Habitual levels of high, but not moderate or low, impact activity are positively related to hip BMD and strength: Results from a population-based study of adolescents

Deere, KC; Sayers, Adrian; Rittweger, Jörn; Tobias, Jon

doi:10.1016/j.bone.2012.02.616

Cited by 4 publications

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“…Overall, previous studies that aimed to understand the relationship between sport in young people and bone health used ionizing imaging tools, such as DXA (Morris et al, 2000;Matthews et al, 2006;Deere et al, 2012;Ito et al, 2017;Júnior et al, 2017;McVeigh et al, 2019). There has been an increasing interest in the use of heel ultrasound as an alternative assessment of bone density, which also provides structural information of bones.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Non-elite Sporting Activity and Calcaneal Bone Density in Adolescents and Young Adults: A Narrative Systematic Review

et al. 2020

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Introduction: Osteoporotic fractures represent a major public health burden. The risk of fragility fractures in late adulthood is strongly impacted by peak bone mass acquisition by the third decade. Weight-bearing sporting activity may be beneficial to peak bone mass accrual, but previous studies have focused on elite sporting activity and have used dual energy X-ray absorptiometry as a measure of bone density. The authors performed a narrative systematic review of individual sports (performed non-competitively or at local level) and calcaneal quantitative ultrasound (cQUS) bone measures in young people. Methods: Multiple databases were systematically searched up until the 31st of March 2019. The authors included studies of participants' mean age (11-35 years), reporting any level of recreational sporting activity and cQUS measures as well as excluding elite/professional sporting physical activity. Studies (title and abstract) were screened independently by two reviewers, and a third reviewer resolved any discrepancies. STROBE guidelines were used to check the reporting of observational studies. The Newcastle-Ottawa Scale was used to assess the risk of bias of the studies included in the review. The systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO). Results: A search yielded 29,512 articles that considered relationships between bone density assessed by any technique and sporting activity. Duplicate and out of scope abstracts were removed. This left 424 papers that were screened by two reviewers; of these, six met the inclusion criteria, including assessment by cQUS. The authors identified papers where sports were considered, included soccer (football), swimming, cycling, gymnastics, dancing, badminton, basketball, fencing, wrestling, and judokas. Although study heterogeneity prohibited meta-analysis, all six included studies reported significant benefits of weight-bearing non-elite sports on cQUS outcomes. Conclusion: Our study found beneficial effects of non-elite sports participation on cQUS in adolescence and young adulthood, although further work is now indicated.

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Section: Introductionmentioning

confidence: 99%

The Relationship Between Non-elite Sporting Activity and Calcaneal Bone Density in Adolescents and Young Adults: A Narrative Systematic Review

et al. 2020

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“…Ambulation level in myelomeningocele is positively associated with bone mass and mineral density (BMD) [3,4,5]. Comparatively, in typically developing (TD) adolescents, BMD is positively associated with Gross Motor Score at 18-months [6], and high levels of physical activity at 17 years, but not medium or low levels of physical activity [7]. Differences in tibia cross-sectional geometry have also been observed in children with spina bifida paralysis shortly after birth, suggesting that genetics, prenatal loading, and/or nonambulatory loading contribute to bone shape as well [8].…”

Section: Introductionmentioning

confidence: 99%

Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development

Chadwick

Mueske

Horenstein

et al. 2018

Bone

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Skeletal loading through daily movement is an important factor in the normal development of bones. This loading is affected by the neurological and muscle deficits that result from myelominingocele (MM). While children with MM have been shown to have atypical gait, decreased bone accrual, and increased fracture risk, it is still unclear what morphological bone differences exist and to what extent they relate to physical developmental and ambulation level. This study analyzed computed tomography images of the tibia from 77 children with MM and 124 typically developing (TD) children between the ages of 6 and 16 years. Differences in cross-sectional roundness along the length of the tibia diaphysis were observed across developmental stages (pre-pubertal, pubertal, post-pubertal) and ambulation level (MM non-ambulatory, MM assistive devices, MM independent, and TD). The results showed that tibia cross-sectional morphology becomes less round with development in TD children (p < 0.017). In children with MM, however, roundness is maintained throughout adolescence (p > 0.017), with greater roundness in less ambulatory children (p < 0.0083). These in vivo results align with mechanobiological modeling studies suggesting that intracortical loads (caused by joint loading) as well as periosteal loads (imposed by surrounding muscles) are critical in promoting non-circular cross-sectional bone shape remodeling.

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“…Overall, previous studies that aimed to understand the relationship between sport in young people and bone health used ionising imaging tools, such as DXA (Deere et al, 2012b;Matthews et al, 2006;. There has been an increasing interest in the use of heel ultrasound as an alternative assessment of bone density that also provides structural information of the bone.…”

Section: Introductionmentioning

confidence: 99%

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

Patel¹

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<p>Osteoporosis is a major worldwide public health problem through its association with fragility fracture. Acquisition of peak bone mass (PBM) is an important contributor to later osteoporosis risk and may be modified by lifestyle factors, including habitual recreational sporting activity (HRSA). Previous studies that have considered the relationship between HRSA and bone health have focused on older people, elite sporting activity and used dual energy X-ray absorptiometry as a measure of bone density, rather than calcaneal quantitative ultrasound (cQUS), the outcome measure in this study. This research is important because it considers younger adults, to determine relationships between HRSA and bone health in adolescents and young adults, and the factors that affect their engagement with HRSA. In this thesis we consider the relationship between HRSA and bone health in three separate studies, reported as four manuscripts: (1) a systematic literature review of studies that considered relationships between non-elite sporting activity and bone health in adolescents and young adults as assessed by calcaneal heel ultrasound; (2) a quantitative study of 452 adolescents and young adults aged 16 to 35 years, who completed a questionnaire detailing sporting activity and relevant lifestyle confounders and underwent heel ultrasound measurements; and (3) nine focus groups of young adults to better understand their knowledge of bone health, the factors that impact it, and the barriers and facilitators to increasing HRSA. The results of the systematic literature review suggested that the available literature was scarce, with few studies focusing on relationships between HRSA and cQUS in adolescents and young adults. The studies available were too heterogeneous to perform a meta-analysis although, through a narrative synthesis, we reported that all six studies included in the systematic literature review reported significant benefits from weight-bearing HRSA on cQUS outcomes. In the quantitative study, selected bone cQUS parameters were positively associated with: BMI (SI- stiffness index, BUA-broadband ultrasound attenuation, and T-score); physical activity (SI, SOS-speed of sound, BUA, and T-score); and past HRSA score (SOS only), with weight-bearing sporting activity such as running (SI and SOS), soccer (SI and BUA) and rugby (T-score and Z-score) associated with better bone health. This study also reported that lifetime sport participation typically declined after individuals’ mid-teens. The qualitative study suggested that knowledge of PBM and risk of osteoporotic fracture were limited in the young adult age group. There was a general awareness of the positive and negative impacts of many lifestyle behaviours such as physical activity, diet, tobacco smoking and alcohol consumption on health in general, but not specifically how these impact PBM and good bone health in later life. Furthermore three main barriers to sports participation that emerged were: a) structural (disorientation in a new living environment, facilities, access to healthcare); b) social (financial and time constraints); and c) personal (social pressures and lack of an understanding of why sporting activity matters for bone health). On the other hand, enablers of sports participation included: a) supportive environments; b) access to health checks including support to avoid injury; and c) education to better understand the benefits of HRSA. In conclusion, HRSA that is of higher impact appears to be associated with more favourable bone health as assessed by heel ultrasound, but few studies have adequately considered these relationships. The quantitative study performed as part of this thesis provides further evidence that high impact HRSA is associated with more favourable bone health in adolescence and early adulthood, and while participation in sport in New Zealand is common until late teens, subsequently HRSA often decreases during the window of PBM acquisition. Knowledge of factors impacting bone health is poor, and barriers and facilitators to HRSA have been identified. Further work to consider how best to address these knowledge and evidence gaps is now warranted, including focus on young school to early adulthood populations to reduce their future fragility fracture risk.</p>

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Habitual levels of high, but not moderate or low, impact activity are positively related to hip BMD and strength: Results from a population-based study of adolescents

Cited by 4 publications

References 0 publications

The Relationship Between Non-elite Sporting Activity and Calcaneal Bone Density in Adolescents and Young Adults: A Narrative Systematic Review

The Relationship Between Non-elite Sporting Activity and Calcaneal Bone Density in Adolescents and Young Adults: A Narrative Systematic Review

Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

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