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Scott R, James R, Barnett CT, Sale C, Varley I. Perspectives from research and practice: A survey on external load monitoring and bone in sport. Front Sports Act Living 2023; 5:1150052. [PMID: 37181251 PMCID: PMC10166824 DOI: 10.3389/fspor.2023.1150052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction There is limited information regarding the association between external load and estimated bone load in sport, which may be important due to the influence exercise can have on bone accrual and injury risk. The aim of this study was to identify external load measuring tools used by support staff to estimate bone load and assess if these methodologies were supported in research. Methods A survey was comprised of 19 multiple choice questions and the option to elaborate on if/how they monitor external load and if/how they used them to estimate bone load. A narrative review was performed to assess how external load is associated to bone in research. Results Participants were required to be working as support staff in applied sport. Support staff (n = 71) were recruited worldwide with the majority (85%) working with professional elite athletes. 92% of support staff monitored external load in their organisation, but only 28% used it to estimate bone load. Discussion GPS is the most commonly used method to estimate bone load, but there is a lack of research assessing GPS metrics with bone load. Accelerometry and force plates were among the most prevalent methods used to assess external load, but a lack of bone specific measurements were reported by support staff. Further research exploring how external load relates to bone is needed as there is no consensus on which method of external load is best to estimate bone load in an applied setting.
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Affiliation(s)
- Reece Scott
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Ruth James
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Cleveland T. Barnett
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Institute of Sport, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ian Varley
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Veras L, Diniz-Sousa F, Boppre G, Moutinho-Ribeiro E, Resende-Coelho A, Devezas V, Santos-Sousa H, Preto J, Vilas-Boas JP, Machado L, Oliveira J, Fonseca H. Mechanical loading prediction through accelerometry data during walking and running. Eur J Sport Sci 2022:1-18. [PMID: 35838070 DOI: 10.1080/17461391.2022.2102437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Currently, there is no way to assess mechanical loading variables such as peak ground reaction forces (pGRF) and peak loading rate (pLR) in clinical settings. The purpose of this study was to develop accelerometry-based equations to predict both pGRF and pLR during walking and running. One hundred and thirty one subjects (79 females; 76.9 ± 19.6kg) walked and ran at different speeds (2-14km·h-1) on a force plate-instrumented treadmill while wearing accelerometers at their ankle, lower back and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave-one-out cross-validation was used to calculate prediction accuracy and Bland-Altman plots. Our pGRF prediction equation was compared with a reference equation previously published. Body mass and peak acceleration were included for pGRF prediction and body mass and peak acceleration rate for pLR prediction. All pGRF equation coefficients of determination were above 0.96, and a good agreement between actual and predicted pGRF was observed, with a mean absolute percent error (MAPE) below 7.3%. Accuracy indices from our equations were better than previously developed equations. All pLR prediction equations presented a lower accuracy compared to those developed to predict pGRF. Walking and running pGRF can be predicted with high accuracy by accelerometry-based equations, representing an easy way to determine mechanical loading in free-living conditions. The pLR prediction equations yielded a somewhat lower prediction accuracy compared with the pGRF equations.
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Affiliation(s)
- Lucas Veras
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Florêncio Diniz-Sousa
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Giorjines Boppre
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Edgar Moutinho-Ribeiro
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Ana Resende-Coelho
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Vítor Devezas
- Obesity Integrated Responsability Unity (CRIO), São João Academic Medical Center, Porto, Portugal
| | - Hugo Santos-Sousa
- Obesity Integrated Responsability Unity (CRIO), São João Academic Medical Center, Porto, Portugal
| | - John Preto
- Obesity Integrated Responsability Unity (CRIO), São João Academic Medical Center, Porto, Portugal
| | - João Paulo Vilas-Boas
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - Leandro Machado
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.,Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal
| | - José Oliveira
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Hélder Fonseca
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
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Imperlini E, Mancini A, Orrù S, Vitucci D, Di Onofrio V, Gallè F, Valerio G, Salvatore G, Liguori G, Buono P, Alfieri A. Long-Term Recreational Football Training and Health in Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062087. [PMID: 32245237 PMCID: PMC7143141 DOI: 10.3390/ijerph17062087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
This narrative review aims to critically analyze the effects of exercise on health in aging. Here we discuss the main clinical and biomolecular modifications induced by long-term recreational football training in older subjects. In particular, the effects induced by long-term recreational football training on cardiovascular, metabolic and musculo-skeletal fitness, together with the modifications in the muscle expression of hallmarks related to oxidative metabolism, DNA repair and senescence suppression pathways and protein quality control mechanisms will be provided. All these topics will be debated also in terms of preventing non-communicable metabolic diseases, in order to achieve successful aging over time.
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Affiliation(s)
| | - Annamaria Mancini
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Stefania Orrù
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Daniela Vitucci
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Valeria Di Onofrio
- Department of Science and Technology, Università Parthenope, 80143 Naples, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Giuliana Salvatore
- IRCCS SDN, 80143 Naples, Italy; (E.I.); (G.S.)
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Pasqualina Buono
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
- Correspondence: (P.B.); (A.A.)
| | - Andreina Alfieri
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
- Correspondence: (P.B.); (A.A.)
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Davison S, Chen L, Gray D, McEnroe B, O'Brien I, Kozerski A, Caruso J. Exercise-based correlates to calcaneal osteogenesis produced by a chronic training intervention. Bone 2019; 128:115049. [PMID: 31454536 DOI: 10.1016/j.bone.2019.115049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 11/29/2022]
Abstract
Thirty workouts on a gravity-independent device (Impulse Training Systems, Newnan GA) evoked significant calcaneal bone mineral content (BMC, +29%) and density (BMD, +33%) gains. High speeds and impact loads were produced per repetition. We examined exercise performance variables from the 30-workout intervention to identify correlates to delta (∆) calcaneal BMC and BMD variance. Workouts included hip extension and seated calf press exercises done with subject's left legs. ∆ values were obtained from the first and 12th workouts for the hip extension movement, and for the first and 24th workouts for the seated calf press exercise. Per exercise the following variables were quantified: peak force (∆PF), peak acceleration (∆PA), impulse (∆I), and dwell times (∆DT). Dwell times are the elapsed time between the end of the eccentric phase, and the start of the next repetition's concentric phase. Pearson Coefficients assessed correlations between performance and criterion variables. With hip extension ∆DT calculated with data from the first and 12th workouts, there were significant correlations with calcaneal ∆BMC (r = -0.64) and ∆BMD (r = -0.63). With seated calf press ∆DT derived as the difference from the first and 24th workouts, there was a significant correlation with calcaneal ∆BMC (r = -0.48), but only a trend (r = -0.45) with ∆BMD as the criterion. No other variables correlated with significant amounts of calcaneal ∆BMC and ∆BMD variance. Negative correlations infer shorter dwell times evoked greater gains. The gravity-independent device warrants continued inquiry to treat and abate calcaneal losses.
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Affiliation(s)
- Steve Davison
- Impulse Training Systems, Newnan, GA 30263, United States of America
| | - Ling Chen
- University of Louisville, Louisville, KY 40292, United States of America
| | - Dane Gray
- University of Louisville, Louisville, KY 40292, United States of America
| | - Bailey McEnroe
- University of Louisville, Louisville, KY 40292, United States of America
| | - Ian O'Brien
- University of Louisville, Louisville, KY 40292, United States of America
| | - Amy Kozerski
- University of Louisville, Louisville, KY 40292, United States of America
| | - John Caruso
- University of Louisville, Louisville, KY 40292, United States of America.
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5
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Kurosaka S, Ueda T, Yamasaki Y, Tanigashira A, Deguchi T, Okihara K, Yuzaki Y. Effect of the "Building Osteo Neatly Exercise" program on quantitative ultrasound parameters and plantar pressure distribution for college-aged females. J Phys Ther Sci 2019; 31:717-723. [PMID: 31631944 PMCID: PMC6751051 DOI: 10.1589/jpts.31.717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/15/2019] [Indexed: 01/23/2023] Open
Abstract
[Purpose] We investigated the effects of a specifically designed exercise program that focused on the arches of the foot and the forefoot (the "Building Osteo Neatly Exercise" program) in college-aged females. [Participants and Methods] Forty college-aged females were divided randomly into experimental and control groups. The experimental group underwent the Building Osteo Neatly Exercise program for 60 min once a week for 4 months. In both groups, the plantar pressure distribution and quantitative ultrasound parameters of the calcaneus (speed of sound and bone area ratio) were evaluated at the beginning and end of the study. The plantar pressure distribution during walking was measured using a pressure plate to evaluate the deviation from the ideal values for the following: contact time, contact duration, peak pressure time, and foot pressure, all measured in the rear foot (the external and internal sides), medial forefoot including (the hallux and second and third toes), and lateral forefoot (the fourth and fifth toes). [Results] After completing the program, the speed of sound and bone area ratio had increased significantly in the experimental group and were significantly higher than those in the control group. The experimental group showed significant improvements in the deviations from the ideal values in contact time and contact duration in the medial forefoot, all four parameters in the lateral forefoot, and pressure in the rear foot. [Conclusion] College-aged females who participated in the Building Osteo Neatly Exercise program once weekly for 4 months exhibited significant improvements in bone strength in the calcaneus and in foot function, as shown by the plantar pressure distribution. Further studies are needed to examine the outcomes of the Building Osteo Neatly Exercise program in an elderly population.
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Affiliation(s)
- Shiho Kurosaka
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
| | - Takeshi Ueda
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
| | - Yuko Yamasaki
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
| | - Ayumi Tanigashira
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
| | - Tatsuya Deguchi
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
| | - Ken Okihara
- Department of Education, Hiroshima University: 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima 739-8527, Japan
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6
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Montgomery G, Abt G, Dobson C, Smith T, Evans W, Ditroilo M. The mechanical loading and muscle activation of four common exercises used in osteoporosis prevention for early postmenopausal women. J Electromyogr Kinesiol 2018; 44:124-131. [PMID: 30611015 DOI: 10.1016/j.jelekin.2018.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/18/2022] Open
Abstract
High impact exercise can reduce postmenopausal bone loss, however stimulus frequency (loading cycles per second) can affect osteogenesis. We aimed to examine the effect of stimulus frequency on the mechanical loading of four common osteoporosis prevention exercises, measuring body acceleration and muscle activation with accelerometry and electromyography (EMG), respectively. Fourteen early postmenopausal women completed randomised countermovement jumps (CMJ), box-drops (BD), heel-drops (HD) and stamp (STP) exercises for continuous and intermittent stimulus frequencies. Sacrum accelerometry and surface electromyography (EMG) of four muscles were recorded. CMJ (mean ± SD: 10.7 ± 4.8 g & 10.0 ± 5.0 g), BD (9.6 ± 4.1 g & 9.5 ± 4.0 g) and HD (7.3 ± 3.8 g & 8.6 ± 4.4 g) conditions generated greater peak acceleration than STP (3.5 ± 1.4 g & 3.6 ± 1.7 g) across continuous and intermittent trials. CMJ and BD generated greater acceleration gradients than STP across continuous and intermittent trials. CMJ generated greater rectus femoris EMG than all other exercises, CMJ and BD generated greater semitendinosus and tibialis anterior EMG than HD across continuous and intermittent trials. CMJ and BD provide greater peak acceleration than STP and remain similar during different stimulus frequencies. CMJ, BD and HD may exceed STP in maintaining postmenopausal bone health.
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Affiliation(s)
- G Montgomery
- Musculoskeletal Science and Sports Medicine, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK.
| | - G Abt
- School of Life Sciences, The University of Hull, Hull, UK
| | - C Dobson
- School of Engineering and Computer Science, The University of Hull, Hull, UK
| | - T Smith
- Faculty of Education, Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - W Evans
- University of Sunderland, Faculty of Applied Sciences, Department of Sport and Exercise Sciences, Sunderland, UK
| | - M Ditroilo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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A systematic review of the exercise effect on bone health: the importance of assessing mechanical loading in perimenopausal and postmenopausal women. Menopause 2018; 24:1208-1216. [PMID: 28538603 DOI: 10.1097/gme.0000000000000872] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aims of this systematic review were to determine the general effects of exercise on areal bone mineral density (BMD) in perimenopausal and postmenopausal women, and to provide information on the most suitable bone-loading exercise regimens that may improve bone health in this population group. METHODS A computerized, systematic literature search was performed in the electronic databases PubMed, Web of Science, CINAHL, SPORTDiscus, and The Cochrane Library, from January 2005 to November 2015, to identify all randomized controlled trials related to exercise in perimenopausal and postmenopausal women. The initial search identified 915 studies, with a final yield of 10 studies. Only randomized controlled trials that examined the effects of exercise programs longer than 24 weeks in women aged 35 to 70 years were included. The 10 studies quantified at least BMD and described training variables adequately (training period, frequency, volume, intensity). RESULTS Ten studies with moderate quality evidence (6.4 ± 1.8 points, range 4-9) were included. Significant changes in lumbar and femoral neck BMD were found mainly with high-impact exercise and whole body vibration interventions. CONCLUSIONS While training effects must be interpreted with caution because of the heterogeneity of the protocols and exercises performed, this systematic review confirmed the effectiveness of impact exercises combined with other forms of training (vibration or strength training) to preserve BMD in perimenopausal and postmenopausal women. Despite the results possibly not representing a general dose-response relationship, we highlight the importance of quantifying loading intensity and frequency by means of accelerometry as these parameters are determinants for bone adaptation.
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Hannam K, Deere KC, Hartley A, Al-Sari UA, Clark EM, Fraser WD, Tobias JH. Habitual levels of higher, but not medium or low, impact physical activity are positively related to lower limb bone strength in older women: findings from a population-based study using accelerometers to classify impact magnitude. Osteoporos Int 2017; 28:2813-2822. [PMID: 27966105 PMCID: PMC5624975 DOI: 10.1007/s00198-016-3863-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/29/2016] [Indexed: 12/16/2022]
Abstract
UNLABELLED This study assessed the effect of accelerometry-measured higher impacts resulting from habitual weight-bearing activity on lower limb bone strength in older women. Despite higher impacts being experienced rarely in this population-based cohort, positive associations were observed between higher vertical impacts and lower limb bone size and strength. INTRODUCTION We investigated whether the benefit of habitual weight-bearing physical activity (PA) for lower limb bone strength in older women is explained by exposure to higher impacts, as previously suggested by observations in younger individuals. METHODS Four hundred and eight women from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), mean 76.8 years, wore tri-axial accelerometers at the waist for a mean of 5.4 days. Y-axis peaks were categorised, using previously identified cutoffs, as low (0.5-1.0 g), medium (1.0-1.5 g), and higher (≥1.5 g) impacts. Mid and distal peripheral quantitative computed tomography scans of the tibia and radius were performed, as were hip and lumbar spine Dual X-ray Absorptiometry (DXA) scans. Regressions between (log transformed) number of low, medium and high impacts, and bone outcomes were adjusted for artefact error grade, age, height, fat and lean mass and impacts in other bands. RESULTS Eight thousand eight hundred and nine (4047, 16,882) low impacts were observed during the measurement week, 345 (99, 764) medium impacts and 42 (17, 106) higher impacts (median with 25th and 75th quartiles). Higher vertical impacts were positively associated with lower limb bone strength as reflected by cross-sectional moment of inertia (CSMI) of the tibia [0.042 (0.012, 0.072) p = 0.01] and hip [0.067 (0.001, 0.133) p = 0.045] (beta coefficients show standard deviations change per doubling in impacts, with 95 % confidence interval). Higher impacts were positively associated with tibial periosteal circumference (PC) [0.015 (0.003, 0.027) p = 0.02], but unrelated to hip BMD. Equivalent positive associations were not seen for low or medium impacts. CONCLUSIONS Despite their rarity, habitual levels of higher impacts were positively associated with lower limb bone size and strength, whereas equivalent relationships were not seen for low or medium impacts.
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Affiliation(s)
- K Hannam
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK
| | - K C Deere
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK
| | - A Hartley
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK
| | - U A Al-Sari
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK
| | - E M Clark
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK
| | | | - J H Tobias
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Southmead Hospital, Bristol, BS10 5NB, UK.
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9
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Measurement of peak impact loads differ between accelerometers - Effects of system operating range and sampling rate. J Biomech 2017; 58:222-226. [PMID: 28528873 DOI: 10.1016/j.jbiomech.2017.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/17/2017] [Accepted: 04/24/2017] [Indexed: 11/22/2022]
Abstract
A wide variety of accelerometer systems, with differing sensor characteristics, are used to detect impact loading during physical activities. The study examined the effects of system characteristics on measured peak impact loading during a variety of activities by comparing outputs from three separate accelerometer systems, and by assessing the influence of simulated reductions in operating range and sampling rate. Twelve healthy young adults performed seven tasks (vertical jump, box drop, heel drop, and bilateral single leg and lateral jumps) while simultaneously wearing three tri-axial accelerometers including a criterion standard laboratory-grade unit (Endevco 7267A) and two systems primarily used for activity-monitoring (ActiGraph GT3X+, GCDC X6-2mini). Peak acceleration (gmax) was compared across accelerometers, and errors resulting from down-sampling (from 640 to 100Hz) and range-limiting (to ±6g) the criterion standard output were characterized. The Actigraph activity-monitoring accelerometer underestimated gmax by an average of 30.2%; underestimation by the X6-2mini was not significant. Underestimation error was greater for tasks with greater impact magnitudes. gmax was underestimated when the criterion standard signal was down-sampled (by an average of 11%), range limited (by 11%), and by combined down-sampling and range-limiting (by 18%). These effects explained 89% of the variance in gmax error for the Actigraph system. This study illustrates that both the type and intensity of activity should be considered when selecting an accelerometer for characterizing impact events. In addition, caution may be warranted when comparing impact magnitudes from studies that use different accelerometers, and when comparing accelerometer outputs to osteogenic impact thresholds proposed in literature.
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10
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Hannam K, Deere KC, Hartley A, Clark EM, Coulson J, Ireland A, Moss C, Edwards MH, Dennison E, Gaysin T, Cooper R, Wong A, McPhee JS, Cooper C, Kuh D, Tobias JH. A novel accelerometer-based method to describe day-to-day exposure to potentially osteogenic vertical impacts in older adults: findings from a multi-cohort study. Osteoporos Int 2017; 28:1001-1011. [PMID: 27798733 PMCID: PMC5306163 DOI: 10.1007/s00198-016-3810-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/12/2016] [Indexed: 10/26/2022]
Abstract
UNLABELLED This observational study assessed vertical impacts experienced in older adults as part of their day-to-day physical activity using accelerometry and questionnaire data. Population-based older adults experienced very limited high-impact activity. The accelerometry method utilised appeared to be valid based on comparisons between different cohorts and with self-reported activity. INTRODUCTION We aimed to validate a novel method for evaluating day-to-day higher impact weight-bearing physical activity (PA) in older adults, thought to be important in protecting against osteoporosis, by comparing results between four cohorts varying in age and activity levels, and with self-reported PA levels. METHODS Participants were from three population-based cohorts, MRC National Survey of Health and Development (NSHD), Hertfordshire Cohort Study (HCS) and Cohort for Skeletal Health in Bristol and Avon (COSHIBA), and the Master Athlete Cohort (MAC). Y-axis peaks (reflecting the vertical when an individual is upright) from a triaxial accelerometer (sampling frequency 50 Hz, range 0-16 g) worn at the waist for 7 days were classified as low (0.5-1.0 g), medium (1.0-1.5 g) or higher (≥1.5 g) impacts. RESULTS There were a median of 90, 41 and 39 higher impacts/week in NSHD (age 69.5), COSHIBA (age 76.8) and HCS (age 78.5) participants, respectively (total n = 1512). In contrast, MAC participants (age 68.5) had a median of 14,322 higher impacts/week. In the three population cohorts combined, based on comparison of beta coefficients, moderate-high-impact activities as assessed by PA questionnaire were suggestive of stronger association with higher impacts from accelerometers (0.25 [0.17, 0.34]), compared with medium (0.18 [0.09, 0.27]) and low impacts (0.13 [0.07,0.19]) (beta coefficient, with 95 % CI). Likewise in MAC, reported moderate-high-impact activities showed a stronger association with higher impacts (0.26 [0.14, 0.37]), compared with medium (0.14 [0.05, 0.22]) and low impacts (0.03 [-0.02, 0.08]). CONCLUSIONS Our new accelerometer method appears to provide valid measures of higher vertical impacts in older adults. Results obtained from the three population-based cohorts indicate that older adults generally experience very limited higher impact weight-bearing PA.
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Affiliation(s)
- K Hannam
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - K C Deere
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - A Hartley
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - E M Clark
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK
| | - J Coulson
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - A Ireland
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - C Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - T Gaysin
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - R Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - A Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - J S McPhee
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - D Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, WC1E 6BT, UK
| | - J H Tobias
- Musculoskeletal Research Unit, University of Bristol School of Clinical Sciences, Bristol, BS10 5NB, UK.
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Short Duration Small Sided Football and to a Lesser Extent Whole Body Vibration Exercise Induce Acute Changes in Markers of Bone Turnover. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3574258. [PMID: 28025642 PMCID: PMC5153460 DOI: 10.1155/2016/3574258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/11/2016] [Accepted: 11/03/2016] [Indexed: 12/24/2022]
Abstract
We aimed to study whether short-duration vibration exercise or football sessions of two different durations acutely changed plasma markers of bone turnover and muscle strain. Inactive premenopausal women (n = 56) were randomized to complete a single bout of short (FG15) or long duration (FG60) small sided football or low magnitude whole body vibration training (VIB). Procollagen type 1 amino-terminal propeptide (P1NP) was increased during exercise for FG15 (51.6 ± 23.0 to 56.5 ± 22.5 μg·L−1, mean ± SD, P < 0.05) and FG60 (42.6 ± 11.8 to 50.2 ± 12.8 μg·L−1, P < 0.05) but not for VIB (38.8 ± 15.1 to 36.6 ± 14.7 μg·L−1, P > 0.05). An increase in osteocalcin was observed 48 h after exercise (P < 0.05), which did not differ between exercise groups. C-terminal telopeptide of type 1 collagen was not affected by exercise. Blood lactate concentration increased during exercise for FG15 (0.6 ± 0.2 to 3.4 ± 1.2 mM) and FG60 (0.6 ± 0.2 to 3.3 ± 2.0 mM), but not for VIB (0.6 ± 0.2 to 0.8 ± 0.4 mM) (P < 0.05). Plasma creatine kinase increased by 55 ± 63% and 137 ± 119% 48 h after FG15 and FG60 (P < 0.05), but not after VIB (26 ± 54%, NS). In contrast to the minor elevation in osteocalcin in response to a single session of vibration exercise, both short and longer durations of small sided football acutely increased plasma P1NP, osteocalcin, and creatine kinase. This may contribute to favorable effects of chronic training on musculoskeletal health.
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Montgomery G, Abt G, Dobson C, Smith T, Ditroilo M. Tibial impacts and muscle activation during walking, jogging and running when performed overground, and on motorised and non-motorised treadmills. Gait Posture 2016; 49:120-126. [PMID: 27400020 DOI: 10.1016/j.gaitpost.2016.06.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/02/2016] [Accepted: 06/27/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To examine tibial acceleration and muscle activation during overground (OG), motorised treadmill (MT) and non-motorised treadmill conditions (NMT) when walking, jogging and running at matched velocities. METHODS An accelerometer recorded acceleration at the mid-tibia and surface EMG electrodes recorded rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA) and soleus (SL) muscle activation during OG, MT and NMT locomotion whilst walking, jogging and running. RESULTS The NMT produced large reductions in tibial acceleration when compared with OG and MT conditions across walking, jogging and running conditions. RF EMG was small-moderately higher in the NMT condition when compared with the OG and MT conditions across walking, jogging and running conditions. ST EMG showed large and very large increases in the NMT when compared to OG and MT conditions during walking whilst SL EMG found large increases on the NMT when compared to OG and MT conditions during running. The NMT condition generated very large increases in step frequency when compared to OG and MT conditions during walking, with large and very large decreases during jogging and very large decreases during running. CONCLUSIONS The NMT generates large reductions in tibial acceleration, moderate to very large increases in muscular activation and large to very large decreases in cycle time when compared to OG and MT locomotion. Whilst this may decrease the osteogenic potential of NMT locomotion, there may be uses for NMTs during rehabilitation for lower limb injuries.
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Affiliation(s)
- G Montgomery
- Sport, Health and Exercise Science Department, University of Hull, Hull, UK.
| | - G Abt
- Sport, Health and Exercise Science Department, University of Hull, Hull, UK
| | - C Dobson
- School of Engineering, University of Hull, Hull, UK
| | - T Smith
- Faculty of Education, Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - M Ditroilo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Taylor P, Vincent H, Atkins S, Sinclair J. Acute exposure to foot orthoses affects joint stiffness characteristics in recreational male runners. COMPARATIVE EXERCISE PHYSIOLOGY 2015. [DOI: 10.3920/cep150006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Commercially available foot orthoses are advocated for the treatment of chronic running injuries, such as patellofemoral pain, yet the mechanisms behind their effects are not well understood. This study aimed to examine the limb and joint stiffness characteristics when running with and without orthotics. Twelve recreational runners ran at 4.0 m/s. Limb stiffness was obtained using a spring-mass model of running by dividing the peak vertical ground reaction force (GRF) by the amount of limb compression. Knee and ankle joint stiffness’s were calculated by dividing the peak sagittal plane joint moment by the joint angular excursion. Differences between orthotic and non-orthotic running conditions were contrasted using paired samples t-tests. The results indicate that both peak knee extensor moment (orthotic = 2.74±0.57 and no-orthotic = 3.12±0.62 Nm/kg) and knee stiffness (orthotic = 5.56±1.08 and no-orthotic = 6.47±1.40 Nm/kg rad) were significantly larger when running without orthotics. This study may give further insight into the mechanical effects of commercially available foot orthoses. The current investigation provides some evidence to suggest that orthoses may be able to improve patellofemoral pathologies in recreational runners although further investigation is required.
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Affiliation(s)
- P.J. Taylor
- School of Psychology, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom
| | - H. Vincent
- Division of Sport Exercise and Nutritional Sciences, School of Sport Tourism and Outdoors, University of Central Lancashire, Fylde road, Preston PR1 2HE, United Kingdom
| | - S. Atkins
- Division of Sport Exercise and Nutritional Sciences, School of Sport Tourism and Outdoors, University of Central Lancashire, Fylde road, Preston PR1 2HE, United Kingdom
| | - J. Sinclair
- Division of Sport Exercise and Nutritional Sciences, School of Sport Tourism and Outdoors, University of Central Lancashire, Fylde road, Preston PR1 2HE, United Kingdom
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14
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Lee KM, Kwon SS, Chung CY, Lee SY, Kim TG, Choi Y, Park MS. Gender- and body-site-specific factors associated with bone mineral density in a non-institutionalized Korean population aged ≥50 years. J Bone Miner Metab 2015; 33:401-9. [PMID: 25001078 DOI: 10.1007/s00774-014-0600-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
Abstract
The aim of this study was to investigate the gender- and body-site-specific factors associated with bone mineral density (BMD) at the femoral neck and lumbar spine in a non-institutionalized population aged ≥50 years characterized by low average calcium intake. The comprehensive data utilized were from the 2010 Fifth Korea National Health and Nutrition Examination Survey, which included health behavior questionnaire, blood and urine tests, dual-energy X-ray absorptiometry, and nutrition intake. The factors associated with BMD at the femoral neck and lumbar spine in both genders were analyzed separately using multiple regression analysis with a stepwise selection. The average daily calcium intake in the male subjects was 565.8 mg and in the female subjects was 443.7 mg. In multiple regression analysis, age, body mass index (BMI), alkaline phosphatase (ALP), lead, daily calcium intake, and cadmium were the significant factors associated with femoral neck BMD in male subjects. BMI, creatinine (Cr), total body fat percentile, lead, ALP, and hypertension were found to be the significant factors associated with lumbar spine BMD in male subjects. In the female subjects, the significant factors associated with femoral neck BMD were age, BMI, ALP, house income, and total body fat percentile, while menopause, Cr, mercury, house income, BMI, and ALP were found to be the significant factors associated with lumbar spine BMD. In conclusion, different factors were associated with BMD depending on gender and the body site tested (femoral neck or lumbar spine). These gender- and body-site-specific factors need to be considered for the prevention and management of osteoporosis.
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Affiliation(s)
- Kyoung Min Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki, 463-707, South Korea
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Nyland J, Wera J, Henzman C, Miller T, Jakob R, Caborn DNM. Preserving knee function following osteoarthritis diagnosis: a sustainability theory and social ecology clinical commentary. Phys Ther Sport 2014; 16:3-9. [PMID: 25165013 DOI: 10.1016/j.ptsp.2014.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 07/21/2014] [Accepted: 07/23/2014] [Indexed: 02/09/2023]
Abstract
To sustain natural systems, there must be an ongoing balance between environmental, social, and economic considerations. A key element of sustainability theory is to identify the most vulnerable surroundings. The most vulnerable knee tissue is the articular cartilage as it is the last line of osteoarthritis (OA) defense. This tissue has a poor capacity for healing. Based on sustainability theory and social ecology concepts we propose that several key factors contribute to knee function preservation. Factors include health history, genetic predisposition, personal behaviors, and socio-environmental factors in addition to local-regional-global physiological system function. Addressing only some of these factors or any one factor in isolation may lead to less than optimal treatment effectiveness. The purpose of this commentary is to introduce a medical, surgical and rehabilitation management approach for patients with knee OA that considers more than physical function improvement. This approach also considers social, emotional, and environmental factors to better ensure patient satisfaction, fulfilled expectations and successful outcomes. A clinical care pathway is presented for a 57-year-old patient with medial compartment knee OA who is contemplating early arthroplasty versus a knee function preservation treatment approach. Early arthroplasty refers to high revision likelihood based on a minimum 15 year prosthesis life-expectancy.
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Affiliation(s)
- J Nyland
- Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, First Floor ACB, 550 S. Jackson St., Louisville, KY, 40202, USA.
| | - J Wera
- Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, First Floor ACB, 550 S. Jackson St., Louisville, KY, 40202, USA
| | - C Henzman
- Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, First Floor ACB, 550 S. Jackson St., Louisville, KY, 40202, USA
| | - T Miller
- Department of Education, School and Counseling Psychology, University of Kentucky, Lexington, KY, 40506, USA
| | - R Jakob
- Orthopadie FMH, 1787 Motier (Vully), Switzerland
| | - D N M Caborn
- Division of Sports Medicine, Department of Orthopaedic Surgery, University of Louisville, First Floor ACB, 550 S. Jackson St., Louisville, KY, 40202, USA
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Kelley S, Hopkinson G, Strike S, Luo J, Lee R. An accelerometry-based approach to assess loading intensity of physical activity on bone. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2014; 85:245-250. [PMID: 25098020 DOI: 10.1080/02701367.2014.897680] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The purpose was to develop a new method for assessing the potential bone-loading intensities of different locomotion activities by using accelerometers. METHOD Thirty participants (women, N = 19; men, N = 11) with an average age of 40 years (SD = 18 years), performed 8 activities (3 self-selected speeds of walking, 3 self-selected speeds of running, and ascending and descending stairs) in the workplace or at home while wearing an accelerometer. The loading intensity for each activity was calculated from measured acceleration by a new method that considers both loading magnitude and frequency. A 1-way repeated-measures analysis of variance was employed to examine whether type of activity had any significant influence on the loading intensity. RESULTS The 8 activities showed different loading intensities (p < .001, partial eta2 = .87). Running had higher loading intensity than walking and ascending or descending stairs (p < .05, Cohen's d = 1.79). The higher the speed of walking or running, the higher the loading intensity (p < .05, Cohen's d = 1.15). The increase of loading intensity in different activities was induced by both the increase of loading magnitude and the shift of loading frequency. CONCLUSIONS This study developed a new method to measure loading intensity of physical activity on bone by using an accelerometer. This method can provide new insight for the assessment of exercise intensity in relation to bone health.
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STILES VICTORIAH, GRIEW PIPPAJ, ROWLANDS ALEXV. Use of Accelerometry to Classify Activity Beneficial to Bone in Premenopausal Women. Med Sci Sports Exerc 2013; 45:2353-61. [DOI: 10.1249/mss.0b013e31829ba765] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Fong Yan A, Sinclair PJ, Hiller C, Wegener C, Smith RM. Impact attenuation during weight bearing activities in barefoot vs. shod conditions: a systematic review. Gait Posture 2013; 38:175-86. [PMID: 23245643 DOI: 10.1016/j.gaitpost.2012.11.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 08/26/2012] [Accepted: 11/17/2012] [Indexed: 02/02/2023]
Abstract
Although it could be perceived that there is extensive research on the impact attenuation characteristics of shoes, the approach and findings of researchers in this area are varied. This review aimed to clarify the effect of shoes on impact attenuation to the foot and lower leg and was limited to those studies that compared the shoe condition(s) with barefoot. A systematic search of the literature yielded 26 studies that investigated vertical ground reaction force, axial tibial acceleration, loading rate and local plantar pressures. Meta-analyses of the effect of shoes on each variable during walking and running were performed using the inverse variance technique. Variables were collected at their peak or at the impact transient, but when grouped together as previous comparisons have done, shoes reduced local plantar pressure and tibial acceleration, but did not affect vertical force or loading rate for walking. During running, shoes reduced tibial acceleration but did not affect loading rate or vertical force. Further meta-analyses were performed, isolating shoe type and when the measurements were collected. Athletic shoes reduced peak vertical force during walking, but increased vertical force at the impact transient and no change occurred for the other variables. During running, athletic shoes reduced loading rate but did not affect vertical force. The range of variables examined and variety of measurements used appears to be a reason for the discrepancies across the literature. The impact attenuating effect of shoes has potentially both adverse and beneficial effects depending on the variable and activity under investigation.
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Affiliation(s)
- Alycia Fong Yan
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Australia.
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Babatunde OO, Forsyth JJ. Quantitative Ultrasound and bone's response to exercise: a meta analysis. Bone 2013; 53:311-8. [PMID: 23269404 DOI: 10.1016/j.bone.2012.12.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 11/20/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022]
Abstract
UNLABELLED The utility of Quantitative Ultrasound (QUS) for assessing and monitoring changes in bone health due to exercise is limited for lack of adequate research evidence. Restrictions to bone density testing and the enduring debate over repeat dual energy absorptiometry testing spells uncertainty over clinical and non-clinical evaluation of exercise for prevention of osteoporosis. This study, via systematic review and meta-analysis, aimed to paint a portrait of current evidence regarding QUS' application to monitoring bone's adaptive response to exercise interventions. METHODS Structured and comprehensive search of databases was undertaken along with hand-searching of key journals and reference lists to locate relevant studies published up to December 2011. Twelve articles met predetermined inclusion criteria. The effect of exercise interventions for improving bone health, as measured by QUS of the calcaneum, was examined across the age spectrum. Study outcomes for analysis: absolute (dB/MHz) or relative change (%) in broadband ultrasound attenuation (BUA) and/or os calcis stiffness index were compared by calculating standardised mean difference (SMD) using fixed- and random-effects models. RESULTS Quality of included trials varied from low to high on a scale of one to three. Four to 36months of exercise led to a significant improvement in calcaneum BUA (0.98 SMD, 95% CI 0.80, 1.16, overall effect Z-value=10.72, p=0.001) across the age spectrum. CONCLUSION The meta-analysis attests to the sensitivity of QUS to exercise-induced changes in bone health across the age groups. QUS may be considered for use in exercise-based bone health interventions for preventing osteoporosis.
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Affiliation(s)
- O O Babatunde
- School of Psychology, Sport and Exercise, Staffordshire University, Stoke on Trent, UK.
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20
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Rowlands A, Stiles V. Accelerometer counts and raw acceleration output in relation to mechanical loading. J Biomech 2012; 45:448-54. [DOI: 10.1016/j.jbiomech.2011.12.006] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 12/01/2011] [Accepted: 12/06/2011] [Indexed: 11/16/2022]
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Eleftheriou KI, Rawal JS, Kehoe A, James LE, Payne JR, Skipworth JR, Puthucheary ZA, Drenos F, Pennell DJ, Loosemore M, World M, Humphries SE, Haddad FS, Montgomery HE. The Lichfield bone study: the skeletal response to exercise in healthy young men. J Appl Physiol (1985) 2011; 112:615-26. [PMID: 22114178 DOI: 10.1152/japplphysiol.00788.2011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The skeletal response to short-term exercise training remains poorly described. We thus studied the lower limb skeletal response of 723 Caucasian male army recruits to a 12-wk training regime. Femoral bone volume was assessed using magnetic resonance imaging, bone ultrastructure by quantitative ultrasound (QUS), and bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) of the hip. Left hip BMD increased with training (mean ± SD: 0.85 ± 3.24, 2.93 ± 4.85, and 1.89 ± 2.85% for femoral neck, Ward's area, and total hip, respectively; all P < 0.001). Left calcaneal broadband ultrasound attenuation rose 3.57 ± 0.5% (P < 0.001), and left and right femoral cortical volume by 1.09 ± 4.05 and 0.71 ± 4.05%, respectively (P = 0.0001 and 0.003), largely through the rise in periosteal volume (0.78 ± 3.14 and 0.59 ± 2.58% for right and left, respectively, P < 0.001) with endosteal volumes unchanged. Before training, DXA and QUS measures were independent of limb dominance. However, the dominant femur had higher periosteal (25,991.49 vs. 2,5572 mm(3), P < 0.001), endosteal (6,063.33 vs. 5,983.12 mm(3), P = 0.001), and cortical volumes (19,928 vs. 19,589.56 mm(3), P = 0.001). Changes in DXA, QUS, and magnetic resonance imaging measures were independent of limb dominance. We show, for the first time, that short-term exercise training in young men is associated not only with a rise in human femoral BMD, but also in femoral bone volume, the latter largely through a periosteal response.
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Affiliation(s)
- Kyriacos I Eleftheriou
- UCL Centre for Health and Human Performance, University College London Hospitals, London
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Jämsä T, Ahola R, Korpelainen R. Measurement of osteogenic exercise - how to interpret accelerometric data? Front Physiol 2011; 2:73. [PMID: 22028693 PMCID: PMC3198512 DOI: 10.3389/fphys.2011.00073] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 10/03/2011] [Indexed: 12/02/2022] Open
Abstract
Bone tissue adapts to its mechanical loading environment. We review here the accelerometric measurements with special emphasis on osteogenic exercise. The accelerometric method offers a unique opportunity to assess the intensity of mechanical loadings. We present methods to interpret accelerometric data, reducing it to the daily distributions of magnitude, slope, area, and energy of signal. These features represent the intensity level of physical activities, and were associated with the changes in bone density, bone geometry, physical performance, and metabolism in healthy premenopausal women. Bone adaptations presented a dose- and intensity dependent relationship with impact loading. Changes in hip were threshold dependent, indicating the importance of high-impacts exceeding acceleration of 4 g or slope of 100 g/s as an osteogenic stimulus. The number of impacts needed was 60/day. We also present the daily impact score to describe the osteogenic potential of daily mechanical loading with a single score. The methodology presented here can be used to study musculoskeletal adaptation to exercise in other target groups as well.
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Affiliation(s)
- Timo Jämsä
- Department of Medical Technology, Institute of Biomedicine, University of Oulu Oulu, Finland
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Whiteley R, Adams R, Ginn K, Nicholson L. Playing level achieved, throwing history, and humeral torsion in Masters baseball players. J Sports Sci 2011; 28:1223-32. [PMID: 20694888 DOI: 10.1080/02640414.2010.498484] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Humeral torsion is thought to be beneficial for throwing. To examine this hypothesis, the throwing and non-throwing arms of 84 Masters baseball players over 35 years of age were measured for humeral torsion, and the highest playing level they achieved and their playing history were recorded. Regression analyses were used to obtain predictors of the highest playing level achieved, throwing arm humeral torsion, and side-to-side difference in humeral torsion. Equations accounting for 36%, 46%, and 12% of the variance respectively were produced. Achieving representative level playing status was associated with the number of seasons played under 16 years of age and having greater throwing arm humeral retrotorsion. Throwing arm humeral retrotorsion was associated with non-throwing arm humeral retrotorsion and an increased number of seasons played before the age of 16 years. A model in which repeated throwing develops an adaptive unilateral bone torsion along with growth in baseball expertise is proposed. Thus dominant arm humeral retrotorsion is a predictor of highest baseball playing level achieved, which in turn is influenced by genetic endowment (as seen in the torsion of the non-throwing arm) and amount of throwing activity, particularly prior to the age of 16.
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Affiliation(s)
- Rod Whiteley
- Physiotherapy, University of Sydney, Forresters Beach, NSW 2260, Australia.
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Waddington G, Dickson T, Trathen S, Adams R. Walking for fitness: is it enough to maintain both heart and bone health? Aust J Prim Health 2011; 17:86-8. [DOI: 10.1071/py10035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 11/22/2010] [Indexed: 11/23/2022]
Abstract
Exercising at levels of whole body accelerations exceeding 3.6 g has been shown to have positive effects on cardiovascular fitness, bone density and balance. This pilot research project evaluated the whole body accelerations and cardiovascular challenge provided by selected walks in the Canberra region of Australia to determine if walks could be ranked according to potential level of impact on both cardiovascular fitness and bone health. Nine participants, who described themselves as walking at least 3 km, three times per week, wore a data logging device recording heart rate, acceleration and GPS position while walking three outdoor tracks: (1) the running track of an athletics stadium; (2) on a hill climb path through bushland; and (3) on a route through suburban streets. There was a significant difference (P < 0.05) for heart rate, distribution of whole body accelerations and average walking speed between track 2 and tracks 1 and 3. There was a significant difference for heart rate, distribution of whole body accelerations and average walking speed between the walks. The running track and the suburban walk provide a moderate exercise challenge, with the hill climb walk providing progressively greater vertical height challenge, resulting in an increased cardiovascular exercise challenge. No participant effectively exceeded the threshold for achieving a positive impact on bone density (100 or more accelerations/day >3.6 g) on track 1, and only two of the nine participants intermittently achieved this threshold on tracks 2 and 3.
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Abstract
As anterior cruciate ligament (ACL) reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training.
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Affiliation(s)
- John Nyland
- Department of Orthopaedic Surgery, Division of Sports Medicine, University of Louisville, Louisville, KY, USA
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Osseous deficits after anterior cruciate ligament injury and reconstruction: a systematic literature review with suggestions to improve osseous homeostasis. Arthroscopy 2010; 26:1248-57. [PMID: 20810081 DOI: 10.1016/j.arthro.2010.03.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 03/21/2010] [Accepted: 03/23/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE This systematic review was performed to improve our understanding of the current evidence regarding the influence of anterior cruciate ligament (ACL) injury and reconstruction on involved lower extremity apparent bone mineral density, bone content, or bone area mass (bone integrity). METHODS Two independent reviewers performed a Medline search from 1966 to January 2010 using the terms "anterior cruciate ligament" or "ACL" combined with "wound" or "injury" and "bone density" or "osteoporosis." Study inclusion criteria were English-language human studies. Reference sections of selected studies were also reviewed. RESULTS Ten studies were identified that met our inclusion criteria. Eight studies performed ACL reconstruction with bone-patellar tendon-bone autografts and interference screw fixation. One study performed ACL reconstruction by use of Achilles tendon allografts with interference screw and staple fixation. Two ACL injury studies either did not involve ACL reconstruction or attempted primary repair with sutures. All studies reported varying levels of decreased bone mineral density, bone content, or bone area mass (bone integrity) at the involved lower extremity after ACL injury that did not return to premorbid levels even with ACL reconstruction and rehabilitation. Sites of reduced bone integrity included the proximal and distal femur, proximal tibia, patella, and calcaneus. Bone loss was increased with limited weight bearing and prolonged disuse or immobilization; however, significant improvements were not observed with accelerated rehabilitation. Some studies reported relations between Lysholm, Tegner, International Knee Documentation Committee survey, or function scores and bone integrity, whereas others reported no or poor relations. CONCLUSIONS Involved lower extremity bone integrity is decreased after ACL injury. Current evidence suggests that premorbid bone integrity is not re-established after ACL reconstruction even when accelerated rehabilitation is performed. Recommendations to improve osseous homeostasis and bone health after ACL injury and reconstruction are provided.
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Rantalainen T, Nikander R, Heinonen A, Multanen J, Häkkinen A, Jämsä T, Kiviranta I, Linnamo V, Komi PV, Sievänen H. Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women. Bone 2010; 46:964-9. [PMID: 20064632 DOI: 10.1016/j.bone.2010.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 12/22/2009] [Accepted: 01/05/2010] [Indexed: 12/31/2022]
Abstract
The strong association between body mass and skeletal robusticity has been attributed to increasing skeletal loading with increasing mass. However, it is unclear whether body mass is merely a coarse substitute for bone loading rather than a true independent predictor of bone strength. As indices of neuromuscular performance, impulse and peak power were determined from vertical ground reaction force during a maximal counter movement jump test in 221 premenopausal and 82 postmenopausal women. Bone compressive (BSI(d) g(2)/cm(4)) and bending (SSImax(mid) mm(3)) strength indices were measured with peripheral quantitative computed tomography (pQCT) at the distal ((d)) and midshaft ((mid)) sites of the tibia. A two-step forced regression model for predicting bone strength indices was constructed. Age, height and body mass were entered first, followed by impulse as an indicator of skeletal loading. The basic model explained 14% (P<0.001) of the variance in BSI(d) in the premenopausal group and 16% (P=0.004) in the postmenopausal group, and 32% (P<0.001) and 25% (P<0.001) of the variance in SSImax(nud) respectively. Entering impulse into the model increased the explanatory power by 9% (P<0.001) and 7% (P<0.001) for BSI(d) and by 8% (P<0.001) and 12% (P<0.001) for SSImax(mid). Furthermore, impulse replaced body mass as an independent significant factor explaining the variance in bone strength. These results indicate that neuromuscular performance should be measured and preferred over body mass in models predicting skeletal robusticity.
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Affiliation(s)
- Timo Rantalainen
- Department of Biology of Physical Activity, University of Jyväskylä, Finland.
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Dériaz O, Najafi B, Ballabeni P, Crettenand A, Gobelet C, Aminian K, Rizzoli R, Gremion G. Proximal tibia volumetric bone mineral density is correlated to the magnitude of local acceleration in male long-distance runners. J Appl Physiol (1985) 2010; 108:852-7. [PMID: 20133440 DOI: 10.1152/japplphysiol.00865.2009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The beneficial effect of physical exercise on bone mineral density (BMD) is at least partly explained by the forces exerted directly on the bones. Male runners present generally higher BMD than sedentary individuals. We postulated that the proximal tibia BMD is related to the running distance, as well as to the magnitude of the shocks (while running) in male runners. A prospective study (three yearly measurements) included 81 healthy male subjects: 16 sedentary lean subjects, and 3 groups of runners (5-30 km/wk, n = 19; 30-50 km/wk, n = 29; 50-100 km/wk, n = 17). Several measurements were performed at the proximal tibia level: volumetric BMD (vBMD) and cortical index (CI), i.e., an index of cortical bone thickness and peak accelerations (an index of shocks during heel strike) while running (measured by a three-dimensional accelerometer). A general linear model assessed the prediction of vBMD or CI by 1) simple effects (running distance, peak accelerations, time); and 2) interactions (for instance, if vBMD prediction by peak acceleration depends on running distance). CI and vBMD 1) increase with running distance to reach a plateau over 30 km/wk; and 2) are positively associated with peak accelerations over 30 km/wk. Running may be associated with high peak accelerations to have beneficial effects on BMD. More important strains are needed to be associated with the same increase in BMD during running sessions of short duration than those of long duration. CI and vBMD are associated with the magnitude of the shocks during heel strike in runners.
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Affiliation(s)
- Olivier Dériaz
- Institut de Recherche en Réadaptation et Clinique Romande de Réadaptation, SUVAcare, Sion, Switzerland.
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Ahola R, Korpelainen R, Vainionpää A, Leppäluoto J, Jämsä T. Time-course of exercise and its association with 12-month bone changes. BMC Musculoskelet Disord 2009; 10:138. [PMID: 19909496 PMCID: PMC2784429 DOI: 10.1186/1471-2474-10-138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Accepted: 11/12/2009] [Indexed: 11/23/2022] Open
Abstract
Background Exercise has been shown to have positive effects on bone density and strength. However, knowledge of the time-course of exercise and bone changes is scarce due to lack of methods to quantify and qualify daily physical activity in long-term. The aim was to evaluate the association between exercise intensity at 3, 6 and 12 month intervals and 12-month changes in upper femur areal bone mineral density (aBMD) and mid-femur geometry in healthy premenopausal women. Methods Physical activity was continuously assessed with a waist-worn accelerometer in 35 healthy women (35-40 years) participating in progressive high-impact training. To describe exercise intensity, individual average daily numbers of impacts were calculated at five acceleration levels (range 0.3-9.2 g) during time intervals of 0-3, 0-6, and 0-12 months. Proximal femur aBMD was measured with dual x-ray absorptiometry and mid-femur geometry was evaluated with quantitative computed tomography at the baseline and after 12 months. Physical activity data were correlated with yearly changes in bone density and geometry, and adjusted for confounding factors and impacts at later months of the trial using multivariate analysis. Results Femoral neck aBMD changes were significantly correlated with 6 and 12 months' impact activity at high intensity levels (> 3.9 g, r being up to 0.42). Trochanteric aBMD changes were associated even with first three months of exercise exceeding 1.1 g (r = 0.39-0.59, p < 0.05). Similarly, mid-femoral cortical bone geometry changes were related to even first three months' activity (r = 0.38-0.52, p < 0.05). In multivariate analysis, 0-3 months' activity did not correlate with bone change at any site after adjusting for impacts at later months. Instead, 0-6 months' impacts were significant correlates of 12-month changes in femoral neck and trochanter aBMD, mid-femur bone circumference and cortical bone attenuation even after adjustment. No significant correlations were found at the proximal or distal tibia. Conclusion The number of high acceleration impacts during 6 months of training was positively associated with 12-month bone changes at the femoral neck, trochanter and mid-femur. These results can be utilized when designing feasible training programs to prevent bone loss in premenopausal women. Trial registration Clinical trials.gov NCT00697957
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Affiliation(s)
- Riikka Ahola
- Department of Medical Technology, Institute of Biomedicine, University of Oulu, Finland.
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Caruso JF, Hari P, Leeper AE, Coday MA, Monda JK, Ramey ES, Hastings LP, Golden MR, Davison SW. Impact of Acceleration on Blood Lactate Values Derived From High-Speed Resistance Exercise. J Strength Cond Res 2009; 23:2009-14. [DOI: 10.1519/jsc.0b013e3181b3dce7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Vainionpää A, Korpelainen R, Väänänen HK, Haapalahti J, Jämsä T, Leppäluoto J. Effect of impact exercise on bone metabolism. Osteoporos Int 2009; 20:1725-33. [PMID: 19262975 DOI: 10.1007/s00198-009-0881-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 01/30/2009] [Indexed: 10/21/2022]
Abstract
SUMMARY Regular impact exercise in premenopausal women caused positive osteogenic effects associated to low basal serum parathormone (PTH) but had no effects on bone turnover markers PINP or TRACP5b. The low serum basal PTH levels during impact exercise may be a sign of increased incorporation of calcium to bone. INTRODUCTION This study aimed to determine the long-term effects of high-impact exercise on bone turnover and calciotropic hormones. METHODS We performed a 12-month population-based, randomized, controlled exercise trial in 120 women (age 35-40 years) randomly assigned to an exercise group (EG; n = 60) or a control group (CG; n = 60). The exercise regimen consisted of supervised high-impact exercises three times per week. Daily impact loading was assessed by using an accelerometer. Bone turnover markers and calciotropic hormones were analyzed at 0, 6, and 12 months. RESULTS Twelve months of impact exercise did not reveal any treatment effects in bone turnover markers PINP or TRAPC5b, whereas serum basal PTH decreased significantly more in the EG than in the CG (-11.2 vs. -2.2 pg/mL; p = 0.03). The change in PTH was dose dependent and most clearly seen in subjects with 96 to 130 daily impacts at 2.5 to 5.3 g (e.g., running or jumping). CONCLUSIONS Regular impact exercise does not cause persistent alterations in bone turnover emphasizing necessity of continuous training to achieve bone benefits. Impact exercise training lowers the serum basal PTH levels and possibly enables greater difference between the basal PTH and transient exercise-induced PTH peaks leading to osteogenic effects.
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Affiliation(s)
- A Vainionpää
- Department of Medical Technology, Institute of Biomedicine, University of Oulu, Oulu, Finland.
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Nordström A, Högström M, Nordström P. Effects of different types of weight-bearing loading on bone mass and size in young males: a longitudinal study. Bone 2008; 42:565-71. [PMID: 18191629 DOI: 10.1016/j.bone.2007.11.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 11/08/2007] [Accepted: 11/20/2007] [Indexed: 11/20/2022]
Abstract
Whether different types of weight bearing loading have different effects on bone mineral accrual in young adults is not well investigated. We measured bone mineral density (BMD, g/cm(2)), bone mineral content (BMC, grams), and bone area (cm(2)) at different sites, in 46 ice hockey players, 18 badminton players and 27 controls, all 17 years of age. A follow up was conducted four years later. The gains in BMD and BMC of the femoral neck and in BMC of the humerus were significantly higher (p<0.05) in badminton players compared with controls during the follow-up time. The badminton players also gained more hip BMC and area compared with the ice hockey players (p<0.05). At the follow-up, the badminton players had higher BMD and BMC at all sites compared with controls (p<0.05). After adjustment for body weight, badminton players had higher hip BMD and BMC, femoral neck BMC, and humeral BMC compared with ice hockey players (p<0.05) at the follow-up. After adjustment for differences in age, there were no differences in BMC or BMD among fathers of badminton players, ice hockey players, or controls, suggesting an absence of selection bias. In conclusion, the novel results of the present study suggest that badminton is associated with higher gains in bone mass and size compared with ice hockey after puberty in men. These differences might be associated with higher strains on the bones from badminton play.
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Affiliation(s)
- Anna Nordström
- Department of Surgical and Perioperative Science, Umeå University, S-901 85 Umeå, Sweden.
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