Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis

A preponderance of evidence from systematic reviews supports the effectiveness of weight‐bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone st...

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Главные авторы: PS Tan, Vina, M Macdonald, Heather, Kim, SoJung, Nettlefold, Lindsay, Gabel, Leigh, C Ashe, Maureen, A McKay, Heather
Формат: Статья
Опубликовано: 2014
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author PS Tan, Vina
M Macdonald, Heather
Kim, SoJung
Nettlefold, Lindsay
Gabel, Leigh
C Ashe, Maureen
A McKay, Heather
author_facet PS Tan, Vina
M Macdonald, Heather
Kim, SoJung
Nettlefold, Lindsay
Gabel, Leigh
C Ashe, Maureen
A McKay, Heather
author_sort PS Tan, Vina
collection USM
description A preponderance of evidence from systematic reviews supports the effectiveness of weight‐bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone strength. Thus, our systematic review extended the scope of the previous review by including all PA intervention and observational studies, including organized sports participation studies, with child or adolescent bone strength as the main outcome. We also sought to discern the skeletal elements (eg, mass, structure, density) that accompanied significant bone strength changes. Our electronic‐database, forward, and reference searches yielded 14 intervention and 23 observational studies that met our inclusion criteria. We used the Effective Public Health Practice Project (EPHPP) tool to assess the quality of studies. Due to heterogeneity across studies, we adopted a narrative synthesis for our analysis and found that bone strength adaptations to PA were related to maturity level, sex, and study quality. Three (of five) weight‐bearing PA intervention studies with a strong rating reported significantly greater gains in bone strength for the intervention group (3% to 4%) compared with only three significant (of nine) moderate intervention studies. Changes in bone structure (eg, bone cross‐sectional area, cortical thickness, alone or in combination) rather than bone mass most often accompanied significant bone strength outcomes. Prepuberty and peripuberty may be the most opportune time for boys and girls to enhance bone strength through PA, although this finding is tempered by the few available studies in more mature groups. Despite the central role that muscle plays in bones’ response to loading, few studies discerned the specific contribution of muscle function (or surrogates) to bone strength. Although not the focus of the current review, this seems an important consideration for future studies. © 2014 American Society for Bone and Mineral Research.
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spelling usm.eprints-358712017-07-26T08:53:21Z http://eprints.usm.my/35871/ Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis PS Tan, Vina M Macdonald, Heather Kim, SoJung Nettlefold, Lindsay Gabel, Leigh C Ashe, Maureen A McKay, Heather RA0421 Public health. Hygiene. Preventive Medicine A preponderance of evidence from systematic reviews supports the effectiveness of weight‐bearing exercises on bone mass accrual, especially during the growing years. However, only one systematic review (limited to randomized controlled trials) examined the role of physical activity (PA) on bone strength. Thus, our systematic review extended the scope of the previous review by including all PA intervention and observational studies, including organized sports participation studies, with child or adolescent bone strength as the main outcome. We also sought to discern the skeletal elements (eg, mass, structure, density) that accompanied significant bone strength changes. Our electronic‐database, forward, and reference searches yielded 14 intervention and 23 observational studies that met our inclusion criteria. We used the Effective Public Health Practice Project (EPHPP) tool to assess the quality of studies. Due to heterogeneity across studies, we adopted a narrative synthesis for our analysis and found that bone strength adaptations to PA were related to maturity level, sex, and study quality. Three (of five) weight‐bearing PA intervention studies with a strong rating reported significantly greater gains in bone strength for the intervention group (3% to 4%) compared with only three significant (of nine) moderate intervention studies. Changes in bone structure (eg, bone cross‐sectional area, cortical thickness, alone or in combination) rather than bone mass most often accompanied significant bone strength outcomes. Prepuberty and peripuberty may be the most opportune time for boys and girls to enhance bone strength through PA, although this finding is tempered by the few available studies in more mature groups. Despite the central role that muscle plays in bones’ response to loading, few studies discerned the specific contribution of muscle function (or surrogates) to bone strength. Although not the focus of the current review, this seems an important consideration for future studies. © 2014 American Society for Bone and Mineral Research. 2014-10 Article PeerReviewed PS Tan, Vina and M Macdonald, Heather and Kim, SoJung and Nettlefold, Lindsay and Gabel, Leigh and C Ashe, Maureen and A McKay, Heather (2014) Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis. Journal of Bone and Mineral Research, 29 (10). pp. 2161-2181. ISSN 0884-0431
spellingShingle RA0421 Public health. Hygiene. Preventive Medicine
PS Tan, Vina
M Macdonald, Heather
Kim, SoJung
Nettlefold, Lindsay
Gabel, Leigh
C Ashe, Maureen
A McKay, Heather
Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title_full Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title_fullStr Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title_full_unstemmed Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title_short Influence of Physical Activity on Bone Strength in Children and Adolescents: A Systematic Review and Narrative Synthesis
title_sort influence of physical activity on bone strength in children and adolescents a systematic review and narrative synthesis
topic RA0421 Public health. Hygiene. Preventive Medicine
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