Is there a critical period for bone response to weight-bearing exercise in children and adolescents? a systematic review

MacKelvie, K. J.; Khan, Khalid; McKay, Heather

doi:10.1136/bjsm.36.4.250

Cited by 297 publications

(225 citation statements)

References 72 publications

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“…Added to the fact that the skeletal responses to continued training over 12 months were greater in the pre/peri-than in the postmenarcheal players, our results are consistent with previous cross-sectional studies of racquet sport athletes and exercise intervention trials that indicated that the pre-and early pubertal years (Tanner stages I to III) may represent the optimal time to enhance bone mass. (2,4,8,18) Importantly, our study provides further insight into the structural basis underlying the exercise-induced changes in bone during growth. It has been suggested that exercise preferentially results in changes in bone structure at the surface(s) already undergoing rapid bone formation due to normal growth.…”

Section: Discussionmentioning

confidence: 80%

Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: A 12-month study in pre/peri- and postmenarcheal tennis players

Ducher

Bass

Saxon

et al. 2010

Journal of Bone and Mineral Research

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Pre-and early puberty may be the most opportune time to strengthen the female skeleton, but there are few longitudinal data to support this claim. Competitive female premenarcheal (pre/peri, n ¼ 13) and postmenarcheal (post, n ¼ 32) tennis players aged 10 to 17 years were followed over 12 months. The osteogenic response to loading was studied by comparing the playing and nonplaying humeri for dual-energy X-ray absorptiometry (DXA) bone mineral content (BMC) and magnetic resonance imaging (MRI) total bone area (ToA), medullary area (MedA), cortical area (CoA), and muscle area (MCSA) at the humerus. Over 12 months, growth-induced gains (nonplaying arm) in BMC, ToA, and CoA were greater in pre/peri (10% to 19%, p < .001) than in post (3% to 5%, p < .05 to .001) players. At baseline, BMC, ToA, CoA, and MCSA were 8% to 18% greater in the playing versus nonplaying arms in pre/peri and post players (all p < .001); MedA was smaller in the playing versus nonplaying arms in post only players ( p < .05). When comparing the annual gains in the playing arm relative to changes in the nonplaying arm, the increases in ToA and CoA were greater in pre/peri than post players (all p < .05). The smaller the side-to-side differences in BMC and CoA at baseline, the larger the exercise benefits at 12 months (r ¼ À0.39 to À0.48, p < .01). The exercise-induced change in MCSA was predictive of the exercise benefits in BMC in pre/peri players only ( p < .05). In conclusion, both pre/peri-and postmenarcheal tennis players showed significant exercise-induced skeletal benefits within a year, with greater benefits in cortical bone geometry in pre/perimenarcheal girls. ß

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Section: Discussionmentioning

confidence: 80%

Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: A 12-month study in pre/peri- and postmenarcheal tennis players

Ducher

Bass

Saxon

et al. 2010

Journal of Bone and Mineral Research

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“…Peak height velocity are usually reached later, in girls at mean age 11.7 while peak bone mineral accrual occur even later, at mean age 12.5 years in girls (31). That is, there is an approximate one-year lag between peak height velocity and peak bone mineral velocity (4,32).…”

Section: Discussionmentioning

confidence: 99%

“…The controls, selected from three neighboring schools, were evaluated in November and December with the followup measurements performed during the same months but two years later. We accepted a two year follow-up in the controls, as data in the literature consistently infer that both growth and accrual of BMC and aBMD over a year and during the ages this study span, occur in a linear fashion (4,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The cases achieved during the study period one summer break for 9 weeks, were no intervention was given, and the controls two summer breaks.…”

Section: Methodsmentioning

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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“…1 Decreased physical activity is regarded as an important aetiological contributor to osteoporosis and increased physical activity is positively correlated with bone mineral content (BMC). 2,3 Health examinations of B16 000 children aged 2-8 years were carried out during [2007][2008] in eight European countries within the 'Identification and prevention of dietary-and lifestyle-induced health effects in children and infants' (IDEFICS) study (http://www.idefics.eu). 4 The present pilot study was conducted on a subsample of the Swedish IDEFICS study population.…”

Section: Introductionmentioning

confidence: 99%

Relation between bone mineral density, biological markers and anthropometric measures in 4-year-old children: a pilot study within the IDEFICS study

et al. 2011

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Objective: To investigate the relationship between bone mineral density (BMD), anthropometric characteristics, levels of biological markers for growth, bone turnover, insulin resistance and fat mass in 4-year-old Swedish children. Methods: Descriptive study with 41 children (28 boys) who had anthropometric measurements and blood samples taken and heel dual-energy X-ray absorptiometry and laser (DXL) performed. The study participants were divided into groups of normalweight (n ¼ 28) and overweight or obese (n ¼ 13) children.Results: There was a significant difference in bone mineral content (BMC), BMD and bone mineral apparent density (BMAD) between overweight and normal-weight children. There was a significant positive correlation between BMC, BMD, BMAD and body mass index standard deviation scores (r ¼ 0.36, 0.34 and 0.29, Po0.01, respectively), waist circumference (r ¼ 0.32, 0.30, Po0.01 and r ¼ 0.26, Po0.05, respectively) and subscapular skinfold (r ¼ 0.26, 0.25 and 0.23, Po0.05, respectively). BMC and BMD correlated significantly with the sum of skinfold measures (r ¼ 0.25 and 0.23, Po0.05, respectively). Adiponectin was significantly inversely correlated with BMC, BMD and BMAD (r ¼ À0.41, À0.40 and À0.41, Po0.01, respectively). Adiponectin was not correlated with skinfold measures. Multiple regression analysis revealed that adiponectin was an independent determinant of BMD, BMC and BMAD. Conclusion: To our knowledge, this is the first study investigating BMD assessed by heel-DXL in relation to anthropometry and metabolic markers in 4-year-old children. Adiponectin was significantly inversely correlated with bone mass parameters. Adiponectin may have an independent role in bone development and metabolism in young children.

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Is there a critical period for bone response to weight-bearing exercise in children and adolescents? a systematic review

Cited by 297 publications

References 72 publications

Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: A 12-month study in pre/peri- and postmenarcheal tennis players

Effects of repetitive loading on the growth-induced changes in bone mass and cortical bone geometry: A 12-month study in pre/peri- and postmenarcheal tennis players

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

Relation between bone mineral density, biological markers and anthropometric measures in 4-year-old children: a pilot study within the IDEFICS study

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