Targeted exercises against hip fragility.
CONCLUSIONS
Compared to high-impact exercises, moderate-magnitude impacts from odd-loading directions have similar ability to thicken vulnerable cortical regions of the femoral neck. Since odd-impact exercises are mechanically less demanding to the body, this type of exercise can provide a reasonable basis for devising feasible, targeted bone training against hip fragility.


BACKGROUND
Regional cortical thinning at the femoral neck is associated with hip fragility. Here, we investigated whether exercises involving high-magnitude impacts, moderate-magnitude impacts from odd directions, high-magnitude muscle forces, low-magnitude impacts at high repetition rate, or non-impact muscle forces at high repetition rate were associated with thicker femoral neck cortex.


METHODS
Using three-dimensional magnetic resonance imaging, we scanned the proximal femur of 91 female athletes, representing the above-mentioned five exercise-loadings, and 20 referents. Cortical thickness at the inferior, anterior, superior, and posterior regions of the femoral neck was evaluated. Between-group differences were analyzed with ANCOVA.


RESULTS
For the inferior cortical thickness, only the high-impact group differed significantly (approximately 60%, p = 0.012) from the reference group, while for the anterior cortex, both the high-impact and odd-impact groups differed (approximately 20%, p = 0.042 and p = 0.044, respectively). Also, the posterior cortex was approximately 20% thicker (p = 0.014 and p = 0.006, respectively) in these two groups.


CONCLUSIONS
Odd-impact exercise-loading was associated, similar to high-impact exercise-loading, with approximately 20% thicker cortex around the femoral neck. Since odd-impact exercises are mechanically less demanding to the body than high-impact exercises, it is argued that this type of bone training would offer a feasible basis for targeted exercise-based prevention of hip fragility.
Nikander
R
R
Bone Research Group, UKK Institute for Health Promotion Research, 33501 Tampere, Finland.
Kannus
P
P
Dastidar
P
P
Hannula
M
M
Harrison
L
L
Cervinka
T
T
Narra
N G
NG
Aktour
R
R
Arola
T
T
Eskola
H
H
Soimakallio
S
S
Heinonen
A
A
Hyttinen
J
J
Sievänen
H
H
D000328:Adult; D015519:Bone Density / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000517:prevention & control*; D005272:Femur Neck / Q000033:anatomy & histology / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008159:Lumbar Vertebrae / Q000502:physiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D013177:Sports / Q000502:physiology; D055815:Young Adult