Cortical and trabecular bone at the radius and tibia in male and female adolescents with Down syndrome:a peripheral quantitative computed tomography (pQCT) study

Abstract Summary We aimed to describe the structure and strength of the tibia and radius of adolescents with Down syndrome. We observed that despite higher levels of volumetric bone mineral density in determined skeletal sites, they are at higher risk of developing osteoporotic fractures in the future due to their lower bone strength indexes. Introduction The aims of the study were to describe the cortical and trabecular volumetric bone mineral density (vBMD), bone mineral content (BMC), area, and bone strength in adolescents with Down syndrome (DS) and to compare them with adolescents without disabilities. Methods Thirty adolescents (11 girls) with DS and 28 without disabilities (10 girls) participated in the study. Peripheral quantitative computed tomography measurements were taken at proximal and distal sites of the tibia and radius. Values of total, trabecular, and cortical BMC; vBMD; and area were obtained of each scan. Cortical thickness and endosteal and periosteal circumferences were also measured, and different bone strength indexes were calculated. Student's t tests were applied between groups. Results The DS group showed greater vBMD at distal radius, BMC at proximal radius, and total and cortical vBMD at proximal tibia. The non-DS group showed higher total and trabecular area at the distal radius and total, cortical, and trabecular BMC and area at distal tibia. Higher values of periosteal and endosteal circumference and bone strength were also found in non-DS group. Conclusions From these results, it can be believed that even with higher vBMD in determined skeletal sites, adolescents with DS are at higher risk of suffering bone fractures due to an increased fragility by lower resistance to load bending or torsion

Longitudinal effects of swimming on bone in adolescents: A pQCT and DXA study

The aims of the present study were, firstly, to evaluate areal bone mineral density (aBMD), bone strength and structure during a swimming season and compare them to those of normo-active controls (CG), and secondly to ascertain whether practising an additional weight-bearing sport other than swimming might improve bone. Twenty-three swimmers who only swam (SWI-PURE; 14 males, 9 females), 11 swimmers who combined swimming with an additional weight-bearing sport (SWI-SPORT; 8 males, 3 females) and 28 controls (CG; 16 males, 12 females) participated in the present study. aBMD was assessed with dual energy X-ray (DXA). Bone mass, area, structure and strength of the non-dominant tibia and radius were measured with peripheral quantitative computed tomography (pQCT). Measurements were performed at the beginning of the swimming season and 8 months later. The only difference among groups for DXA and pQCT variables was found for arm aBMD, which was higher in the SWI-SPORT than in the CG group at both pre- and post-evaluation. Group by time interactions (GxT) were found for trochanter aBMD when comparing SWI-SPORT to CG and SWI-SPORT to SWI-PURE, favouring in both cases SWI-SPORT. No GxT were found for the radius. For the tibia, GxT were found between SWI-SPORT and CG and between SWI-PURE and CG, in both cases favouring the swimmers. A season of swimming does not confer any additional benefits to aBMD, but may confer minor benefits to structure and mass. Complementing swimming with a weight-bearing activity is beneficial to bone

Comparison Of Body Composition Methods For The Assessment Of Body Fat In Adolescent Soccer Players

Anthropometry, dual energy x-ray absorptiometry (DXA) and air displacement plethysmography (ADP) are widely used for assessing body fat percentage (%BF). The accuracy among body composition methods in different kind of populations such as children, adults, obese persons, and athletes has been studied but there are some discrepancies between them. PURPOSE: To compare %BF assessed by DXA, ADP and anthropometry in adolescent soccer players. METHODS: %BF was assessed in ninety-two soccer players (64 males, 13.3 ± 0.5 y; 28 females, 13.3 ± 0.6 y) by anthropometry, DXA and ADP. Anthropometry measurements were registered following the recommendations of the ISAK. Anthropometry %BF was calculated using the equation proposed by Slaughter et al for adolescents. ADP %BF was calculated with 3 different formulas: (i) the general Siri equation (ADPSiri); (ii) the age- and sex-specific equation by Lohman (ADPLohman) and (iii) the age- and sex-specific equation by Silva (ADPSilva). Agreement and differences between methods were assessed by two-paired samples t tests and calculating the 95% limits of agreement. RESULTS: In the whole sample, ADPSiri ADPLohman ADPSilva and anthropometry underestimated %BF by 2.0, 6.9, 6.2, and 6.0% respectively compared to DXA (all p<0.05). The 95% limits of agreement ranged from ±5.91% to ±10.78%. Similar results dividing by sex were found. CONCLUSION: Although the 3 used methodologies have been several times described as valid for the assessment of %BF, based in our data it seems that ADP, anthropometry and DXA are not interchangeable for the assessment of %BF in adolescent soccer players

Is Bone Tissue Really Affected by Swimming? A Systematic Review

BACKGROUND: Swimming, a sport practiced in hypogravity, has sometimes been associated with decreased bone mass. AIM: This systematic review aims to summarize and update present knowledge about the effects of swimming on bone mass, structure and metabolism in order to ascertain the effects of this sport on bone tissue. METHODS: A literature search was conducted up to April 2013. A total of 64 studies focusing on swimmers bone mass, structure and metabolism met the inclusion criteria and were included in the review. RESULTS: It has been generally observed that swimmers present lower bone mineral density than athletes who practise high impact sports and similar values when compared to sedentary controls. However, swimmers have a higher bone turnover than controls resulting in a different structure which in turn results in higher resistance to fracture indexes. Nevertheless, swimming may become highly beneficial regarding bone mass in later stages of life. CONCLUSION: Swimming does not seem to negatively affect bone mass, although it may not be one of the best sports to be practised in order to increase this parameter, due to the hypogravity and lack of impact characteristic of this sport. Most of the studies included in this review showed similar bone mineral density values in swimmers and sedentary controls. However, swimmers present a higher bone turnover than sedentary controls that may result in a stronger structure and consequently in a stronger bone

Longitudinal Effects Of Swimming On Bone Mass, Structure And Strength

PURPOSE: To investigate the changes over a swimming season in bone mineral density (BMD), bone mineral content (BMC), bone strength and bone structure in adolescent swimmers and compared them to normo-active controls (CG). METHODS: BMD and BMC were measured longitudinally (8 months) by Dual Energy X-ray Absorptiometry at the whole body, lumbar spine and non-dominant hip. Bone strength was measured at the midshaft radius and tibia with peripheral quantitative computed tomography (pQCT). Swimmers were divided into two groups; swimmers that swam and performed an extra-weight bearing sport (SWI-SPORT; n=11) and swimmers that only swam (SWI; n=23). Both groups were compared between them and to CG (n=28). ANCOVA for repeated measures x 2 (time) were performed between pre- and post-intervention to determine the effects of swimming on BMC and BMD values adjusting by change in height and subtotal lean, initial age and final Tanner stage and calcium intake for DXA values. For pQCT the same analyses were performed adjusting by change in object length, initial age and final Tanner stage. RESULTS: Eight months of swimming training had no effect on BMD or BMC, as no differences were found between SWI-PURE and CG acquisition. Nevertheless, practicing an extra-weight bearing sport in addition to swimming seemed to positively stimulate bone mass acquisition as SWI-SPORT was the only group that improved all measured skeletal sites and also a group by time interaction was found for the trochanter and total hip BMD when comparing SWI-SPORT to CG (p<0.05). Regarding pQCT measures, no group by time interactions were found for the radius. For the tibia, SWI-SPORT presented higher improvements in cortical thickness, resistance to fracture load (X-axis), and polar strain index than CG (all group by time interactions p<0.05). SWI-PURE also presented higher improvements in polar strain index when compared to CG (group by time interaction p<0.05). CONCLUSION: Swimming seems to be a neutral sport to practice regarding BMD and BMC acquisition. Nevertheless, it might entail some minor improvements in bone strength. Practicing a weight bearing sport in addition to swimming improves both bone mass acquisition and bone strength

The muscle-bone unit in adolescent swimmers

Most researchers adjust bone by lean mass when comparing swimmers with controls. This adjustment is done under the assumption that lean affects bone similarly in both groups. Nonetheless, we found that the muscle-bone association is uncoupled in swimmers, and consequently, researchers should avoid this adjustment when evaluating swimmers’ bone. Introduction: To examine the functional and structural muscle-bone unit in adolescent swimmers. Methods: Sixty-five swimmers (34 girls/31 boys) and 119 controls (51 girls/68 boys) participated in the study. Muscle cross-sectional area (MCSA), bone mineral content (BMC), and polar strength-strain index (SSIPOL) were measured in the non-dominant radius by peripheral quantitative computed tomography (pQCT). Subtotal BMC and lean mass were evaluated with dual-energy X-ray absorptiometry (DXA). Handgrip and isometric knee extension (IKE) tests were performed to determine muscle force. The effect of MCSA, lean and force on SSIPOL, and BMC were tested, and the functional and structural muscle-bone ratios of swimmers and controls were compared. Results: Both muscle size (MCSA and lean) and muscle force (handgrip and IKE) influenced BMC and SSIPOL in swimmers and controls similarly. Swimmers presented normal MCSA and lean values for their height, but when compared with controls, swimmers presented a higher amount of lean and MCSA for the same BMC or SSIPOL (structural muscle-bone unit). For the functional muscle-bone unit, different results were found for the lower and upper limbs, as no differences were found for the upper limbs, while for the lower limbs, swimmers presented higher muscle force for the same amount of BMC. Conclusions: The contradictory results regarding BMC in swimmers found in previous studies could partly be explained with the findings of the present study that reinforce the idea that swimming is not an effective sport to practice regarding bone mass and that the muscle-bone unit is different in swimmers than in controls

Do 6 Months Of Whole Body Vibration Training Improve Bone Mass Acquisition Of Adolescent Swimmers?

Whole body vibration (WBV) training has been suggested to be an effective type of training for improving bone mass. PURPOSE: To determine the effects of WBV training on bone mass acquisition in adolescent swimmers. METHODS: Sixty-four swimmers were followed over 8 months. Participants were divided in to two groups: The first group consisted of forty-one swimmers (14.2±1.8 y) who completed a WBV protocol 15 minutes of training 3 days per week during 6 months (WBV training increased each month starting with a peak acceleration of 3.6 g and ending at 11.6 during the last month) while continuing with their habitual water training (VIB). The second group consisted of twenty-three swimmers (15.0±2.2 y) who continued with their regular swimming training (SWI) (both groups performed an average of 10 hours per week of water training). Bone mineral density (BMD) and content (BMC) were measured longitudinally (8 months) by Dual Energy X-ray Absorptiometry at the whole body, lumbar spine and non-dominant hip. Analysis of covariance (ANCOVA) for repeated measures x2 (time) were performed to check differences within groups between pre and post intervention and to determine the effects of the intervention on BMD and BMC values adjusting by change in height and subtotal lean, initial age and final Tanner stage and calcium intake. RESULTS: Six months of WBV training had little effect on bone mass, as no differences were found between VIB and SWI for absolute change or percentage change for BMD values. For BMC, VIB presented higher absolute and percentage changes in both trochanter (7% increase in VIB vs. 3% in SWI) and total hip (6% increase in VIB vs. 3% in SWI) than SWI, although there was no group by time interaction. CONCLUSION: WBV training might entail minor benefits to BMC acquisition in adolescent swimmers. A minimum compliance of sixty percent was needed to improve BMC, which in the present study consisted of attending at least 2 of the 3 weekly days of training. Future studies using WBV should try to perform more sessions per week at higher intensities to determine if this type of training could be highly beneficial to bone or if other high-impact trainings might be more suitable to improve bone mass in this population

Association Between Physical Fitness and Bone Strength and Structure in 3- to 5-Year-Old Children

Background: The positive association between physical fitness and bone structure has been widely investigated in children and adolescents, yet no studies have evaluated this influence in young children (ie, preschoolers). Hypothesis: Fit children will present improved bone variables when compared with unfit children, and no sex-based differences will emerge in the sample. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Handgrip strength, standing long jump (SLJ), speed/agility, balance, and cardiorespiratory fitness (CRF) were assessed using the Assessing FITness levels in PREschoolers (PREFIT) test battery in 92 children (50 boys; age range, 3-5 years). A peripheral quantitative computed tomography scan was performed at 38% of the length of the nondominant tibia. Cluster analysis from handgrip strength, SLJ, speed/agility, and CRF was developed to identify fitness groups. Bone variables were compared between sexes and between cluster groups. The association between individual physical fitness components and different bone variables was also tested. Results: Three cluster groups emerged: fit (high values on all included physical fitness variables), strong (high strength values and low speed/agility and CRF), and unfit (low strength, speed/agility, and CRF). The fit group presented higher values than the strong and unfit groups for total and cortical bone mineral content, cortical area, and polar strength strain index (all P < 0.05). The fit group also presented a higher cortical thickness when compared with the unfit group (P < 0.05). Handgrip, SLJ, and speed/agility predicted all bone variables except for total and cortical volumetric bone mineral density. No differences were found for bone variables between sexes. Conclusion: The results suggest that global fitness in preschoolers is a key determinant for bone structure and strength but not volumetric bone mineral density. Clinical Relevance: Physical fitness is a determinant for tibial bone mineral content, structure, and strength in very young children. Performing physical fitness tests could provide useful information related to bone health in preschoolers

Impact of exercise training on the sarcopenia criteria in non-alcoholic fatty liver disease: A systematic review and meta-analysis

Indexación ScopusSarcopenia is a highly prevalent complication of non-alcoholic fatty liver disease (NAFLD). We aimed to conduct a systematic review and meta-analyses to elucidate the exercise training (ET)'s efficacy on NAFLD adult patients' sarcopenia criteria. We identified relevant randomized controlled trials (RCT) in electronic databases PubMed, CINAHL, and Scopus. We selected seven RCT from 66 screened studies. The ET programs included endurance or combined (endurance and resistance) training. No study performed resistance training alone. The physical function improved with endurance or combined training (mean differences [MD] 8.26 mL/Kg*min [95% CI 5.27 to 11.24 mL/Kg*min], p < 0.0001); Muscle mass showed no evidence of the beneficial effects of endurance or combined training (MD 1.01 Kg [95% CI -1.78 to 3.80 Kg], p = 0.48). None of the selected studies evaluated muscle strength. Endurance and combined training increase physical function criteria but do not improve muscle mass criteria on sarcopenia in NAFLD patients. These results must be interpreted with caution for the small number of patients included in the RCTs analyzed, the different characteristics of the ET carried out, the non-use of resistance training, which prevents assess its effect on sarcopenia despite the evidence that recommends it and does not assessment muscle strength criteria in RCT include. Future research should include muscle strength assessments and resistance training to evaluate the effects in this condition. Exercise training is beneficial for sarcopenia in NAFLD but is necessary more experimental evidence to define the best type of training that positively affects the three criteria of sarcopenia. PROSPERO reference number CRD42020191471. © 2021 PAGEPress Publications. All rights reserved.https://www.pagepressjournals.org/index.php/bam/article/view/963