Exercise in the Prevention of Osteoporosis-Related Fractures

Beck, Belinda R.; Winters-Stone, Kerri M.

doi:10.1007/978-1-59745-459-9_9

Cited by 3 publications

(2 citation statements)

References 238 publications

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“…Unloading the skeleton, for instance because of limb immobilization, prolonged bed rest, or spinal cord injury, causes bone loss. [ 3 ] However, the association of PA with bone mineral density (BMD) and bone microarchitecture depends on activity type, intensity, duration, and loading. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

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Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs

Nissen

Esser

Bui

et al. 2023

J of Bone & Mineral Res

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The reasons for the association between physical activity (PA) and bone microarchitecture traits are unclear. We examined whether these associations were consistent with causation and/or with shared familial factors using a cross-sectional study of 47 dizygotic and 93 monozygotic female twin pairs aged 31-77 years. Images of the nondominant distal tibia were obtained using high-resolutionperipheral quantitative computed tomography. The bone microarchitecture was assessed using StrAx1.0 software. Based on a self-completed questionnaire, a PA index was calculated as a weighted sum of weekly hours of light (walking, light gardening), moderate (social tennis, golf, hiking), and vigorous activity (competitive active sports) = light + 2 * moderate + 3 * vigorous. We applied Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) to test whether cross-pair cross-trait associations changed after adjustment for within-individual associations. Within-individual distal tibia cortical cross-sectional area (CSA) and cortical thickness were positively associated with PA (regression coefficients [β] = 0.20 and 0.22), while the porosity of the inner transitional zone was negatively associated with PA (β = À0.17), all p < 0.05. Trabecular volumetric bone mineral density (vBMD) and trabecular thickness were positively associated with PA (β = 0.13 and 0.14), and medullary CSA was negatively associated with PA (β = À0.22), all p ≤ 0.01. Cross-pair crosstrait associations of cortical thickness, cortical CSA, and medullary CSA with PA attenuated after adjustment for the within-individual association (p = 0.048, p = 0.062, and p = 0.028 for changes). In conclusion, increasing PA was associated with thicker cortices, larger cortical area, lower porosity of the inner transitional zone, thicker trabeculae, and smaller medullary cavities. The attenuation of cross-pair crosstrait associations after accounting for the within-individual associations was consistent with PA having a causal effect on the improved cortical and trabecular microarchitecture of adult females, in addition to shared familial factors.

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Section: Introductionmentioning

confidence: 99%

“…[ 3 ] However, the association of PA with bone mineral density (BMD) and bone microarchitecture depends on activity type, intensity, duration, and loading. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs

Nissen

Esser

Bui

et al. 2023

J of Bone & Mineral Res

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Osteoporosis: Nonpharmacologic Management

Kasturi

Adler

2011

PM&R

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Osteoporosis is a chronic disorder of the skeleton causing increased bone fragility and fractures. In the second of our 3-part series, we discuss the beneficial effects of nonpharmacologic agents in the management of osteoporosis. We review the evidence supporting the use of exercise, whole-body vibration, hip protectors, low-intensity pulsed ultrasound, bracing, and vertebral augmentation procedures. The mechanism of action, precautions, and expected outcomes are discussed. Nonpharmacologic management of osteoporosis blends in very well with an overall exercise prescription. The nonpharmacologic interventions discussed are readily available and easy to implement. The use of such techniques demonstrates the important role of the physiatrist in the management of osteoporosis.

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Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial

Simson

Miller

Ford³

et al. 2017

Trials

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BackgroundLower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain.Methods/designForty participants, 25–45 years old with chronic (>3 months), non-specific low back pain will be recruited. Participants will be randomised to receive either motor control and manual therapy (n = 20) or general strength and conditioning (n = 20) exercise treatments for 6 months. The motor control/manual therapy group will receive twelve 30-min sessions, ten in the first 3 months (one or two per week) and two in the last 3 months. The general exercise group will attend two 1-hour sessions weekly for 3 months, and one or two a week for the following 3 months. Primary outcome measures are average lumbar spine intervertebral disc T2 relaxation time and changes in thickness of the transversus abdominis muscle on a leg lift using magnetic resonance imaging (MRI). Secondary outcomes include muscle size and fat content, vertebral body fat content, intervertebral disc morphology and water diffusion measured by MRI, body composition using dual energy X-ray absorptiometry, physical function through functional tests, changes in corticospinal excitability and cortical motor representation of the spinal muscles using transcranial magnetic stimulation and self-reported measure of pain symptoms, health and disability. Outcome measures will be conducted at baseline, at the 3-month follow-up and at 6 months at the end of intervention. Pain, depressive symptomology and emotions will be captured fortnightly by questionnaires.DiscussionChronic low back pain is ranked the highest disabling disorder in Australia. The findings of this study will inform clinical practice guidelines to assist with decision-making approaches where outcomes beyond pain are sought for adults with chronic low back pain.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12615001270505. Registered on 20 November 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1913-8) contains supplementary material, which is available to authorized users.

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Exercise in the Prevention of Osteoporosis-Related Fractures

Cited by 3 publications

References 238 publications

Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs

Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs

Osteoporosis: Nonpharmacologic Management

Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial

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