| 1. |
- Buttazzoni, Christian, et al.
(författare)
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A Pediatric Bone Mass Scan has Poor Ability to Predict Peak Bone Mass: An 11-Year Prospective Study in 121 Children.
- 2015
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Ingår i: Calcified Tissue International. - : Springer Science and Business Media LLC. - 1432-0827 .- 0171-967X. ; 96:5, s. 379-388
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Tidskriftsartikel (refereegranskat)abstract
- This 11-year prospective longitudinal study examined how a pre-pubertal pediatric bone mass scan predicts peak bone mass. We measured bone mineral content (BMC; g), bone mineral density (BMD; g/cm(2)), and bone area (cm(2)) in femoral neck, total body and lumbar spine by dual-energy X-ray absorptiometry in a population-based cohort including 65 boys and 56 girls. At baseline all participants were pre-pubertal with a mean age of 8 years (range 6-9), they were re-measured at a mean 11 years (range 10-12) later. The participants were then mean 19 years (range 18-19), an age range that corresponds to peak bone mass in femoral neck in our population. We calculated individual BMC, BMD, and bone size Z scores, using all participants at each measurement as reference and evaluated correlations between the two measurements. Individual Z scores were also stratified in quartiles to register movements between quartiles from pre-pubertal age to peak bone mass. The correlation coefficients (r) between pre-pubertal and young adulthood measurements for femoral neck BMC, BMD, and bone area varied between 0.37 and 0.65. The reached BMC value at age 8 years explained 42 % of the variance in the BMC peak value; the corresponding values for BMD were 31 % and bone area 14 %. Among the participants with femoral neck BMD in the lowest childhood quartile, 52 % had left this quartile at peak bone mass. A pediatric bone scan with a femoral neck BMD value in the lowest quartile had a sensitivity of 47 % [95 % confidence interval (CI) 28, 66] and a specificity of 82 % (95 % CI 72, 89) to identify individuals who would remain in the lowest quartile at peak bone mass. The pre-pubertal femoral neck BMD explained only 31 % of the variance in femoral neck peak bone mass. A pre-pubertal BMD scan in a population-based sample has poor ability to predict individuals who are at risk of low peak bone mass.
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| 2. |
- Cöster, Marcus E., et al.
(författare)
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Effects of an 8-year childhood physical activity intervention on musculoskeletal gains and fracture risk
- 2016
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Ingår i: Bone. - : Elsevier BV. - 8756-3282. ; 93, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- Background Physical activity (PA) in childhood is associated with musculoskeletal benefits while the effect on fracture risk is yet to be determined. The aim of this study was to evaluate whether extension of a PA intervention leads to improvement in musculoskeletal traits with an accompanied reduced fracture risk. We hypothesized that the PA program would have beneficial effects in both sexes, but more so in girls since they tend to be less physically active than boys during this time frame. Methods In one elementary school we increased physical education (PE) from 60 to 200 min per school week and followed 65 girls and 93 boys from a mean age of 7 years until a mean age of 15 years. Thirty-nine girls and 37 boys in three other schools continued with 60 min of PE per week during the same years and served as controls. We measured bone mineral content (BMC), areal bone mineral density (aBMD), and bone area annually with dual energy X-ray absorptiometry, and leg muscle strength with a computerized dynamometer. In 3534 children within the same PE program (1339 in the intervention and 2195 in the control group) we registered incident fractures during the 8-year study period and estimated annual sex-specific fracture incidence rate ratios (IRRs). Results Girls in the intervention group annually gained more total body less head aBMD, spine aBMD (p < 0.01), femoral neck BMC (p < 0.05), lumbar vertebrae size (p < 0.05), and knee flexion strength (p < 0.05) than girls in the control cohort. In boys we found no group differences. There was an inverse correlation between number of years with extra PE and the annual IRR of sustaining fractures in both girls (r = − 0.90 (95% CI − 0.98 to − 0.51); p < 0.001) and boys (r = − 0.74 (95% CI − 0.94 to − 0.02); p < 0.05). Conclusion In this 8-year pediatric school-based moderate exercise intervention program there is an inverse correlation in both sexes between annual IRR and each additional year of extra PA. A sub-cohort of girls in the intervention group had greater gains in bone mass, bone size, and muscle strength, which could possibly explain the inverse correlation between years within the PA program and fracture risk, while in boys the reason for the inverse correlation remains unknown. It should be noted that differences in unreported factors such as skeletal maturity status, diet, and spare time PA could confound our inferences. That is, true causality cannot be stated.
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| 3. |
- Cöster, Marcus E., et al.
(författare)
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How does a physical activity programme in elementary school affect fracture risk? : A prospective controlled intervention study in Malmo, Sweden
- 2017
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Recent evidence from the 7-year followup of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention. Setting: The study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school. Participants: We included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study. Intervention: We launched an 8-year intervention programme with 40 min of moderate PA per school day, while the controls continued with the Swedish national standard of 60 min of PA per week. Primary outcome measure: We used the regional radiographic archive to register objectively verified fractures and we estimated annual fracture incidences and incidence rate ratios (IRRs). Results: During the first year after initiation of the intervention, the fracture IRR was 1.65 (1.05 to 2.08) (mean 95% CI). For each year of the study, the fracture incidence rate in the control group compared with the intervention group increased by 15.7% (5.6% to 26.8%) (mean 95% CI). After 8 years, the IRR of fractures was 52% lower in the intervention group than in the control group (IRR 0.48 (0.25 to 0.91) (mean 95% CI))]. Conclusions: Introduction of the school-based intervention programme is associated with a higher fracture risk in the intervention group during the first year followed by a gradual reduction, so that during the eighth year, the fracture risk was lower in the intervention group.
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| 4. |
- Detter, Fredrik, et al.
(författare)
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A 3-year school-based exercise intervention improves muscle strength - a prospective controlled population-based study in 223 children
- 2014
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intense physical activity (PA) improves muscle strength in children, but it remains uncertain whether moderately intense PA in a population-based cohort of children confers these benefits. Methods: We included children aged 6-9 years in four schools where the intervention school increased the school curriculum of PA from 60 minutes/week to 40 minutes/school day while the control schools continued with 60 minutes/week for three years. We measured muscle strength, as isokinetic Peak Torque (PT) (Nm) of the knee flexors in the right leg at speeds of 60 degrees/second and 180 degrees/second, at baseline and at follow-up, in 47 girls and 76 boys in the intervention group and 46 girls and 54 boys in the control group and then calculated annual changes in muscle strength. Data are provided as means with 95% confidence intervals. Results: Girls in the intervention group had 1.0 Nm (0.13, 1.9) and boys 1.9 Nm (0.9, 2.9) greater annual gain in knee flexor PT at 60 degrees/second, than girls and boys in the control group. Boys in the intervention group also had 1.5 Nm (0.5, 2.5) greater annual gain in knee flexors PT at 180 degrees/second than boys in the control group. Conclusion: A 3-year moderately intense PA intervention program within the school curriculum enhances muscle strength in both girls and boys.
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| 5. |
- FRITZ, JESPER, et al.
(författare)
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A seven-year physical activity intervention for children increased gains in bone mass and muscle strength
- 2016
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Ingår i: Acta Pædiatrica. - : Wiley. - 0803-5253. ; 105:10, s. 1216-1224
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study evaluated the musculoskeletal effects of increased physical activity on children, starting at six to nine years of age. Methods: In one school we increased the physical education of 72 girls and 100 boys to 200 minutes per week over seven years. In three other schools, 45 girls and 47 boys continued to receive 60 minutes per week. We measured areal bone mineral density (aBMD) with dual energy X-ray absorptiometry and muscle strength with computerised dynamometer at baseline and after seven years and tibial cortical thickness with peripheral quantitative computed tomography after seven years. Results: Girls in the intervention group gained 0.04 g/cm2 (0.01-0.08) more total spine aBMD (p <0.05) and 6.2Nm (1.6, 10.7) more knee flexion strength (p <0.01) than control group girls and had a 0.1 mm (0.0, 0.3) higher tibial cortical thickness at follow-up (p <0.05). Boys in the intervention group gained 7.3Nm (0.4, 14.2) more knee extension strength (p <0.05) and 7.4Nm (2.3, 12.4) more knee flexion strength (p <0.01) than the control group boys, but their aBMD was no higher than the control group. Conclusion: A seven-year, population-based moderately intense exercise intervention enhanced gains in spine bone mass in girls and knee muscle strength in both genders.
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| 6. |
- Karlsson, Magnus, et al.
(författare)
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Daglig skolidrott ger ökad benmassa och successivt minskad frakturrisk
- 2019
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Ingår i: Läkartidningen. - 0023-7205. ; 116:12
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Tidskriftsartikel (refereegranskat)abstract
- In the Bunkeflo project, one elementary school increased duration of school physical activity (PA) to 200 minutes/week while 3 control schools continued with 60 minutes/week throughout the nine elementary school years. We then registered fractures in 3534 children, and evaluated the duration of PA, bone mass and muscle strength in a subsample (n=140) during the intervention and 3 years after. The PA intervention was associated with higher duration of PA both during and 3 years after the intervention. With each year of intervention, the fracture incidence rate ratio (IRR) declined in the intervention children so that it was 0.48 (95% CI 0.25, 0.91) the eighth year of intervention. These findings were accompanied by beneficial gain in musculoskeletal traits in both intervention girls and boys (p<0.05). Nine years of daily school-based PA is associated with a progressive reduction in fracture risk, accompanied by beneficial musculoskeletal gains and a more physically active lifestyle.
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| 7. |
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| 8. |
- Alwis, Gayani, et al.
(författare)
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A 2-year school-based exercise programme in pre-pubertal boys induces skeletal benefits in lumbar spine.
- 2008
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 97, s. 1564-1571
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to evaluate if a general school-based exercise intervention programme in pre-pubertal boys would render site-specific benefits in bone mineral accrual and gain in femoral neck structure. Methods: Eighty boys aged 7-9 years were included in a curriculum-based exercise intervention programme comprising 40 min of general physical activity per school day (200 min/week) for 2 years. Fifty-seven age-matched boys, assigned to the general Swedish school curriculum of 60 min/week, served as controls. Bone mineral content was measured with dual X-ray absorptiometry of the total body, the third lumbar vertebra and hip. Specific software, the hip structural analyses, evaluated the structural properties of the femoral neck. Annual changes were compared. The level of physical activity was estimated through questionnaires and accelerometers. Results: The mean annual bone mineral content gain in third lumbar vertebra was 3.0 percentage points (p < 0.01) and in width 1.3 percentage points (p < 0.01) greater in the intervention than in the control group. The weekly duration of exercise estimated through the questionnaire correlated with gain in bone mineral content in third lumbar vertebra (r = 0.25, p = 0.005) and vertebra width (r = 0.20, p = 0.02). Conclusion: A school-based exercise intervention programme in pre-pubertal boys enhances the skeletal benefits at lumbar spine.
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| 9. |
- Alwis, Gayani, et al.
(författare)
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A school-curriculum-based exercise intervention program for two years in pre-pubertal girls does not influence hip structure.
- 2008
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Ingår i: Dynamic Medicine. - : Springer Science and Business Media LLC. - 1476-5918. ; 7, s. 8-8
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: It is known that physical activity during growth has a positive influence on bone mineral accrual, and is thus possibly one strategy to prevent osteoporosis. However, as bone geometry, independent of areal bone mineral density (aBMD), influences fracture risk, this study aimed to evaluate whether hip structure in pre-pubertal girls is also affected by a two-year exercise intervention program. METHODS: Forty-two girls aged 7-9 years in a school-curriculum-based exercise intervention program comprising 40 minutes of general physical activity per school day (200 minutes per week) were compared with 43 age-matched girls who participated in the general Swedish physical education curriculum comprising a mean of 60 minutes per week. The hip was scanned by dual energy X-ray absorptiometry (DXA) and the hip structural analysis (HSA) software was applied to evaluate bone mineral content (BMC, g), areal bone mineral density (aBMD, g/cm2), periosteal diameter, cross-sectional area (CSA, cm2), section modulus (Z, cm3) and cross-sectional moment of inertia (CSMI, cm4) of the femoral neck (FN). Annual changes were compared. Subjective duration of physical activity was estimated by questionnaire and objective level of everyday physical activity at follow-up by means of accelerometers worn for four consecutive days. All children remained at Tanner stage 1 throughout the study. Group comparisons were made by independent student's t-test between means and analyses of covariance (ANCOVA). RESULTS: At baseline, the two groups did not differ with regard to age, anthropometrics or bone parameters. No between-group differences were observed for annual changes in the FN variables measured. CONCLUSION: A two-year school-based moderately intense general exercise program for 7-9-year-old pre-pubertal girls does not influence structural changes in the FN.
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| 10. |
- Alwis, Gayani, et al.
(författare)
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Bone mineral accrual and gain in skeletal width in pre-pubertal school children is independent of the mode of school transportation - one-year data from the prospective observational pediatric osteoporosis prevention (POP) study.
- 2007
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 8:1, s. 66-66
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Tidskriftsartikel (refereegranskat)abstract
- Background: Walking and cycling to school could be an important regular source of physical activity in growing children. The aim of this 12 months prospective observational study was thus to evaluate the effect of self-transportation to school on bone mineral accrual and gain in bone width in pre-pubertal children, both traits independently contributing to bone strength. Methods: Ninety-seven girls and 133 boys aged 7-9 years were recruited as a part of the Malmo Pediatric Osteoporosis Prevention (POP) Study in order to evaluate the influence of self-selected school transportation for the accrual of bone mineral and bone width. Children who walked or cycled to school were compared with children who went by bus or car. Bone mineral content (BMC) was measured by dual energy X-ray absorptiometry (DXA) in the lumbar spine (L2-L4), third lumbar vertebra (L3) and hip, and bone width was calculated at L3 and femoral neck (FN). Changes during the first 12 months were compared between the groups. Subjective duration of physical activity was estimated by a questionnaire and objective level of everyday physical activity at follow-up by accelerometers worn for four consecutive days. All children remained in Tanner stage 1 throughout the study. Comparisons were made by independent student's t-tests between means, ANCOVA and Fisher's exact tests. Results: There were no differences in baseline or annual changes in BMC or bone width when the transportation groups were compared. No differences were detected in objectively measured daily level of physical activity by accelerometer. All children reached above 60 minutes of moderate to intense daily physical activity per day, the international recommended level of daily physical activity according to the United Kingdom Expert Consensus Group. Conclusion: The everyday physical activity in these pre-pubertal children seems to be so high that the school transportation contributes little to their total level of physical activity. As a result, the choice of school transportation seems not to influence the accrual of bone mineral or gain in bone size during a I2-month follow-up period.
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