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Sustained skeletal benefit from childhood mechanical loading

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Abstract

Summary

Preliminary prospective, longitudinal results suggest that pre-menarcheal exposure to artistic gymnastics is associated with greater radius BMC, aBMD, and projected area throughout growth and into early adulthood, more than 4 years after activity cessation. Any loss of benefit associated with de-training appears to be temporary.

Introduction

Mechanical loading may enhance bone accrual during growth, but prospective evidence of benefit retention is limited. This prospective, longitudinal cohort study tests whether gymnastics is linked to distal radius advantages during growth and four or more years post-training cessation.

Methods

Semi-annually, female ex/gymnasts and non-gymnasts underwent height and weight measurements; questionnaires assessed calcium intake, physical activity, and maturation. Annual dual energy X-ray absorptiometry scans (Hologic QDR 4500W) measured total body fat-free mass, skull areal density (aBMD), and bone mineral content (BMC); forearm scans measured ultradistal and 1/3 radius area, BMC, and aBMD. Analysis inclusion criteria were: (1) achievement of gynecological age >4 years and (2) for gymnasts, >2 years of pre-menarcheal training (>6 h/week), ceasing between 0.5 year pre-menarche and 1 year post-menarche. Hierarchical linear modeling (HLM v6.0) evaluated outcomes for ex/gymnasts versus non-gymnasts; a slope/intercept discontinuity evaluated de-training effects.

Results

Data from 14 non-gymnasts and six ex/gymnasts represented outcomes from 4 years pre-menarche to 9 years post-menarche. All adjusted distal radius parameters were higher in ex/gymnasts than non-gymnasts (p < 0.02). Ultradistal BMC, ultradistal aBMD, and 1/3 aBMD temporarily decreased with gymnastic cessation (p < 0.04); ultradistal area, 1/3 area, and 1/3 BMC did not change significantly. Skull outcomes did not differ between groups or change with activity cessation.

Conclusion

Gymnastic exposure during childhood and early puberty is associated with greater radius bone mass, size, and aBMD. Despite brief de-training losses in density and mass, significant skeletal benefits are manifested throughout growth and at least 4 years beyond activity cessation into early adulthood.

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Acknowledgments

This work was supported by funding from the Orthopedic Research and Education Foundation and from the National Institutes of Health (National Institute of Arthritis, Musculoskeletal and Skin Diseases: R03 AR047613, R01 AR054145). We would also like to acknowledge Cathy Riley, Christina Morganti, Moira Davenport, Nicole Gero, and Jill Kanaley, whose assistance in data collection, analysis, and other aspects of this research were instrumental in the success of this longitudinal project.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopedics and Rehabilitation, University of Wisconsin, 1685 Highland Avenue, 6th Floor, Madison, WI, 53705-2281, USA

    T. A. Scerpella

  2. Department of Orthopedic Surgery, SUNY Upstate Medical University, Institute for Human Performance, 505 Irving Avenue, Syracuse, NY, 13210, USA

    J. N. Dowthwaite

  3. Department of Public Health and Preventative Medicine, SUNY Upstate Medical University, Institute for Human Performance, 505 Irving Avenue, Syracuse, NY, 13210, USA

    P. F. Rosenbaum

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  1. T. A. Scerpella
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  2. J. N. Dowthwaite
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  3. P. F. Rosenbaum
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Correspondence to J. N. Dowthwaite.

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Scerpella, T.A., Dowthwaite, J.N. & Rosenbaum, P.F. Sustained skeletal benefit from childhood mechanical loading. Osteoporos Int 22, 2205–2210 (2011). https://doi.org/10.1007/s00198-010-1373-4

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  • DOI: https://doi.org/10.1007/s00198-010-1373-4

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