Effects of Two Exercise Programs on Bone Strength and Architecture

 描述(由申请人提供)： 运动可以提高面骨密度(ABMD)，并被认为可以降低老年人患骨质疏松症的风险。预防骨质疏松症对退伍军人非常重要，因为骨骼健康状况不佳会导致骨折和功能残疾。然而，并不是所有形式的运动都对骨骼有相同的影响，因此研究最有效的运动来提高骨骼强度是有必要的。目前，被证明影响BMD的练习通常涉及地面反作用力(GRF)，其中包括步行和跳跃等活动，以及联合反作用力(JRF)，如举重和划船。由于退伍军人面临着不同的骨科挑战，GRF可能并不总是安全、可行或舒适的，因此有必要确定JRF对这一人群的骨骼健康可能有什么影响。在这项随机试验中，50名年龄在60岁到75岁之间的老年女性和男性将参加为期24周的GRF或JRF锻炼，每周至少3次。主要目的是调查老年人的GRF和/或JRF运动是否导致股骨颈和腰椎的骨强度和体积骨密度(VBMD)的变化。这项建议的基本原理是，尽管GRF和JRF都显示出对骨密度的好处，但尖端的骨骼特异性成像和分析技术将被用来产生关于GRF和JRF运动对骨强度影响的新信息。定量计算机断层扫描将用于测量vBMD和骨结构。结合有限元分析和统计形状建模的三维图像分析将基于从定量计算机断层扫描获得的参数，提供骨强度和几何形状变化的定量测量。这些技术可以全面评估运动对骨骼在结构失效(骨折)之前可能经历的应力和应变的影响。这项拟议的研究意义重大，因为它对骨质疏松性骨折高危部位的两种不同运动策略进行了比较，并将为未来的最终运动试验建立一种比较手段。这项研究具有创新性，因为它使用了最先进的技术来分析和确定骨强度和骨形状，以及骨密度。从这项研究中获得的信息将有助于确定最佳运动处方，以提高老年退伍军人的骨强度。

 DESCRIPTION (provided by applicant): Exercise improves areal bone mineral density (aBMD) and is thought to decrease the risk of osteoporosis in older adults. Preventing osteoporosis is of major importance to Veterans since poor bone health can lead to fractures and functional disability. However, not all forms of exercise have the same effect on bone, so investigating the most effective exercises to improve bone strength is warranted. Currently, the exercises shown to influence aBMD typically involve ground reaction forces (GRF), which include activities such as walking and jumping, and joint reaction forces (JRF), such as weight lifting and rowing. Due to the distinct orthopedic challenges that combat Veterans face, GRF may not always be safe, feasible, or comfortable, so it is necessary to determine what effects JRF may have on bone health in this population. In this randomized trial, 50 older women and men, aged 60 to 75 years, will participate in 24 weeks of supervised GRF or JRF exercise at least 3 times a week. The primary aim is to investigate if GRF and/or JRF exercise in older adults lead to changes in bone strength and volumetric BMD (vBMD) at the femoral neck and lumbar spine. The rationale for this proposal is that, although GRF and JRF have both shown benefit to aBMD, cutting-edge bone-specific imaging and analysis techniques will be used to generate novel information regarding the effects of GRF and JRF exercise on bone strength. Quantitative computed tomography will be used to measure vBMD and bone architecture. 3-D image analysis with finite element analysis and statistical shape modeling will provide quantitative measures of changes in bone strength and geometry based on parameters obtained from quantitative computed tomography. These techniques provide a comprehensive assessment of the effects of exercise on the stress and strain that bone can experience before structural failure (fracture). The proposed research is significant because it compares two different exercise strategies on bone sites at high risk for osteoporotic fracture and will establish a means of comparison for a future definitive exercise trial. This research is innovative because it uses state-of-the-art technology to analyze and determine bone strength and bone shape, in addition to bone mineral density. Information gained from this research will help to define the optimal exercise prescription to improve bone strength in aging Veterans.