AbstractOsteoporosis is considered a pediatric disease with geriatric consequences. However, measuring bone strength in children is complex and creates a practical problem for health professionals, teachers and parents. A non-invasive measure of muscle fitness that correlates to bone strength may provide a means to monitor bone strength throughout the lifespan. Therefore, the purpose of this study was to investigate the relationship between common muscle function tests (relative grip strength (RGS), peak vertical jump power (PP)) and bone strength in the radial diaphysis and epiphysis of a healthy population. Healthy participants (n=147 (81 female)) performed a bilateral grip strength test using a hand dynamometer, and a maximal vertical jump test. Peak vertical jump power was calculated from maximal jump height using the Sayer’s equation. Moment of inertia (MoI), cortical area (CoA), cortical bone mineral density (cBMD), and polar strength-strain index (SSIp) were measured using peripheral Quantitative Computed Tomography (pQCT) to determine bone strength parameters at the 66% radial site (predominantly cortical bone). At the 4% site (trabecular bone site), bone mineral content (vBMC.tb), bone mineral density (vBMD.tb), total area (ToA.tb) and bone strength index (BSIc) were measured. Hierarchical multiple regression analyses determined the relationship of each muscle function test for each bone envelope (cortical and trabecular). For the cortical bone measurements: RGS, and PP were both significantly correlated with CoA, MoI, and SSIp. Peak vertical jump power predicted bone strength parameters to a greater extent compared to RGS. For the trabecular bone envelope, RGS was not a predictor of bone strength however peak power was a significant predictor of bone strength parameters. Peak vertical jump power was a significant predictor of bone strength at both trabecular and cortical radial sites. Interestingly PP, a lower limb measurement explained the most variance in the bone strength of the upper limb.
Ashe, M. C., Liu-Ambrose, T. Y. L., Cooper, D. M. L., Khan, K. M., & McKay, H. A. (2008). Muscle power is related to tibial bone strength in older women. Osteoporosis International, 19(12), 1725–1732. https://doi.org/10.1007/s00198-008-0655-6
Augat, P., Iida, H., Jiang, Y., Diao, E., & Genant, H. K. (1998). Distal radius fractures: mechanisms of injury and strength prediction by bone mineral assessment. Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society, 16(5), 629–635. https://doi.org/10.1002/jor.1100160517
Baptista, F., Mil-Homens, P., Carita, A., Janz, K., & Sardinha, L. (2016). Peak vertical jump power as a marker of bone health in children. International Journal of Sports Medicine, 37(08), 653–658. https://doi.org/10.1055/s-0042-105290
Best, A., Holt, B., Troy, K., & Hamill, J. (2017). Trabecular bone in the calcaneus of runners. PLOS ONE, 12(11), e0188200. https://doi.org/10.1371/journal.pone.0188200
Boonen, S., Cheng, X. G., Nijs, J., Nicholson, P. H. F., Verbeke, G., Lesaffre, E., … Dequeker, J. (1997). Factors associated with cortical and trabecular bone loss as quantified by peripheral computed tomography (pQCT) at the ultradistal radius in aging women. Calcified Tissue International, 60(2), 164–170. https://doi.org/10.1007/s002239900208
Canadian Society for Exercise Physiology, Canada, & Health Canada. (2003). The Canadian physical activity, fitness & lifestyle approach: CSEP health & fitness program’s health-related appraisal & counselling strategy. Ottawa, Ont.: Canadian Society for Exercise Physiology.
Cointry, G., Ferretti, J. L., Reina, P. S., Nocciolono, L. M., Rittweger, J., & Capozza, R. F. (2014). The pQCT “Bone Strength Indices”(BSIs, SSI). Relative mechanical impact and diagnostic value of the indicators of bone tissue and design quality employed in their calculation in healthy men and pre-and post-menopausal women. Journal of Musculoskeletal and Neuronal Interactions, 14(1), 29–40.
Cooper, C., Campion, G., & Melton, L. J. (1992). Hip fractures in the elderly: A world-wide projection. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2(6), 285–289. https://doi.org/10.1007/bf01623184
Dequeker, J., & Van Tendeloo, G. (1982). Metacarpal bone mass and upper-extremity strength in 18-year-old boys. Investigative Radiology, 17(4), 427–429. https://doi.org/10.1097/00004424-198207000-00026
Ferretti, J. L., Cointry, G. R., Capozza, R. F., Capiglioni, R., & Chiappe, M. A. (2001). Analysis of biomechanical effects on bone and on the muscle-bone interactions in small animal models. Journal of Musculoskeletal & Neuronal Interactions, 1(3), 263–274.
Földhazy, Z., Arndt, A., Milgrom, C., Finestone, A., & Ekenman, I. (2005). Exercise-induced strain and strain rate in the distal radius. The Journal of Bone and Joint Surgery. British Volume, 87-B(2), 261–266. https://doi.org/10.1302/0301-620X.87B2.14857
Frank, A. W., Lorbergs, A. L., Chilibeck, P. D., Farthing, J. P., & Kontulainen, S. A. (2010). Muscle cross sectional area and grip torque contraction types are similarly related to pQCT derived bone strength indices in the radii of older healthy adults. Journal of musculoskeletal & neuronal interactions. 10. 136-41.
Frank, A. W., Labas, M. C., Johnston, J. D., & Kontulainen, S. A. (2012). Site-specific variance in radius and tibia bone strength as determined by muscle size and body mass. Physiotherapy Canada, 64(3), 292–301. https://doi.org/10.3138/ptc.2010-40BH
Glüer, C.-C., Blake, G., Lu, Y., Blunt, B. A., Jergas, M., & Genant, H. K. (1995). Accurate assessment of precision errors: how to measure the reproducibility of bone densitometry techniques. Osteoporosis International, 5(4), 262–270. https://doi.org/10.1007/BF01774016
Golden, N. H. (2000). Osteoporosis prevention: A pediatric challenge. Archives of Pediatrics & Adolescent Medicine, 154(6), 542–543.
Greene, D. A., Naughton, G. A., Bradshaw, E., Moresi, M., & Ducher, G. (2012). Mechanical loading with or without weight-bearing activity: Influence on bone strength index in elite female adolescent athletes engaged in water polo, gymnastics, and track-and-field. Journal of Bone and Mineral Metabolism, 30(5), 580–587. https://doi.org/10.1007/s00774-012-0360-6
Haapasalo, H., Kontulainen, S., Sievänen, H., Kannus, P., Järvinen, M., & Vuori, I. (2000). Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: A peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone, 27(3), 351–357. https://doi.org/10.1016/s8756-3282(00)00331-8
Hasegawa, Y., Schneider, P., & Reiners, C. (2001). Age, sex, and grip strength determine architectural bone parameters assessed by peripheral quantitative computed tomography (pQCT) at the human radius. Journal of Biomechanics, 34(4), 497–503. https://doi.org/10.1016/s0021-9290(00)00211-6
Hsieh, Y.-F., Robling, A. G., Ambrosius, W. T., Burr, D. B., & Turner, C. H. (2001). Mechanical loading of diaphyseal bone in vivo: The strain threshold for an osteogenic response varies with location. Journal of Bone and Mineral Research, 16(12), 2291–2297. https://doi.org/10.1359/jbmr.2001.16.12.2291
Innes, E. (1999). Handgrip strength testing: A review of the literature. Australian Occupational Therapy Journal, 46(3), 120–140. https://doi.org/10.1046/j.1440-1630.1999.00182.x
Janz, K. (2002). Physical activity and bone development during childhood and adolescence. Implications for the prevention of osteoporosis. Minerva Pediatrica, 54(2), 93–104.
Janz, K. F., Letuchy, E. M., Burns, T. L., Francis, S. L., & Levy, S. M. (2015). Muscle power predicts adolescent bone strength: Iowa Bone Development Study. Medicine & Science in Sports & Exercise, 47(10), 2201–2206. https://doi.org/10.1249/MSS.0000000000000648
Kaji, H., Kosaka, R., Yamauchi, M., Kuno, K., Chihara, K., & Sugimoto, T. (2005). Effects of age, grip strength and smoking on forearm volumetric bone mineral density and bone geometry by peripheral quantitative computed tomography: Comparisons between Female and Male. Endocrine Journal, 52(6), 659–666. https://doi.org/10.1507/endocrj.52.659
Kannus, P., Haapasalo, H., Sankelo, M., Sievänen, H., Pasanen, M., Heinonen, A., … Vuori, I. (1995). Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Annals of Internal Medicine, 123(1), 27–31. https://doi.org/10.7326/0003-4819-123-1-199507010-00003
Kontulainen, S. A., Johnston, J. D., Liu, D., Leung, C., Oxland, T. R., & McKay, H. A. (2008). Strength indices from pQCT imaging predict up to 85% of variance in bone failure properties at tibial epiphysis and diaphysis. Journal of Musculoskeletal & Neuronal Interactions, 8(4), 401–409.
Kontulainen, S., Sievänen, H., Kannus, P., Pasanen, M., & Vuori, I. (2003). Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: A Peripheral quantitative computed tomography study between young and old starters and controls. Journal of Bone and Mineral Research, 18(2), 352–359. https://doi.org/10.1359/jbmr.2003.18.2.352
Lambert, C., Beck, B. R., Harding, A. T., Watson, S. L., & Weeks, B. K. (2019). Impact versus resistance training for bone in young women: Preliminary Findings Of The OPTIMA-Ex Trial: 3067 Board #113 May 31 3:30 PM - 5:00 PM. Medicine & Science in Sports & Exercise, 51(Supplement), 845. https://doi.org/10.1249/01.mss.0000563025.70640.3b
Lanyon, L. E. (1996). Using functional loading to influence bone mass and architecture: Objectives, mechanisms, and relationship with estrogen of the mechanically adaptive process in bone. Bone, 18(1 Suppl), 37S-43S. https://doi.org/10.1016/8756-3282(95)00378-9
Lorbergs, A. L., Farthing, J. P., Baxter-Jones, A. D. G., & Kontulainen, S. A. (2011). Forearm muscle size, strength, force, and power in relation to pQCT-derived bone strength at the radius in adults. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquée, Nutrition Et Métabolisme, 36(5), 618–625. https://doi.org/10.1139/h11-065
Macdonald, H., Kontulainen, S., Petit, M., Janssen, P., & McKay, H. (2006). Bone strength and its determinants in pre- and early pubertal boys and girls. Bone, 39(3), 598–608. https://doi.org/10.1016/j.bone.2006.02.057
Marks, R. (2009). Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009. International Journal of General Medicine, 1. https://doi.org/10.2147/IJGM.S5906
Mathiowetz, V., Weber, K., Volland, G., & Kashman, N. (1984). Reliability and validity of grip and pinch strength evaluations. The Journal of Hand Surgery, 9(2), 222–226. https://doi.org/10.1016/s0363-5023(84)80146-x
Mosley, J. R., & Lanyon, L. E. (1998). Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats. Bone, 23(4), 313–318. https://doi.org/10.1016/s8756-3282(98)00113-6
Nellans, K. W., Kowalski, E., & Chung, K. C. (2012). The epidemiology of distal radius fractures. Hand Clinics, 28(2), 113–125. https://doi.org/10.1016/j.hcl.2012.02.001
Rantalainen, T., Nikander, R., Heinonen, A., Multanen, J., Häkkinen, A., Jämsä, T., … Sievänen, H. (2010). Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women. Bone, 46(4), 964–969. https://doi.org/10.1016/j.bone.2010.01.002
Sayers, S. P., Harackiewicz, D. V., Harman, E. A., Frykman, P. N., & Rosenstein, M. T. (1999). Cross-validation of three jump power equations. Medicine and Science in Sports and Exercise, 31(4), 572–577. https://doi.org/10.1097/00005768-199904000-00013
Schoenau, E., Neu, C. M., Beck, B., Manz, F., & Rauch, F. (2002). Bone mineral content per muscle cross-sectional area as an index of the functional muscle-bone unit. Journal of Bone and Mineral Research: American Society for Bone and Mineral Research, 17(6), 1095–1101. https://doi.org/10.1359/jbmr.2002.17.6.1095
Stengel, S. V. (2005). Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. Journal of Applied Physiology, 99(1), 181–188. https://doi.org/10.1152/japplphysiol.01260.2004
Sugiyama, T., Price, J. S., & Lanyon, L. E. (2010). Functional adaptation to mechanical loading in both cortical and cancellous bone is controlled locally and is confined to the loaded bones. Bone, 46(2), 314–321. https://doi.org/10.1016/j.bone.2009.08.054
Sumnik, Z., Land, C., Coburger, S., Neu, C., Manz, F., Hrach, K., & Schoenau, E. (2006). The muscle-bone unit in adulthood: Influence of sex, height, age and gynecological history on the bone mineral content and muscle cross-sectional area. Journal of Musculoskeletal and Neuronal Interactions, 6(2), 195.
Turner, C. H., & Robling, A. G. (2003). Designing exercise regimens to increase bone strength. Exercise and Sport Sciences Reviews, 31(1), 45–50. https://doi.org/10.1097/00003677-200301000-00009
Van der Meulen, M. C. H., Jepsen, K. J., & Mikić, B. (2001). Understanding bone strength: Size isn’t everything. Bone, 29(2), 101–104.https://doi.org/10.1016/s8756-3282(01)00491-4
Wapniarz, M., Lehmann, R., Reincke, M., Schönau, E., Klein, K., & Allolio, B. (1997). Determinants of radial bone density as measured by PQCT in pre- and postmenopausal women: The role of bone size. Journal of Bone and Mineral Research, 12(2), 248–254. https://doi.org/10.1359/jbmr.1922.214.171.124
Warden, S. J., Mantila Roosa, S. M., Kersh, M. E., Hurd, A. L., Fleisig, G. S., Pandy, M. G., & Fuchs, R. K. (2014). Physical activity when young provides lifelong benefits to cortical bone size and strength in men. Proceedings of the National Academy of Sciences, 111(14), 5337–5342. https://doi.org/10.1073/pnas.1321605111
Warden, Stuart J., Bogenschutz, E. D., Smith, H. D., & Gutierrez, A. R. (2009). Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players. Bone, 45(5), 931–941. https://doi.org/10.1016/j.bone.2009.07.075
Warden, Stuart J., Carballido-Gamio, J., Avin, K. G., Kersh, M. E., Fuchs, R. K., Krug, R., & Bice, R. J. (2019). Adaptation of the proximal humerus to physical activity: A within-subject controlled study in baseball players. Bone, 121, 107–115. https://doi.org/10.1016/j.bone.2019.01.008
Yingling, V. R., Webb, S. L., Inouye, C., O, J., & Sherwood, J. J. (2020). Muscle Power Predicts Bone Strength in Division II Athletes. Journal of strength and conditioning research, 34(6), 1657–1665. https://doi.org/10.1519/JSC.0000000000002222
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Vanessa Yingling, Rebekkah Reichert, Andrew Denys, Priscilla Franson, Kimberly Espartero, Maria Alvarez, Kirstie Huynh, Karen Serrano Vides, Arianna Mazzarini