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Targeted exercises against hip fragility

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Abstract

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.

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Acknowledgments

We thank all the participants for their contribution and time, including Saturdays, for this study. The collaboration with the involved sports associations and sports clubs as well as with their coaches is greatly appreciated. We thank Ms Taru Helenius for managing the measurement schedule, Ms Ulla Hakala and Ms Ulla Honkanen for DXA and pQCT measurements at the UKK Institute, and Ms Arja Hilander and Ms Anu Kuhanen for the MRI measurements at the Tampere University Hospital. The help of Chief Physicist Pertti Ryymin from the Tampere University Hospital in defining the appropriate MRI sequence for this study is gratefully acknowledged. The financial support of the Medical Fund of the Pirkanmaa Hospital District, Finnish Ministry of Education, National Graduate School for Musculoskeletal Disorders and Biomaterials, and the Päivikki and Sakari Sohlberg Foundation is greatly appreciated.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Bone Research Group, UKK Institute for Health Promotion Research, P. O. Box 30, 33501, Tampere, Finland

    R. Nikander, P. Kannus & H. Sievänen

  2. Section of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland

    P. Kannus

  3. Department of Radiology, Regional Medical Imaging Center, Tampere University Hospital and Pirkanmaa Hospital District, Tampere, Finland

    P. Dastidar, L. Harrison & S. Soimakallio

  4. Tampere University Medical School, Tampere, Finland

    P. Dastidar, L. Harrison & S. Soimakallio

  5. Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland

    M. Hannula, L. Harrison, T. Cervinka, N. G. Narra, R. Aktour, T. Arola, H. Eskola & J. Hyttinen

  6. Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    A. Heinonen

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  1. R. Nikander
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Correspondence to H. Sievänen.

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Nikander, R., Kannus, P., Dastidar, P. et al. Targeted exercises against hip fragility. Osteoporos Int 20, 1321–1328 (2009). https://doi.org/10.1007/s00198-008-0785-x

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