Evidence of sustained skeletal benefits from impact-loading exercise in young females: a 3-year longitudinal study.

UNLABELLED: The skeletal effects from intensive exercise throughout puberty are undefined. Forty-five female gymnasts and 52 controls were studied over 3 years, including a heredity aspect. The effects of size, maturity, exercise, and diet were identified using a multilevel regression model. Results demonstrated sustained skeletal benefits resulting from exercise throughout all stages of pubertal development. INTRODUCTION: Weight-bearing exercise is beneficial for peak bone mass development. However, whether skeletal benefits achieved with exercise are maintained if training remains intensive throughout the pubertal years is not entirely clear. The influence of familial resemblance for bone mass remains undefined in physically active versus inactive children. The aim of this study was to investigate the long-term influences of impact-loading exercise on bone quantity and quality in young females after controlling for growth, maturation, and hereditary factors. MATERIALS AND METHODS: At baseline, 45 gymnasts (G) and 52 normally active controls (C) 8-17 years of age were recruited. Anthropometry, diet, physical activity, and quantitative ultrasound (QUS) were measured annually for 3 consecutive years. DXA scans of total body (TB) and lumbar spine (LS) bone mineral content (BMC) and density (BMD) were taken three times at 1-year intervals. A multilevel regression model was fitted, and the independent effects of body size, maturity, physical activity, and diet were identified over time. To assess heredity influences, 27 G mothers and 26 C mothers volunteered for cross-sectional measurements of anthropometry, QUS, and BMC/BMD. RESULTS AND CONCLUSIONS: Gymnasts were smaller and lighter (as were their mothers) than controls, but they had significantly higher QUS and axial and appendicular BMC and BMD, with > 170 g more bone mineral in TB across puberty (after adjustment for maturity [years from peak height velocity], height, weight, energy, and protein intake). Gymnasts had up to 24-51% higher BMC and 13-28% higher BMD, depending on skeletal site. These results provide evidence of sustained skeletal benefits from impact-loading exercise, which are unlikely to result entirely from heredity, throughout pubertal years.

Evaluation of a computer assisted instruction resource in nursing education.

The STEP-DIET program, a computer assisted instruction (CAI) tool, was developed to prepare dietetic students for their hospital based practical training in the academic setting. This study aimed to evaluate the potential for using the programme within nursing education. The evaluation framework of Kirkpatrick [I. Forsyth, A. Jolliffe, D. Stevens (Eds.), Evaluating a Course, second ed. Kogan Page, London, p. 5] was employed to assess student response to STEP-DIET and its effectiveness as a teaching tool, with regards to perceived learning achievements. Knowledge and attitudes towards nutrition education were also investigated. Quantitative and qualitative methodologies were employed, with nine second and six final year BSc (Adult) nursing students completing questionnaires and taking part in two focus groups, separated by year group. Students rated STEP-DIET highly in terms of design and content and reported a number of perceived learning achievements including increase in nutritional knowledge, understanding of Type 2 diabetes management and the dietitian's role, however there was a reluctance to accept CAI as a teaching method. Students reported a poor knowledge of nutrition, but recognised its importance. This study demonstrates that multidisciplinary learning by the sharing of resources has benefits to students. However, the integration of CAI into taught programmes needs to be managed to take into account student's reluctance to rely on this method of instruction.