Targeted exercises against hip fragility

• Published in: Osteoporosis international Vol. 20; no. 8; pp. 1321 - 1328
• Main Authors: Nikander, R, Kannus, P, Dastidar, P, Hannula, M, Harrison, L, Cervinka, T, Narra, N. G, Aktour, R, Arola, T, Eskola, H, Soimakallio, S, Heinonen, A, Hyttinen, J, Sievänen, H
• Format: Journal Article
• Language: English
• Published: London London : Springer-Verlag 01.08.2009; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adult; Biological and medical sciences; Bone Density - physiology; Bone diseases; Bone fragility; Cortical bone; Diseases of the osteoarticular system; Endocrinology; Exercise; Exercise - physiology; Feasibility Studies; Female; Femoral neck; Femoral Neck Fractures - prevention & control; Femur Neck - anatomy & histology; Femur Neck - physiology; Hip joint; Humans; Imaging, Three-Dimensional - methods; Lumbar Vertebrae - physiology; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical sciences; Medicine; Medicine & Public Health; Original Article; Orthopedics; Osteoporosis. Osteomalacia. Paget disease; Preventive medicine; Rheumatology; Sports - physiology; Women; Young Adult; Femoral neck; Bone fragility; Exercise; Magnetic resonance imaging; Cortical bone; Physical exercise; Osteoporosis; Diseases of the osteoarticular system; Medical imagery; Nuclear magnetic resonance imaging; Hip
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-008-0785-x

Summary Compared to high-impact exercises, moderate-magnitude impacts from odd-loading directions have similar ability to thicken vulnerable cortical regions of the femoral neck. Since odd-impact exercises are mechanically less demanding to the body, this type of exercise can provide a reasonable basis for devising feasible, targeted bone training against hip fragility. Introduction Regional cortical thinning at the femoral neck is associated with hip fragility. Here, we investigated whether exercises involving high-magnitude impacts, moderate-magnitude impacts from odd directions, high-magnitude muscle forces, low-magnitude impacts at high repetition rate, or non-impact muscle forces at high repetition rate were associated with thicker femoral neck cortex. Methods Using three-dimensional magnetic resonance imaging, we scanned the proximal femur of 91 female athletes, representing the above-mentioned five exercise-loadings, and 20 referents. Cortical thickness at the inferior, anterior, superior, and posterior regions of the femoral neck was evaluated. Between-group differences were analyzed with ANCOVA. Results For the inferior cortical thickness, only the high-impact group differed significantly (~60%, p = 0.012) from the reference group, while for the anterior cortex, both the high-impact and odd-impact groups differed (~20%, p = 0.042 and p = 0.044, respectively). Also, the posterior cortex was ~20% thicker (p = 0.014 and p = 0.006, respectively) in these two groups. Conclusions Odd-impact exercise-loading was associated, similar to high-impact exercise-loading, with ~20% thicker cortex around the femoral neck. Since odd-impact exercises are mechanically less demanding to the body than high-impact exercises, it is argued that this type of bone training would offer a feasible basis for targeted exercise-based prevention of hip fragility.