Bone Mass in Lifetime Tennis Athletes

131

The aim of the study was to analyze the relation between sports and bone mass. Seven hundred and four men with no history of chronic disease were questioned on their adolescent and adult sporting activities. Their total body (TB) and regional (head, spine, arms and legs) bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry. BMD measurements and ratios of regional BMD to TB BMD were compared using a multiple regression analysis. Probands (mean age 30 years) were engaged in 14 sports activities: rugby, soccer, other team sports, endurance running, fighting sports, bodybuilding, multiple weightbearing activities, swimming, swimming with flippers, biking, rowing, climbing, triathlon and multiple mixed activities. They stated that they were practising a physical activity at the amateur level: 7.1 h/week between the ages of 11 and 18 years and 9 h/week between age 18 years and the day of the interview (no significant difference between physical activities). Rowers and swimmers had low TB BMD (1.22 and 1.17 g/cm2) and low leg BMD (1.37 and 1.31 g/cm2). Participants in rugby, soccer, other team sports and fighting sports had a high TB BMD (1.27-1.35 g/cm2) and high leg BMD (1.41-1.5 g/cm2). For head BMD, there was no stastistical difference among the different groups. Constructed ratios pointed out the site-specific adaptation of the skeleton: soccer player and runners had a higher leg ratio; bodybuilders, fighters, climbers and swimmers had a higher arm ratio; rugby players had a higher spine ratio. Head ratio was higher in non-weightbearing sports (rowing, swimming) than in weightbearing sports (rugby, team sports, soccer, fighting sports and bodybuilding). Thus the BMD and ratio differences among the 14 disciplines seem to be site-specific and related to the supposedly high and unusual strains created at certain sites during sport training by muscle stress and gravitational forces. Head ratio is closely related to the type of practice; its value could predict whether sport participants have developed the maximal peak bone mass they could achieve.

Section: Discussionsupporting

confidence: 87%

Bone Mineral Density of 704 Amateur Sportsmen Involved in Different Physical Activities

Morel

Combe

Francisco

et al. 2001

131

“…These studies have shown differences in appendicular bone mass of as much as 25% between affected and unaffected limbs. The converse of this is found in athletes who use their limbs asymmetrically in sporting activity, for example tennis players, who have substantially greater bone mineral content in the serving forearm than in the contralateral forearm [15].…”

Section: Discussionmentioning

confidence: 97%

An Investigation of the Diagnostic Value of Bilateral Femoral Neck Bone Mineral Density Measurements

Petley

Taylor

Murrills

et al. 2000

This paper describes a study to assess the clinical value of bilateral femoral neck bone mineral density (BMD) measurements. Although a range of factors will determine clinical decisions, the classification of the site with the lowest T-score is likely to have significant bearing on the management of a patient. While it is common practice to measure BMD at the lumbar spine and a single neck of femur, knowledge of the BMD of the second femur may also be of diagnostic value. Using dual-energy X-ray absorptiometry, BMD of the lumbar spine and right and left femoral neck was measured in a group of 2372 white, Caucasian women (mean age +/- SD, 56.6 +/- 13.9 years) routinely referred for bone densitometry. Analysis of the measurements showed a significant (p = 0.02) but small difference between the mean BMD of the right (0.840 +/- 0.152 g/cm2) and left (0.837 +/- 0.150 g/cm2) femoral neck. Further investigation of femur scans revealed 79 (3.3%) patients in whom one side was osteoporotic while the other side and spine were normal or osteopenic using the World Health Organization diagnostic criteria in combination with manufacturer's reference data. Patients in whom the femoral neck BMD measurements differed by less than the precision error of the system were then excluded. This left only 51 (2.2%) patients, that is 29 (1.2%) for right femur and spine scan and 22 (0.9%) for left femur and spine scan, in whom knowledge of both femoral neck BMD measurements could have altered the classification of the lowest site assessed to osteoporotic. These data suggest that there is only a small benefit from performing bilateral femoral neck BMD measurements. Since BMD measurements are only one of a range of factors considered as part of a patient's management, it is suggested that the extra time, cost and radiation dose associated with measurement of the second femur may not be justified.

“…Evidence demonstrating the importance of exercise for the skeleton comes from immobilization and bedrest studies [21,22], cross-sectional studies showing that physically active subjects have significant higher BMD than age-matched sedentary controls [for overview see, for example, 18,[23][24][25], and within-subject studies indicating that athletes have greater bone mass in their dominant playing extremity than in their nondominant one [26,27]. The only study design that allows causal inferences, however, is the controlled intervention trial, especially when the groups are formed by randomization.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Exercise Training Programs on Bone Mass: A Meta-analysis of Published Controlled Trials in Pre- and Postmenopausal Women

Wolff

Croonenborg

Kemper

et al. 1999

508

281

With the aging of the population, the medical and social costs of skeletal fragility leading to fractures will cause an immense burden on society unless effective prophylactic and therapeutic regimens can be developed. Exercise is suggested as a possible regimen against involutional bone loss. The purpose of the present meta-analysis is to address a quantitative review of the randomized controlled trials (RCTs) and nonrandomized controlled trials (CTs) on the effects of exercise training programs on bone mass, measured as bone mineral density (BMD) or bone mineral content (BMC), of the lumbar spine (LS) and the femoral neck (FN) in pre- and postmenopausal women. The literature from 1966 through December 1996 was searched for published RCTs and CTs. Study treatment effect is defined as the difference between percentage change in bone mass per year in the training group and the control group. Overall treatment effects (OTs) with the 95% confidence intervals of these study treatment effects were calculated using inverse-variance weighting. Of the 62 articles identified, 25 met the inclusion criteria and were maintained for further analyses. The weighted OTs for the RCTs showed very consistently that the exercise training programs prevented or reversed almost 1% of bone loss per year in both LS and FN for both pre- and postmenopausal women. The two OTs that could be calculated for strength training programs did not reach significance. The OTs for the CTs were almost twice as high as those for the RCTs, which gives an indication of the confounding introduced by the nonrandom allocation of the subjects to groups.