Current risks factors and emerging biomarkers for bone stress injuries in military personnel

Greeves, Julie P.; Beck, Belinda Ruth; Nindl, Bradley C.; O’Leary, Thomas J.

doi:10.1016/j.jsams.2023.04.006

Cited by 9 publications

(7 citation statements)

References 118 publications

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“…Se define a las fracturas por estrés como aquellas fracturas producto de un esfuerzo repetitivo y sostenido en el tiempo que supera la capacidad fisiológica de adaptación y remodelado óseo. 1 Se trata de una entidad conocida, de la que hay múltiples estadísticas, difíciles de comparar entre sí, porque refieren que los pacientes realizaban entrenamiento militar, pero no explican en qué consiste, ni dan detalles importantes, como su frecuencia e intensidad. Tampoco hay consenso respecto al tratamiento.…”

Section: Discussionunclassified

Fracturas de tibia por estrés y hallazgos patológicos asociados en reclutas

Coria,

Fedún Rodríguez,

García

et al. 2024

Rev. Asoc. Arg. Ort. y Traumatol

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Introduction: Tibial stress fractures are a very common condition in military recruits. Our objective is to demonstrate that stress fractures are associated with other diseases. Materials and Methods: 42 stress fractures in 34 patients were retrospectively evaluated. Every patient had recently joined the Argentine Army and consulted for painful symptoms in the tibia. A clinical and scintigraphic diagnosis of stress fracture was made. Patient data, associated diseases, and risk factors were documented. Inclusion criteria: recent incorporation, same training, age between 16 and 23 years. Trauma, simulators, tumoral pathology, and cases with negative scintigraphy were excluded. Results: We studied 42 stress fractures in 34 patients, 14 were men and 20 were women. The average age was 20 years. There were no significant differences in the number of injuries regarding the affected limb. 64.7% had associated diseases, 73% in women and 27 % in men. Among the women with stress fractures, 80% had associated diseases, compared to 43% for men. Different diseases were found with lower limb varus and valgus imbalances. Varus was the most associated with fractures. Conclusions: A high rate of associated diseases was found in patients with tibial stress fractures with a predominance of lower limb varus imbalances. Associated diseases were more likely to be found in women with stress fractures than in men.

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Section: Discussionunclassified

Fracturas de tibia por estrés y hallazgos patológicos asociados en reclutas

Coria,

Fedún Rodríguez,

García

et al. 2024

Rev. Asoc. Arg. Ort. y Traumatol

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“…Factors secreted into the circulation following exercise by skeletal muscle fibers and other cell types, termed exerkines, are facilitators of local and systemic exercise adaptations. Acute and chronic RET alter circulating concentrations of multiple exerkines including growth factors, cytokines, and hormones such as growth hormone (GH), insulin‐like growth factor‐1 (IGF‐1), interleukin‐6 (IL‐6), brain‐derived neurotrophic factor (BDNF), irisin, sex steroids, and others (Chow et al., 2022; Greeves et al., 2023; Zunner et al., 2022). Sex‐based differences in exerkine responses exist, highlighted by greater IL‐6 and testosterone increases following acute exercise in men (Benini et al., 2015) and differential responses of IGF‐1 and GH at different timepoints following acute and chronic RET (Hatfield et al., 2021; Pierce et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Circulating extracellular vesicle characteristics differ between men and women following 12 weeks of concurrent exercise training

Kargl,

Sterczala,

Santucci

et al. 2024

Physiological Reports

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Concurrent resistance and endurance exercise training (CET) has well‐studied benefits; however, inherent hormonal and genetic differences alter adaptive responses to exercise between sexes. Extracellular vesicles (EVs) are factors that contribute to adaptive signaling. Our purpose was to test if EV characteristics differ between men and women following CET. 18 young healthy participants underwent 12‐weeks of CET. Prior to and following CET, subjects performed an acute bout of heavy resistance exercise (AHRET) consisting of 6 × 10 back squats at 75% 1RM. At rest and following AHRET, EVs were isolated from plasma and characteristics and miRNA contents were analyzed. AHRET elevated EV abundance in trained men only (+51%) and AHRET‐induced changes were observed for muscle‐derived EVs and microvesicles. There were considerable sex‐specific effects of CET on EV miRNAs, highlighted by larger variation following the 12‐week program in men compared to women at rest. Pathway analysis based on differentially expressed EV miRNAs predicted that AHRET and 12 weeks of CET in men positively regulates hypertrophy and growth pathways more so than in women. This report highlights sex‐based differences in the EV response to resistance and concurrent exercise training and suggests that EVs may be important adaptive signaling factors altered by exercise training.

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“…For example, training to improve strength and power has emerged as a priority among military populations in preparation for performing physically demanding operational tasks (Nindl et al., 2013 , 2016 ; Vaara et al., 2022 ). Notably, these same military populations are also at risk of poor bone health and bone stress injuries (Greeves et al., 2023 ; Koltun et al., 2022 ; Waterman et al., 2016 ). As such, it is important to understand how training programs designed to improve muscle strength and power may impact bone and bone metabolism.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to the direct effects of weight‐bearing physical activity to stimulate bone adaptation via mechanotransduction by bone cells, there can also be indirect effects via changes in the biochemical milieu. Myokines, such as insulin‐like growth factor 1 (IGF‐1) and irisin, are released following exercise and have been implicated in bone remodeling (Greeves et al., 2023 ; Kirk et al., 2020 ). Acute increases in IGF‐1 have been observed following a ballistic exercise bout in a combined sample of males and females, which was not influenced by 12 weeks of training (Sterczala et al., 2022 ), and in resistance trained males and females (Hatfield et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of acute resistance exercise on bone turnover in young adults before and after concurrent resistance and interval training

Koltun,

Sterczala,

Sekel

et al. 2024

Physiological Reports

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Weight‐bearing physical activity can stimulate bone adaptation. This investigation explored the effect of an acute bout of resistance exercise before and after resistance+interval training on circulating biomarkers of bone metabolism and muscle‐bone crosstalk. Healthy young male and female participants (n = 21 male, 28 ± 4 years; n = 17 female, 27 ± 5 years) performed a 6 × 10 squat test (75% 1RM) before and after a 12‐week resistance+interval training program. Before and after completion of the training program, blood samples were collected at rest, immediately postexercise, and 2 h postexercise. Blood samples were analyzed for βCTX, P1NP, sclerostin, osteocalcin, IGF‐1, and irisin. Significant effects of acute exercise (main effect of time) were observed as increases in concentrations of IGF‐1, irisin, osteocalcin, and P1NP from rest to postexercise. A sex*time interaction indicated a greater decline in βCTX concentration from rest to 2 h postexercise and a greater increase in sclerostin concentration from rest to immediately postexercise in male compared with female participants. Sex differences (main effect of sex) were also observed for irisin and P1NP concentrations. In summary, changes in concentrations of biochemical markers of bone metabolism and muscle‐bone crosstalk were observed in males and females after an acute bout of resistance exercise and following 12 weeks of resistance+interval training.

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Current risks factors and emerging biomarkers for bone stress injuries in military personnel

Cited by 9 publications

References 118 publications

Fracturas de tibia por estrés y hallazgos patológicos asociados en reclutas

Fracturas de tibia por estrés y hallazgos patológicos asociados en reclutas

Circulating extracellular vesicle characteristics differ between men and women following 12 weeks of concurrent exercise training

Effect of acute resistance exercise on bone turnover in young adults before and after concurrent resistance and interval training

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