Regional Changes in Density and Microarchitecture in the Ultradistal Tibia of Female Recruits After U.S. Army Basic Combat Training

Sundaramurthy, Aravind; Xu, Chun Hua; Hughes, Julie M.; Gaffney‐Stomberg, Erin; Guerriere, Katelyn I.; Popp, Kristin L.; Bouxsein, Mary L.; Reifman, Jaques; Unnikrishnan, Ginu

doi:10.1007/s00223-019-00548-7

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Recent studies have examined the effect of exercise on bone microarchitecture. A 2019 study showed that among 90 female army recruits, eight weeks of basic combat training led to significant increases trabecular bone density driven by increases in trabecular thickness, and site-specific increases in cortical bone density, driven by increased cortical thickness, in regions of greatest loading [61]. Although many studies have reported equivocal or negative effects for exercise interventions in postmenopausal women, a recent systematic review [62] and meta-analysis [63] concluded that medium and high-intensity exercises-but not low intensity exercises-are effective at improving bone in the lumbar spine and hip in this population.…”

Section: Prospective Interventionsmentioning

confidence: 99%

Effect of external mechanical stimuli on human bone: a narrative review

et al. 2022

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Bone is a living composite material that has the capacity to adapt and respond to both internal and external stimuli. This capacity allows bone to adapt its structure to habitual loads and repair microdamage. Although human bone evolved to adapt to normal physiologic loading (for example from gravitational and muscle forces), these same biological pathways can potentially be activated through other types of external stimuli such as pulsed electromagnetic fields, mechanical vibration, and others. This review summarizes what is currently known about how human bone adapts to various types of external stimuli. We highlight how studies on sports-specific athletes and other exercise interventions have clarified the role of mechanical loading on bone structure. We also discuss clinical scenarios, such as spinal cord injury, where mechanical loading is drastically reduced, leading to rapid bone loss and permanent alterations to bone structure. Finally, we highlight areas of emerging research and unmet clinical need.

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Section: Prospective Interventionsmentioning

confidence: 99%

Effect of external mechanical stimuli on human bone: a narrative review

et al. 2022

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“…(1) The physical activity that occurs during basic combat training (BCT), a rigorous period at the beginning of a soldier's career, causes adaptive bone formation in the tibia, which is a common location for stress fractures. (2)(3)(4)(5) Adaptive bone formation may confer increases in bone strength (6) and fatigue resistance, (7) which could have important implications for stress fracture prevention. (8) During military training, females have a threefold greater risk of stress fractures than males.…”

Section: Introductionmentioning

confidence: 99%

Changes in Distal Tibial Microarchitecture During Eight Weeks of U.S. Army Basic Combat Training Differ by Sex and Race

et al. 2023

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Basic combat training (BCT) is a physically rigorous period at the beginning of a soldier's career that induces bone formation in the tibia. Race and sex are determinants of bone properties in young adults but their influences on changes in bone microarchitecture during BCT are unknown. The purpose of this work was to determine the influence of sex and race on changes in bone microarchitecture during BCT. Bone microarchitecture was assessed at the distal tibia via high‐resolution peripheral quantitative computed tomography at the beginning and end of 8 weeks of BCT in a multiracial cohort of trainees (552 female, 1053 male; mean ± standard deviation [SD] age = 20.7 ± 3.7 years) of which 25.4% self‐identified as black, 19.5% as race other than black or white (other races combined), and 55.1% as white. We used linear regression models to determine whether changes in bone microarchitecture due to BCT differed by race or sex, after adjusting for age, height, weight, physical activity, and tobacco use. We found that trabecular bone density (Tb.BMD), thickness (Tb.Th), and volume (Tb.BV/TV), as well as cortical BMD (Ct.BMD) and thickness (Ct.Th) increased following BCT in both sexes and across racial groups (+0.32% to +1.87%, all p < 0.01). Compared to males, females had greater increases in Tb.BMD (+1.87% versus +1.40%; p = 0.01) and Tb.Th (+0.87% versus +0.58%; p = 0.02), but smaller increases in Ct.BMD (+0.35% versus +0.61%; p < 0.01). Compared to black trainees, white trainees had greater increases in Tb.Th (+0.82% versus +0.61%; p = 0.03). Other races combined and white trainees had greater increases in Ct.BMD than black trainees (+0.56% and + 0.55% versus +0.32%; both p ≤ 0.01). Changes in distal tibial microarchitecture, consistent with adaptive bone formation, occur in trainees of all races and sexes, with modest differences by sex and race. Published 2023. This article is a U.S. Government work and is in the public domain in the USA. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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“…Basic combat training (BCT) is performed at the beginning of military life, lasts 12 weeks, and aims to transform trainees from civilians to soldiers [1,2]. In the case of military universities such as the Hellenic Army Academy, first-grade cadets participate in BCT [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Predictors of Soft Tissue Injuries during Basic Combat Training

Nikolaidis

Havenetidis

2023

Sci

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Strenuous exercise, such as military training, is known to demand a high degree of physical performance and to cause injuries. The present study aimed to (a) monitor the incidence of soft tissue injuries (blisters, contusions, and lacerations) among cadets during Basic Combat Training (BCT), and (b) identify possible risk factors for these injuries. Participants were 315 first-grade cadets (women, n = 28; men, n = 287), recruited from the Hellenic Army Academy. Seven weeks of BCT resulted in an overall cadet injury rate of 24.1% (n = 76) with 13.7% being injured one time, whereas 10.4% of participants were injured 2–6 times. The incidence of injuries was 2.9 soft tissue injuries per 1000 training hours. The logistic regression model using sex, being an athlete, nationality, weight, height, body mass index, and percentage of body fat (BF) to predict soft tissue injury was not statistically significant (χ2(7) = 5.315, p = 0.622). The results of this study showed that BCT caused a large number of soft tissue injuries similar to the number reported for musculoskeletal injuries. In conclusion, following BCT, soft tissue injury characteristics (occurrence, severity, treatment) are similar to those applied in musculoskeletal injuries for Army cadets. However, risk factors such as sex, nationality, and BF have not been related to soft tissue injury prediction as previously shown for musculoskeletal injuries for the same sample group.

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Regional Changes in Density and Microarchitecture in the Ultradistal Tibia of Female Recruits After U.S. Army Basic Combat Training

Cited by 6 publications

References 27 publications

Effect of external mechanical stimuli on human bone: a narrative review

Effect of external mechanical stimuli on human bone: a narrative review

Changes in Distal Tibial Microarchitecture During Eight Weeks of U.S. Army Basic Combat Training Differ by Sex and Race

Incidence and Predictors of Soft Tissue Injuries during Basic Combat Training

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