Osteoporosis International

, Volume 19, Issue 11, pp 1567–1577 | Cite as

The BPAQ: a bone-specific physical activity assessment instrument

  • B. K. Weeks
  • B. R. BeckEmail author
Original Article



A newly developed bone-specific physical activity questionnaire (BPAQ) was compared with other common measures of physical activity for its ability to predict parameters of bone strength in healthy, young adults. The BPAQ predicted indices of bone strength at clinically relevant sites in both men and women, while other measures did not.


Only certain types of physical activity (PA) are notably osteogenic. Most methods to quantify levels of PA fail to account for bone relevant loading. Our aim was to examine the ability of several methods of PA assessment and a new bone-specific measure to predict parameters of bone strength in healthy adults.


We recruited 40 men and women (mean age 24.5). Subjects completed the modifiable activity questionnaire, Bouchard 3-day activity record, a recently published bone loading history questionnaire (BLHQ), and wore a pedometer for 14 days. We also administered our bone-specific physical activity questionnaire (BPAQ). Calcaneal broadband ultrasound attenuation (BUA) (QUS-2, Quidel) and densitometric measures (XR-36, Norland) were examined. Multiple regression and correlation analyses were performed on the data.


The current activity component of BPAQ was a significant predictor of variance in femoral neck bone mineral density (BMD), lumbar spine BMD, and whole body BMD (R2 = 0.36–0.68, p < 0.01) for men, while the past activity component of BPAQ predicted calcaneal BUA (R2 = 0.48, p = 0.001) for women.


The BPAQ predicted indices of bone strength at skeletal sites at risk of osteoporotic fracture while other PA measurement tools did not.


Bone mass Exercise Ground reaction force Pedometer 



The authors would like to acknowledge the assistance of Dr Rod Barrett and Dr Justin Kavanagh in the data collection phase of the project. There were no external funding sources for this project.

Conflict of interest



  1. 1.
    Rubin CT (1984) Skeletal strain and the functional significance of bone architecture. Calcif Tissue Int 36(Suppl 1):S11–18CrossRefPubMedGoogle Scholar
  2. 2.
    Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37:411–417CrossRefPubMedGoogle Scholar
  3. 3.
    O’Connor JA, Lanyon LE, MacFie H (1982) The influence of strain rate on adaptive bone remodelling. J Biomech 15:767–781CrossRefPubMedGoogle Scholar
  4. 4.
    Turner CH, Owan I, Takano Y (1995) Mechanotransduction in bone: Role of strain rate. Am J Physiol 269:E438–442PubMedGoogle Scholar
  5. 5.
    Kannus P, Haapasalo H, Sankelo M et al (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31CrossRefPubMedGoogle Scholar
  6. 6.
    Burr DB, Milgrom C, Fyhrie D et al (1996) In vivo measurement of human tibial strains during vigorous activity. Bone 18:405–410CrossRefPubMedGoogle Scholar
  7. 7.
    Ekenman I, Halvorsen K, Westblad P et al (1998) Local bone deformation at two predominant sites for stress fractures of the tibia: An in vivo study. Foot Ankle Int 19:479–484CrossRefPubMedGoogle Scholar
  8. 8.
    Lanyon LE, Hampson WG, Goodship AE et al (1975) Bone deformation recorded in vivo from strain gauges attached to the human tibial shaft. Acta Orthop Scand 46:256–268CrossRefPubMedGoogle Scholar
  9. 9.
    Milgrom C, Miligram M, Simkin A et al (2001) A home exercise program for tibial bone strengthening based on in vivo strain measurements. Am J Phys Med Rehabil 80:433–438CrossRefPubMedGoogle Scholar
  10. 10.
    Milgrom C, Radeva-Petrova DR, Finestone A et al (2007) The effect of muscle fatigue on in vivo tibial strains. J Biomech 40:845–850CrossRefPubMedGoogle Scholar
  11. 11.
    Milgrom C, Finestone A, Levi Y et al (2000) Do high impact exercises produce higher tibial strains than running? Br J Sports Med 34:195–199CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Hurrion PD, Dyson R, Hale T (2000) Simultaneous measurement of back and front foot ground reaction forces during the same delivery stride of the fast-medium bowler. J Sports Sci 18:993–997CrossRefPubMedGoogle Scholar
  13. 13.
    Perttunen JO, Kyrolainen H, Komi PV et al (2000) Biomechanical loading in the triple jump. J Sports Sci 18:363–370CrossRefPubMedGoogle Scholar
  14. 14.
    Salci Y, Kentel BB, Heycan C et al (2004) Comparison of landing maneuvers between male and female college volleyball players. Clin Biomech 19:622–628CrossRefGoogle Scholar
  15. 15.
    Dolan SH, Williams DP, Ainsworth BE et al (2006) Development and reproducibility of the bone loading history questionnaire. Med Sci Sports Exerc 38:1121–1131CrossRefPubMedGoogle Scholar
  16. 16.
    Turner CH, Robling AG (2003) Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev 31:45–50CrossRefPubMedGoogle Scholar
  17. 17.
    Turner CH, Robling AG (2005) Exercises for improving bone strength. Br J Sports Med 39:188–189CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Snow CM, Williams DP, LaRiviere J et al (2001) Bone gains and losses follow seasonal training and detraining in gymnasts. Calcif Tissue Int 69:7–12CrossRefPubMedGoogle Scholar
  19. 19.
    Kriska AM, Bennett PH (1992) An epidemiological perspective of the relationship between physical activity and NIDDM: from activity assessment to intervention. Diabetes Metab Rev 8:355–372CrossRefPubMedGoogle Scholar
  20. 20.
    Bouchard C, Tremblay A, Leblanc C et al (1983) A method to assess energy expenditure in children and adults. Am J Clin Nutr 37:461–467PubMedGoogle Scholar
  21. 21.
    Pluijm SM, Graafmans WC, Bouter LM et al. (1999) Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. 9:550–556Google Scholar
  22. 22.
    Prins SH, Jorgensen HL, Jorgensen LV et al. (1998) The role of quantitative ultrasound in the assessment of bone: a review. 18:3–17Google Scholar
  23. 23.
    Wuster C, Hadji P (2001) Use of quantitative ultrasound densitometry (QUS) in male osteoporosis. 69:225–228Google Scholar
  24. 24.
    Sievanen H, Kannus P, Nieminen V et al (1996) Estimation of various mechanical characteristics of human bones using dual energy x-ray absorptiometry: Methodology and precision. Bone 18:17S–27SCrossRefPubMedGoogle Scholar
  25. 25.
    Peterman MM, Hamel AJ, Cavanagh PR et al (2001) In vitro modeling of human tibial strains during exercise in micro-gravity. J Biomech 34:693–698CrossRefPubMedGoogle Scholar
  26. 26.
    McKay H, Tsang G, Heinonen A et al (2005) Ground reaction forces associated with an effective elementary school based jumping intervention. Br J Sports Med 39:10–14CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Hert J, Liskova M, Landa J (1971) Reaction of bone to mechanical stimuli. Part 1. Continuous and intermittent loading of tibia in rabbit. Folia Morphol 19:290–300Google Scholar
  28. 28.
    Umemura Y, Ishiko T, Yamauchi T et al (1997) Five jumps per day increase bone mass and breaking force in rats. J Bone Miner Res 12:1480–1485CrossRefPubMedGoogle Scholar
  29. 29.
    Robling AG, Burr DB, Turner CH (2001) Recovery periods restore mechanosensitivity to dynamically loaded bone. J Exp Biol 204:3389–3399PubMedGoogle Scholar
  30. 30.
    Robling AG, Hinant FM, Burr DB et al (2002) Shorter, more frequent mechanical loading sessions enhance bone mass. Med Sci Sports Exerc 34:196–202CrossRefPubMedGoogle Scholar
  31. 31.
    Robling AG, Hinant FM, Burr DB et al (2002) Improved bone structure and strength after long-term mechanical loading is greatest if loading is separated into short bouts. J Bone Miner Res 17:1545–1554CrossRefPubMedGoogle Scholar
  32. 32.
    Frederick EC, Determan JJ, Whittlesey SN et al (2006) Biomechanics of skateboarding: Kinetics of the Ollie. J Appl Biomech 22:33–40CrossRefPubMedGoogle Scholar
  33. 33.
    Kellis E, Katis A, Vrabas IS (2006) Effects of an intermittent exercise fatigue protocol on biomechanics of soccer kick performance. Scand J Med Sci Sports 16:334–344CrossRefPubMedGoogle Scholar
  34. 34.
    Otago L (2004) Kinetic analysis of landings in netball: is a footwork rule change required to decrease ACL injuries? J Sci Med Sport 7:85–95CrossRefPubMedGoogle Scholar
  35. 35.
    Taaffe DR, Snow Harter C, Connolly DA et al (1995) Differential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletes. J Bone Miner Res 10:586–593CrossRefPubMedGoogle Scholar
  36. 36.
    Bass S, Delmas PD, Pearce G et al (1999) The differing tempo of growth in bone size, mass, and density in girls is region-specific. J Clin Invest 104:795–804CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Bradney M, Karlsson MK, Duan Y et al (2000) Heterogeneity in the growth of the axial and appendicular skeleton in boys: Implications for the pathogenesis of bone fragility in men. J Bone Miner Res 15:1871–1878CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  1. 1.School of Physiotherapy and Exercise ScienceGriffith University, Gold Coast CampusGold CoastAustralia

Personalised recommendations