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High-impact exercise stimulated localised adaptation of microarchitecture across distal tibia in postmenopausal women

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Abstract

Summary

We provided evidence that a 6-month regular hopping exercise intervention can increase trabecular number and possibly trabecular volume fraction of the distal tibia. Our novel localised analysis demonstrated region-specific changes, predominantly in the anterior region, in postmenopausal women.

Introduction

The localisation of bone remodelling and microarchitectural adaptation to exercise loading has not been demonstrated previously in vivo in humans. The aim of this study is to assess the feasibility of using 3D image registration and high-resolution peripheral quantitative computed tomography (HR-pQCT) to investigate the effect of high-impact exercise on human trabecular bone variables and remodelling rate across the distal tibia.

Methods

Ten postmenopausal women were recruited for 6-month unilateral hopping exercises, with HR-pQCT scans taken of both exercise leg (EL) and control leg (CL) for each participant before and after the intervention. A 3D image registration was used to ensure measurements were taken at the same region. Short-term reproducibility tests were conducted prior to the assessment using identical setup. The results were assessed comparing CL and EL, and interaction (time × leg) using a two-way repeated measures analysis of variance (RM-ANOVA).

Results

Across the whole tibia, we observed significant increases in trabecular number (Tb.N) (+ 4.4%) and trabecular bone formation rate (tBFR) (3.3%), and a non-significant increase in trabecular bone volume fraction (BV/TV) (+ 1%) in the EL. Regional resorption was higher in the CL than the EL, with this difference being statistically significant at the lateral tibia. In the EL, tBFR was significantly higher in the anterior region than the medial but a trabecular bone resorption rate (tBRR) showed no significant regional variation. Conversely in the CL, both tBFR and tBRR were significantly higher in the anterior and lateral than the medial region.

Conclusion

We demonstrated that it was possible to detect exercise-related bone adaptation with 3D registration of HR-pQCT scan data. Regular hopping exercise increased Tb.N and possibly BV/TV across the whole distal tibia. A novel finding of the study was that tBFR and tBRR responses to loading were localised: changes were achieved by formation rate exceeding resorption rate in the exercise leg, both globally and at the anterior region where turnover was greatest.

Trial registration

clinicaltrials.gov: NCT03225703

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Acknowledgements

The authors would like to thank all participants involved in this study as well as Ganggang Xiang, Yaqi Qian and Chenguang Zhao from the Loughborough University, for their contribution in segmenting the images. We would also like to acknowledge the Mellanby Centre for Bone Research at The University of Sheffield and the NIHR Clinical Research Facility, Sheffield Teaching Hospitals, for providing access to the HR-pQCT scanner.

Funding

This study was jointly supported by the Loughborough University Health & Wellbeing Research Challenge Seed Corn fund and the NIHR Leicester Biomedical Research Centre.

Author information

Authors and Affiliations

  1. Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China

    J. Du

  2. Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Leicestershire, UK

    J. Du, S. Li & V. V. Silberschmidt

  3. School of Sport, Exercise and Health Science, Loughborough University, Leicestershire, UK

    C. Hartley & K. Brooke-Wavell

  4. Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK

    M. A. Paggiosi & J. S. Walsh

Authors
  1. J. Du
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  2. C. Hartley
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  4. M. A. Paggiosi
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  5. J. S. Walsh
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  6. S. Li
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  7. V. V. Silberschmidt
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Corresponding author

Correspondence to S. Li.

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Conflicts of interest

SL received grant support from Loughborough University. KBW received grant support from NIHR Leicester Biomedical Research Centre. JSW received grant support from National Institute for Health Research. The remaining authors declare no competing financial interests.

Ethics approval

The present study was registered at clinicaltrials.gov: NCT03225703: The Effect of High-Impact Exercise on Bone and Articular Cartilage in Postmenopausal Women.

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All participants provided written informed consent.

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All participants provided written informed consent for publication.

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Mimics, Abaqus and Matlab were used with official license. Custom code is not available.

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Appendix

Appendix

Fig 5
figure 5

Rates of bone formation (tBFR) and resorption (tBRR) per month between EL and CL for each RVE to demonstrate local variation

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Fig 6
figure 6

Mean difference in BV/TV, Tb.Th, Tb.SP, Tb.N, Tb.BS, PTb.N/TTb.N and stiffness of each RVE between pre- and post-intervention for EL and CL

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Du, J., Hartley, C., Brooke-Wavell, K. et al. High-impact exercise stimulated localised adaptation of microarchitecture across distal tibia in postmenopausal women. Osteoporos Int 32, 907–919 (2021). https://doi.org/10.1007/s00198-020-05714-4

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