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Background: Exercise optimizes peak bone mass accrual, particularly if the loading is high magnitude and distributed in abnormal directions. Little is known about the influence of early intense training in sport during peak bone mass accrual, especially in boys. Methods: Ninety-eight males aged 6–24 years (gymnasts, swimmers, and controls) completed the bone-specific physical activity questionnaire and a 7-day exercise diary. Dual-energy X-ray absorptiometry determined bone mineral properties of the total body (less head) and lumbar spine (LS, L1–L4) and total lean mass. Subgroup analyses were conducted for juniors (prepubescent), adolescents (11–16 y), and seniors (17–24 y). Results: Lean mass was positively associated with total body less head and LS bone outcomes in all 3 age groups (R2 =.632–.770, P <.05), and bone-specific physical activity questionnaire scores were associated with LS bone mineral density in adolescents and seniors (R2 =.440 and.591, P <.05). Senior gymnasts had significantly higher LS bone mineral density (in grams per square centimeter) and Z-scores than swimmers (P =.004) and controls (P =.012). Conclusions: Elite gymnastics is associated with superior peak bone mass accrual in young males. The benefits appear more pronounced during young adulthood compared with prepuberty, potentially reflecting an extended time course for bone adaptation. [ABSTRACT FROM AUTHOR]

The Trabecular Bone Score (TBS), a gray-level textural assessment derived from dual-energy X-ray absorptiometry images, serves as a validated index of trabecular bone microarchitecture. Over the past decade, significant evidence has highlighted the usefulness of TBS in primary and secondary osteoporosis, leading to its integration with the Fracture Risk Assessment Tool (FRAX) and bone mineral density (BMD) T-score adjustments. This review explores the role of TBS in fracture prediction, treatment initiation, and monitoring. Studies confirm that TBS enhances fracture risk prediction in both primary and secondary osteoporosis when combined with BMD and clinical risk factors. Evidence also suggests that including TBS alongside BMD and FRAX offers significant potential for treatment stratification, considering the overall skeletal profile, such as bone mass, bone quality, and clinical risk factors. Consequently, TBS has become a standard part of clinical care worldwide. Future enhancements hope to adjust for soft tissue thickness, broadening the applicability of TBS across diverse body types and pediatric populations. [ABSTRACT FROM AUTHOR]

The health and well-being of retired rugby union and league players, particularly regarding the long-term effects of concussions, are of major concern. Concussion has been identified as a major risk factor for neurodegenerative diseases, such as Alzheimer's and Amyotrophic Lateral Sclerosis (ALS), in athletes engaged in contact sports. This study aimed to assess differences in specific biomarkers between UK-based retired rugby players with a history of concussion and a non-contact sports group, focusing on biomarkers associated with Alzheimer's, ALS, and CTE. We randomly selected a sample of male retired rugby or non-contact sport athletes (n = 56). The mean age was 41.84 ± 6.44, and the mean years since retirement from the sport was 7.76 ± 6.69 for participants with a history of substantial concussions (>5 concussions in their career) (n = 30). The mean age was 45.75 ± 11.52, and the mean years since retirement was 6.75 ± 4.64 for the healthy controls (n = 26). Serum biomarkers (t-tau, RBP-4, SAA, Nf-L, and retinol), plasma cytokines, and biomarkers associated with serum-derived exosomes (Aβ42, p-tau181, p-tau217, and p-tau231) were analyzed using validated commercial ELISA assays. The results of the selected biomarkers were compared between the two groups. Biomarkers including t-tau and p-tau181 were significantly elevated in the history of the substantial concussion group compared to the non-contact sports group (t-tau: p < 0.01; p-tau181: p < 0.05). Although between-group differences in p-tau217, p-tau231, SAA, Nf-L, retinol, and Aβ42 were not significantly different, there was a trend for higher levels of Aβ42, p-tau217, and p-tau231 in the concussed group. Interestingly, the serum-derived exosome sizes were significantly larger (p < 0.01), and serum RBP-4 levels were significantly reduced (p < 0.05) in the highly concussed group. These findings indicate that retired athletes with a history of multiple concussions during their careers have altered serum measurements of exosome size, t-tau, p-tau181, and RBP-4. These biomarkers should be explored further for the prediction of future neurodegenerative outcomes, including ALS, in those with a history of concussion. [ABSTRACT FROM AUTHOR]

Athletic populations require high-precision body composition assessments to identify true change. Least significant change determines technical error via same-day consecutive tests but does not integrate biological variation, which is more relevant for longitudinal monitoring. The aim of this study was to assess biological variation using least significant change measures from body composition methods used on athletes, including surface anthropometry (SA), air displacement plethysmography (BOD POD), dual-energy X-ray absorptiometry (DXA), and bioelectrical impedance spectroscopy (BIS). Thirty-two athletic males (age = 31 ± 7 years; stature = 183 ± 7 cm; mass = 92 ± 10 kg) underwent three testing sessions over 2 days using four methods. Least significant change values were calculated from differences in Day 1 Test 1 versus Day 1 Test 2 (same-day precision), as well as Day 1 Test 1 versus Day 2 (consecutive-day precision). There was high agreement between same-day and consecutive-day fat mass and fat-free mass measurements for all methods. Consecutive-day precision error in comparison with the same-day precision error was 50% higher for fat mass estimates from BIS (3,607 vs. 2,331 g), 25% higher from BOD POD (1,943 vs. 1,448 g) and DXA (1,615 vs. 1,204 g), but negligible from SA (442 vs. 586 g). Consecutive-day precision error for fat-free mass was 50% higher from BIS (3,966 vs. 2,276 g) and SA (1,159 vs. 568 g) and 25% higher from BOD POD (1,894 vs. 1,450 g) and DXA (1,967 vs. 1,461 g) than the same-day precision error. Precision error in consecutive-day analysis considers both technical error and biological variation, enhancing the identification of small, yet significant changes in body composition of resistance-trained male athletes. Given that change in physique is likely to be small in this population, the use of DXA, BOD POD, or SA is recommended. [ABSTRACT FROM AUTHOR]

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. This article aimed to comprehensively review the studies into potential blood-based biomarkers of CTE, discussing common themes and limitations, as well as suggesting future research directions. While the interest in blood-based biomarkers of CTE has recently increased, the research is still in its early stages. The main issue for many proposed biomarkers is their lack of selectivity for CTE. However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether dietary protein consumption can attenuate resistance exercise-induced muscle damage (EIMD). Managing EIMD may accelerate muscle recovery and allow frequent, high-quality exercise to promote muscle adaptations. This systematic review and meta-analysis examined the impact of peri-exercise protein supplementation on resistance EIMD. Methods: A literature search was conducted on PubMed, SPORTDiscus, and Web of Science up to March 2021 for relevant articles. PEDro criteria were used to assess bias within included studies. A Hedges' g effect size (ES) was calculated for indirect markers of EIMD at h post-exercise. Weighted ESs were included in a random effects model to determine overall ESs over time. Results: Twenty-nine studies were included in the systematic review and 40 trials were included in ≥1 meta-analyses (16 total). There were significant overall effects of protein for preserving isometric maximal voluntary contraction (MVC) at 96 h (0.563 [0.232, 0.894]) and isokinetic MVC at 24 h (0.639 [0.116, 1.162]), 48 h (0.447 [0.104, 0.790]), and 72 h (0.569 [0.136, 1.002]). Overall ESs were large in favour of protein for attenuating creatine kinase concentration at 48 h (0.836 [−0.001, 1.673]) and 72 h (1.335 [0.294, 2.376]). Protein supplementation had no effect on muscle soreness compared with the control. Conclusion: Peri-exercise protein consumption could help maintain maximal strength and lower creatine kinase concentration following resistance exercise but not reduce muscle soreness. Conflicting data may be due to methodological divergencies between studies. Standardised methods and data reporting for EIMD research are needed. [ABSTRACT FROM AUTHOR]

Milk-based proteins are a common choice of post-exercise nutrition to enhance exercise recovery and adaptation. Peri-exercise milk protein ingestion may attenuate exercise-induced muscle damage (EIMD), which is a particular risk to untrained individuals. However, most research has been conducted with males, and due to potential sex differences in EIMD, research with both sexes is required. This parallel-group randomized controlled trial examined the impact of milk protein ingestion on recovery from EIMD. Untrained males and females performed a single bout of leg-based resistance exercise and consumed a milk protein (MILK-PRO: n = 4 males, n = 8 females) or isoenergetic control (CON: n = 4 males, n = 8 females) supplement over 4 days post-exercise (17 doses total). Maximum strength was assessed ≥3 wk pre- and 72 and 168 h post-exercise, and measures of leg circumference, range of motion, muscle soreness, pressure-pain threshold (PPT), and serum creatine kinase concentration ([CK]) were conducted pre-, immediately post-, and 24, 48, 72, and 168 h post-exercise. Resistance exercise induced mild muscle damage that was not attenuated with MILK-PRO relative to CON. Peak increases in [CK] and reductions in PPT were greater in males compared with females. Changes in other markers were comparable between sexes. We conclude that moderate resistance exercise in naïve individuals induces muscle damage without compromising muscle strength. We support sex differences in EIMD and emphasize the need for further research with both sexes. Milk protein ingestion was not beneficial for recovery from EIMD, thus alternative management strategies should be investigated. This trial was prospectively registered at ClinicalTrials.gov PRS (protocol ID: 290580A). [ABSTRACT FROM AUTHOR]

Key Clinical Message: In MS patients, especially those frail or malnourished, combining home‐based exercise twice weekly with essential amino acids and vitamin D may improve body composition, strength, and physical performance, enabling long‐term functional improvements. Multiple sclerosis (MS) is associated with reduced bone and muscle strength and function. We aimed to investigate the effectiveness of a 24‐week intervention in a 57‐year‐old frail female with MS. The participant completed a 2×/week exercise intervention and ingested 2×/day a supplement containing 7.5 g essential amino acids and 500 IU cholecalciferol. Body composition, 6‐m gait speed (GS), handgrip strength (HGS), 30‐sec arm‐curl test (30ACT), 6‐min walking test (6MWT), 30‐sec chair‐stand test (30CST), and plasma concentrations of 25‐hydroxyvitamin D3 [25(OH)D3], insulin‐like growth factor 1 (IGF‐1), and amino acids were assessed at baseline, and at Weeks 12 and 24. Plasma 25(OH)D3 increased from 23.2 to 41.3 ng/mL and IGF‐1 from 131.6 to 140.7 ng/mL from baseline to post‐intervention. BMI, total lean tissue mass (LTM), fat mass, bone mineral content, and the sum of 17 amino acids increased by 3.8, 1.0, 3.5, 0.2, and 19%, respectively, at Week 24. There were clinically significant increases in regional LTM (6.9% arms and 6.3% legs) and large increases in GS (67.3%), dominant HGS (31.5%), non‐dominant HGS (11.8%), dominant 30ACT (100%), non‐dominant 30ACT (116.7%), 6MWT (125.6%), and 30CST (44.4%). The current intervention was effective in improving components of physical fitness and body composition in a female with MS. [ABSTRACT FROM AUTHOR]

The practice of rapid weight loss (RWL) in mixed martial arts (MMA) is an increasing concern but data remain scarce. The aim of this study was to investigate the prevalence, magnitude, methods, and influencers of RWL in professional and amateur MMA athletes. MMA athletes (N = 314; 287 men and 27 women) across nine weight categories (strawweight to heavyweight), completed a validated questionnaire adapted for this sport. Sex-specific data were analyzed, and subgroup comparisons were made between athletes competing at professional and amateur levels. Most athletes purposefully reduced body weight for competition (men: 97.2%; women: 100%). The magnitude of RWL in 1 week prior to weigh-in was significantly greater for professional athletes compared with those competing at amateur level (men: 5.9% vs. 4.2%; women: 5.0% vs. 2.1% of body weight; p < .05). In the 24 hr preceding weigh-in, the magnitude of RWL was greater at professional than amateur level in men (3.7% vs. 2.5% of body weight; p < .05). Most athletes "always" or "sometimes" used water loading (72.9%), restricting fluid intake (71.3%), and sweat suits (55.4%) for RWL. Coaches were cited as the primary source of influence on RWL practices (men: 29.3%; women: 48.1%). There is a high reported prevalence of RWL in MMA, at professional and amateur levels. Our findings, constituting the largest inquiry to date, call for urgent action from MMA organizations to safeguard the health and well-being of athletes competing in this sport. [ABSTRACT FROM AUTHOR]

During preseason training, rugby union (RU) athletes endeavor to enhance physical performance characteristics that are aligned with on-field success. Specific physique traits are associated with performance; therefore body composition assessment is routinely undertaken in elite environments. This study aimed to quantify preseason physique changes in elite RU athletes with unique morphology and divergent ethnicity. Twenty-two White and Polynesian professional RU athletes received dual-energy X-ray absorptiometry assessments at the beginning and conclusion of an 11-week preseason. Interactions between on-field playing position and ethnicity in body composition adaptations were explored, and the least significant change model was used to evaluate variations at the individual level. There were no combined interaction effects with the variables position and ethnicity and any body composition measure. After accounting for baseline body composition, Whites gained more lean mass during the preseason than Polynesians (2,425 ± 1,303 g vs. 1,115 ± 1,169 g; F = 5.4, p =.03). Significant main effects of time were found for whole body and all regional measures with fat mass decreasing (F = 31.1–52.0, p <.01), and lean mass increasing (F = 12.0–40.4, p <.01). Seventeen athletes (nine White and eight Polynesian) had a reduction in fat mass, and eight athletes (six White and two Polynesian) increased lean mass. This study describes significant and meaningful physique changes in elite RU athletes during a preseason period. Given the individualized approach applied to athletes in regard to nutrition and conditioning interventions, a similar approach to that used in this study is recommended to assess physique changes in this population. [ABSTRACT FROM AUTHOR]

Adolescence is a period characterized by large accumulation of bone mass. Body composition is an important determinant of bone mass. This study aimed to assess the relationship of bone mass with lean mass (LM) and fat mass (FM) in normal-weight and overweight adolescents with consideration of sex, sexual maturation and physical activity covariates. A total of 118 adolescents (60 girls and 58 boys) aged between 10 and 14 years participated in the study. Individuals were classified as normal weight or overweight according to body mass index. Bone mineral density (BMD), bone mineral content (BMC), LM, and FM were measured by dual-energy X-ray absorptiometry. In normal-weight adolescents, LM (β D0:725, p < 0.001) and FM (β D0:185, p D 0.019) were associated with lumbar spine BMC, whereas in overweight adolescents only LM (β D 0:736, p < 0.001) was associated with lumbar spine BMC. Furthermore, in the normal-weight group, FM and LM were associated with total body less head BMD (LM, β D0:792, p < 0.001; FM, β D0:257, p D 0.007) and lumbar spine BMD (LM, β D0:553, p < 0.001; FM, β D0:199, p < 0.035). In the overweight group, only LM was associated with total body less head BMD (β D0:682, p < 0.001) and lumbar spine BMD(β D0:528, p<0.001). LM was the main predictor of bone mass in normal-weight and overweight adolescents. FM was associated with bone mass in normal-weight adolescents only. LM may be considered an important and useful marker in adolescents, when investigating bone health in this population. Activities that promote LM gain to reduce the risk of bone fractures and diseases in adulthood are recommended. [ABSTRACT FROM AUTHOR]

Although athletes from sports such as rugby have greater lean mass and strength during their playing careers, little is known about these characteristics post-retirement. Therefore, this study investigated lean mass, strength, and muscle quality in retired elite and amateur rugby players and non-contact athletes. Retired elite male rugby players (n=42, 43.9±10.3 y; 101.1±13.4 kg; 1.82±0.09 m), amateur rugby players (n=46, 48.0±10.5 y; 98.9±16.6 kg; 1.79±0.07 m) and non-contact athletes (n=30, 51.3±12.5 y; 91.3±13.4 kg; 1.79±0.07 m) received one total body dual-energy X-ray absorptiometry assessment of appendicular lean mass (ALM) and ALM index (ALMI). Grip strength was measured, and muscle quality (grip strength/unit of arm lean mass) was calculated. Sarcopenia was identified as ALMI<7.23 kg/m2 and handgrip strength<37.2 kg. Total lean mass, ALM and grip strength were greater in the elite rugby compared to amateur rugby and non-contact groups (p<0.01). There were no significant differences in muscle quality or sarcopenia prevalence. Retired elite rugby players had greater lean mass and grip strength than amateur rugby and non-contact athletes, although muscle quality was similar. The greater lean mass and strength might reflect genetic influences or previous participation in a highly physical sport. [ABSTRACT FROM AUTHOR]

Background: This study examined the prevalence of visceral obesity in Chinese adults across different body mass index (BMI) groups and their associated lipid profiles and demographic risk factors. Methods: A total of 1653 Chinese adults were recruited for the study. Abdominal quantitative computed tomography (CT) imaging was performed to derive the visceral adipose tissue (VAT) at the lumbar vertebrae (L2–L3) levels. Visceral obesity was defined using established cutoff values. Fasting serum total cholesterol, total glucose, high-density lipoprotein, and low-density lipoprotein were measured. Results: Visceral obesity was prevalent in 35% of men and 22% of women with normal BMI (18.5–24 kg/m2) and 86% of men and 78% of women with high BMI (≥24 kg/m2). In both sexes, participants with normal BMI and visceral obesity had higher levels of TC, TG and LDL and lower HDL compared to those with normal VAT. The risk factors for visceral obesity in women with normal BMI were an age ≥50 years and BMI ≥22.3 kg/m2 and in men included a BMI ≥22.5 kg/m2. Conclusion: Visceral obesity was observed in the participants with normal BMI and was associated with an adverse lipid profile. The BMI cutoff points were lower than the normally accepted values. [ABSTRACT FROM AUTHOR]

Introduction: Resistance training can induce skeletal muscle hypertrophy and strength gains, but is also associated with acute muscle damage, characterised by muscle soreness, impaired muscle function, and structural damage to muscle cell membranes and its components. These consequences can be detrimental to future exercise performance and dampen long-term training adaptations. Previous research has considered resistance exercise intensity as a factor in exercise-induced muscle damage (EIMD), though a clear direction of the findings has not yet been established. Further, female populations are heavily underrepresented in this field of study. Therefore, we here propose a study protocol designed to examine sex differences in the muscle damage response to resistance exercise performed with low or high loads in a population of untrained, young adults. Methods: This study will employ a randomised parallel group design. Twenty-four males and 24 females will perform an acute leg-based resistance exercise session at either 30% (low-load) or 80% (high-load) of their pre-determined one-repetition maximum (1RM). Maximal leg strength will be determined by a 1RM test 3 wk before and 72 and 168 h after the exercise bout. Additionally, muscle damage will be assessed immediately before the exercise bout and immediately, 24, 48, 72, and 168 h after the exercise bout through measures of muscle soreness, limb circumference, range of motion, and serum concentrations of creatine kinase and interleukin-6. The outcomes of this trial could inform sex-specific resistance training recommendations and help bridge the sex data gap in sport and exercise science research. [ABSTRACT FROM AUTHOR]

Background: The extent of concussion injury in the rugby codes for women is unclear. Objective: Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods: We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women's concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results: The pooled analysis match injury incidence of women's concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women's rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women's rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions: Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women's rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences. [ABSTRACT FROM AUTHOR]

Background: Concerns have intensified over the health and wellbeing of rugby union and league players, and, in particular, about the longer-term effects of concussion. The purpose of this study was to investigate whether there were differences in mental health, sleep and alcohol use between retired elite and amateur rugby code players and non-contact athletes, and to explore associations with sports-related concussion. Methods: 189 retired elite (ER, n = 83) and amateur (AR, n = 106) rugby code players (rugby union n = 145; rugby league n = 44) and 65 former non-contact athletes (NC) were recruited to the UK Rugby Health Project between 2016 and 2018. Details on sports participation and concussion history were obtained by questionnaire, which also included questions on mental health, anger, sleep, mood, alcohol use, social connections and retirement from injury. Data were compared between sports groups (ER, AR and NC), between exposure of three or more or five or more concussions and for years in sport. Results: ER reported more concussions than AR (5.9 ± 6.3 vs. 3.7 ± 6.3, p = 0.022) and NC (0.4 ± 1.0, p < 0.001). ER had a higher overall negative mental health score (indicating poor mental health) than AR (10.4 ± 6.3 vs. 7.4 ± 6.5, d = 0.47, p = 0.003) and NC (7.1 ± 4.8, d = 0.57, p = 0.006) and a lower overall positive score (indicating good mental health) than NC (8.9 ± 4.1 vs. 10.7 ± 3.4, d = 0.46, p = 0.021). Negative scores were highest and positive scores lowest in those reporting three or more concussions (d = 0.36, p = 0.008; d = 0.28, p = 0.040, respectively) or five or more concussions (d = 0.56, p < 0.001; d = 0.325, p = 0.035, respectively). Reported symptoms for sleep disruption were more prevalent in ER than NC, and in former athletes with three or more concussions (d = 0.41–0.605, p < 0.05). There were no significant differences in alcohol score (p = 0.733). Global anger score and covert anger expression was higher in former athletes with five or more concussions (d = 0.32, p = 0.035; d = 0.37, p = 0.016). AR reported greater attachment to friends than NC (d = 0.46, p = 0.033) and 20% of ER reported that they would not turn to anyone if they had a problem or felt upset about anything. Conclusion: There was a significantly higher prevalence of adverse mental health and sleep disruption in ER and in former athletes who reported a higher number of concussions. Anger and irritability were more prevalent in former athletes with a history of five or more concussions. Strategies are needed to address mental health and sleep disturbance in elite rugby code athletes, who are also less likely to seek help should they need it. Further research is needed to elucidate causation, and the neurobiological connection between concussion, sub-concussions and longer-term psychological health and wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: The etiology of age-related bone loss is less clear in men. This study is aimed to observe the variations of endogenous sex hormone concentrations with increasing of age in men, and investigate their relations to bone mass, marrow adiposity, and muscle adiposity. Methods: A total of 199 community-dwelling Chinese men (aged 41 to 82 years) were included and measured of serum total estradiol, total testosterone, and follicle-stimulating hormone (FSH) concentrations by enzyme-linked immunosorbent assay (ELISA). Vertebral trabecular volumetric bone mineral density (vBMD) was measured by quantitative computed tomography for all participants, and vertebral marrow fat content and erector muscle fat content were quantified by Chemistry-shift-encoding magnetic resonance imaging in 62 participants. Results: In this population, FSH concentration increased (p < 0.001) gradually with aging. Lower vBMD was independently associated with higher FSH concentration (β = -0.216, p < 0.001), but not with total estradiol or total testosterone. For each standard deviation increase in FSH there was a 50% higher risk of an individual having osteopenia or osteoporosis (vBMD < 120 mg/cm3). Marrow fat content and erector muscle fat content were greater in osteopenic and osteoporotic men, but there were no associations with sex hormones concentrations. Conclusion: In summary, FSH but not total estradiol or total testosterone is related to vertebral trabecular vBMD in middle-aged and older Chinese men. Neither marrow adiposity nor muscle adiposity is associated with sex hormones. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate longitudinal body mass and body composition changes in one professional rugby union team (n=123), (i) according to position [forwards (n=58) versus backs (n=65)], analysis of players with 6 consecutive seasons of DXA scans (n=21) and, (iii) to examine differences by playing status [academy and international], over 7 years. Players [mean age: 26.8 y, body mass index: 28.9+kg.m2 ] received DXA scans at fourtime points within each year. A modest (but non-significant) increase in mean total mass (0.8 kg) for professional players was reflected by increased lean mass and reduced body fat mass. At all-time points, forwards had a significantly greater total mass, lean mass and body fat percentage compared to backs (p<0.05). Academy players demonstrated increased total and lean mass and decreased body fat percentage over the first 3 years of senior rugby, although this was not significant. Senior and academy international players had greater lean mass and lower body fat percentage (p<0.05) than non-international counterparts. Despite modest increases in total mass; reflected by increased lean mass and reduced fat mass, no significant changes in body mass or body composition, irrespective of playing position were apparent over 7 years. [ABSTRACT FROM AUTHOR]

Purpose: To compare the body size and 3-compartment body composition between academy and senior professional rugby league players using dual-energy X-ray absorptiometry (DXA). Methods: Academy (age 18.1 ± 1.1 y, n = 34) and senior (age 26.2 ± 4.6 y, n = 63) rugby league players received 1 total-body DXA scan. Height, body mass, and body-fat percentage alongside total and regional fat mass, lean mass, and bone mineral content (BMC) were compared. Independent t tests with Cohen d effect sizes and multivariate analysis of covariance (MANCOVA), controlling for height and body mass, with partial eta-squared (tj2) effect sizes, were used to compare total and regional body composition. Results: Senior players were taller (183.2 ± 5.8 vs 179.2 ±5.7 cm, P - .001, d = 0.70) and heavier (96.5 ± 9.3 vs 86.5 ± 9.0 kg, P < .001, d = 1.09) with lower body-fat percentage (16.3 ± 3.7 vs 18.0 ± 3.7%, P= .032, d = 0.46) than academy players. MANCOVA identified significant overall main effects for total and regional body composition between academy and senior players. Senior players had lower total fat mass (P < .001, r/2 = 0.15), greater total lean mass (P < .001, t]2 = 0.14), and greater total BMC (P = .001, T]2 = 0.12) than academy players. For regional sites, academy players had significantly greater fat mass at the legs (P < .001, n22 = 0.29) than senior players. Conclusions: The lower age, height, body mass, and BMC of academy players suggest that these players are still developing musculoskeletal characteristics. Gradual increases in lean mass and BMC while controlling fat mass is an important consideration for practitioners working with academy rugby league players, especially in the lower body. [ABSTRACT FROM AUTHOR]

Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur. [ABSTRACT FROM AUTHOR]

Background: Developing Interventions for Children's Exercise (DICE) is an initiative aimed at determining effective school-based exercise programs. To assess feasibility, we conducted a pilot study of exercise sessions which varied in duration and frequency. Methods: Exercise interventions were delivered to Year 3 pupils (age 7-8 years; n = 73) in primary schools within Yorkshire, UK. Evaluations were conducted using focus group sessions, questionnaires and observations. Results: The study revealed positive aspects of all interventions, including favorable effects on children's concentration during lessons and identified the value of incorporation of the DICE concept into curriculum lessons. Children appeared enthused and reported well-being and enjoyment. Areas requiring attention were the need for appropriate timetabling of sessions and ensuring the availability of space. Conclusion: The concept and sessions were well-accepted by teachers who confirmed their full support of any future implementation There appears to be potential for the encouragement and empowerment of teachers to support physical activity and healthy school environments, and to take an interest in the health of their pupils. Ultimately, these findings should assist in the design of successful exercise interventions in the school setting. [ABSTRACT FROM AUTHOR]

Background: Rugby union and rugby league are popular team contact sports, but they bring a high risk of injury. Although previous studies have reported injury occurrence across one or several seasons, none have explored the total number of injuries sustained across an entire career. As the first to do so, the aim of this study was to report on cumulative injuries and their perceived long-term impact in retired rugby code athletes compared to athletes from non-contact sports. Methods: One hundred and eighty-nine former rugby code athletes (rugby union n = 145; rugby league n = 44) and 65 former non-contact athletes were recruited to the UK Rugby Health Project between September 2016 and December 2018. Details on sports participation, sports injuries and concussion history, sports injury-related surgeries, and previous and current health were obtained from a validated, online self-report questionnaire. Results: Former elite rugby code athletes (n = 83) reported more total injuries per player (median 39, IQR 35) than former amateur rugby code athletes (n = 106; median 23, IQR 30; p = 0.014) and non-contact sports athletes (n = 65; median 7.5, IQR 15; p < 0.001). Concussion was the most frequently reported injury for the elite and amateur rugby code groups, followed by upper/lower back and knee ligament injuries. These injuries also presented with the highest recurrence. Rugby code groups reported a higher continued impact of previous concussion, neck injuries, shoulder dislocation, ACL tears, and knee ligament injuries (p = 0.003–0.045). The reported prevalence of osteoarthritis was more than twofold greater in the elite rugby code group than in non-contact athletes (51% v 22%, p < 0.001). The prevalence of back pain and/or severe and regular joint pain was high across all groups (47–80%), particularly the elite rugby code group. The total number of joint injuries and sport injury-related surgeries was higher in those who reported current osteoarthritis and current severe and regular joint pain (p < 0.001–p = 0.028). Conclusion: Across multiple injury types, past participation in rugby union and rugby league, particularly at elite level, is associated with a high cumulative injury load and a continued impact of previous injuries post-retirement. Given the high number of reported concussions (and their recurrence) and associations between previous injuries during a player's career and current musculoskeletal conditions, efforts should be prioritized to reduce the occurrence and recurrence of injuries in rugby codes at all levels of the sport. Strategies should also be developed for supporting the specific physical health needs of rugby code athletes post-retirement. [ABSTRACT FROM AUTHOR]

Background and Purpose: Muscle weakness and bone fragility are both associated with hip fracture. In general, muscle contractions create forces to the bone, and bone strength adapts to mechanical loading through changes in bone architecture and mass. However, the relationship between impairment of muscle and bone function remain unclear. In particular, the associations of muscle with properties of proximal femur cortical and trabecular bone are still not well understood. The aim of this study was to explore the associations of hip/thigh muscle density (CT attenuation value in Hounsfield units) and size with cortical and trabecular bone mineral density (BMD) of the proximal femur. Materials and Methods: Three-dimensional quantitative computed tomography (QCT) imaging of the lumber, hip and mid-thigh was performed in a total of 301 participants (mean age 68.4 ± 6.1 years, 194 women and 107 men) to derive areal BMD (aBMD) and volumetric BMD (vBMD). Handgrip strength (HGS) and the Timed Up and Go (TUG) test were also performed. From the CT images, cross-sectional area (CSA), and density were determined for the gluteus maximus muscle (G.MaxM), trunk muscle at the vertebrae L2 level, and mid-thigh muscle. Multivariate generalized linear models were applied to assess associations. Results: Total hip (TH) aBMD was associated significantly with G.MaxM CSA (men: P = 0.042; women: P < 0.001) and density (men: P = 0.012; women: P = 0.043). In women, 0.035 cm2 of mid-thigh CSA (95% CI, 0.014–0.057; P = 0.002) increased per SD increase in TH aBMD, but this significance was not observed in men (P = 0.095). Trunk muscle density and CSA were not associated with proximal femur BMD. The associations of hip/thigh muscle parameters with femoral neck BMD were weaker than those with trochanter and intertrochanter BMD. Furthermore, compared to muscle density, muscle CSA showed better associations with vBMD. G.MaxM CSA was associated with trochanter (TR) Cort. vBMD in men (β, 19.898; 95% CI, 0.924–38.871; P = 0.040) and in women (β, 15.426; 95% CI, 0.893–29.958; P = 0.038). Handgrip strength was only associated with TR aBMD (β, 0.038; 95% CI, 0.006–0.070; P = 0.019) and intertrochanter aBMD (β, 0.049; 95% CI, 0.009–0.090; P = 0.016) in men. Conclusions: We observed positive associations of the gluteus and thigh muscle size with proximal femur volumetric BMD. Specifically, the gluteus maximus muscle CSA was associated with trochanter cortical vBMD in both men and women. [ABSTRACT FROM AUTHOR]

Polynesian individuals are leaner with greater musculature than Caucasians of an equivalent size, and this genetically different morphology provides a physique that is often compatible with success in a number of sports, including rugby union. Evidence indicates that Polynesians have greater stores of absolute and relative abdominal fat mass and this is known to confer cardiometabolic risk. The aims of this study were to (1) explore the relationship between ethnicity, visceral adipose tissue (VAT), and cardiometabolic disease risk markers in elite Caucasian and Polynesian rugby union athletes, and (2) assess the impact of a pre-season training programme on these markers. Twenty-two professional rugby union athletes of Caucasian (n = 11) and Polynesian (n = 11) descent underwent physique assessment via surface anthropometry, dual-energy X-ray absorptiometry, and magnetic resonance imaging before and after an 11-week pre-season. A fasted blood test was undertaken at both time points. Compared to Caucasians, at baseline Polynesians displayed significantly higher VAT (771 ± 609 cm3 vs 424 ± 235 cm3; p = 0.043), triglycerides (1.0 ± 0.9 mmol/L vs 0.6 ± 0.2 mmol/L; p = 0.050), and low-density lipoprotein cholesterol (3.1 ± 0.9 mmol/L vs 2.3 ± 0.7 mmol/L; p = 0.019). Similar changes were observed in both groups over the pre-season period in VAT and blood biochemical markers. Polynesian rugby union athletes were more likely than Caucasians to exhibit risk factors associated with cardiometabolic disease, such as elevated VAT and unfavourable lipid profiles. Further longitudinal research is required to identify and explain the short- and long-term risk of cardiometabolic disease in athletes of Polynesian descent. [ABSTRACT FROM AUTHOR]

Aim : This study investigated cerebral hemodynamic responses to a neurovascular coupling (NVC) test in retired contact athletes with a history of repeated mild traumatic brain injury (mTBI) and in controls with no history of mTBI. Methods : Twenty-one retired rugby players (47.7 ± 12.9 year old; age at retirement: 38.5 ± 8.9 year; number of years playing rugby: 12.7 ± 3.7 year) with a history of three or more diagnosed concussions (8.9 ± 7.9 concussions per player) and 23 controls with no history of mTBI (46.5 ± 12.8 year old) performed a NVC test to detect task-orientated cerebral hemodynamic changes using functional near-infrared spectroscopy (fNIRS). Results : The NVC showed a statistically significant reduction in the cerebral hemodynamic response in comparison to the control group which had a greater relative increase of oxyhemoglobin (O2Hb). There were reductions in left middle frontal gyrus (MFG) O2Hb (−0.015 ± 0.258 μM) and relative increases in deoxyhemoglobin (HHb; −0.004 ± 0.159 μM) in the same region for the mTBI group in comparison to the control group (−0.160 ± 0.311 μM; −0.121 ± 0.076 μM for O2Hb and HHb, respectively). The mTBI group induced a greater rate of oxygen extraction compared to the control group. Conclusion : This was the first study to examine cerebral hemodynamic changes in retired rugby players in response to a NVC test, and we found reduced cerebral hemodynamic responses in participants with a history of mTBI compared to controls. These results suggest altered cerebral metabolic demands in participants with a history of multiple head injuries. Further research is needed to ascertain an understanding of the changes in hemodynamics from playing into retirement. [ABSTRACT FROM AUTHOR]

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Improvements in running economy (RE) are thought to lead to improvements in running performance (P). Multiple interventions have been designed with the aim of improving RE in middle and long-distance runners. The aim of this study was to assess the effect of interventions of at least 2-weeks' duration on RE and P and to determine whether there is a relationship between changes in RE (ΔRE) and changes in running performance (ΔP). A database search was carried out in Web of Science, Scopus and SPORTDiscus. In accordance with a PRISMA checklist 10 studies reporting 12 comparisons between interventions and controls were included in the review. There was no correlation between percentage ΔRE and percentage ΔP (r = 0.46, P = 0.936, 12 comparisons). There was a low risk of reporting bias but an unclear risk of bias for other items. Meta-analyses found no statistically significant differences between interventions and controls for RE (SMD (95% CI) = −0.37 (−1.43, 0.69), 204 participants, p = 0.49) or for P (SMD (95% CI) = −0.65 (−26.02, 24.72, 204 participants, p = 0.99). There is a need for studies of greater statistical power, methodological quality, duration and homogeneity of intervention and population. Standardised measures of performance and greater control over non-intervention training are also required. [ABSTRACT FROM AUTHOR]

Purpose: This pilot study investigated differences in lean tissue mass, muscle strength, muscle quality (strength per unit of muscle mass; MQ), and functional performance in healthy younger and older individuals. The most robust predictors of appendicular lean mass (ALM) were then determined in each group.Methods: Fifty younger (18-45 years) and 50 older (60-80 years) participants completed tests of upper and lower body strength alongside body composition by dual-energy X-ray absorptiometry from which upper- and lower-body MQ were estimated. Available cut-points for older people were used to determine low upper-body MQ in both groups. Low lower-body MQ was determined as at least two standard deviations below the mean of the younger group. Functional performance was assessed by gait speed. Sarcopenia was identified using two established definitions.Results: Upper and lower body strength, ALM, lower-body MQ and gait speed were significantly higher in the younger group (all p < 0.002). Sarcopenia was identified in 2-4% of the older group. Low upper-body MQ was evident in 32% and 42% of the younger and older group, respectively. Low lower-body MQ was observed in 4% of younger participants, and 50% of older participants. In both groups, the most robust predictors of ALM were upper and lower body strength (young R2 = 0.74, 0.82; older R2 = 0.68, 0.72).Conclusions: Low MQ despite low prevalence rates of sarcopenia in both groups suggests a need for age-specific MQ cut-points. Muscle quality assessments might be useful complementary prognostic tools alongside existing sarcopenia definitions. [ABSTRACT FROM AUTHOR]

This study investigated the change in body composition and bone mineral content (BMC) of senior rugby league (RL) players between 2008 and 2014. Twelve male professional RL players (age, 24.6 ± 4.0 years; stature, 183.4 ± 8.4 cm) received a dual-energy X-ray absorptiometry scan during preseason in 2008 and 2014. Between 2008 and 2014,very likelyincreases in leg lean mass (LM), total trunk and leg BMC, and alikelyincrease in arm BMC andpossibleincreases in body mass (BM), total and trunk fat mass (FM), and total, trunk and arm LM were observed.Unlikelydecreases andunclearchanges in leg and arm FM were also found.Largenegative correlations were observed between age and BM (r = −0.72), LM (r = −0.70), FM (r = −0.61) and BMC (r = −0.84) change. Three participants (19.1 ± 1.6 years) increased LM by 7.0–9.3 kg. Younger players had the largest increases in LM during this period, although an older player (30-year old) still increased LM. Differences in body composition change were also observed for participants of the same age, thus contextual factors should be considered. This study demonstrates the individuality of body composition changes in senior professional rugby players, while considering the potential change in young athletes. [ABSTRACT FROM PUBLISHER]

Muscle health is a critical component in the struggle against physical frailty and the efforts to maintain metabolic health until the limit of chronological age. Consensus opinion is to evaluate muscle health in terms of muscle mass, strength and functional capability. There has been considerable variability in the components of muscle health which have been investigated in addition to variability in the tools of assessment and protocol for measurement. This is in stark contrast to the validated measurement of bone health across the adult life span. The purpose of this review was to identify indices of muscle mass, strength and functional capability most responsive to change with ageing and where possible to provide an estimate of the rate of change. We suggest lean tissue mass (LTM) or skeletal muscle (SM) is best evaluated from the thigh region due to its greater responsiveness to ageing compared to the whole body. The anterior compartment of the thigh region undergoes a preferential age-related decline in SM and force generating capacity. Therefore, we suggest that knee extensor torque is measured to represent the force generating capacity of the thigh and subsequently, to express muscle quality (strength per unit tissue). Finally, we suggest measures of functional capability which allow participants perform to a greater maximum are most appropriate to track age-related difference in functional capacity across the adult lifespan. This is due to their ability encompass a broad spectrum of abilities. This review suggests indices of muscular health for which reference ranges can be generated across the lifespan. [ABSTRACT FROM AUTHOR]

Background: The conventional measurement of obesity utilises the body mass index (BMI) criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM), and specifically visceral adipose tissue (VAT) mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a) to compare five anthropometric predictors of %FM and VAT mass, and (b) to explore new cut-points for the best of these predictors to improve the characterisation of obesity. Methods: BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist/height0.5 (WHT.5R) were measured and calculated for 81 adults (40 women, 41 men; mean (SD) age: 38.4 (17.5) years; 94% Caucasian). Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0) was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC) to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass). Results: The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes. Conclusions: In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation and the identification of individuals who would most benefit from therapeutic intervention. [ABSTRACT FROM AUTHOR]

ABSTRACT Low body weight is an established risk factor for osteoporosis and fracture, but the skeletal risks of higher adiposity are unclear and appear sex-specific and site-dependent. The aim of this study was to investigate associations of total fat mass (TFM), visceral adipose tissue (VAT), and C-reactive protein (CRP) with bone mineral density (BMD) and prevalent vertebral fracture (VF) in men and women aged 62 years. A total of 352 men and women aged 62.5 ± 0.5 years from the Newcastle Thousand Families Study cohort received dual-energy X-ray absorptiometry (DXA) evaluations of femoral neck and lumbar spine BMD, of the lateral spine for vertebral fracture assessment, and of the whole body for TFM and VAT (GE Lunar CoreScan, Madison, WI, USA). Plasma CRP, FRAX scores, falls in the last 12 months, and occupation at age 50 years were also included in the analysis. Vertebral fractures were less prevalent in women than in men (odds ratio [OR] = 0.33, p < 0.001) and BMD or FRAX scores did not differ between participants with and without VF. Women with VF were heavier and had higher TFM, VAT, and CRP than women without ( p < 0.001). In women, greater (+1 SD) TFM and VAT increased the odds of any grade VF (TFM: OR = 1.06, p = 0.001; VAT: OR = 2.50, p = 0.002), and greater VAT mass increased the odds of prevalent mild VF (OR = 2.60, p = 0.002). In contrast, there were no associations in men. In both sexes, after controlling for body weight, neither VAT nor CRP were associated with BMD. In conclusion, irrespective of BMD, total and visceral adiposity were associated with prevalent VF in women but not in men. High fat mass, particularly if visceral, should be considered when assessing VF risk in women. Risk factors for VF in men require further investigation, particularly given their high prevalence. © 2017 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

There have been few reports of advanced body composition profiles of elite fast bowlers in the sport of cricket. Therefore, the aim of the current study was to determine total, regional and unilateral body composition characteristics of elite English first-class cricket fast bowlers in comparison with matched controls, using dual-energy X-ray absorptiometry (DXA). Twelve male fast bowlers and 12 age-matched, non-athletic controls received one total-body DXA scan. Anthropometric data were obtained as well as left and right regional (arms, legs and trunk) fat mass, lean mass and bone mineral content. Fast bowlers were significantly taller and heavier than controls (P < 0.05). Relative to body mass, fast bowlers possessed greater lean mass in the trunk (80.9 ± 3.7 vs. 76.7 ± 5.9%;P = 0.047) and bone mineral content in the trunk (2.9 ± 0.3 vs. 2.6 ± 0.3%;P = 0.049) and legs (5.4 ± 0.5 vs. 4.6 ± 0.6%;P = 0.003). In the arm region, fast bowlers demonstrated significantly greater unilateral differences in bone mineral content (10.6 ± 6.6 vs. 4.5 ± 3.9%;P = 0.012). This study provides specific body composition values for elite-level fast bowlers and highlights the potential for muscle and bone imbalances that may be useful for conditioning professionals. Our findings also suggest beneficial adaptations in body composition and bone mass in fast bowlers compared with their non-athletic counterparts. [ABSTRACT FROM AUTHOR]

Super League (SL) and Championship (RLC) rugby league players will compete against each other in 2015 and beyond. To identify possible discrepancies, this study compared the anthropometric profile and body composition of current SL (full-time professional) and RLC (part-time semi-professional) players using dual-energy X-ray absorptiometry (DXA). A cross-sectional design involved DXA scans on 67 SL (n=29 backs, n=38 forwards) and 46 RLC (n=20 backs, n=26 forwards) players during preseason. A one-way ANOVA was used to compare age, stature, body mass, soft tissue fat percentage, bone mineral content (BMC), total and regional (i.e., arms, legs and trunk) fat and lean mass between SL forwards, SL backs, RLC forwards and RLC backs. No significant differences in age, stature or body mass were observed. SL forwards and backs had relatively less soft tissue fat (17.5 ± 3.7 and 14.8 ± 3.6 vs. 21.4 ± 4.3 and 20.8 ± 3.8%), greater BMC (4,528 ± 443 and 4,230 ± 447 vs. 4,302 ± 393 and 3,971 ± 280 g), greater trunk lean mass (37.3 ± 3.0 and 35.3 ± 3.8 vs. 34.9 ± 32.3 and 32.3 ± 2.6 kg) and less trunk fat mass (8.5 ± 2.7 and 6.2 ± 2.1 vs. 10.7 ± 2.8 and 9.5 ± 2.9 kg) than RLC forwards and backs. Observed differences may reflect selection based on favourable physical attributes, or training adaptations. To reduce this discrepancy, some RLC players should reduce fat mass and increase lean mass, which may be of benefit for the 2015 season and beyond. [ABSTRACT FROM AUTHOR]

Introduction Dual-energy X-ray absorptiometry is rarely utilized in the clinical care of patients with complex regional pain syndrome, but may be useful for the non-invasive determination of regional bone fragility and fracture risk, as well as muscular atrophy and regional body composition. This is the first report in the literature of complex regional pain syndrome and musculoskeletal co-morbidities in an athlete, and is the first to focus on dual-energy X-ray absorptiometry for the clinical assessment of complex regional pain syndrome. Case presentation In this report, we describe the case of a 29-year-old Caucasian man with type 1 complex regional pain syndrome. His body mass index was 29.4kg/m2 at the time of presentation. Despite severe complex regional pain syndrome in the left limb and long term use of a wheelchair, the patient participated in high-performance powerlifting. Dual-energy X-ray absorptiometry revealed marked unilateral differences in bone strength and lean mass between the affected regions and the contralateral regions. Low bone mineral density for age was found in the left hip, with Z-scores ranging from -2.2 to -3.0, and the patient had previously suffered two fractures. Bone density Z-scores in the right hip and legs were normal. Conclusions Dual-energy X-ray absorptiometry is a valuable tool for the clinical investigation of musculoskeletal health in patients with complex regional pain syndrome. Regional osteoporosis in complex regional pain syndrome patients is complicated and should be investigated and monitored. Physical activity is possible for some complex regional pain syndrome patients, depending on the type of exercise and the region affected, and it may protect bone density and strength at non-affected skeletal sites. [ABSTRACT FROM AUTHOR]

There is an ongoing concern about the risk of injury to the spine in professional rugby players. The objective of this study was to investigate the prevalence of vertebral fracture using vertebral fracture assessment (VFA) dual energy X-ray absorptiometry (DXA) imaging in professional male rugby players. Ninety five professional rugby league (n = 52) and union (n = 43) players (n = 95; age 25.9 (SD 4.3) years; BMI: 29.5 (SD 2.9) kg.m2) participated in the research. Each participant received one VFA, and one total body and lumbar spine DXA scan (GE Lunar iDXA). One hundred and twenty vertebral fractures were identified in over half of the sample by VFA. Seventy four were graded mild (grade 1), 40 moderate (grade 2) and 6 severe (grade 3). Multiple vertebral fractures (≥2) were found in 37 players (39%). There were no differences in prevalence between codes, or between forwards and backs (both 1.2 v 1.4; p>0.05). The most common sites of fracture were T8 (n = 23), T9 (n = 18) and T10 (n = 21). The mean (SD) lumbar spine bone mineral density Z-score was 2.7 (1.3) indicating high player bone mass in comparison with age- and sex-matched norms. We observed a high number of vertebral fractures using DXA VFA in professional rugby players of both codes. The incidence, aetiology and consequences of vertebral fractures in professional rugby players are unclear, and warrant timely, prospective investigation. [ABSTRACT FROM AUTHOR]

The characterisation of bone geometry in male and female athletes may increase our understanding of how physical loading may enhance bone strength in both sexes. This study investigated sexual dimorphism in hip geometry of athletes and age- and sex-matched non-athletes. Dual energy X-ray absorptiometry of the left proximal femur was performed in 62 male ( n = 31; 30.2 ± 4.6 years) and female ( n = 31; 27.9 ± 5.2 years) competitive endurance runners, and 36 male ( n = 18; 28.7 ± 5.8 years) and female ( n = 18; 29.1 ± 5.3 years) non-athletes. The hip structural analysis programme determined areal bone mineral density (aBMD), bone area (BA), hip axis length, cross-sectional area (CSA), and cross-sectional moment of inertia (CSMI) of the femoral neck. Strength indices were derived from the femoral strength index (FSI) (Yoshikawa et al., J Bone Miner Res 9:1053-1064, ). Despite similar size-adjusted aBMD, sexual dimorphism was apparent for BA, CSA and CSMI, with superior values in men compared to women ( P < 0.01). FSI was greater in male and female athletes than non-athletes ( P < 0.01). From all groups, results in male athletes inferred greatest resistance to axial (CSA) and bending loads (FSI). Estimates of bone strength (FSI) were greater in female athletes than male and female non-athletes, supporting the osteogenic value of regular loading of the hip. [ABSTRACT FROM AUTHOR]

Understanding of the active beneficial processes of adventure learning remains elusive. Resilience may provide one foundation for understanding the positive adaptation derived from Outdoor Adventure Education (OAE) and Adventure Therapy (AT) programming. From a neurological perspective, resilience may be explained by the brain's innate capability to adapt its structure (growth of new cells) and function (re-wiring of existing cells) directly in response to environmental exposure. This paper explores the role of known brain responses to experiences analogous to adventure programming based on themes from a key literature review. The fundamental paradigm of "stress and recovery" contends that a balance of neurobiological processes help realign psychosocial equilibrium in the short term and over time. Through progressive, repeated exposure to custom-built outdoor challenges, the concept of brain resilience may provide a scientific platform for understanding the mechanisms of achieving meaningful, authentic and healthy outcomes. It could also help to begin to illuminate a section of the black box of adventure processes. [ABSTRACT FROM AUTHOR]

Loading of the skeleton is important for the development of a functionally and mechanically appropriate bone structure, and can be achieved through impact exercise. Proximal femur cross-sectional geometry was assessed in the male athletes (n = 55) representing gymnastics, endurance running and swimming, and non-athletic controls (n = 22). Dual energy X-ray absorptiometry (iDXA, GE Healthcare, UK) measurements of the total body (for body composition) and the left proximal femur were obtained. Advanced hip structural analysis (AHA) was utilised to determine the areal bone mineral density (aBMD), hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and the femoral strength index (FSI). Gymnasts and runners had greater age, height and weight adjusted aBMD than in swimmers and controls (p < 0.05). Gymnasts and runners had greater resistance to axial loads (CSA) and the runners had increased resistance against bending forces (CSMI) compared to swimmers and controls (p < 0.01). Controls had a lower FSI compared to gymnasts and runners (1.4 vs. 1.8 and 2.1, respectively, p < 0.005). Lean mass correlated with aBMD, CSA and FSI (r = 0.365-0.457, p < 0.01), particularly in controls (r = 0.657-0.759, p < 0.005). Skeletal loading through the gymnastics and running appears to confer a superior bone geometrical advantage in the young adult men. The importance of lean body mass appears to be of particular significance for non-athletes. Further characterisation of the bone structural advantages associated with different sports would be of value to inform the strategies directed at maximising bone strength and thus, preventing fracture. [ABSTRACT FROM AUTHOR]

Loading of the skeleton is important for the development of a functionally and mechanically appropriate bone structure, and can be achieved through impact exercise. Proximal femur cross-sectional geometry was assessed in the male athletes ( n = 55) representing gymnastics, endurance running and swimming, and non-athletic controls ( n = 22). Dual energy X-ray absorptiometry (iDXA, GE Healthcare, UK) measurements of the total body (for body composition) and the left proximal femur were obtained. Advanced hip structural analysis (AHA) was utilised to determine the areal bone mineral density (aBMD), hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and the femoral strength index (FSI). Gymnasts and runners had greater age, height and weight adjusted aBMD than in swimmers and controls ( p < 0.05). Gymnasts and runners had greater resistance to axial loads (CSA) and the runners had increased resistance against bending forces (CSMI) compared to swimmers and controls ( p < 0.01). Controls had a lower FSI compared to gymnasts and runners (1.4 vs. 1.8 and 2.1, respectively, p < 0.005). Lean mass correlated with aBMD, CSA and FSI ( r = 0.365-0.457, p < 0.01), particularly in controls ( r = 0.657-0.759, p < 0.005). Skeletal loading through the gymnastics and running appears to confer a superior bone geometrical advantage in the young adult men. The importance of lean body mass appears to be of particular significance for non-athletes. Further characterisation of the bone structural advantages associated with different sports would be of value to inform the strategies directed at maximising bone strength and thus, preventing fracture. [ABSTRACT FROM AUTHOR]

Harley, JA, Hind, K, and O'Hara, JP. Three-compartment body composition changes in elite rugby league players during a super league season, measured by dual-energy X-ray absorptiometry. J Strength Cond Res 25(4): 1024-1029, 2011-This study investigated the acute changes in body composition that occur over the course of a competitive season in elite rugby league players. Twenty elite senior players from an English Super League rugby league team underwent a total-body dual-energy X-ray absorptiometry scan at 3 phases of a competitive season: preseason (February), midseason (June), and postseason (September). Body mass (BM), fat mass (FM), lean mass, percentage body fat, and bone mineral content (BMC) were reported at each phase. Between the start and midpoint of the season, BM, lean mass, FM, and body fat percentage showed no significant change (p > 0.05); however, BMC was significantly increased (+0.71%; 30.70 ± 38.00 g; p < 0.05). Between the midseason and postseason phase, BM and BMC showed no significant change (p > 0.05); however, significant changes were observed in lean mass (-1.54%; 1.19 ± 1.43 kg), FM (+4.09%; 0.57 ± 1.10 kg), and body fat percentage (+4.98%; 0.78 ± 1.09%; p < 0.05). The significant changes in body composition seen over the latter stages of the competitive season may have implications for performance capabilities at this important stage of competition. An increase in FM and decrease in lean mass may have a negative effect on the power/BM ratio, and therefore may be a cause for concern for playing, coaching, and medical staff. Coaching and strength and conditioning staff should aim to prescribe appropriate training and nutritional practices with the aim of maintaining the players' optimal body composition until the conclusion of the competitive season, in order that performance capabilities are maximized over the entire competition period. [ABSTRACT FROM AUTHOR]

The article describes a study which used dual-energy x-ray absorptiometry to investigate the acute changes in body composition that occur in rugby players over the course of a competitive season. Scans were conducted during the preseason, midseason, and postseason on the players’ body mass, fat mass, lean mass, percentage of body fat, and bone mineral content.

The Extra Load Index (ELI) has been proposed as a suitable method of assessing the relative economy of load carriage systems. The purpose of this study was to determine, based on empirical evidence, that the ELI can accommodate variations in both body composition and added load. In total, 30 women walked carrying loads of up to 70% body mass at self-selected walking speeds whilst expired air was collected. In addition, each of the women had body composition assessed via dual energy X-ray absorptiometry. Results show that the ELI is independent of body composition variables, the magnitude of additional loads and the speed of progression. Consequently, it is suggested that it represents an appropriate method of comparing load carriage systems in both scientific and commercial arenas. Statement of Relevance:This paper demonstrates that ELI is independent of body composition, added load and speed and is therefore an appropriate method to generalise comparisons of load carriage systems. It has the advantage of being easily understood by manufacturers and consumers whilst retaining appropriate scientific precision. [ABSTRACT FROM AUTHOR]

Although the influence of weight-bearing activity on bone mass has been widely investigated in white women, few studies have been conducted in black, African populations. We investigated bone mineral density (BMD) in black South African women, with and without a history of load-carrying on the head. We also investigated whether load carrying may offer protection against low BMD in users of injectable progestin contraception (IPC). Participants were 32 black, South African women (22.4 +/- 3.2 years). Load carrying history was determined by questionnaire and interview; participants were grouped as load carriers (LC; n = 18) or non-load carriers (NLC; n = 14). Ten women were using IPC and 6 were load-carriers. Total body (TB), lumbar spine (LS) and total hip (H) BMD were measured by dual energy X-ray absorptiometry. There were no differences in BMD between LC and NLC, and after controlling for age and BMI using two-tailed partial correlations. IPC users had lower BMD at all sites compared to non-IPC users (p < 0.05) and there were no associations between load carrying and BMD in this group. When IPC users were excluded from analysis, LC had higher LS BMD than NLC (p < 0.005). Correlations were found between the weight of load carried and LS BMD (r = 0.743, p < 0.005), and between years of load carrying and LS and TB BMD (r = 0.563, r = 0.538, respectively; both p < 0.05). Load carrying on the head may offer osteogenic benefits to the spine but these benefits did not appear in women using IPC. [ABSTRACT FROM AUTHOR]