Aucun titre de diapositive

1
Advanced Detection of Bone Quality ADOQ (June 23
2006) Association between Increased Physical
Activity and Bone Architecture (WP4)

• René Rizzoli MD
• Nathalie Farpour-Lambert MD
• Service of Bone Diseases
• WHO Collaborating Center for Osteoporosis and
  Bone Diseases
• Department of Rehabilitation and Geriatrics
• Sport Medicine Unit
• Department of Pediatrics
• University Hospitals, Geneva, Switzerland

2
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Staff in Geneva
• R. Rizzoli MD
• N. Farpour-Lambert MD, pediatrician, sport
  medicine
• X. Martin, sport teacher, coordinator
• M.-A. Schaad RN
• Sigaud RN
• Radiologist technician G. Conicella
• Staff of the Nuclear Medicine Division (DXA)
• D. Hans, C. Durosier
• Secretary and other administrative staff

3
Hypothesis
Bone Mineral Mass/Strength
45
90
Pubertal stage
Age (Yrs)
4
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Objectives
• To evaluate the influence of weight-bearing
  versus
• non weight-bearing competitive sports on
  peripheral bone macro- and micro-architecture
• To evaluate the influence on peripheral bone
  macro- and micro-architecture of long-term
  one-sided increased mechanical loading through
  racket sports
• To compare peripheral bone macro- and
  micro-architecture in males and females at the
  end of growth
• To correlate peripheral bone macro- and
  micro-architecture with the number of hours and
  duration of intense training, and whether the
  latter was started before or during puberty

5
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Objectives (continued)
• 5. To determine volumetric bone mineral density
  in the above-mentioned conditions
• 6. To determine bone mineral mass in the
  above-mentioned conditions
• 7. To determine indices of bone strength in the
  above-mentioned conditions

6
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Subjects Inclusions Criteria
• Cross-sectional study in male and female elite
  athletes
• (gt 5 hours/week, regional or national level,
  eumenorrheic)
• Age (at peak bone mass) 18-30 yrs
• Middle-long distance runners (gt 1500 m race,
  weight-bearing)
• Swimmers (non weight-bearing)
• Tennis players
• Sedentary controls ( 2 hours sport organized
  activity/week)
• Women 4 years postmenarche
• Women 6 cycles/year over the last 2 years

7
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Subjects Exclusion Criteria
• Medications influencing bone metabolism
• (except contraceptive pill)
• Chronic disease (except exercise-induced asthma
  treated by beta-adrenergic agents)
• Previous fracture at site of measurement

8
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Recruitement
• National team and regional clubs
• Swiss-tennis organisation
• Local runner teams
• Geneva-natation club and Swiss Swimming Team
• Relatives or friends of the elite athlets, or
  university students

9
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Variables Questionnaire
• ADOQ questionnnaire (with amendments)
• Family history of bone diseases
• Menarche, menstrual history
• Age of beginning of sport activities
• Estimation of integrated sport intensity (per
  week)
• Number of competitions/year
• Number and duration of resistance training
  sessions/week
• Dietary intakes (3-day diary, including 1
  week-end day)
• History of sport injuries
• History of stature and body weight gains
• Time in the year with respect to sport competition

10
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Variables Measurements (during sport peak
  season)
• Peripheral bone macro- and microarchitecture
  (pQCT)
• Peripheral volumetric bone mineral density
• (cortical and cancellous compartments)
• Height, weight, BMI, sitting height
• Physical activity and energy expenditure using a
  one-week record with a motion sensor (Actigraph
  MTI)
• Muscle power in lower limbs (force platform)
• Muscle mass, lower limb bone and muscle masses
  (DXA)

11
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Side non dominant
• (tennisplayers, both sides for upper limbs)
• DXA lumbar spine, proximal femur, forearm, whole
  body

12
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Statistics
• For an expected difference of 0.75 SD, 25
  subjects per group and per gender -gt 200
  altogether
• Analysis of variance, or non-parametric test if
  non-normal variable
• Analysis of covariance
• Regression analysis (single and multiple)

13
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)

• Analysis
• Peripheral bone macro- and micro-architecture in
  healthy young adults -gt normative values in both
  genders at peak bone mass
• Peripheral bone macro- and micro-architecture in
  relation with type of sport, uni- or bilateral
  load
• Peripheral bone macro- and microarchitecture in
  relation with sport duration, growth, nutrition
• Peripheral bone macro- and micro-architecture in
  relation with muscle mass and strength

14
Advanced Detection of Bone Quality ADOQ
Association between Increased Physical
Activity and Bone Architecture (WP4)
Milestones (June 2006) In 2004 September
submission to ethics committee November start
of advertisement In 2005 March Instrument
delivery April Internal validation, beginning
of recruitment
15
Number
Women
Men
Controls
62
14
Runners
16
30
Swimmers
6
2
Tennis
4
12
Total
146
16
(No Transcript)
17
(No Transcript)
18
TOTAL AREA
Site
Cont.F
Cont.H
AthletsF
AthletsH
SwimF
SwimH
TennisF
TennisH
Average
Radius L
249
350
238
333
262
339
268
353
SD
38
62
44
68
56
5
51
46
n
54
12
13
21
6
2
4
9
Average
Radius R
290
205
403
290
396
SD
55
66
60
40
n
5
1
3
3
8
Average
Tibia L
603
863
660
855
669
872
771
923
SD
104
173
94
124
169
52
60
100
n
57
11
13
21
6
2
4
8
Average
Tibia R
715
876
649
901
796
SD
269
125
n
3
1
1
3
1
19
(No Transcript)
20
(No Transcript)