Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures

Heinonen, Ari; Kannus, Pekka; Sievänen, Harri; Oja, Pekka; Pasanen, Matti; Rinne, Marjo; Uusi‐Rasi, Kirsti; Vuori, Ilkka

doi:10.1016/s0140-6736(96)04214-6

Cited by 400 publications

(300 citation statements)

References 31 publications

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“…Our findings are in accordance with observational studies and intervention trials showing that muscle mass primarily affects bone size and not volumetric density in the loaded skeletal sites [11,12]. Furthermore, our findings are concordant with studies showing that testosterone positively affects bone mineral density [16].…”

Section: Discussionsupporting

confidence: 92%

“…There is strong evidence that exercise is beneficial to the skeleton, probably because it is associated with a substantial increment of the mechanical stimulation of bone both directly and indirectly through the enhancement of muscle strength [11]. Accordingly, it has been demonstrated that strength training reduces the risk of fractures and slows down the ageassociated decline of mineral density [12].…”

Section: Introductionmentioning

confidence: 99%

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Correlates of bone quality in older persons

Lauretani

Bandinelli²,

Russo

et al. 2006

Bone

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Purpose of the study-In a population-based sample of older persons, we studied the relationship between tibial bone density and geometry and factors potentially affecting osteoporosis.Methods-Of the 1260 participants aged 65 years or older eligible for the InCHIANTI study, 1155 received an interview and 915 (79.2%) had complete data on tibial QCTscans and other variables used in the analysis presented here. The final study population included 807 persons (372 men and 435 women, age range 65-96 years) after exclusion of participants affected by bone diseases or treated with drugs that interfere with bone metabolism.Results-In both sexes, calf cross-sectional muscle area (CSMA) was significantly and independently associated with total bone cross-sectional area (tCSA) and cortical bone crosssectional area (cCSA) but not with trabecular or cortical volumetric bone mineral density (vBMD). Bioavailable testosterone (Bio-T) was independently associated with both trabecular and cortical vBMD in both sexes. In women, independently of confounders, 25(OH)-vitamin D was positively associated with tCSA and cortical vBMD, while PTH was negatively associated with cortical vBMD. IL-1 beta was negatively correlated with cortical vBMD in women, while TNF-alpha was associated with enhanced bone geometrical adaptation in men.Conclusions-Physiological parameters that are generically considered risk factors for osteoporosis were associated with specific bone parameters assessed by tibial QCT. Factors known to be associated with increased bone reabsorption, such as 25(OH)-vitamin D, PTH and Bio-T, affected mainly volumetric BMD, while factors associated with bone mechanical stimulation, such as CSMA, affected primarily bone geometry. Our results also suggested that pro-inflammatory cytokines might be considered as markers of bone resorption.*Corresponding

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Correlates of bone quality in older persons

Lauretani

Bandinelli²,

Russo

et al. 2006

Bone

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“…The so far published prospective controlled exercise intervention studies, most elegant support this view (14)(15)(16)(18)(19)(20), whereas similar effects could not be found in the post-pubertal period (12). Furthermore, published data indicate that the physical activity ought to include high-impact activities (21)(22)(23)(24) and that the training should probably be initiated before or in early puberty (25), if the purpose is to reach the most beneficial anabolic skeletal effects. There is also evidence that moderate intense school-based physical education classes do increase the level of physical activity and improve the physical fitness (26).…”

Section: Introductionmentioning

confidence: 99%

Daily Physical Education in the School Curriculum in Prepubertal Girls during 1 Year is Followed by an Increase in Bone Mineral Accrual and Bone Width—Data from the Prospective Controlled Malmö Pediatric Osteoporosis Prevention Study

et al. 2006

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The aim of this study was to evaluate a general school-based one-year exercise intervention program in a population-based cohort of girl at Tanner stage I. Fifty-three girls aged 7 to 9 years were included. The school curriculum based exercise intervention program included 40 minutes per school day. Fifty healthy age-matched girls assigned to the general school curriculum of 60 minutes physical activity per week served as controls. Bone mineral content (BMC; g) and areal bone mineral density (aBMD; g/cm 2 ) were measured with dual X-ray absorptiometry (DXA) of the total body (TB), lumbar spine (L2-L4 vertebra), the third lumbar vertebra (L3), the femoral neck (FN) and the leg. Volumetric bone mineral density (vBMD; g/cm 3 ) and bone width were calculated at L3 and FN. Total lean body mass and total fat mass were estimated from the total body scan. No differences were at baseline found in age, anthropometrics or bone parameters when the groups were compared. The annual gain in BMC was in the cases 4.7 percentage points higher in lumbar spine and 9.5 percentage points higher in L3 than in the controls (both p<0.001). The annual gain in aBMD was in the cases 2.8 percentage points higher in lumbar spine and 3.1 percentage points higher in L3 than in the controls (both p<0.001). The annual gain in bone width was in the cases 2.9 percentage points higher in L3 than in the controls (p<0.001).A general school-based exercise program in 7 -9-year-old girls enhances the accrual of BMC and aBMD and increases bone width.

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“…In a randomised, controlled trial involving 98 healthy, sedentary, 35-to 45-year-old women, those who participated in 18 months of three weekly sessions of progressive highimpact training had significantly greater increases in femoral neck BMD than sedentary controls (+1.6% vs −0.2%, respectively) [34]. Just as noted, impact intensity has been used to explain the differences found between female gymnasts and swimmers and controls after a 12-month programme.…”

Section: Physical Activitymentioning

confidence: 97%

Osteoporosis, falls and exercise

Meléndez-Ortega

2007

Eur Rev Aging Phys Act

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Osteoporosis, a manifestation of bone atrophy that leads to great susceptibility to fractures, is a very important public health problem today because of its great morbidity, mortality and important economic repercussions. It is a problem that will tend to become more serious with the increase in the number of elderly persons. Bone mass is gained during adolescence, reaches a plateau during the third decade and remains stable until approximately age 50, after which a progressively gradual loss is observed. There is no real cure for osteoporosis, but a series of strategies can be used to reduce bone loss and improve bone mass. Osteoporosis has been considered a disease that accompanies the process of ageing; however, this fatalistic attitude should be discarded, as it is possible to correct and decrease the risk factors. Intervention strategies are based on three pillars: nutrition, physical activity and pharmacological agents. Physical activities and exercise programmes are important because they not only can counter the loss of bone mass but also improve neuromuscular capacity, maintaining and increasing strength and muscle mass, which can help to avoid falls and reduce their impact and consequences. The general principles that apply to any exercise programme also apply to preventing bone mass loss. They also can be applied to persons with osteoporosis. However, to understand the peculiarities of these programmes, the propensity for suffering fractures of these former groups should be kept in mind. Special care should be taken to avoid falls and injuries. Weight-bearing exercise and resistance training are recommended for the prevention programmes. Other activities such as tai-chi, dancing, gymnastic or callisthenic exercises can help to improve balance, gait and muscle coordination and diminish the risk of falling. These programmes should be complemented with postural education and a series of safety precautions.

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Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures

Cited by 400 publications

References 31 publications

Correlates of bone quality in older persons

Correlates of bone quality in older persons

Daily Physical Education in the School Curriculum in Prepubertal Girls during 1 Year is Followed by an Increase in Bone Mineral Accrual and Bone Width—Data from the Prospective Controlled Malmö Pediatric Osteoporosis Prevention Study

Osteoporosis, falls and exercise

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