Comparison of Tibial Geometry,Density,and Strength in College-Aged Female Eumenorrheic Dancers,Gymnasts,and Runners: A Peripheral Quantitative Computed Tomography Study
Restricted accessResearch articleFirst published online September, 2022
Comparison of Tibial Geometry,Density,and Strength in College-Aged Female Eumenorrheic Dancers,Gymnasts,and Runners: A Peripheral Quantitative Computed Tomography Study
Weightbearing activities such as gymnastics, soccer, weightlifting, and running have often been used as benchmarks in skeletal research since they have been shown to promote densitometric and geometric benefits. In comparison with other sports, there is a paucity of information in relation to dance and its osteogenic potential.
Objective
This study aimed to compare tibial geometry, density, and strength in college-aged dancers versus gymnasts and runners.
Methods
A total of 60 trained eumenorrheic collegiate-aged female dancers (n = 11), gymnasts (n = 11), runners (n = 19), and sedentary controls (n = 19) were included in the study. Bone measurements, including total area (ToA), volumetric (total vBMD) and cortical density (CoD), compressive bone strength (BSI), and polar strength stress index (SSIp) of the dominant limb, were assessed using peripheral quantitative computed tomography (pQCT) at the distal and proximal tibia (4% and 66% of limb length).
Results
No significant differences in ToA, CoD, CoA, and total vBMD were found between dancers and the comparison athletes at the measured sites. In addition, strength indices (BSI and SSIp) at the distal and proximal sites were similar between the dancing and both athlete groups.
Conclusion
Results suggest dance elicits similar structural adaptations at the tibia compared to benchmark high-impact and repetitive impact sports; thus, indicating dance, in its various forms, can have apositive effect on important bone variables that influence density and strength. These adaptations may potentially delay or prevent bone fragility later in life. Future studies should compare individual styles of dance separately, longitudinally, and include other important lower (e.g., hip) and upper body (e.g., radius) sites to further identify which forms provide the greatest osteogenic benefits.
Get full access to this article
View all access options for this article.
References
1.
Office of the Surgeon General (US).Bone Health and Osteoporosis: A Report of the Surgeon General.Rockville, Maryland: Office of the Surgeon General (US), 2004.
2.
FelsenbergD, BoonenS.The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management.Clin Ther.2005;27(1):1–11.
3.
SeemanE, HopperJL, BachLA, . Reduced bone mass in daughters of women with osteoporosis.N Engl J Med.1989;320(9):554–8.
4.
SorokoSB, Barrett-ConnorE, EdelsteinSL, Kritz-SilversteinD.Family history of osteoporosis and bone mineral density at the axial skeleton: the Rancho Bernardo Study.J Bone Min Res.1994;9(6):761–9.
5.
BartheN, Basse-CathalinatB, MeunierPJ, . Measurement of bone mineral density in mother-daughter pairs for evaluating the family influence on bone acquisition: a GRIO survey.Osteoporos Int.1998;8(4):379–84.
6.
PocockNA, EismanJA, YeatesMG, . Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density.J Clin Investig.1986;78(3):618–21.
7.
SaxonLK, TurnerCH.Estrogen receptor beta: the antimechanostat.Bone.2005;36(2):185–92.
8.
SeemanE, DelmasPD.Bone quality-the material and structural basis of bone strength and fragility.N Engl J Med.2006;354(21):2250–61.
9.
AckermanKE, Cano SokoloffN, NardoDEMaffazioliG, . Fractures in relation to menstrual status and bone parameters in young athletes.Med Sci Sports Exerc.2015;47(8):1577–86.
10.
ZankerC.The effect of energy balance on endocrine function and bone health in youth.Unpublished manuscript, 2006.
11.
HeaneyRP, AbramsS, Dawson-HughesB, . Peak bone mass.Osteoporos Int.2000;11(12):985–1009.
12.
KhanK, McKayH, KannusP, . Physical Activity and Bone Health.Champaign, Illinois: Human Kinetics, 2001.
13.
WardenSJ, FuchsRK, CastilloAB, TurnerCH.Does exercise during growth influence osteoporotic fracture risk later in life?J Musculo-skelet Neuronal Interact.2005;5(4):344–6.
14.
KaptogeS, DalzellN, JakesRW, . Hip section modulus, a measure of bending resistance, is more strongly related to reported physical activity than BMD.Osteoporos Int.2003;14(11):941–9.
15.
RoblingAG, DuijvelaarKN, GeeversJV, . Modulation of ap-positional and longitudinal bone growth in the rat ulna by applied static and dynamic force.Bone.2001;29(2):105–13.
16.
BaileyDA, McKayHA, MirwaldRL, . A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the University of Saskatchewan bone mineral accrual study.J Bone Mineral Res.1999;14(10):1672–9.
17.
CurreyJD.Bones: Structure and Mechanics. Princeton, New Jersey: Princeton University Press, 2002.
18.
NikanderR, SievanenH, Uusi-RasiK, . Loading modalities and bone structures at nonweight-bearing upper extremity and weight-bearing lower extremity: a pQCT study of adult female athletes.Bone.2006;39(4):886–94.
19.
BurrDB.Muscle strength, bone mass, and age-related bone loss.J Bone Miner Res.1997; 12(10):1547–51.
20.
BruininksBD, KorakJA, SciboraLM, . Swimming and bone density: a DXA and pQCT study examining swimming as an osteogenic activity.JEPonline.2019;22(1):75–91.
21.
FehlingPC, AlekelL, ClaseyJ, . A comparison of bone mineral densities among female athletes in impact loading and active loading sports.Bone.1995;17(3):205–10.
22.
FredericsonM, ChewK, NgoJ, . Regional bone mineral density in male athletes: a comparison of soccer players, runners and controls.Br J Sports Med.2007;4l(10):664–8.
23.
HeinonenA, SievanenH, KannusP, . 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.2002;70(6):469–74.
24.
HelgeEW, KanstrupIL.Bone density in female elite gymnasts: impact of muscle strength and sex hormones.Med Sci Sports Exerc.2002;34(1):174–80.
25.
MuddLM, FornettiW, PivarnikJM.Bone mineral density in collegiate female athletes: comparison among sports.J Athl Train.2007;42(3):403–8.
26.
NikanderR, SievanenH, HeinonenA, KannusP.Femoral neck structure in adult female athletes subjected to different loading modalities.J Bone Miner Res.2005;20(3):520–8.
27.
ProctorKL, AdamsWC, ShaffrathJD, Van LoanMD.Upper-limb bone mineral density of female collegiate gymnasts versus controls.Med Sci Sports Exerc.2002;34(11):1830–5.
28.
RectorRS, RogersR, RuebelM, HintonPS.Participation in road cycling vs running is associated with lower bone mineral density in men.Metabolism.2008;57(2):226–32.
29.
TaaffeDR, RobinsonTL, SnowCM, MarcusRHigh-impact exercise promotes bone gain in well-trained female athletes.J Bone Miner Res.1997;12(2):255–60.
30.
MillerM, KojetinS, SciboraLM.Site-specific effects of swimming on bone density in female collegiate swimmers.Int J Exerc Sci.2019;13(1):249–59.
31.
BennellK, KhanK, MatthewsB, . Activity-associated differences in bone mineral are evident before puberty: a cross-sectional study of 130 female novice dancers and controls.Pediatr Exerc Sci.2000;12(4):371–81.
32.
MatthewsBL, BennellKL, McKayHA, . Dancing for bone health: a 3-year longitudinal study of bone mineral accrual across puberty in female non-elite dancers and controls.Osteoporos Int.2006;17(7):1043–54.
33.
BuckhardtP, WynnE, KriegMA, . The effects of nutrition, puberty and dancing in adolescent ballet dancers.J Dance Med Sci.2011;15(2):51–60.
34.
HinrichsT, ChaeEH, LehmannR, . Bone mineral density in athletes of different disciplines: a cross-sectional study.Open Sports Sci J.2010;3:129–33.
35.
GlaserDL, KaplanFS.Osteoporosis: definition and clinical presentation.Spine.1997;22(24):12S–16S.
36.
RauchF, SchoenauE.Changes in bone density during childhood and adolescence: an approach based on bone's biological organization.J Bone Miner Res.2001;16(4):597–604.
37.
PetitMA, BeckTJ, KontulainenSA.Examining the developing bone: what do we measure and how do we do it?J Musculoskelet Neuronal Interact.2005;5(3):213–24.
38.
RauchF, SchönauE.Peripheral quatitative computed tomography of the distal radius in young subjects—new reference data and interpretation of results.J Musculoskelet Neuronal Interact.2005;5(2):119–26.
39.
ForwoodMR.Mechanical effects on the skeleton: are there clinical implications?Osteoporos Int.2001;12(1):77–83.
40.
KontulainenSA, JohnstonJD, LiuD, . Strength indices from pQCT imaging predict up to 85% of variance in bone failure properties at tibial epiphysis and diaphysis.J Musculoskelet Neuronal Interact.2008;8(4):401–9.
41.
SchoenauE.Bone mass increases in puberty: what makes it happen?Horm Res.2006;65(2):2–10.
42.
SmockAJ, HughesJM, PoppKL, . Bone volumetric density, geometry, and strength in female and male collegiate runners.Med Sci Sports Exerc.2009;4l(11):2026–32.
43.
BruininksBD, MeadTP, SmockAJ, . Differences in bone strength indices between trained male and female athletes competing in the same sport: a pQCT study.JEPonline.2020;23(4):70–87.
44.
R Development Core Team. R: A language and environment for statistical computing.R Foundation for Statistical Computing, Vienna, Austria, 2010.
45.
HernandezC, BeaupreGS, CarterDR.A theoretical analysis of the relative influences of peak BMD, age-related bone loss and menopause on the development of osteoporosis.Osteoporos Int.2003;14(10):843–7.
46.
BonjourJP, ChevalleyT, RizzoliR, FerrariS.Gene-environmental in the skeletal response to nutrition and exercise during growth. In: DalyRM, PetitMA (eds): Optimizing Bone Mass and Strength: The Role of Physical Activity and Nutrition During Growth.Basel: Karger, 2007.
MartinRBurrDB, SharkeyNA.Skeletal Tissue Mechanics. New York: Springer, 1998.
49.
RoblingAG, CastilloAB, TurnerCH.Biomechanical and molecular regulation of bone remodeling.Ann Rev Biomed Eng.2006;8:455–98.
50.
AndreoliA, MonteleoneM, Van LoanM, . Effects of different sports on bone density and muscle mass in highly trained athletes.Med Sci Sports Exerc.2001;33(4):507–11.
51.
HeinonenA, OjaP, KannusP, . Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton.Bone.1995;17(3):197–203.
52.
TaaffeDR, Snow-HarterC, ConnollyDA, . Differential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletes.J Bone Miner Res.1995;10(4):586–93.
53.
BrambleDM, LiebermanDE.Endurance running and the evolution of Homo.Nature.2004;432(7015):345–52.
JanzKF, RaoS, BaumannHJ, SchultzJL.Measuring children's vertical ground reaction forces with accelerometry during walking, running, and jumping: the Iowa Bone Development study.Pediatr Exerc Sci.2003;15(1):34–43.
56.
LanyonLE.Using functional loading to influence bone mass and architecture: objectives, mechanisms, and relationship with estrogen of the mechanically adaptive process in bone.Bone.1996;18(1 Suppl):S37–S43.
57.
MosleyJR, LanyonLE.Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats.Bone.1998;23(4):313–8.
58.
ChockleyC.Ground reaction force comparison between jumps landing on the full foot and jumps landing en pointe in ballet dancers.J Dance Med Sci.2008;12(1):5–8.
59.
KuligK, FietzerAL, PopovichJMJr.Ground reaction forces and knee mechanics in the weight acceptance phase of a dance leap take-off and landing.J Sports Sci.2011;29(2):125–31.
60.
WalterHL, DochertyCL, SchraderJ.Ground reaction forces in ballet dancers landing in flat shoes versus pointe shoes.J Dance Med Sci.2011;15(2):61–4.
61.
FrostHM.Bone's mechanostat: a 2003 update.Anat Rec A Discov Mol Evol Biol.2003;275(2):1081–101.
62.
DonahueSW, GalleySA.Microdamage in bone: implications for fracture, repair, remodeling, and adaptation.Crit Rev Biomed Eng.2006;34(3):215–71.
63.
TournisS, MichopoulouE, FatourosIG, . Effect of rhythmic gymnastics on volumetric bone mineral density and bone geometry in premenarcheal female athletes and controls.J Clin Endocrinol Metab.2010;95(6):2755–62.
64.
FrostHM.On the estrogen-bone relationship and postmenopausal bone loss: a new model.J Bone Miner Res.1999;l4(9):l473–7.
65.
NilssonO, MarinoR, De LucaF, . Endocrine regulation of the growth plate.Horm Res.2005;64(4):157–65.
66.
Van derEerden BC, KarperienM, WitJM.Systemic and local regulation of the growth plate.Endocr Rev.2003;24(6):782–801.
67.
FrostHM.On our age-related bone loss: insights from a new paradigm.J Bone Miner Res.1997;12(10):1539–46.
68.
TorstveitMK, Sundgot-BorgenJ.Participation in leanness sports but not training volume is associated with menstrual dysfunction: a national survey of 1276 elite athletes and controls.Br J Sports Med.2005;39(3):141–7.
69.
AckermanKE, PierceL, GuerecaG, . Hip structural analysis in adolescent and young adult oligoamenorrheic and eumenorrheic athletes and nonathletes.J Clin Endocrinol Metab.2013;98(4):1742–9.
70.
AckermanKE, NazemT, ChapkoD, . Bone microarchitecture is impaired in adolescent amenorrheic athletes compared with eumenorrheic athletes and nonathletic controls.J Clin Endocrinol Metab.2011;96(10):3123–33.
71.
KhanK, RobynMG, SaulA, . Retired elite female ballet dancers and nonathletic controls have similar bone mineral density at weight bearing sites.J Bone Miner Res.1996;ll(10):1566–74.
72.
KeayN, FogelmanI, BlakeG.Bone mineral density in professional female dancers.Br J Sports Med.1997;31(2):143–7.
73.
ToWK, PhilM, WongMWN, LamIYL.Bone mineral density differences between adolescent dancers and non-exercising adolescent females.J Pediatr Adolesc Gynecol.2005;18(5):337–42.
74.
DucherG, EserP, HillB, BassS.History of amenorrhoea compromises some of the exercise-induced benefits in cortical and trabecular bone in the peripheral and axial skeleton: a study in retired elite gymnasts.Bone.2009;45(4):760–7.
