Is a School‐Based Physical Activity Intervention Effective for Increasing Tibial Bone Strength in Boys and Girls?

This 16‐month randomized, controlled school‐based study compared change in tibial bone strength between 281 boys and girls participating in a daily program of physical activity (Action Schools! BC) and 129 same‐sex controls. The simple, pragmatic intervention increased distal tibia bone strength in prepubertal boys; it had no effect in early pubertal boys or pre or early pubertal girls.

[1]  K M Khan,et al.  “Bounce at the Bell”: a novel program of short bouts of exercise improves proximal femur bone mass in early pubertal children , 2005, British Journal of Sports Medicine.

[2]  A. Heinonen,et al.  High-Impact Exercise and Bones of Growing Girls: A 9-Month Controlled Trial , 2000, Osteoporosis International.

[3]  H. Sievänen.  Hormonal influences on the muscle-bone feedback system: a perspective. , 2005, Journal of musculoskeletal & neuronal interactions.

[4]  K M Khan,et al.  A school-based exercise intervention augments bone mineral accrual in early pubertal girls. , 2001, The Journal of pediatrics.

[5]  Heather A McKay,et al.  Lessons learned from Action Schools! BC--an 'active school' model to promote physical activity in elementary schools. , 2006, Journal of science and medicine in sport.

[6]  D. Davies.  Foetus into Man , 1990 .

[7]  P. Ravaud,et al.  A priori postulated and real power in cluster randomized trials: mind the gap , 2005, BMC medical research methodology.

[8]  G. Salem,et al.  American College of Sports Medicine position stand. Exercise and physical activity for older adults. , 2009, Medicine and science in sports and exercise.

[9]  J. Lappe,et al.  Accuracy of Pubertal Tanner Staging Self-Reporting , 2006, Journal of pediatric endocrinology & metabolism : JPEM.

[10]  P. Crocker,et al.  Validation of the Physical Activity Questionnaire for Older Children , 1997 .

[11]  James M. Tanner,et al.  Fetus into Man , 1978 .

[12]  K M Khan,et al.  Augmented trochanteric bone mineral density after modified physical education classes: a randomized school-based exercise intervention study in prepubescent and early pubescent children. , 2000, The Journal of pediatrics.

[13]  Heather A McKay,et al.  A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. , 2003, Pediatrics.

[14]  D. Burr,et al.  Stiffness of compact bone: effects of porosity and density. , 1988, Journal of biomechanics.

[15]  P. Kannus.  Preventing osteoporosis, falls, and fractures among elderly people , 1999, BMJ.

[16]  J. Pritchett.  Longitudinal growth and growth-plate activity in the lower extremity. , 1992, Clinical orthopaedics and related research.

[17]  Diane J Catellier,et al.  School-level intraclass correlation for physical activity in adolescent girls. , 2004, Medicine and science in sports and exercise.

[18]  Heather A McKay,et al.  Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys. , 2004, Bone.

[19]  T. Andriacchi,et al.  Changes in the gait patterns of growing children. , 1981, The Journal of bone and joint surgery. American volume.

[20]  J. J. Bauer,et al.  Jumping Improves Hip and Lumbar Spine Bone Mass in Prepubescent Children: A Randomized Controlled Trial , 2001, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[21]  T. Binkley,et al.  Randomized Trial of Physical Activity and Calcium Supplementation on Bone Mineral Content in 3‐ to 5‐Year‐Old Children , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[22]  Y. Umemura,et al.  Five Jumps per Day Increase Bone Mass and Breaking Force in Rats , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  Peter R. Cavanagh,et al.  Exercise and physical activity for older adults , 1998 .

[24]  G Pearce,et al.  Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density, and bone strength: a controlled prospective study. , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[25]  Pekka Kannus,et al.  Effect of Long‐Term Impact‐Loading on Mass, Size, and Estimated Strength of Humerus and Radius of Female Racquet‐Sports Players: A Peripheral Quantitative Computed Tomography Study Between Young and Old Starters and Controls , 2002, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[26]  A. Heinonen,et al.  A Randomized School‐Based Jumping Intervention Confers Site and Maturity‐Specific Benefits on Bone Structural Properties in Girls: A Hip Structural Analysis Study , 2002, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[27]  H K Genant,et al.  Accuracy of cortical and trabecular bone measurements with peripheral quantitative computed tomography (pQCT). , 1998, Physics in medicine and biology.

[28]  T. Einhorn.  Bone strength: The bottom line , 1992, Calcified Tissue International.

[29]  David Q. Thomas,et al.  Vertical Ground Reaction Forces of Children during One- and Two-Leg Rope Jumping , 2002, Research quarterly for exercise and sport.

[30]  J. Prochaska,et al.  Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. , 2003, American journal of preventive medicine.

[31]  P. Naylor,et al.  Action Schools! BC: A Socioecological Approach to Modifying Chronic Disease Risk Factors in Elementary School Children , 2006, Preventing chronic disease.

[32]  J M Bland,et al.  The intracluster correlation coefficient in cluster randomisation , 1998, BMJ.

[33]  W. Hayes,et al.  Bone compressive strength: the influence of density and strain rate. , 1976, Science.

[34]  J. Adams,et al.  Bone geometry and density in the skeleton of pre-pubertal gymnasts and school children. , 2005, Bone.

[35]  C. Snow,et al.  Gains in hip bone mass from high-impact training are maintained: a randomized controlled trial in children. , 2002, The Journal of pediatrics.

[36]  C. Irwin,et al.  Validity of self-report of pubertal maturation in early adolescents. , 1990, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[37]  I. Litt,et al.  Adolescents' self-assessment of sexual maturation. , 1980, Pediatrics.

[38]  V. Gilsanz.  Bone density in children: a review of the available techniques and indications. , 1998, European journal of radiology.

[39]  K M Khan,et al.  Bone Mineral Response to a 7‐Month Randomized Controlled, School‐Based Jumping Intervention in 121 Prepubertal Boys: Associations With Ethnicity and Body Mass Index , 2002, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[40]  Alexander G Robling,et al.  Designing Exercise Regimens to Increase Bone Strength , 2003, Exercise and sport sciences reviews.

[41]  C. Milgrom,et al.  A Home Exercise Program for Tibial Bone Strengthening Based on In Vivo Strain Measurements , 2001, American journal of physical medicine & rehabilitation.

[42]  P. Kannus,et al.  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. , 2002, International journal of sports medicine.

[43]  D. Bailey,et al.  Measuring general levels of physical activity: preliminary evidence for the Physical Activity Questionnaire for Older Children. , 1997, Medicine and science in sports and exercise.

[44]  D. Burr,et al.  Recovery periods restore mechanosensitivity to dynamically loaded bone. , 2001, The Journal of experimental biology.

[45]  T. Binkley,et al.  Bone response to jumping is site-specific in children: a randomized trial. , 2003, Bone.

[46]  Heather McKay,et al.  Bone strength and its determinants in pre- and early pubertal boys and girls. , 2006, Bone.

[47]  S. Barr.  Associations of social and demographic variables with calcium intakes of high school students. , 1994, Journal of the American Dietetic Association.

[48]  A Heinonen,et al.  Ground reaction forces associated with an effective elementary school based jumping intervention , 2004, British Journal of Sports Medicine.

[49]  D. Altman,et al.  CONSORT statement: extension to cluster randomised trials , 2004, BMJ : British Medical Journal.

[50]  M. Järvinen,et al.  Femoral Neck Response to Exercise and Subsequent Deconditioning in Young and Adult Rats , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.