Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women

Sinaki, Mehrsheed; Itoi, Eiji; Wahner, Heinz W.; Wollan, Peter C.; Gelzcer, R.; Mullan, Brian P.; Collins, Douglas A.; Hodgson, Stephen F.

doi:10.1016/s8756-3282(02)00739-1

Cited by 358 publications

(192 citation statements)

References 22 publications

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“…In the presence of weakened musculature a more rapid response to reach maximum amplitude may be required to in order to satisfy the equilibrium requirements. Indeed, this hypothesis may help to explain the reduced risk of subsequent vertebral fracture seen after a programme of back-extensor strengthening [40].…”

Section: Discussionmentioning

confidence: 99%

Paraspinal muscle control in people with osteoporotic vertebral fracture

et al. 2007

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The high risk of sustaining subsequent vertebral fractures after an initial fracture cannot be explained solely by low bone mass. Extra-osseous factors, such as neuromuscular characteristics may help to explain this clinical dilemma. Elderly women with (n = 11) and without (n = 14) osteoporotic vertebral fractures performed rapid shoulder flexion to perturb the trunk while standing on a flat and short base. Neuromuscular postural responses of the paraspinal muscles at T6 and T12, and deep lumbar multifidus at L4 were recorded using intramuscular electromyography (EMG). Both groups demonstrated bursts of EMG that were initiated either before or shortly after the onset of shoulder flexion (P < 0.05). Paraspinal and multifidus onset occurred earlier in the non-fracture group (50-0 ms before deltoid onset) compared to the fracture group (25 ms before and 25 ms after deltoid onset) in the flat base condition. In the short base condition, EMG amplitude increased significantly above baseline earlier in the non-fracture group (75-25 ms before deltoid onset) compared to the fracture group (25-0 ms before deltoid onset) at T6 and T12; yet multifidus EMG increased above baseline earlier in the fracture group (50-25 ms before deltoid) compared to the non-fracture group (25-0 ms before deltoid). Time to reach maximum amplitude was shorter in the fracture group. Hypothetically, the longer time to initiate a postural response and shorter time to reach maximum amplitude in the fracture group may indicate a neuromuscular contribution towards subsequent fracture aetiology. This response could also be an adaptive characteristic of the central nervous system to minimise vertebral loading time.

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Section: Discussionmentioning

confidence: 99%

Paraspinal muscle control in people with osteoporotic vertebral fracture

et al. 2007

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“…This might be due to insufficient quality or quantity of the loading of the spine to produce measurable changes in BMD in this region. Specific exercises directed at strengthening of back muscles, which in the study by Sinaki et al (43) resulted in a long-term reduction of the incidence of vertebral fractures in postmenopausal women but not in an increase of BMD of the spine (probably due to insufficient loading), were not included in the program. In fact, in the current study, an increase in lumbar spine BMD with time was found in both the usual care and RAPIT groups.…”

Section: Discussionmentioning

confidence: 99%

Slowing of bone loss in patients with rheumatoid arthritis by long‐term high‐intensity exercise: Results of a randomized, controlled trial

Jong

Munneke

Lems

et al. 2004

Arthritis & Rheumatism

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Objective. Patients with rheumatoid arthritis (RA) are more at risk for the development of osteoporosis and osteoporotic fractures than are their healthy peers. In this randomized, controlled, multicenter trial, the effectiveness of a 2-year high-intensity weight-bearing exercise program (the RheumatoidArthritis-Patients-In-Training [RAPIT] program) on bone mineral density (BMD) was compared with usual care physical therapy, and the exercise modalities associated with changes in BMD were determined.Methods. Three hundred nine patients with RA were assigned to an intervention group, either the RAPIT program or usual care physical therapy. The primary end points were BMD of the hip and spine. The exercise modalities examined were aerobic fitness, muscle strength, and, as a surrogate for those effects not directly measured by the RAPIT program, attendance rate.Results. The data on the 136 RAPIT participants and 145 usual care participants who completed the study were analyzed. The mean rate of decrease in hip BMD, but not in lumbar spine BMD, was smaller in patients participating in the RAPIT program when compared with that in the usual care group, with a mean decrease of 1.6% (95% confidence interval [95% CI] 0.8-2.5) over the first year and 0.5% (95% CI 1.1-2.0) over the second year. The change in hip BMD was significantly and independently associated with changes in both muscle strength (multivariate odds ratio [OR] 1.75, 95% CI 1.07-2.86) and aerobic fitness (OR 1.79, 95% CI 1.10-2.90), but not with the attendance rate (OR 1.00, 95% CI 0.99-1.00).Conclusion. A long-term high-intensity weightbearing exercise program for RA patients is effective in slowing down the loss of BMD at the hip. The exercise modalities associated with this effect are muscle strength and aerobic fitness.

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“…Many investigators have shown that muscle strength [15][16][17][18] and muscle mass 4,19,20 are associated with site-matched bone mineral density (BMD). Walsh et al 4 established that the prevalence of sarcopenia was 12.5% in premenopausal osteopenic women, while in postmenopausal women, the value was 25% for those with osteopenia and 50% for those with osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Adverse effects of coexistence of sarcopenia and metabolic syndrome in Japanese women

et al. 2012

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BACKGROUND/OBJECTIVES: Little information is available regarding the interactions of sarcopenia and metabolic syndrome (MetS) in the risks of these age-associated diseases in women. The present cross-sectional study was performed to investigate whether the coexistence of sarcopenia and MetS further increases the risks of lifestyle-related diseases in Japanese women. SUBJECTS/METHODS: Healthy Japanese women (n ¼ 533) aged 30-84 participated in this study. MetS was defined as higher body mass index, fasting plasma glucose, systolic or diastolic blood pressure and blood lipid abnormalities. Appendicular muscle mass and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. The criterion of low muscle mass and strength defined median skeletal muscle index (appendicular muscle mass/height 2 , kg/m 2 ) and handgrip strength. RESULTS: Two-way ANCOVA with adjustment for age, body fat percentage and whole-body lean tissue mass indicated that sarcopenia and MetS interacted to produce a significant effect on HbA1c, systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity in Japanese women. The systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity were significantly higher in women with coexisting sarcopenia and MetS than in healthy controls or in those with sarcopenia or MetS alone. The HbA1c in the coexisting sarcopenia and MetS group was higher than in healthy controls and sarcopenia subjects. CONCLUSIONS: The coexistence of sarcopenia and MetS further increases the risks of cardiovascular diseases, such as type 2 diabetes mellitus, hypertension, arterial stiffness and hyperlipidemia even adjustment of age and body composition in adult Japanese women.

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Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women

Cited by 358 publications

References 22 publications

Paraspinal muscle control in people with osteoporotic vertebral fracture

Paraspinal muscle control in people with osteoporotic vertebral fracture

Slowing of bone loss in patients with rheumatoid arthritis by long‐term high‐intensity exercise: Results of a randomized, controlled trial

Adverse effects of coexistence of sarcopenia and metabolic syndrome in Japanese women

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