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plor
Instructor
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Posted: Fri Aug 4th, 2006 04:01 pm |
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I believe that it is fairly well documented that muscle pull facilitates bone growth more than weightbearing per se, but that any weight bearing facilitates muscle use, so....
Adult studies have shown that women can improve the bone density in their (lumbar, I believe) spine, but NOT their hip (I believe femoral neck) by walking, but can improve both by running. I found the two recent studies below with a medline search for "children standing, bone density", both support the finding that the spine is easier to affect than the leg in children as well.
Many peds studies in bone density seem to relate to children with metabolic problems, what population are you speaking of?
[url=javascript:AL_get(this, 'jour', 'Int J Sports Med.');]Int J Sports Med.[/url] 2002 Nov;23(8):575-81.[img]http://www.ncbi.nlm.nih.gov/entrez/query/egifs/http:--http://www.thieme.de-images-logo_tc.jpg[/img] [url=javascript opUpMenu2_Set(Menu12439773);]Links[/url] Does previous participation in high-impact training result in residual bone gain in growing girls? One year follow-up of a 9-month jumping intervention. The Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland.
The skeletal response to exercise and training on bone is exceptionally good during the growing years. However, it is not known whether the benefit of training on bone is maintained after the training. This 20-month follow-up study assessed the effect of a 9-month jumping intervention on bone gain and physical performance in 99 girls (mean age 12.5 +/- 1.5 years at the beginning of the study) one year after the end of the intervention. Both bone mineral content (BMC), by dual energy X-ray absorptiometry (DXA) at the lumbar spine and proximal femur, and physical performance parameters (standing long jump, leg extension strength, and shuttle run tests) were measured at baseline and at 20 months. A multivariate regression analysis was first used to determine the best predictors of the BMC accrual by time. Analysis showed that age at baseline and square of age, changes in height and weight, and pubertal development into Tanner stages 4 and 5 during the follow-up explained the majority of the BMC gain. Then, the effect of participation in the 9-month exercise intervention on BMC accrual and physical performance was analysed adding this variable (participation: yes/no) into the model. The regression analysis showed that the trainees (N = 50) had 4.9 % (95 % CI, 0.9 % to 8.8 %, p = 0.017) greater BMC increase in the lumbar spine than the controls (N = 49). The mean 20-month BMC increase in the lumbar spine was 28 % (SD 19) in the trainees compared to 22 % (12) increase in the controls. In the proximal femur, the trend was similar but the obtained 2 to 3 % higher BMC accrual in the trainees (compared to that in controls) were statistically insignificant. Among the performance variables, using the same model that best predicted the BMC accrual, the only statistically significant between-groups difference, in favour of the trainees, was the improvement in the standing long jump test (6.4 %, 95 % CI, 2.3 % to 10.4 %, p = 0.002). Improvements in the leg extension strength and shuttle run tests showed no between-groups difference. In conclusion, although the greatest proportion of bone mineral accrual in growing girls is attributable to growth, an additional bone gain achieved by jumping training is maintained at the lumbar spine at least a year after the end of the training.
PMID: 12439773 [PubMed - indexed for MEDLINE]
[url=javascript:AL_get(this, 'jour', 'Arch Dis Child.');]Arch Dis Child.[/url] 2004 Feb;89(2):131-5. [url=javascriptopUpMenu2_Set(Menu14736627);]Links[/url] A randomised controlled trial of standing programme on bone mineral density in non-ambulant children with cerebral palsy. The Manchester School of Physiotherapy, Manchester Royal Infirmary, Manchester, UK.
BACKGROUND: Severely disabled children with cerebral palsy (CP) are prone to low trauma fractures, which are associated with reduced bone mineral density. AIMS: To determine whether participation in 50% longer periods of standing (in either upright or semi-prone standing frames) would lead to an increase in the vertebral and proximal tibial volumetric trabecular bone mineral density (vTBMD) of non-ambulant children with CP. METHODS: A heterogeneous group of 26 pre-pubertal children with CP (14 boys, 12 girls; age 4.3-10.8 years) participated in this randomised controlled trial. Subjects were matched into pairs using baseline vertebral vTBMD standard deviation scores. Children within the pairs were randomly allocated to either intervention (50% increase in the regular standing duration) or control (no increase in the regular standing duration) groups. Pre- and post-trial vertebral and proximal tibial vTBMD was measured by quantitative computed tomography (QCT). RESULTS: The median standing duration was 80.5% (9.5-102%) and 140.6% (108.7-152.2%) of the baseline standing duration in the control group and intervention group respectively. The mean vertebral vTBMD in the intervention group showed an increase of 8.16 mg/cm3 representing a 6% mean increase in vertebral vTBMD. No change was observed in the mean proximal tibial vTBMD. CONCLUSION: A longer period of standing in non-ambulant children with CP improves vertebral but not proximal tibial vTBMD. Such an intervention might reduce the risk of vertebral fractures but is unlikely to reduce the risk of lower limb fractures in children with CP.
PMID: 14736627 [PubMed - indexed for MEDLINE]
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kdmpt
Instructor
| Joined: | Fri Jul 7th, 2006 |
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Posted: Sat Jul 29th, 2006 12:03 am |
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Customer wants to know: Recent studies have shown that standers do not provide the bones input for improved bone density. Standers of course, do provide an extended stretch to the leg and back muscles and affect the cardiovascular system. I also understand that it is the loading and unloading of the joints that does support gains in bone density.
I am working with a few families to use a lift system (that they may need for transfers) as a standing support. I have found standing slings that can be used with these systems. These children are then free to move around with use of their legs in contact with the ground. I hope to find some research to support some benefit to bone density using this method.
Any suggestions?
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