously reported in the skeleton of competitive female gymnasts are also demonstrated in young children with a current or past participation history in recreational or precompetitive gymnastics. One hundred and sixty-three children (30 gymnasts, 61 ex-gymnasts, and 72 nongymnasts) between 4 and 6 years of age were recruited and measured annually for 4 years (not all participants were measured at every occasion). Total-body (TB), lumbar spine (LS), and femoral neck (FN) bone mineral content (BMC) were measured by dual-energy X-ray absorptiometry (DXA). Multilevel random-effects models were constructed and used to predict differences in TB, LS, and FN BMC between groups while controlling for differences in body size, physical activity, and diet. Gymnasts had 3% more TB and 7% more FN BMC than children participating in other recreational sports at year 4 (p < .05). No differences were found at the LS between groups, and there were no differences between ex-gymnasts' and nongymnasts' bone parameters (p > .05). These findings suggest that recreational and precompetitive gymnastics participation is associated with greater BMC. This is important because beginner gymnastics skills are attainable by most children and do not require a high level of training. Low-level gymnastics skills can be implemented easily into school physical education programs, potentially affecting skeletal health.
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Affiliation(s)
- Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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