Effects of Two Exercise Programs on Bone Strength and Architecture

 描述（由申请人提供）： 运动可以改善骨密度（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至关重要，因为骨骼健康状况不佳可能导致骨折和功能障碍。然而，并非所有形式的运动对骨骼都有相同的影响，因此调查最有效的运动来提高骨骼强度是必要的。目前，影响aBMD的运动通常涉及地面反作用力（GRF），包括步行和跳跃等活动，以及关节反作用力（JRF），如举重和划船。由于作战退伍军人面临的独特骨科挑战，GRF可能并不总是安全，可行或舒适的，因此有必要确定JRF可能对该人群的骨骼健康产生什么影响。在这项随机试验中，50名年龄在60至75岁之间的老年女性和男性将参加24周的监督GRF或JRF运动，每周至少3次。主要目的是调查老年人GRF和/或JRF运动是否会导致股骨颈和腰椎骨强度和体积BMD（vBMD）的变化。这一提议的基本原理是，尽管GRF和JRF都显示出对aBMD的益处，但尖端的骨特异性成像和分析技术将用于生成关于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。具有有限元分析和统计形状建模的3-D图像分析将提供基于从定量计算机断层扫描获得的参数的骨强度和几何形状的变化的定量测量。这些技术提供了一个全面的评估运动的影响，对应力和应变，骨可以经历结构故障（骨折）之前。这项研究意义重大，因为它比较了两种不同的运动策略对骨质疏松性骨折高危骨部位的影响，并将为未来的确定性运动试验建立一种比较方法。这项研究是创新的，因为它使用最先进的技术来分析和确定骨强度和骨形状，以及骨矿物质密度。从这项研究中获得的信息将有助于确定最佳的运动处方，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.