Osteoporosis International

, Volume 25, Issue 3, pp 1025–1032 | Cite as

A school-based resistance intervention improves skeletal growth in adolescent females

  • B. BernardoniEmail author
  • J. Thein-Nissenbaum
  • J. Fast
  • M. Day
  • Q. Li
  • S. Wang
  • T. Scerpella
Original Article



Twenty-two sixth-grade girls who participated in a 7-month school-based resistance-training program were compared to 22 controls. In a subanalysis of Tanner breast II (T2) and III (T3) subjects (n = 21 controls subjects (CON), n = 17 subjects in the high-intervention (INT)-dose group (HI)), T2 HI had greater narrow neck (NN) width gains than T2 CON (p < 0.05) and T3 HI had greater L3 bone mineral density (BMD) gains than T3 CON (p < 0.05).


Physical activity modulates bone growth during adolescence, but an effective activity has not been identified for general use. The purpose of this study was to examine the effect of a school-based resistance-training program on skeletal growth in pre-menarcheal females.


Sixth-grade girls participated in a 7-month, resistance-training program (INT) embedded in physical education (PE) classes. Age- and maturity-matched CON from a neighboring school participated in the standard PE classes. INT dose defined high (HI) and low (LO) groups. At baseline (BL) and follow-up (FU), non-INT organized physical activity (PA, hours per week) and maturity status were recorded; DXA scans assessed total body, distal radius, proximal femur, and lumbar spine. Regression models analyzed growth in bone outcomes for HI versus CON, accounting for age, Tanner stage, height, and PA.


Forty-four girls (22 HI, 22 CON) were 11.7 ± 0.3 years of age at BL; all were ≤6 months postmenarche and did not differ in bone growth over the course of the intervention (p > 0.05). However, in a subanalysis limited to subjects who were T2 or T3 at BL (n = 21 CON, n = 17 HI), T2 HI had greater gains in NN width (p = 0.01) compared to T2 CON, while T3 HI had greater gains in L3 BMD (p = 0.03) compared to T3 CON.


In a group of T2 and T3 sixth-grade girls, a school-based resistance-training intervention produced maturity-specific differential gains for HI versus CON at the hip and spine.


Adolescents Bone growth Exercise intervention Resistance training 



This research was supported by the UW Institute for Clinical and Translational Research, funded through a Clinical and Translational Science Award, 9U54TR000021 from NIH/NCATS.

Conflicts of interest



  1. 1.
    Sabatier JP, Guaydier-Souquieres G, Benmalek A, Marcelli C (1999) Evolution of lumbar bone mineral content during adolescence and adulthood: a longitudinal study in 395 healthy females 10–24 years of age and 206 premenopausal women. Osteoporos Int 9:476–482PubMedCrossRefGoogle Scholar
  2. 2.
    Cadogan J, Blumsohn A, Barker ME, Eastell R (1998) A longitudinal study of bone gain in pubertal girls: anthropometric and biochemical correlates. J Bone Miner Res 13:1602–1612PubMedCrossRefGoogle Scholar
  3. 3.
    Bailey DA (1997) The Saskatchewan Pediatric Bone Mineral Accrual Study: bone mineral acquisition during the growing years. Int J Sports Med 18(Suppl 3):S191–S194PubMedCrossRefGoogle Scholar
  4. 4.
    Ferrari SL, Deutsch S, Choudhury U, Chevalley T, Bonjour JP, Dermitzakis ET, Rizzoli R, Antonarakis SE (2004) Polymorphisms in the low-density lipoprotein receptor-related protein 5 (LRP5) gene are associated with variation in vertebral bone mass, vertebral bone size, and stature in whites. Am J Hum Genet 74:866–75PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Duncan CS, Blimkie CJ, Cowell CT, Burke ST, Briody JN, Howman-Giles R (2002) Bone mineral density in adolescent female athletes: relationship to exercise type and muscle strength. Med Sci Sports Exerc 34:286–294PubMedCrossRefGoogle Scholar
  6. 6.
    Courteix D, Lespessailles E, Peres SL, Obert P, Germain P, Benhamou CL (1998) Effect of physical training on bone mineral density in prepubertal girls: a comparative study between impact-loading and non-impact-loading sports. Osteoporos Int 8:152–158PubMedCrossRefGoogle Scholar
  7. 7.
    Cassell C, Benedict M, Specker B (1996) Bone mineral density in elite 7- to 9-yr-old female gymnasts and swimmers. Med Sci Sports Exerc 28:1243–1246PubMedCrossRefGoogle Scholar
  8. 8.
    Grimston SK, Willows ND, Hanley DA (1993) Mechanical loading regime and its relationship to bone mineral density in children. Med Sci Sports Exerc 25:1203–1210PubMedGoogle Scholar
  9. 9.
    Dowthwaite JN, Flowers PP, Spadaro JA, Scerpella TA (2007) Bone geometry, density, and strength indices of the distal radius reflect loading via childhood gymnastic activity. J Clin Densitom 10:65–75PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Dowthwaite JN, Scerpella TA (2009) Skeletal geometry and indices of bone strength in artistic gymnasts. J Musculoskelet Neuronal Interact 9:198–214PubMedCentralPubMedGoogle Scholar
  11. 11.
    Ward KA, Roberts SA, Adams JE, Mughal MZ (2005) Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. Bone 36:1012–1018PubMedCrossRefGoogle Scholar
  12. 12.
    Dyson K, Blimkie CJ, Davison KS, Webber CE, Adachi JD (1997) Gymnastic training and bone density in pre-adolescent females. Med Sci Sports Exerc 29:443–450PubMedCrossRefGoogle Scholar
  13. 13.
    Lohman T, Going S, Pamenter R, Hall M, Boyden T, Houtkooper L, Ritenbaugh C, Bare L, Hill A, Aickin M (1995) Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study. J Bone Miner Res 10:1015–1024PubMedCrossRefGoogle Scholar
  14. 14.
    Friedlander AL, Genant HK, Sadowsky S, Byl NN, Gluer CC (1995) A two-year program of aerobics and weight training enhances bone mineral density of young women. J Bone Miner Res 10:574–585PubMedCrossRefGoogle Scholar
  15. 15.
    Karlsson MK, Johnell O, Obrant KJ (1995) Is bone mineral density advantage maintained long-term in previous weight lifters? Calcif Tissue Int 57:325–328PubMedCrossRefGoogle Scholar
  16. 16.
    Conroy BP, Kraemer WJ, Maresh CM, Fleck SJ, Stone MH, Fry AC, Miller PD, Dalsky GP (1993) Bone mineral density in elite junior Olympic weightlifters. Med Sci Sports Exerc 25:1103–1109PubMedCrossRefGoogle Scholar
  17. 17.
    Heinonen A, Sievanen H, Kannus P, Oja P, Vuori I (2002) Site-specific skeletal response to long-term weight training seems to be attributable to principal loading modality: a pQCT study of female weightlifters. Calcif Tissue Int 70:469–474PubMedCrossRefGoogle Scholar
  18. 18.
    Nichols DL, Sanborn CF, Love AM (2001) Resistance training and bone mineral density in adolescent females. J Pediatr 139:494–500PubMedCrossRefGoogle Scholar
  19. 19.
    Blimkie CJ, Rice S, Webber CE, Martin J, Levy D, Gordon CL (1996) Effects of resistance training on bone mineral content and density in adolescent females. Can J Physiol Pharmacol 74:1025–1033PubMedCrossRefGoogle Scholar
  20. 20.
    Morris FL, Naughton GA, Gibbs JL, Carlson JS, Wark JD (1997) Prospective ten-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass. J Bone Miner Res 12:1453–1462PubMedCrossRefGoogle Scholar
  21. 21.
    Macdonald HM, Kontulainen SA, Petit MA, Beck TJ, Khan KM, McKay HA (2008) Does a novel school-based physical activity model benefit femoral neck bone strength in pre- and early pubertal children?. Osteoporos Int 19:1445–1456Google Scholar
  22. 22.
    Dowthwaite JN, Scerpella TA (2011) Distal radius geometry and skeletal strength indices after peripubertal artistic. Osteoporos Int 22:207–216PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Taylor SJ, Whincup PH, Hindmarsh PC, Lampe F, Odoki K, Cook DG (2001) Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol 15:88–94PubMedCrossRefGoogle Scholar
  24. 24.
    Borenstein M, Rothstein H, Cohen J (2001) Sample Power V2.0. SPSS, ChicagoGoogle Scholar
  25. 25.
    Length RV (2009) Java applets for power and sample size, calculated on 16 Apr 2009Google Scholar
  26. 26.
    Scerpella TA, Dowthwaite JN, Gero NM, Kanaley JA, Ploutz-Snyder RJ (2010) Skeletal benefits of pre-menarcheal gymnastics are retained after activity. Pediatr Exerc Sci 22:21–33PubMedGoogle Scholar
  27. 27.
    Cohen J (1992) A power primer. Psychol Bull 112:155–159PubMedCrossRefGoogle Scholar
  28. 28.
    Petit MA, McKay HA, MacKelvie KJ, Heinonen A, Khan KM, Beck TJ (2002) A randomized school-based jumping intervention confers site and maturity-specific benefits on bone structural properties in girls: a hip structural analysis study. J Bone Miner Res 17:363–372PubMedCrossRefGoogle Scholar
  29. 29.
    Mackelvie KJ, McKay HA, Khan KM, Crocker PR (2001) A school-based exercise intervention augments bone mineral accrual in early pubertal girls. J Pediatr 139:501–508PubMedCrossRefGoogle Scholar
  30. 30.
    Dowthwaite JN, DiStefano JG, Ploutz-Snyder RJ, Kanaley JA, Scerpella TA (2006) Maturity and activity-related differences in bone mineral density: Tanner I vs II and gymnasts vs. non-gymnasts. Bone 39:895–900PubMedCrossRefGoogle Scholar
  31. 31.
    McKay HA, Petit MA, Schutz RW, Prior JC, Barr SI, Khan KM (2000) Augmented trochanteric bone mineral density after modified physical education classes: a randomized school-based exercise intervention study in prepubescent and early pubescent children. J Pediatr 136:156–162PubMedCrossRefGoogle Scholar
  32. 32.
    Meyer U, Romann M, Zahner L, Schindler C, Puder JJ, Kraenzlin M, Rizzoli R, Kriemler S (2011) Effect of a general school-based physical activity intervention on bone mineral content and density: a cluster-randomized controlled trial. Bone 48:792–797PubMedCrossRefGoogle Scholar
  33. 33.
    Scerpella TA, Dowthwaite JN, Rosenbaum PF (2011) Sustained skeletal benefit from childhood mechanical loading. Osteoporos Int 22:2205–2210PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    Fuchs RK, Bauer JJ, Snow CM (2001) Jumping improves hip and lumbar spine bone mass in prepubescent children: a randomized controlled trial. J Bone Miner Res 16:148–156PubMedCrossRefGoogle Scholar
  35. 35.
    Gunter K, Baxter-Jones AD, Mirwald RL, Almstedt H, Fuller A, Durski S, Snow C (2008) Jump starting skeletal health: a 4-year longitudinal study assessing the effects of jumping on skeletal development in pre and circum pubertal children. Bone 42:710–718PubMedCrossRefGoogle Scholar
  36. 36.
    Janz KF, Letuchy EM, Eichenberger Gilmore JM, Burns TL, Torner JC, Willing MC, Levy SM (2010) Early physical activity provides sustained bone health benefits later in childhood. Med Sci Sports Exerc 42:1072–1078PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Frost HM (2000) The Utah paradigm of skeletal physiology: an overview of its insights for bone, cartilage and collagenous tissue organs. J Bone Miner Metab 18:305–316PubMedCrossRefGoogle Scholar
  38. 38.
    Seeman E (2003) Periosteal bone formation—a neglected determinant of bone strength. N Engl J Med 349:320–323PubMedCrossRefGoogle Scholar
  39. 39.
    Mora S, Goodman WG, Loro ML, Roe TF, Sayre J, Gilsanz V (1994) Age-related changes in cortical and cancellous vertebral bone density in girls: assessment with quantitative CT. AJR Am J Roentgenol 162:405–409PubMedCrossRefGoogle Scholar
  40. 40.
    Ausili E, Rigante D, Salvaggio E, Focarelli B, Rendeli C, Ansuini V, Paolucci V, Triarico S, Martini L, Caradonna P (2012) Determinants of bone mineral density, bone mineral content, and body composition in a cohort of healthy children: influence of sex, age, puberty, and physical activity. Rheumatol Int 32:2737–2743PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • B. Bernardoni
    • 1
    • 2
    Email author
  • J. Thein-Nissenbaum
    • 2
  • J. Fast
    • 1
  • M. Day
    • 1
  • Q. Li
    • 3
  • S. Wang
    • 3
  • T. Scerpella
    • 2
  1. 1.University of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Department of Orthopaedics and RehabilitationUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.Department of Statistics and BioinformaticsUniversity of Wisconsin - MadisonMadisonUSA

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