title: Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur.
abstract: Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted.
  
  
  
  The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction. Sideways falls heighten femoral neck fracture risk by loading the relatively weak superolateral region of femoral neck. Recent studies exploring regional adaptation of the femoral neck to physical activity have identified heterogeneous adaptation, with adaptation principally occurring within inferomedial weight-bearing regions and little to no adaptation occurring in the superolateral femoral neck. There is a need to develop novel physical activities that better target and strengthen the superolateral femoral neck within the proximal femur. Design of these activities may be guided by subject-specific musculoskeletal modeling and finite-element modeling approaches.
authors.affiliation: Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA.
authors.forename: Robyn K
authors.initials: RK
authors.lastname: Fuchs
authors.affiliation: Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA.
authors.forename: Mariana E
authors.initials: ME
authors.lastname: Kersh
authors.affiliation: Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA.
authors.forename: Julio
authors.initials: J
authors.lastname: Carballido-Gamio
authors.affiliation: Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Thompson
authors.affiliation: Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California, Irvine, CA, USA.
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Keyak
authors.affiliation: Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA. stwarden@iu.edu.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Warden
mesh_terms: D000058:Accidental Falls; D015444:Exercise; D005081:Exercise Therapy; D005265:Femoral Neck Fractures / Q000517:prevention & control*; D005269:Femur; D006801:Humans; D010024:Osteoporosis / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D016474:Weight-Bearing
keywords: Bone density; Bone mass; Bone structure; Exercise; Femoral neck; Osteoporosis