Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Abe, Shinya; Narra, Nathaniel; Nikander, Riku; Hyttinen, Jari; Kouhia, Reijo; Sievänen, Harri

doi:10.1016/j.bone.2016.07.021

Cited by 20 publications

(30 citation statements)

References 65 publications

(117 reference statements)

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“…In the present study, the femoral neck PI in men was significantly higher than that in women, which was close to those of the inferior femoral neck porosity measurements reported by Bell et al As bone structure adapts to habitual mechanical loading, which is known to be a key stimulus for osteogenesis, the difference in the results between genders may be related to the differences in hip joint loads. Women have significantly greater hip flexion than men during walking, which may result in greater compression load on the inferior region of the femoral neck and reduction in cortical porosity .…”

Section: Discussionsupporting

confidence: 91%

“…27,28 However, significant individual variation exists in cortical bone porosity, especially in men: Low porosity has been noted in some elderly subjects, and high porosity has been observed in some young adults. 23,29 Similar results were reported by Tong et al, 30 who demonstrated that cortical porosity of the inferior femoral neck was higher in younger subjects than in older subjects. A positive correlation was observed between the tibial PI and age in postmenopausal women, which is in accordance with the effect of age on tibial porosity observed in previous studies.…”

Section: Discussionsupporting

confidence: 78%

“…The femoral neck PI demonstrated a negative correlation with age in men, which contradicts the findings of most previous studies . However, significant individual variation exists in cortical bone porosity, especially in men: Low porosity has been noted in some elderly subjects, and high porosity has been observed in some young adults . Similar results were reported by Tong et al, who demonstrated that cortical porosity of the inferior femoral neck was higher in younger subjects than in older subjects.…”

Section: Discussionsupporting

confidence: 42%

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Assessment of porosity index of the femoral neck and tibia by 3D ultra‐short echo‐time MRI

Chen

Yuan

2017

Magnetic Resonance Imaging

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 42%

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Assessment of porosity index of the femoral neck and tibia by 3D ultra‐short echo‐time MRI

Chen

Yuan

2017

Magnetic Resonance Imaging

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“…It also raises the question as to whether physical activity–induced bone adaptation occurs at this location. Initial studies using three‐dimensional (3D) imaging techniques have explored adaptation of the superior femoral neck to physical activity, but the data remain inconclusive . Some studies suggested physical activity may positively influence the superior femoral neck, whereas others reported no effect …”

Section: Introductionmentioning

confidence: 99%

“…Initial studies using three-dimensional (3D) imaging techniques have explored adaptation of the superior femoral neck to physical activity, but the data remain inconclusive. (15)(16)(17)(18) Some studies suggested physical activity may positively influence the superior femoral neck, (15,16) whereas others reported no effect. (17,18) The aim of the current study was to explore spatial adaptation of the proximal femur to chronic physical activity and to evaluate whether adaptation occurred at the superior femoral neck and influenced strength under loading from a fall onto the greater trochanter.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneous Spatial and Strength Adaptation of the Proximal Femur to Physical Activity: A Within-Subject Controlled Cross-Sectional Study

Warden

Carballido‐Gamio

Weatherholt

et al. 2019

Journal of Bone and Mineral Research

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Physical activity (PA) enhances proximal femur bone mass, as assessed using projectional imaging techniques. However, these techniques average data over large volumes, obscuring spatially heterogeneous adaptations. The current study used quantitative computed tomography, statistical parameter mapping, and subject‐specific finite element (FE) modeling to explore spatial adaptation of the proximal femur to PA. In particular, we were interested in adaptation occurring at the superior femoral neck and improving strength under loading from a fall onto the greater trochanter. High/long jump athletes (n = 16) and baseball pitchers (n = 16) were utilized as within‐subject controlled models as they preferentially load their take‐off leg and leg contralateral to their throwing arm, respectively. Controls (n = 15) were included but did not show any dominant‐to‐nondominant (D‐to‐ND) leg differences. Jumping athletes showed some D‐to‐ND leg differences but less than pitchers. Pitchers had 5.8% (95% confidence interval [CI] 3.9%–7.6%) D‐to‐ND leg differences in total hip volumetric bone mineral density (vBMD), with increased vBMD in the cortical compartment of the femoral neck and trochanteric cortical and trabecular compartments. Voxel‐based morphometry analyses and cortical bone mapping showed pitchers had D‐to‐ND leg differences within the regions of the primary compressive trabeculae, inferior femoral neck, and greater trochanter but not the superior femoral neck. FE modeling revealed pitchers had 4.1% (95% CI 1.4%–6.7%) D‐to‐ND leg differences in ultimate strength under single‐leg stance loading but no differences in ultimate strength to a fall onto the greater trochanter. These data indicate the asymmetrical loading associated with baseball pitching induces proximal femur adaptation in regions associated with weight bearing and muscle contractile forces and increases strength under single‐leg stance loading. However, there were no benefits evident at the superior femoral neck and no measurable improvement in ultimate strength to common injurious loading during aging (ie, fall onto the greater trochanter), raising questions as to how to better target these variables with PA. © 2019 American Society for Bone and Mineral Research.

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Do bone geometric properties of the proximal femoral diaphysis reflect loading history, muscle properties, or body dimensions?

Niinimäki

Narra

Härkönen

et al. 2019

American J Hum Biol

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Objectives: The aim of this study was to investigate activity-induced effects from bone geometric properties of the proximal femur in athletic vs nonathletic healthy females by statistically controlling for variation in body size, lower limb isometric, and dynamic muscle strength, and cross-sectional area of Musculus gluteus maximus. Methods: The material consists of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in either high jump, triple jump, soccer, squash, powerlifting, endurance running or swimming, and a group of physically active nonathletic women (N = 20). Cross-sectional bone geometric properties were calculated for the lesser trochanter, sub-trochanter, and mid-shaft of the femur regions. Bone geometric properties were analyzed using a general linear model that included body size, muscle size, and muscle strength as covariates. Results: Body size and isometric muscle strength were positively associated with bone geometric properties at all three cross-sectional levels of the femur, while muscle size was positively associated with bone properties only at the femur mid-shaft. When athletes were compared to nonathletic females, triple jump, soccer, and squash resulted in greater values in all studied cross-sections; high jump and endurance running resulted in greater values at the femoral mid-shaft cross-section; and swimming resulted in lower values at sub-trochanter and femur mid-shaft cross-sections. Conclusions: Activity effects from ground impact loading were associated with higher bone geometric values, especially at the femur mid-shaft, but also at lesser and sub-trochanter cross-sections. Bone geometric properties along the femur can be used to assess the mechanical stimuli experienced, where ground impact loading seems to be more important than muscle loading.

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Exercise loading history and femoral neck strength in a sideways fall: A three-dimensional finite element modeling study

Cited by 20 publications

References 65 publications

Assessment of porosity index of the femoral neck and tibia by 3D ultra‐short echo‐time MRI

Assessment of porosity index of the femoral neck and tibia by 3D ultra‐short echo‐time MRI

Heterogeneous Spatial and Strength Adaptation of the Proximal Femur to Physical Activity: A Within-Subject Controlled Cross-Sectional Study

Do bone geometric properties of the proximal femoral diaphysis reflect loading history, muscle properties, or body dimensions?

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