Physical activity induced adaptation can increase proximal femur strength under loading from a fall onto the greater trochanter

Fuchs, Robyn K.; Carballido‐Gamio, Julio; Keyak, Joyce H.; Kersh, Mariana E.; Warden, Stuart J.

doi:10.1016/j.bone.2021.116090

Cited by 7 publications

(4 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The thin superior femoral neck cortex was consistently one of the most important regions for predicting proximal femur strength during both single-leg stance and sideways fall in agreement with previous findings (Mayhew et al 2005 ) that the superior neck is the weakest link of the proximal femur and a common fracture location in both clinical (LaCroix et al 2010 ) and laboratory settings (Palanca et al 2021 ). The loading-specific VIP maps provided here are consistent with the exercise-induced bone accrual within the superior femoral head, inferior neck, medial intertrochanteric, and greater trochanter causing a proximal femur strength increase varying from 4.9% in sideways fall to 19% in single-leg stance (Fuchs et al 2021 ), supporting the use of exercise prescription that promotes a more uniform response of proximal femur strength to exercise (Abe et al 2016 ) (Martelli et al 2020 ). Furthermore, the BMD changes in the inferior neck impacting strength in single-leg stance are consistent with earlier observations in baseball pitchers, which were considered to indirectly protect the weakest link in the superior neck by causing an inferior shift of the neutral axis (Warden et al 2020 ).…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Geometry and bone mineral density determinants of femoral neck strength changes following exercise

O’Rourke

Beck

Harding

et al. 2022

Biomech Model Mechanobiol

View full text Add to dashboard Cite

Physical exercise induces spatially heterogeneous adaptation in bone. However, it remains unclear where the changes in BMD and geometry have the greatest impact on femoral neck strength. The aim of this study was to determine the principal BMD-and-geometry changes induced by exercise that have the greatest effect on femoral neck strength. Pre- and post-exercise 3D-DXA images of the proximal femur were collected of male participants from the LIFTMOR-M exercise intervention trial. Meshes with element-by-element correspondence were generated by morphing a template mesh to each bone to calculate changes in BMD and geometry. Finite element (FE) models predicted femoral neck strength changes under single-leg stance and sideways fall load. Partial least squares regression (PLSR) models were developed with BMD-only, geometry-only, and BMD-and-geometry changes to determine the principal modes that explained the greatest variation in neck strength changes. The PLSR models explained over 90% of the strength variation with 3 PLS components using BMD-only (R2 > 0.92, RMSE < 0.06 N) and 8 PLS components with geometry-only (R2 > 0.93, RMSE < 0.06 N). Changes in the superior neck and distal cortex were most important during single-leg stance while the superior neck, medial head, and lateral trochanter were most important during a sideways fall. Local changes in femoral neck and head geometry could differentiate the exercise groups from the control group. Exercise interventions may target BMD changes in the superior neck, inferior neck, and greater trochanter for improved femoral neck strength in single-leg stance and sideways fall.

show abstract

Section: Discussionsupporting

confidence: 81%

“…Finally, this study only considered middle-aged and older men and does not consider sex-related differences. Women are at greater risk of hip fragility fracture and may not show the same patterns of response to exercise as men, meaning our results may not be generalisable to the opposite sex (Fuchs et al 2021 ).…”

Section: Discussionmentioning

confidence: 71%

Geometry and bone mineral density determinants of femoral neck strength changes following exercise

O’Rourke

Beck

Harding

et al. 2022

Biomech Model Mechanobiol

View full text Add to dashboard Cite

show abstract

“…The femoral neck is situated in the articular capsule of the hip, in normal gait, the greatest stresses occur in the sub—capital and mid-femoral neck region, where maximum compressive stresses occur inferiorly [ 37 ]. In response to this mechanical need, the femoral neck cross-section is oval in shape, with the cortical bone forming a ring—shaped shell and the interior filled with cancellous bone to ensure the overall bone mechanical properties of the femoral neck [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

The role of microscopic properties on cortical bone strength of femoral neck

Xia¹,

Cai

Kan

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Femoral neck fractures are serious consequence of osteoporosis (OP), numbers of people are working on the micro—mechanisms of femoral neck fractures. This study aims to investigate the role and weight of microscopic properties on femoral neck maximum load (Lmax), funding the indicator which effects Lmax most. Methods A total of 115 patients were recruited from January 2018 to December 2020. Femoral neck samples were collected during the total hip replacement surgery. Femoral neck Lmax, micro—structure, micro—mechanical properties, micro—chemical composition were all measured and analyzed. Multiple linear regression analyses were performed to identify significant factors that affected the femoral neck Lmax. Results The Lmax, cortical bone mineral density (cBMD), cortical bone thickness (Ct. Th), elastic modulus, hardness and collagen cross—linking ratio were all significantly decreased, whereas other parameters were significantly increased during the progression of OP (P < 0.05). In micro—mechanical properties, elastic modulus has the strongest correlation with Lmax (P < 0.05). The cBMD has the strongest association with Lmax in micro—structure (P < 0.05). In micro—chemical composition, crystal size has the strongest correlation with Lmax (P < 0.05). Multiple linear regression analysis showed that elastic modulus was most strongly related to Lmax (β = 0.920, P = 0.000). Conclusions Compared with other parameters, elastic modulus has the greatest influence on Lmax. Evaluation of microscopic parameters on femoral neck cortical bone can clarify the effects of microscopic properties on Lmax, providing a theoretical basis for the femoral neck OP and fragility fractures.

show abstract

“…Regular exercise and physical activities are known to have beneficial effects on body systems including iron and bone metabolism 19 – 21 . Muscle contraction during physical activities provide mechanical stimulation for bone tissue, and in so doing, activates bone cells and consequently enhances bone formation via cytokine release and direct cell-to-cell communication 22 .…”

Section: Introductionmentioning

confidence: 99%

Mild-intensity physical activity prevents cardiac and osseous iron deposition without affecting bone mechanical property or porosity in thalassemic mice

Charoenphandhu

Sooksawanwit

Aeimlapa

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Thalassemia causes anemia, ineffective erythropoiesis, bone loss and iron accumulation in several tissues, e.g., liver, bone and heart, the last of which leads to lethal cardiomyopathy and arrhythmia. Although exercise reportedly improves bone density in thalassemic mice, exercise performance is compromised and might pose risk of cardiovascular accident in thalassemic patients. Therefore, we sought to explore whether mild-intensity physical activity (MPA) with 30–50% of maximal oxygen consumption was sufficient to benefit the heart and bone. Herein, male hemizygous β-globin knockout (BKO) mice and wild-type littermates were subjected to voluntary wheel running 1 h/day, 5 days/week for 3 months (MPA group) or kept sedentary (SDN; control). As determined by atomic absorption spectroscopy, BKO-MPA mice had less iron accumulation in heart and bone tissues compared with BKO-SDN mice. Meanwhile, the circulating level of fibroblast growth factor-23—a factor known to reduce serum iron and intestinal calcium absorption—was increased early in young BKO-MPA mice. Nevertheless, MPA did not affect duodenal calcium transport or body calcium retention. Although MPA restored the aberrant bone calcium-phosphorus ratio to normal range, it did not change vertebral calcium content or femoral mechanical properties. Microstructural porosity in tibia of BKO-MPA mice remained unaltered as determined by synchrotron radiation X-ray tomographic microscopy. In conclusion, MPA prevents cardiac and bone iron accumulation, which is beneficial to thalassemic patients with limited physical fitness or deteriorated cardiac performance. However, in contrast to moderate-intensity exercise, MPA does not improve bone mechanical properties or reduce bone porosity.

show abstract

Physical activity induced adaptation can increase proximal femur strength under loading from a fall onto the greater trochanter

Cited by 7 publications

References 42 publications

Geometry and bone mineral density determinants of femoral neck strength changes following exercise

Geometry and bone mineral density determinants of femoral neck strength changes following exercise

The role of microscopic properties on cortical bone strength of femoral neck

Mild-intensity physical activity prevents cardiac and osseous iron deposition without affecting bone mechanical property or porosity in thalassemic mice

Contact Info

Product

Resources

About