Kannus P, Järvinen T L, Sievänen H, Kvist M, Rauhaniemi J, Maunu V M, Hurme T, Jozsa L, Järvinen M
Accident & Trauma Research Center, UKK-Institute, Tampere, Finland.
J Bone Miner Res. 1996 Sep;11(9):1339-46. doi: 10.1002/jbmr.5650110919.
Disuse is associated with bone loss, which may not be recoverable. It is not known whether intensified remobilization is beneficial in restoring disuse-related bone loss nor if any such benefit would depend upon continuing mobilization for its maintenance. After an immobilization period of 3 weeks, the effects of free remobilization (11 weeks), and low-and high-intensity treadmill running (11 weeks) with and without subsequent deconditioning (18 weeks) on the bone mineral content (BMC) and density (BMD) of the hindlimb femora of Sprague-Dawley rats (n = 98) were studied using a dual-energy X-ray absorptiometric (DXA) scanner. Our hypothesis was that intensified remobilization is beneficial in restoring the BMC and BMD from disuse to normal while subsequent deconditioning is deleterious to these parameters. Immobilization for 3 weeks produced a significant BMC and BMD loss in the immobilized left femur (range -4.4 to -12.8%; p < 0.05-0.001). In the groups with free remobilization (free cage activity), the body weight-adjusted BMCs and BMDs always remained below those in the controls (range -2.3 to -12.1%; p values ranging from NS to < 0.01). Both low- and high-intensity running restored BMC and BMD in the immobilized limb, the effect being better in the latter group. In both of these groups, the values of the immobilized left limbs and those of the free right limbs exclusively exceeded the corresponding values of the age-matched control rats (left limb values 3.0-21.1% higher with p values ranging from NS to < 0.01; right limb values 7.9-21.4% higher with p < 0.05-0.01). However, after the deconditioning period of 18 weeks, the above described beneficial effects of low- and high-intensity running were lost, the left and right limb BMC and BMD values being lower than those in the age-matched controls (range -3.8 to -8.7%; p values ranging from NS to < 0.05). In conclusion, this study clearly indicates the need for greater than normal activity to restore the BMC and BMD after disuse to normal levels. However, the benefits of intensified remobilization are lost if the activity is terminated, and therefore, after immobilization and disuse, bone loading activities should be continued, perhaps indefinitely.
废用与骨质流失相关,而这种骨质流失可能无法恢复。目前尚不清楚强化活动恢复与废用相关的骨质流失是否有益,也不清楚这种益处是否依赖于持续活动来维持。在3周的固定期后,使用双能X线吸收测定仪(DXA)扫描仪研究了自由活动(11周)以及低强度和高强度跑步机跑步(11周)且后续有无失用状态(18周)对98只Sprague-Dawley大鼠后肢股骨的骨矿物质含量(BMC)和骨密度(BMD)的影响。我们的假设是,强化活动有利于将BMC和BMD从废用状态恢复到正常水平,而随后的失用状态对这些参数有害。3周的固定导致固定的左股骨出现显著的BMC和BMD损失(范围为-4.4%至-12.8%;p<0.05-0.001)。在自由活动组(自由笼内活动)中,体重校正后的BMC和BMD始终低于对照组(范围为-2.3%至-12.1%;p值从无统计学意义到<0.01)。低强度和高强度跑步均使固定肢体的BMC和BMD得到恢复,后一组的效果更好。在这两组中,固定的左肢和自由的右肢的值均仅超过年龄匹配的对照大鼠的相应值(左肢值高3.0%-21.1%,p值从无统计学意义到<0.01;右肢值高7.9%-21.4%,p<0.05-0.01)。然而,在18周的失用期后,上述低强度和高强度跑步的有益效果消失,左、右肢的BMC和BMD值低于年龄匹配的对照组(范围为-3.8%至-8.7%;p值从无统计学意义到<0.05)。总之,本研究明确表明,需要比正常活动量更大的活动量才能将废用后的BMC和BMD恢复到正常水平。然而,如果活动终止,强化活动的益处就会丧失,因此,在固定和废用后,应持续进行骨负荷活动,或许需要无限期进行。