Adaptive Skeletal Responses to Mechanical Loading during Adolescence
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Adolescence, defined as the period between puberty and maturity, provides a window of opportunity for positive skeletal adaptations to mechanical loading unlike any other period in life. Age-related bone loss highlights the importance of accumulating sufficient bone mass during formative years. Adolescents who regularly engage in weight-bearing mechanical loading appear advantaged in site-specific markers of bone mass. The positive influence of physical activity on bone mineral accrual during growth has been extensively studied; however, few studies have examined skeletal responses to mechanical loading during adolescence. Weight-bearing physical activity, particularly high-impact sports such as gymnastics, is recognised as being more osteogenic than weight-supported activities. Unilateral loading activities such as tennis or squash provide a direct comparison of skeletal response without sampling bias or genetic confounding. Intervention and longitudinal studies show evidence of positive skeletal adaptations; however, sustainability of skeletal advantages remains unclear. Limitations inherent with single-plane dual x-ray absorptiometry technology are well recognised. The integration of densitometric data with structural responses to mechanical loading using 3-dimensional imaging technologies such as peripheral quantitative computed tomography and magnetic resonance imaging appears vital to enhancing our understanding of adolescent musculoskeletal health.
KeywordsBone Mineral Density Femoral Neck Bone Mineral Content Lumbar Spine Bone Mineral Density Total Body Bone Mineral Content
Support from the New South Wales Sporting Injuries Committee and the New South Wales Institute of Sport was integral in the development of this review paper. The authors have no conflicts of interest that are directly relevant to the content of this review.
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