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Physical activity, skeletal health and fractures in a long term perspective.

Karlsson, Magnus K LU (2004) In Journal of Musculoskeletal and Neuronal Interactions - Jmni 4(1). p.12-21
Abstract
Exercise during adolescence, especially during the pre-pubertal years, builds a skeleton with a high bone mineral density (BMD) and possibly a larger skeleton with a different skeletal architecture. This would lead to a stronger skeleton more resistant to trauma. These changes could be of biological significance for fracture reduction, if they were maintained into old age where fragility fractures exponentially rise. The Achilles heel of exercise is its cessation. Most BMD benefits achieved by exercise appear to be eroded with cessation of exercise. Reduced exercise intensity after a period of high activity, may maintain some residual BMD benefits into old age. A decreased fracture rate in the population could perhaps be achieved by... (More)
Exercise during adolescence, especially during the pre-pubertal years, builds a skeleton with a high bone mineral density (BMD) and possibly a larger skeleton with a different skeletal architecture. This would lead to a stronger skeleton more resistant to trauma. These changes could be of biological significance for fracture reduction, if they were maintained into old age where fragility fractures exponentially rise. The Achilles heel of exercise is its cessation. Most BMD benefits achieved by exercise appear to be eroded with cessation of exercise. Reduced exercise intensity after a period of high activity, may maintain some residual BMD benefits into old age. A decreased fracture rate in the population could perhaps be achieved by promoting a physically active life style with lifelong high activity. But what happens if the activity in former athletes is reduced to the same level as in individuals who never exercised? The null hypothesis that exercise has no effect on fracture rates in old age cannot be rejected on the basis of any published, randomised, prospective data. Instead we have to rely on retrospective observational and case control studies, all hypothesis-generating, not hypothesis-testing. Existing data suggest that there could be a reduced fracture risk in former athletes. This notion may be correct, but consistently replicated sampling bias may produce the same observation and any biological explanation for this fracture reduction is unclear. Residual structural skeletal benefits, improved muscle strength, coordination and balance are all traits possibly maintained in former athletes after their active career. These traits may possibly reduce the number of fractures in later life. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Musculoskeletal and Neuronal Interactions - Jmni
volume
4
issue
1
pages
12 - 21
publisher
International Society of Musculoskeletal and Neuronal Interactions
external identifiers
  • scopus:2642532136
ISSN
1108-7161
language
English
LU publication?
yes
id
3939b7bd-5935-4d89-901e-eb0dd3594cb1 (old id 131889)
alternative location
http://www.ismni.org/jmni/pdf/15/03KARLSSON.pdf
date added to LUP
2007-07-24 14:05:45
date last changed
2017-08-20 04:34:16
@article{3939b7bd-5935-4d89-901e-eb0dd3594cb1,
  abstract     = {Exercise during adolescence, especially during the pre-pubertal years, builds a skeleton with a high bone mineral density (BMD) and possibly a larger skeleton with a different skeletal architecture. This would lead to a stronger skeleton more resistant to trauma. These changes could be of biological significance for fracture reduction, if they were maintained into old age where fragility fractures exponentially rise. The Achilles heel of exercise is its cessation. Most BMD benefits achieved by exercise appear to be eroded with cessation of exercise. Reduced exercise intensity after a period of high activity, may maintain some residual BMD benefits into old age. A decreased fracture rate in the population could perhaps be achieved by promoting a physically active life style with lifelong high activity. But what happens if the activity in former athletes is reduced to the same level as in individuals who never exercised? The null hypothesis that exercise has no effect on fracture rates in old age cannot be rejected on the basis of any published, randomised, prospective data. Instead we have to rely on retrospective observational and case control studies, all hypothesis-generating, not hypothesis-testing. Existing data suggest that there could be a reduced fracture risk in former athletes. This notion may be correct, but consistently replicated sampling bias may produce the same observation and any biological explanation for this fracture reduction is unclear. Residual structural skeletal benefits, improved muscle strength, coordination and balance are all traits possibly maintained in former athletes after their active career. These traits may possibly reduce the number of fractures in later life.},
  author       = {Karlsson, Magnus K},
  issn         = {1108-7161},
  language     = {eng},
  number       = {1},
  pages        = {12--21},
  publisher    = {International Society of Musculoskeletal and Neuronal Interactions},
  series       = {Journal of Musculoskeletal and Neuronal Interactions - Jmni},
  title        = {Physical activity, skeletal health and fractures in a long term perspective.},
  volume       = {4},
  year         = {2004},
}