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长期单侧活动对青少年女子网球运动员骨密度的影响。

Effect of long-term unilateral activity on bone mineral density of female junior tennis players.

作者信息

Haapasalo H, Kannus P, Sievänen H, Pasanen M, Uusi-Rasi K, Heinonen A, Oja P, Vuori I

机构信息

Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland.

出版信息

J Bone Miner Res. 1998 Feb;13(2):310-9. doi: 10.1359/jbmr.1998.13.2.310.

Abstract

High peak bone mass in early adulthood is an important protective factor against osteoporotic fractures in later life, but little is known about the effects of exercise on growing bone. The purpose of this cross-sectional study was to determine at which state of maturity (Tanner stage), the areal bone mineral density (BMD) differences between the playing and nonplaying arms of junior tennis players become obvious, and to clarify in each developmental stage which training and background variables, if any, could explain the interindividual differences in bones' response to mechanical loading. Ninety-one 7- to 17-year-old female tennis players and 58 healthy female controls were measured. In each Tanner stage, differences in BMD in playing and nonplaying (dominant and nondominant) arms (proximal humerus, humeral shaft, and distal radius) and BMD of the lumbar spine and nondominant distal radius were compared between the controls and players. Within each Tanner stage of players, the associations between training and background variables and BMD differences were analyzed with Spearman rank correlation coefficients. In players, BMD differences between the playing and nonplaying arms were significant (P < 0.05- < 0.001) in all Tanner stages, with the mean difference ranging from 1.6 to 15.7%. In controls, these dominant-to-nondominant arm differences were clearly smaller (ranging from -0.2 to 4.6%), but significant at some measured sites. In comparison with the relative side-to-side arm differences between the players and controls (i.e., examination of the training effect), the mean difference was not obvious and significant until the adolescent growth spurt (i.e., the girls in Tanner stage III with a mean age of 12.6 years). In the lumbar spine, significant BMD differences between players and controls were not found until Tanner stage IV (mean age 13.5 years; 8.7%, P < 0.05) and V (mean age 15.5 years; 12.4%, P < 0.05). In a nonloaded site of the skeleton (nondominant distal radius), no significant BMD differences were found between the players and controls in any Tanner stage. In the correlation analysis, the Tanner I and II players (mean ages 9.4 and 10.8 years) showed no significant associations between any of the predictive variables and the side-to-side BMD differences, while in Tanner stages III, IV, and V, such associations could be found; the total amount of training hours during the playing career and the number of training sessions per week showed a significant and systematic correlation (rs ranging from 0.43 to 0.80) with the side-to-side BMD differences in several measured bone sites. In conclusion, this study suggests that in a majority of female junior tennis players, the benefit of unilateral activity on bone density does not become clearly evident until the adolescent growth spurt or Tanner stage III. The total amount of training during the player's career and the current training frequency (sessions per week) seem to best explain the training effect on bone tissue, leaving, however, room for speculation on the still unknown factors that modulate the loading response of a growing bone.

摘要

成年早期的高骨峰值是预防晚年骨质疏松性骨折的重要保护因素,但关于运动对骨骼生长的影响却知之甚少。这项横断面研究的目的是确定在哪个成熟阶段(坦纳阶段),青少年网球运动员优势侧与非优势侧手臂的骨面积密度(BMD)差异变得明显,并在每个发育阶段阐明哪些训练和背景变量(如果有的话)可以解释个体骨骼对机械负荷反应的差异。对91名7至17岁的女性网球运动员和58名健康女性对照者进行了测量。在每个坦纳阶段,比较了对照组和运动员优势侧与非优势侧(优势和非优势)手臂(近端肱骨、肱骨干和桡骨远端)以及腰椎和非优势侧桡骨远端的BMD差异。在运动员的每个坦纳阶段,用斯皮尔曼等级相关系数分析训练和背景变量与BMD差异之间的关联。在运动员中,所有坦纳阶段优势侧与非优势侧手臂的BMD差异均有统计学意义(P<0.05 - <0.001),平均差异范围为1.6%至15.7%。在对照组中,这些优势侧与非优势侧手臂的差异明显较小(范围为-0.2%至4.6%),但在某些测量部位有统计学意义。与运动员和对照组之间相对的双侧手臂差异(即训练效果的检查)相比,直到青春期生长突增期(即平均年龄为12.6岁的坦纳III期女孩),平均差异才变得明显且有统计学意义。在腰椎,直到坦纳IV期(平均年龄13.5岁;8.7%,P<0.05)和V期(平均年龄15.5岁;12.4%,P<0.05)才发现运动员与对照组之间有显著的BMD差异。在骨骼的非负荷部位(非优势侧桡骨远端),在任何坦纳阶段运动员与对照组之间均未发现显著的BMD差异。在相关性分析中,坦纳I期和II期的运动员(平均年龄分别为9.4岁和10.8岁)在任何预测变量与双侧BMD差异之间均未显示出显著关联,而在坦纳III期、IV期和V期则可以发现这种关联;职业生涯中的总训练小时数和每周的训练次数与几个测量骨部位的双侧BMD差异显示出显著且系统的相关性(rs范围为0.43至0.80)。总之,这项研究表明,在大多数女性青少年网球运动员中,直到青春期生长突增期或坦纳III期,单侧活动对骨密度的益处才会明显显现。运动员职业生涯中的总训练量和当前的训练频率(每周的训练次数)似乎最能解释训练对骨组织的影响,然而,对于调节生长中骨骼负荷反应的仍未知因素,仍有推测的空间。

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