Acute effects of brain-responsive neurostimulation in drug-resistant partial onset epilepsy.

OBJECTIVE: Understanding the acute effects of responsive stimulation (AERS) based on intracranial EEG (iEEG) recordings in ambulatory patients with drug-resistant partial epilepsy, and correlating these with changes in clinical seizure frequency, may help clinicians more efficiently optimize responsive stimulation settings. METHODS: In patients implanted with the NeuroPace® RNS® System, acute changes in iEEG spectral power following active and sham stimulation periods were quantified and compared within individual iEEG channels. Additionally, acute stimulation-induced acute iEEG changes were compared within iEEG channels before and after patients experienced substantial reductions in clinical seizure frequency. RESULTS: Responsive stimulation resulted in a 20.7% relative decrease in spectral power in the 2-4 second window following active stimulation, compared to sham stimulation. On several detection channels, the AERS features changed when clinical outcomes improved but were relatively stable otherwise. AERS change direction associated with clinical improvement was generally consistent within detection channels. CONCLUSIONS: In this retrospective analysis, patients with drug-resistant partial epilepsy treated with direct brain-responsive neurostimulation showed an acute stimulation related reduction in iEEG spectral power that was associated with reductions in clinical seizure frequency. SIGNIFICANCE: Identifying favorable stimulation related changes in iEEG activity could help physicians to more rapidly optimize stimulation settings for each patient.

Variations in lower body stiffness during sports-specific tasks in well-trained female athletes.

The present study aimed to assess the differences in leg stiffness and the associated performance variables between athletes from various training backgrounds during tasks relevant to athletic training. Forty-seven female participants (20 nationally identified netballers, 13 high-level endurance athletes and 14 age-matched controls) completed a sprint, anticipated sidestep change of direction and unilateral repetitive hopping task to assess leg stiffness and the relationship of stiffness between the different tasks. Leg stiffness and performance variables were evaluated with a 10-camera motion analysis system and force plate, and leg stiffness was derived through the McMahon and Cheng methodology (1990). Significant differences were evident in leg stiffness, and the contributing performance variables between groups across all assessed tasks (p < 0.001-0.017). Furthermore, results indicated the control group displayed no leg stiffness relationship between the evaluated tasks, while the stiffness relationship between tasks within athletic populations reflected training-specific demands of athletes. The results of this study indicated that the athletic training background of individuals may contribute to inherent leg stiffness differences between groups. Furthermore, the stiffness relationship observed between tasks suggests practitioners should take care in the selection of task used to monitor leg stiffness from a performance or injury risk perspective.

A Low-Carbohydrate Ketogenic Diet Reduces Body Mass Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes.

Greene, DA, Varley, BJ, Hartwig, TB, Chapman, P, and Rigney, M. A low-carbohydrate ketogenic diet reduces body mass without compromising performance in powerlifting and Olympic weightlifting athletes. J Strength Cond Res 32(12): 3382-3391, 2018-Weight class athletes use weight-making strategies to compete in specific weight categories with an optimum power-to-weight ratio. There is evidence that low carbohydrate diets might offer specific advantages for weight reduction without the negative impact on strength and power previously hypothesized to accompany carbohydrate restriction. Therefore, the purpose of this study was to determine whether a low-carbohydrate ketogenic diet (LCKD) could be used as a weight reduction strategy for athletes competing in the weight class sports of powerlifting and Olympic weightlifting. Fourteen intermediate to elite competitive lifting athletes (age 34 ± 10.5, n = 5 female) consumed an ad libitum usual diet (UD) (>250 g daily intake of carbohydrates) and an ad libitum LCKD (≤50 g or ≤10% daily intake of carbohydrates) in random order, each for 3 months in a crossover design. Lifting performance, body composition, resting metabolic rate, blood glucose, and blood electrolytes were measured at baseline, 3 months, and 6 months. The LCKD phase resulted in significantly lower body mass (-3.26 kg, p = 0.038) and lean mass (-2.26 kg, p = 0.016) compared with the UD phase. Lean mass losses were not reflected in lifting performances that were not different between dietary phases. No other differences in primary or secondary outcome measures were found between dietary phases. Weight class athletes consuming an ad libitum LCKD decreased body mass and achieved lifting performances that were comparable with their UD. Coaches and athletes should consider using an LCKD to achieve targeted weight reduction goals for weight class sports.

Wearable technology reveals gait compensations, unstable walking patterns and fatigue in people with multiple sclerosis.

OBJECTIVE: People with multiple sclerosis (PwMS) often experience a decline in gait performance, which can compromise their independence and increase falls. Ankle joint contractures in PwMS are common and often result in compensatory gait patterns to accommodate reduced ankle range of motion (ROM). APPROACH: Using advances in wearable technology, the aim of this study was to quantify head and pelvis movement patterns that occur in PwMS with disability and determine how these secondary gait compensations impact on gait stability. Twelve healthy participants and 12 PwMS participated in the study. Head and pelvis movements were measured using two tri-axial accelerometers. Measures of gait compensation, mobility, variability, asymmetry, stability and fatigue were assessed during a 6 min walking test. MAIN RESULTS: Compared to healthy controls, PwMS had greater vertical asymmetry in their head and pelvic movements (Cohen's d = 1.85 and 1.60). Lower harmonic ratios indicated that PwMS were more unstable than controls (Cohen's d = -1.61 to -3.06), even after adjusting for their slower walking speeds. In the PwMS, increased compensatory movements were correlated with reduced ankle active ROM (r = -0.71), higher disability (EDSS) scores (r = 0.58), unstable gait (r = -0.76), reduced mobility (r = -0.76) and increased variability (r = 0.83). SIGNIFICANCE: Wearable device technology provides an efficient and reliable way to screen for excessive compensatory movements often present in PwMS and provides clinically important information that impacts on mobility, stride time variability and gait stability. This information may help clinicians identify PwMS at high risk of falling and develop better rehabilitation interventions that, in addition to improving mobility, may help target the underlying causes of unstable gait.

An Alternative Test of Tackling Ability in Rugby League Players.

This study investigated the relationship between 2 tests of tackling ability, muscle strength, and power in semiprofessional rugby league players. Thirty-one players, 19 first-grade and 12 second-grade, underwent tests of muscle strength (1-repetition-maximum bench press, chin-up, and squat) and power (plyometric push-up and countermovement jump). Tackling ability was assessed via video analysis of under-and over-the-ball tackle drills. The first-grade players had significantly greater scores in both the under-the-ball (P = .03, effect size [ES] = 0.84, 95% CI 0.07-1.50) and over-the-ball tackling-ability tests (P < .001, ES =1.86, 95% CI 0.83-2.52) than the second-grade players. A large, significant relationship was found between under- and over-the-ball tackling ability (r = .55, 95% CI .24-.76, P = .001). Lower-body strength (r = .37, 95% CI .02-.64, P = .04) was moderately associated with under-the-ball tackling ability, whereas over-the-ball tackling ability was moderately associated with plyometric push-up performance (r = .39, 95% CI .04-.65, P = .03). This study found that over-the-ball tackling ability was significantly associated with under-the-ball tackling in semiprofessional rugby league players. Furthermore, it was found that, compared with the second-grade players, the first-grade players had superior tackle ability in both tackle drills. In this study it was observed that plyometric push-up peak power was significantly related to over-the-ball tackling ability and absolute lower-body strength was associated with under-the-ball tackling ability. These findings provide skill coaches and strength and conditioning staff a greater understanding of elements that contribute to effective tackling ability.

Relationship Between 2 Standardized Tackling Proficiency Tests and Rugby League Match-Play Tackle Performance.

This study investigated the relationship between 2 different assessments of tackling ability, physical qualities, and match-play performance in semiprofessional rugby league players. A total of 18 semiprofessional rugby league players (mean [SD]: age = 23.1 [2.0] y and body mass = 98.8 [11.8] kg) underwent tests of upper- and lower-body strength and power. Tackling ability was assessed using video analysis of under- and over-the-ball tackle drills. A total of 2360 tackles were analyzed from match play. Over-the-ball tackle ability was positively related to the proportion of dominant tackles (Spearman rank-order correlation coefficients [rs] = .52; 95% confidence interval [CI] .07-.79, P = .03) and average play-the-ball speeds (rs = .50; 95% CI .04-.78, P = .03) and negatively related to tackles that conceded offloads (rs = -.55; 95% CI -.78 to .04, P = .04). Under-the-ball tackle ability was significantly related to the proportion of dominant tackles (rs = .57; 95% CI .14-.82, P = .01) and missed tackles (rs = -.48; 95% CI -.77 to .02, P = .05). Good over-the-ball tacklers performed proportionally more dominant tackles, allowed significantly fewer offloads, and had longer average play-the-ball speeds. Good under-the-ball tacklers missed proportionately fewer tackles. This study suggests that both the under-the-ball and over-the-ball standardized tackle assessments are associated with varying indicators of match-play tackle performance and justifies the practical utility of these tests to assess and develop both types of tackles.

Bone Health of Young Male Gymnasts: A Systematic Review.

PURPOSE: To synthesize existing literatures on the impact of gymnastics participation on the skeletal health of young male gymnasts. METHODS: Following a systematic search, 12 studies were included in this review. Quality of included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE modified) criteria. RESULTS: Assessment of skeletal health varied between and within imaging modality protocols. Gymnasts had higher total bone content, greater total and trabecular bone density, larger bone size, a thicker cortex, and higher estimates of bone strength than controls. Recreational studies reported no difference in height or weight between gymnasts and controls; however, elite gymnasts were shorter and lighter than nongymnasts. STROBE scores ranged from 65% to 95%. CONCLUSION: Gymnastics participation may be beneficial to the bone health of young males as gymnasts had higher bone density and bone mineral content, larger bones, and greater estimates of bone strength than controls.

Changes in Rugby League Tackling Ability During a Competitive Season: The Relationship With Strength and Power Qualities.

Speranza, MJA, Gabbett, TJ, Greene, DA, Johnston, RD, and Sheppard, JM. Changes in rugby league tackling ability during a competitive season: the relationship with strength and power qualities. J Strength Cond Res 31(12): 3311-3318, 2017-This study examined the relationship between changes in tackling ability, and muscular strength and power during a semiprofessional rugby league competitive season. Twelve semiprofessional rugby league players (mean ± SD age, 23.3 ± 2.0 years) underwent tests of upper- and lower-body strength and power during the preseason period. Tackling ability was tested using video analysis of a standardized one-on-one tackling drill. Players repeated these tests after round 15 of a 25-match competitive season. Changes in 1 repetition maximum (1RM) squat (rs = 0.70; p < 0.02) and squat relative to body mass (rs = 0.73; p < 0.01) were significantly related to changes in tackling ability. Players with the greatest improvements in tackling ability (i.e., "responders") retained 1RM squat (effect size, ES = 0.85, p = 0.09) and squat relative to body mass (ES = 0.82, p = 0.15) to a greater extent than the "nonresponders." The results of this study suggest that players who retained lower-body strength were able to improve tackling ability during the competitive season, whereas reductions in lower-body strength were associated with decrements in tackling ability. This study highlights the importance of the development and maintenance of lower-body muscular strength for effective tackling performance throughout the rugby league season.

Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis.

Higgins, TR, Greene, DA, Baker, MK. Effects of cold water immersion and contrast water therapy for recovery from team sport: a systematic review and meta-analysis. J Strength Cond Res 31(5): 1443-1460, 2017-To enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within high level team sport. Initially, athletes relied solely on anecdotal support. As there has been an increase in the volume of research into recovery including a number of general reviews, an opportunity existed to narrow the focus specifically examining the use of hydrotherapy for recovery in team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data were extracted and the standardized mean differences were calculated with 95% confidence interval (CI). The analysis of pooled data was conducted using a random-effect model, with heterogeneity assessed using I. Twenty-three peer reviewed articles (n = 606) met the criteria. Meta-analyses results indicated CWI was beneficial for recovery at 24 hours (countermovement jump: p = 0.05, CI: -0.004 to 0.578; All-out sprint: p = 0.02, -0.056 to 0.801) following team sport. The CWI was beneficial for recovery at 72 hours (fatigue: p = 0.03, CI: 0.061-1.418) and CWT was beneficial for recovery at 48 hours (fatigue: p = 0.04, CI: 0.013-0.942) following team sport. The CWI was beneficial for neuromuscular recovery 24 hours following team sport, whereas CWT was not beneficial for recovery following team sport. In addition, when evaluating accumulated sprinting, CWI was not beneficial for recovery following team sports. In evaluating subjective measures, both CWI (72 hours) and CWT (24 hours) were beneficial for recovery of perceptions of fatigue, following team sport. However neither CWI nor CWT was beneficial for recovery, of perceptions of muscle soreness, following team sport.

The effect of calcium and vitamin D supplementation on bone health of male Jockeys.

OBJECTIVES: Engagement in high volumes of physical activity coupled with energy restriction during periods of musculoskeletal development may compromise bone health. Jockeys limit caloric intakes on a weekly basis often from their mid-to-late teens. The aim of this study was to establish whether calcium and vitamin D supplementation would improve bone turnover markers (BTM) and non-weight bearing bone properties of young male jockeys. DESIGN: A six-month randomised, double-blinded, placebo-controlled trial with two groups of apprentice male jockeys was conducted. METHODS: Participants (age 20.18±3.23years) were supplemented with 800mg of calcium and 400IU of vitamin D (n=8) or a placebo (n=9) daily. Bone properties were assessed at the ultra-distal (4%) and proximal (66%) radius using pQCT at baseline and six months. Vitamin D, P1NP and CTX were assessed. RESULTS: ANCOVA results for blood-borne markers indicated higher vitamin D levels (18.1%, p=0.014, partial η2=0.38) and lower CTX (ng·L-1) (-24.8%, p=0.011, partial η2=0.40) in the supplemented group with no differences observed in P1NP. Analysis of bone variables indicated no between group differences in either trabecular or cortical bone properties at the 4% and 66% sites post-intervention. CONCLUSIONS: This trial is the first to examine the efficacy of calcium and vitamin D supplementation in improving non-weight bearing bone properties in a young male athletic population. Results indicate positive alterations to bone metabolism; however, longer duration or higher dosage appears to be required to detect changes in bone material properties at the radius. Further examination of such interventions in weight-restricted athletes is warranted.

Lower Body Stiffness Modulation Strategies in Well Trained Female Athletes.

Millett, EL, Moresi, MP, Watsford, ML, Taylor, PG, and Greene, DA. Lower body stiffness modulation strategies in well trained female athletes. J Strength Cond Res 30(10): 2845-2856, 2016-Lower extremity stiffness quantifies the relationship between the amount of leg compression and the external load to which the limb are subjected. This study aimed to assess differences in leg and joint stiffness and the subsequent kinematic and kinetic control mechanisms between athletes from various training backgrounds. Forty-seven female participants (20 nationally identified netballers, 13 high level endurance athletes and 14 age and gender matched controls) completed a maximal unilateral countermovement jump, drop jump and horizontal jump to assess stiffness. Leg stiffness, joint stiffness and associated mechanical parameters were assessed with a 10 camera motion analysis system and force plate. No significant differences were evident for leg stiffness measures between athletic groups for any of the tasks (p = 0.321-0.849). However, differences in joint stiffness and its contribution to leg stiffness, jump performance outcome measures and stiffness control mechanisms were evident between all groups. Practitioners should consider the appropriateness of the task utilised in leg stiffness screening. Inclusion of mechanistic and/or more sports specific tasks may be more appropriate for athletic groups.

GPS and Injury Prevention in Professional Soccer.

This study investigated the relationship between GPS variables measured in training and gameplay and injury occurrences in professional soccer. Nineteen professional soccer players competing in the Australian Hyundai A-League were monitored for 1 entire season using 5 Hz Global Positioning System (GPS) units (SPI-Pro GPSports) in training sessions and preseason games. The measurements obtained were total distance, high-intensity running distance, very-high-intensity running distance, new body load, and meters per minute. Noncontact soft tissue injuries were documented throughout the season. Players' seasons were averaged over 1- and 4-week blocks according to when injuries occurred. These blocks were compared with each other and with players' seasonal averages. Players performed significantly higher meters per minute in the weeks preceding an injury compared with their seasonal averages (+9.6 and +7.4% for 1- and 4-week blocks, respectively) (p < 0.01), indicating an increase in training and gameplay intensity leading up to injuries. Furthermore, injury blocks showed significantly lower average new body load compared with seasonal averages (-15.4 and -9.0% for 1- and 4-week blocks, respectively) (p < 0.01 and p = 0.01). Periods of relative underpreparedness could potentially leave players unable to cope with intense bouts of high-intensity efforts during competitive matches. Although limited by Fédération Internationale de Football Association regulations, the results of this study isolated 2 variables predicting soft tissue injuries for coaches and sports scientists to consider when planning and monitoring training.

Tibial bone responses to 6-month calcium and vitamin D supplementation in young male jockeys: A randomised controlled trial.

Young male jockeys compromise bone health by engaging in caloric restriction and high volumes of physical activity during periods of musculoskeletal growth and development. The aim of this randomised, double-blinded, placebo-controlled trial was to establish whether calcium and vitamin D supplementation would improve bone properties of young male jockeys. We conducted a 6-month trial with two groups of weight-, height- and age-matched apprentice male jockeys (age=20.2 ± 3.2 yrs). Participants were supplemented with 800 mg of calcium and 400 IU of vitamin D (S, n=8) or a placebo (cellulose) (P, n=9) daily for 6-months. Baseline calcium intake was (669.7 ± 274.3 (S) vs 790.4 ± 423.9 (P) and vitamin D 64.6 ± 19.5 (S) vs 81.2 ± 24.4 (P) with no statistical differences. Peripheral quantitative computed tomography (pQCT) measured ultra-distal (4%) and proximal (66%) tibial bone properties at baseline and 6 months. Blood-borne markers of bone turnover, P1NP and CTX and vitamin D concentration were assessed. After co-varying for height, weight and baseline bone measurements, the supplemented group displayed greater post-intervention bone properties at the 66% proximal site with cortical content (mgmm) 6.6% greater (p<0.001), cortical area (mm(2)) 5.9% larger (p<0.001), cortical density (mgcm(2)) 1.3% greater (p=0.001), and total area (mm(2)) 4% larger (p=0.003). No other between group differences in bone variables were observed. Blood analysis indicated higher vitamin D levels (18.1%, p=0.014) and lower CTx (ng/L) (-24.8%, p=0.011) in the supplemented group with no differences observed in P1NP. This is the first randomised controlled trial to examine the efficacy of calcium and vitamin D supplementation in improving bone properties in a highly vulnerable, young athletic, weight-restricted population. Results using pQCT indicate beneficial effects of supplementation on bone properties in as little as six months. Although the study size is small, this intervention appears promising as a strategy for improving bone health in young athletes in weight-restricted sports.

The Effect of Calcium or Calcium and Vitamin D Supplementation on Bone Mineral Density in Healthy Males: A Systematic Review and Meta-Analysis.

Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardized mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES = 0.644; 95% CI = 0.406-0.883; p < .001), followed by total hip (ES = 0.483, 95% CI= 0.255-0.711, p < .001), femoral neck (ES = 0.402, 95% CI = 0.233-0.570, p = .000) and lumbar spine (ES = 0.306, 95% CI = 0.173-0.440,p < .001). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomized controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.

The impact of data reduction on the intra-trial reliability of a typical measure of lower limb musculoskeletal stiffness.

Double-leg repeated jumping tasks are commonly used as measures of lower limb stiffness in exercise science research. Within similar stiffness calculations, variation in data-reduction criteria exists. The impact of these varied data-reduction methods on stiffness measures is unknown. Sixteen adolescent female participants from varied physical activity backgrounds performed 15 self-paced, bent-knee continuous jumps (CJb) on two force plates. Leg stiffness was calculated as the ratio of the peak force and the centre of mass displacement for each contact. Using combinations of criteria based on previous literature, 83 data-reduction methods were applied to the raw data. Data reduction suitability was assessed based on intra-trial reliability, the number of participants excluded and the average contacts excluded. Four data-reduction methods were deemed suitable for use with adolescent female populations, with three consecutive contacts within 1 SD of the average jump frequency considered optimal. The average individual stiffness values were not greatly influenced by the data-reduction method; however, for a single participant, a stiffness change of up to 6 kN · m(-1) (30%) was observed. The role and potential impact of data-reduction methods used to evaluate measures of lower limb stiffness during repeated jumping tasks warrants consideration.

Skeletal adaptations associated with pre-pubertal gymnastics participation as determined by DXA and pQCT: a systematic review and meta-analysis.

UNLABELLED: Participation in gymnastics prior to puberty offers an intriguing and unique model, particularly in girls. The individuality comes from both upper and lower limbs being exposed to high mechanical loading through year long intensive training programs, initiated at a young age. Studying this unique model and the associated changes in musculoskeletal health during growth is an area of specific interest. Previous reviews on gymnastics participation and bone health have been broad; and not limited to a particular maturation period, such as pre-puberty. OBJECTIVES: To determine the difference in skeletal health between pre-pubertal girls participating in gymnastics compared with non-gymnasts. DESIGN: Meta-analysis. METHODS: Following a systematic search, 17 studies were included in this meta-analysis. All studies used dual-energy X-ray absorptiometry to assess bone mineral density and bone mineral content. In addition, two studies included peripheral quantitative computed tomography. RESULTS: Following the implementation of a random effects model, gymnasts were found to have greater bone properties than non-gymnasts. The largest difference in bone health between gymnasts and non-gymnasts was observed in peripheral quantitative computed tomography-derived volumetric bone mineral density at the distal radius (d=1.06). CONCLUSIONS: Participation in gymnastics during pre-pubertal growth was associated with skeletal health benefits, particularly to the upper body.

Mechanical loading with or without weight-bearing activity: influence on bone strength index in elite female adolescent athletes engaged in water polo, gymnastics, and track-and-field.

Bone health is considered not to benefit from water-based sports because of their weight-supported nature, but available evidence primarily relies on DXA technology. Our purpose was to investigate musculoskeletal health in the upper and lower body in well-trained adolescent female athletes using pQCT and compare these athletes with less-active, age- and sex-matched peers. Bone mineral content, volumetric cortical and trabecular BMD, total and cortical area, and bone strength index were assessed at the distal and proximal tibia and radius in four groups of adolescent females (mean age, 14.9 years) including water polo players (n = 30), gymnasts (n = 25), track-and-field athletes (n = 34), and nonactive controls (n = 28). Water polo players did not show any benefit in bone strength index or muscle size in the lower leg when compared with controls. In contrast, gymnasts showed 60.1 % and 53.4 % greater bone strength index at the distal and proximal tibia, respectively, than nonactive females (p < 0.05). Similarly, track-and-field athletes displayed 33.9 % and 14.7 % greater bone strength index at the distal and proximal tibia, respectively, compared with controls (p < 0.05). In the upper body, water polo players had 31.9 % greater bone strength index at the distal radius, but not the radial shaft, and 15.2 % larger forearm muscle cross-sectional area than controls (p < 0.05). The greatest musculoskeletal benefits in the upper body were found in gymnasts. In conclusion, despite training at an elite level, female water polo players did not show any benefits in musculoskeletal health in the lower leg and only limited benefits in the upper body when compared with nonactive girls.

Influence of drop-landing exercises on bone geometry and biomechanical properties in prepubertal girls: a randomized controlled study.

We conducted a 28-week school-based exercise trial of single-leg drop-landing exercise with 42 girls (Tanner stage 1, 6-10 years old) randomly assigned to control (C), low-drop (LD), or high-drop (HD) exercise groups. The LD and HD groups performed single-leg drop-landings (three sessions/week and 50 landings/session) from 14 and 28 cm, respectively, using the nondominant leg. Single-leg peak ground-reaction impact forces in a subsample ranged between 2.5 and 4.4 times body weight. Dependent variables were bone geometry and biomechanical properties using magnetic resonance imaging. No differences (P > 0.05) were found among groups at baseline for age, stature, lean tissue mass (DXA--Lunar 3.6-DPX), leisure-time physical activity, average daily calcium intake, or measures of knee extensor or flexor torque. A series of ANOVA and ANCOVA tests showed no within- or between-group differences from baseline to posttraining. Group comparisons assessing magnitude of change in side-to-side differences in geometry (area cm(2)) and cross-sectional moment of inertia (cm(4)) at proximal, mid, and distal sites revealed negligible effect sizes. Our findings suggest that strictly controlled unimodal, unidirectional single-leg drop-landing exercises involving low to moderate peak ground-reaction impact forces do not influence geometrical or biomechanical measures in the developing prepubertal female skeleton.

Adaptive skeletal responses to mechanical loading during adolescence.

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.