Eastman, K, O'Leary, TJ, Carswell, A, Walsh, N, Izard, R, Fraser, W and Greeves, J (2023) Distal Tibial Bone Properties and Bone Stress Injury Risk in Young Men Undergoing Arduous Physical Training. Calcified Tissue International and Musculoskeletal Research, 113. pp. 317-328. ISSN 0171-967X

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Abstract

Trabecular microarchitecture contributes to bone strength, but its role in bone stress injury (BSI) risk in young healthy adults is unclear. Tibial volumetric BMD (vBMD), geometry, and microarchitecture, whole-body areal BMD, lean and fat mass, biochemical markers of bone metabolism, aerobic fitness, and muscle strength and power were measured in 201 British Army male infantry recruits (age 20.7 [4.3] years, BMI 24.0 ± 2.7 kg·m2) in week one of basic training. Tibial scans were performed at the ultra-distal site, 22.5 mm from the distal endplate of the non-dominant leg using High Resolution Peripheral Quantitative Computed Tomography (XtremeCT, Scanco Medical AG, Switzerland). Binary logistic regression analysis was performed to identify associations with lower body BSI confirmed by MRI. 20 recruits (10.0%) were diagnosed with a lower body BSI. Pre-injured participants had lower cortical area, stiffness and estimated failure load (p = 0.029, 0.012 and 0.011 respectively) but tibial vBMD, geometry, and microarchitecture were not associated with BSI incidence when controlling for age, total body mass, lean body mass, height, total 25(OH)D, 2.4-km run time, peak power output and maximum dynamic lift strength. Infantry Regiment (OR 9.3 [95%CI, 2.6, 33.4]) Parachute versus Line Infantry, (p ≤ 0.001) and 2.4-km best effort run time (1.06 [95%CI, 1.02, 1.10], p < 0.033) were significant predictors. Intrinsic risk factors, including ultradistal tibial density, geometry, and microarchitecture, were not associated with lower body BSI during arduous infantry training. The ninefold increased risk of BSI in the Parachute Regiment compared with Line Infantry suggests that injury propensity is primarily a function of training load and risk factors are population-specific.

Item Type:	Article
Uncontrolled Keywords:	Humans; Exercise; Risk Factors; Adult; Male; Muscle Strength; Young Adult; Bone health; Bone stress injury; Dual x-ray absorptiometry; High-resolution peripheral quantitative computed tomography; Training; Adult; Humans; Male; Young Adult; Risk Factors; Exercise; Muscle Strength; 0601 Biochemistry and Cell Biology; 0903 Biomedical Engineering; 1103 Clinical Sciences; Endocrinology & Metabolism
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport & Exercise Sciences
Publisher:	Springer
SWORD Depositor:	A Symplectic
Date Deposited:	02 Oct 2023 12:23
Last Modified:	02 Oct 2023 12:30
DOI or ID number:	10.1007/s00223-023-01111-1
URI:	https://researchonline.ljmu.ac.uk/id/eprint/21664

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