The reliability of dual-energy X-ray absorptiometry measurements of bone mineral density in the metatarsals

Fuller, Joel T.; Archer, Jane; Buckley, Jonathan D.; Tsiros, Margarita D.; Thewlis, Dominic

doi:10.1007/s00256-015-2227-0

Cited by 6 publications

(11 citation statements)

References 14 publications

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“…Our assessment of bone mineral density was reliable for the 2MT and 5MT total ROI’s. These results were consistent with the findings of other research, which also found good reliability in the 2MT and 5MT [ 12 , 14 ]. In addition to the total ROI, this study found good reliability of the proximal and shaft ROI’s and poor reliability of the distal ROI.…”

Section: Discussionsupporting

confidence: 93%

“…Recently, a novel method of measuring the bone mineral density of ex-vivo metatarsals was created and found to be reliable using DXA technology. This method was adapted for the total BMD of in vivo metatarsals and found to be reliable [ 12 ]. It is uncertain how further region of interest (ROI) divisions such as proximal, shaft, and distal sections affect these results.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Pritchard

Smoliga

Nguyen

et al. 2017

Journal of Foot and Ankle Research

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BackgroundMetatarsal fractures, especially of the fifth metatarsal, are common injuries of the foot in a young athletic population, but the risk factors for this injury are not well understood. Dual-energy x-ray absorptiometry (DXA) provides reliable measures of regional bone mineral density to predict fracture risk in the hip and lumbar spine. Recently, sub-regional metatarsal reliability was established in fresh cadaveric specimens and associated with ultimate fracture force. The purpose of this study was to assess the reliability of DXA bone mineral density measurements of sub-regions of the second and fifth metatarsals in a young, active population.MethodsThirty two recreationally active individuals participated in the study, and the bone density of the second (2MT) and fifth (5MT) metatarsals of each subject was measured using a Hologic QDR x-ray bone densitometer. Scans were analyzed separately by two raters, and regional bone mineral density, bone mineral content, and area measurements were calculated for the proximal, shaft, and distal regions of the bone. Intra-rater, inter-rater, and scan-rescan reliability were then determined for each region.ResultsProximal and shaft bone mineral density measurements of the second and fifth metatarsal were reliable. ICC’s were variable across regions and metatarsals, with the distal region being the poorest.ConclusionsBone mineral density measurements of the metatarsals may be a better indicator of fracture risk of the metatarsals than whole body measurements. A reliable method for measuring the regional bone mineral densities of the metatarsals was found. However, inter-rater reliability and scan-rescan reliability for the distal regions were poor. Future research should examine the relationship between DXA bone mineral density measurements and fracture risk at the metatarsals.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Pritchard

Smoliga

Nguyen

et al. 2017

Journal of Foot and Ankle Research

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“…This indicates that some adaptation was still occurring in contractile tissue after 26 weeks of using minimalist shoes. Minimalist shoes cause a more plantar flexed ankle at initial ground contact and increase the mechanical work required by the ankle plantar flexors and it is likely that this caused the increase in strength (Firminger & Edwards, 2016; Fuller et al., 2016; Goss et al., 2015). Previous research demonstrated that 12 weeks of running in minimalist shoes increased intrinsic foot muscle cross‐sectional area (Miller, Whitcome, Lieberman, Norton, & Dyer, 2014).…”

Section: Discussionmentioning

confidence: 99%

Longer‐term effects of minimalist shoes on running performance, strength and bone density: A 20‐week follow‐up study^*

Fuller

Thewlis

Tsiros

et al. 2018

European Journal of Sport Science

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This study investigated whether male runners improve running performance, running economy, ankle plantar flexor strength, and alter running biomechanics and lower limb bone mineral density when gradually transitioning to using minimalist shoes for 100% of weekly running. The study was a planned follow-up of runners (n = 50) who transitioned to minimalist or conventional shoes for 35% of weekly structured training in a previous 6-week randomised controlled trial. In that trial, running performance and economy improved more with minimalist shoes than conventional shoes. Runners in each group were instructed to continue running in their allocated shoe during their own preferred training programme for a further 20 weeks while increasing allocated shoe use to 100% of weekly training. At the 20-week follow-up, minimalist shoes did not affect performance (effect size: 0.19; p = 0.218), running economy (effect size: ≤ 0.24; p ≥ 0.388), stride rate or length (effect size: ≤ 0.12; p ≥ 0.550), foot strike (effect size: ≤ 0.25; p ≥ 0.366), or bone mineral density (effect size: ≤ 0.40; p ≥ 0.319). Minimalist shoes increased plantar flexor strength more than conventional shoes when runners trained with greater mean weekly training distances (shoe*distance interaction: p = 0.036). After greater improvements with minimalist shoes during the initial six weeks of a structured training programme, increasing minimalist shoe use from 35% to 100% over 20 weeks, when runners use their own preferred training programme, did not further improve performance, running economy or alter running biomechanics and lower limb bone mineral density. Minimalist shoes improved plantar flexor strength more than conventional shoes in runners with greater weekly training distances.

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“…Ex vivo, aBMD explains ~80% of the variance in metatarsal fracture force 28 . Unfortunately, in vivo studies report low precision and accuracy for measuring metatarsal aBMD, thereby limiting clinical utility 29,30 …”

Section: Factors Associated With Metatarsal Bsimentioning

confidence: 99%

“…28 Unfortunately, in vivo studies report low precision and accuracy for measuring metatarsal aBMD, thereby limiting clinical utility. 29,30 Peripheral quantitative computed tomography (pQCT) has been used to measure the second metatarsal in cadaveric feet at 15% and 50% of the length with good precision (CV; 2.4% to 5.6% for distal site; 0.1% to 2.4% for mid-shaft). 31 However, no data are available in living individuals.…”

Section: Bone Strengthmentioning

confidence: 99%

A Narrative Review of Metatarsal Bone Stress Injury in Athletic Populations: Etiology, Biomechanics, and Management

Troy

Davis

Tenforde

2021

PM&R

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Metatarsal bone stress injuries (BSIs) are common in athletic populations. BSIs are overuse injuries that result from an accumulation of microdamage that exceeds bone remodeling. Risk for metatarsal BSI is multifactorial and includes factors related to anatomy, biology, and biomechanics. In this article, anatomic factors including foot type, metatarsal length, bone density, bone geometry, and intrinsic muscle strength, which each influence how the foot responds to load, are discussed. Biologic factors such as low energy availability and impaired bone metabolism influence the quality of the bone. Finally, the influence of biomechanical loads to bone such as peak forces, load rates, and loading cycles are reviewed. General management of metatarsal BSI is discussed, including acute care, rehabilitation, treatment of refractory metatarsal BSI, and evaluation of healing/return to sport. Finally, we identify future research priorities and emerging treatments for metatarsal BSI.

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The reliability of dual-energy X-ray absorptiometry measurements of bone mineral density in the metatarsals

Abstract: Reliable measurements of BMD were achieved for the first, second and fifth metatarsals.

Cited by 6 publications

References 14 publications

Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Longer‐term effects of minimalist shoes on running performance, strength and bone density: A 20‐week follow‐up study^*

A Narrative Review of Metatarsal Bone Stress Injury in Athletic Populations: Etiology, Biomechanics, and Management

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The reliability of dual-energy X-ray absorptiometry measurements of bone mineral density in the metatarsals

Abstract: Reliable measurements of BMD were achieved for the first, second and fifth metatarsals.

Cited by 6 publications

References 14 publications

Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual‐energy x‐ray absorptiometry (DXA)

Longer‐term effects of minimalist shoes on running performance, strength and bone density: A 20‐week follow‐up study*

A Narrative Review of Metatarsal Bone Stress Injury in Athletic Populations: Etiology, Biomechanics, and Management

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Product

Resources

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Longer‐term effects of minimalist shoes on running performance, strength and bone density: A 20‐week follow‐up study^*