Eva Wulff Helge

Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women.

We examined long‐term musculoskeletal and cardiac adaptations elicited by recreational football (FG, n=9) and running (RG, n=10) in untrained premenopausal women in comparison with a control group (CG, n=9). Training was performed for 16 months (∼2 weekly 1‐h sessions). For FG, right and left ventricular end‐diastolic diameters were increased by 24% and 5% (P<0.05), respectively, after 16 months. Right ventricular systolic function measured by tricuspid annular plane systolic excursion (TAPSE) increased (P<0.05) in FG after 4 months and further (P<0.05) after 16 months (15% and 32%, respectively). In RG and CG, cardiac structure, E/A and TAPSE remained unchanged. For FG, whole‐body bone mineral density (BMD) was 2.3% and 1.3% higher (P<0.05) after 16 months, than after 4 and 0 months, respectively, with no changes for RG and CG. FG demonstrated substantial improvements (P<0.05) in fast (27% and 16%) and slow (16% and 17%) eccentric muscle strength and rapid force capacity (Imp30ms: 66% and 65%) after 16 months compared with 4 and 0 months, with RG improving Imp30ms by 64% and 46%. In conclusion, long‐term recreational football improved muscle function, postural balance and BMD in adult women with a potential favorable influence on the risk of falls and fractures. Moreover, football training induced consistent cardiac adaptations, which may have implications for long‐term cardiovascular health.

Recreational football training decreases risk factors for bone fractures in untrained premenopausal women

The present intervention was designed to investigate whether a 14‐week period of regular recreational association football (F) or endurance running (R) has an effect on the risk of falls and bone fractures due to gains in muscle function and volumetric bone mineral density (vBMD). Fifty healthy untrained Danish premenopausal women were randomized into two training groups (F and R) that trained 1.8±0.3 (±SD) and 1.9±0.3 h/week, respectively, and these groups were compared with an inactive control group (C). Jumping and dynamic muscle strength were tested and tibial vBMD was measured using peripheral quantitative computed tomography. Total vBMD in left and right tibia increased by 2.6±2.3% and 2.1±1.8% (P<0.005), respectively, in F and by 0.7±1.3% (P=0.05) and 1.1±1.5% (P<0.01), respectively, in R without any significant changes in C. Similar results were found for trabecular vBMD. In F, peak jump power increased by 3±6% (P<0.05), and hamstring strength during fast (240°/s) and slow (30°/s) contractions increased by 11±25% and 9±21%, respectively, (P<0.05) without any significant changes in R or C. In conclusion, 14 weeks of regular recreational football improved peak jump power, maximal hamstring strength and vBMD in the distal tibia, suggesting a decreased fracture risk due to stronger bones and a reduced risk of falling.

Bone density in female elite gymnasts: impact of muscle strength and sex hormones.

PURPOSE The aim of this study was to investigate BMD in Danish female elite gymnasts and the relationships to maximal muscle strength, sex hormone concentrations, and menstrual status. METHODS Six artistic gymnasts, five rhythmic gymnasts, and six controls aged 15-20 yr served as subjects. BMD (g x cm(-2)) of lumbar spine, proximal femur, distal radius, and whole body were measured by dual-energy x-ray absorptiometry (DXA) scanning. Maximal muscle strength (Nm) was measured in isokinetic trunk extension, trunk flexion, and knee extension. Serum concentrations of estrogen and progesterone in follicular and luteal phases were evaluated. RESULTS Three out of six artistic gymnasts had amenorrhea, and two artistic and one rhythmic gymnast experienced oligomenorrhea. BMD in artistic gymnasts was greater than controls (24-45%, P < 0.05) in all sites except whole body. BMD in rhythmic gymnasts was greater than controls (4-26%, P < 0.05) in all sites except distal radius. In gymnasts, BMD correlated to both maximal muscle strength (0.60 < r < 0.85, P < 0.05) and serum progesterone (0.65 < r < 0.75, P < 0.05). CONCLUSION In spite of oligomenorrhea or amenorrhea, it is possible for female gymnasts to maintain a high BMD in both the axial (L2-L4) and appendicular skeleton. The correlations between BMD and maximal muscle strength and progesterone concentration in gymnasts may indicate that within the same athletic group, progesterone concentration has a permissive role in bone formation, thus affecting the positive impact of muscle strength.

Recreational football improves bone mineral density and bone turnover marker profile in elderly men

This study examined the effect of recreational football and resistance training on bone mineral density (BMD) and bone turnover markers (BTMs) in elderly men. Twenty‐six healthy sedentary men (age 68.2 ± 3.2 years) were randomized into three groups: football (F; n = 9) and resistance training (R; n = 9), completing 45–60 min training two to three times weekly, and inactive controls (C; n = 8). Before, after 4 months, and after 12 months, BMD in proximal femur (PF) and whole body (WB) were determined together with plasma osteocalcin (OC), procollagen type‐1 amino‐terminal propeptide (P1NP), and carboxy‐terminal type‐1 collagen crosslinks (CTX‐1). In F, BMD in PF increased up to 1.8% (P < 0.05) from 0 to 4 months and up to 5.4% (P < 0.001) from 0 to 12 months; WB‐BMD remained unchanged. After 4 and 12 months of football, OC was 45% and 46% higher (P < 0.001), and P1NP was 41% and 40% higher (P < 0.001) than at baseline, respectively. After 12 months, CTX‐1 showed a main effect of 43% (P < 0.05). In R and C, BMD and BTM remained unchanged. In conclusion, 4 months of recreational football for elderly men had an osteogenic effect, which was further developed after 12 months, whereas resistance training had no effect. The anabolic response may be due to increased bone turnover, especially improved bone formation.

Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy

Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months). Fifty‐seven men aged 67 (range: 43–74) were randomly assigned to a football group (FG, n = 29) or a usual care control group (CON, n = 28). The primary outcome was change in lean body mass (LBM) assessed by dual‐energy X‐ray absorptiometry scanning. Secondary outcomes included changes in knee‐extensor muscle strength (one repetition maximum), fat percentage, and maximal oxygen uptake (VO2max). Mean heart rate during training was 137.7 (standard deviation 13.7) bpm or 84.6 (3.9)% HRmax. In FG, LBM increased by 0.5 kg [95% confidence interval (CI) 0.1–0.9; P = 0.02] with no change in CON (mean group difference 0.7 kg; 95% CI 0.1–1.2; P = 0.02). Also, muscle strength increased in FG (8.9 kg; 95% CI 6.0–11.8; P < 0.001) with no change in CON (mean group difference 6.7 kg; 95% CI 2.8–10.7; P < 0.001). In FG, VO2max increased (1.0 mL/kg/min; 95% CI 0.2–1.9; P = 0.02) and fat percentage tended to decrease (0.7%; 95%CI 1.3–0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT.

Musculoskeletal health profile for elite female footballers versus untrained young women before and after 16 weeks of football training

Abstract We investigated the musculoskeletal health profile of elite female football players (ET) in comparison to untrained (UT) young women subjected to 16 weeks of football training (2 × 1 h per week). DXA scans, blood sampling, sprint testing and Flamingo postural balance testing were carried out for 27 Danish national team players and 28 untrained women, with eight women being tested after training. At baseline total BMD and BMC were 13% (1.305 ± 0.050 versus 1.159 ± 0.056 g · cm−2) and 23% (3047 ± 235 versus 2477 ± 526 g) higher (P <0.001) and leg BMD and BMC were 24 and 28% higher (P <0.01) in ET than in UT. Resting plasma osteocalcin was 45% higher in ET than in UT (28.8 ± 10.9 versus 19.9 ± 9.9 µg · L−1, P <0.05). Total lean body mass was 14% higher (50.4 ± 3.3 versus 44.3 ± 4.0 kg) in ET compared with UT, with no difference in total body mass. The number of Flamingo test falls was 56–63% less (P <0.01) and 30 m sprinting speed was 31% faster (P <0.001) in ET than UT. After 16 weeks of football training for UT, lean body mass increased by 1.4 ± 0.5 kg and the number of left leg falls decreased by 29% (P <0.05). No significant changes occurred in BMD or BMC, but plasma osteocalcin increased (P <0.05) by 37%. In summary, elite women footballers have an impressive musculoskeletal health profile compared with untrained controls, but short-term football training seems to reduce the risk of falls and increase bone formation.

Street football is a feasible health-enhancing activity for homeless men: biochemical bone marker profile and balance improved.

This case‐control study investigated the feasibility of street football as a health‐enhancing activity for homeless men, specifically the musculoskeletal effects of 12 weeks of training. Twenty‐two homeless men participated in the football group (FG) and 10 served as controls (C). Plasma osteocalcin, TRACP5b, leptin, and postural balance were measured, and whole‐body DXA scanning was performed. The attendance rate was 75% (2.2 ± 0.7 sessions per week). During 60 min of training, the total distance covered was 5534 ± 610 m, with 1040 ± 353, 2744 ± 671, and 864 ± 224 m covered by high‐intensity, low‐intensity, and backwards/sideways running, respectively. In FG, osteocalcin increased by 27% from 20.1 ± 11.1 to 25.6 ± 11.8 ng/mL (P = 0.007). Postural balance increased by 39% (P = 0.004) and 46% (P = 0.006) in right and left leg. Trunk bone mineral density increased by 1.0% from 0.959 ± 0.095 to 0.969 ± 0.090 g/cm2 (P = 0.02). No effects were observed in C. In conclusion, street football appears to be a feasible training activity with musculoskeletal health benefits for homeless men. The attendance rate and the training intensity were high, and 12 weeks of training resulted in a substantial anabolic response in bone metabolism. Postural balance improved markedly, and the overall risk of falling, and hospitalization due to sudden trauma, could be reduced by street football for homeless men.

Positive effects on bone mineralisation and muscular fitness after 10 months of intense school-based physical training for children aged 8–10 years: the FIT FIRST randomised controlled trial

Objectives We investigated whether musculoskeletal fitness of school children aged 8–10 years was affected by frequent intense PE sessions. Design and participants 295 Danish school children aged 8–10 years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes). Intervention SSG or CST was performed 3×40 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness. Results Analysis of baseline-to-10 months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8 mg/cm2, 95% CI 3 to 13; CST vs CON: 7 mg/cm2, 95% CI 2 to 13, p<0.05) and leg BMC (SSG vs CON: 11 g, 95% CI 4 to 18; CST vs CON: 11 g, 95% CI 3 to 18, p<0.05). SSG had higher change scores in leg aBMD compared with CON and CST (SSG vs CON: 19 mg/cm2, 95% CI 11 to 39, p<0.05; SSG vs CST: 12 mg/cm2, 95% CI 3 to 21, p<0.05), and CST had higher change scores in whole-body BMC compared with CON (CST vs CON: 25 g, 95% CI 10 to 39, p<0.05). Both training types resulted in higher change scores in postural balance (SSG vs CON: 2.4 fewer falls/min, 95% CI 0.3 to 4.5, CST vs CON: 3.6 fewer falls/min, 95% CI 1.3 to 5.9, p<0.05) and jump length (SSG vs CON: 10%, 95% CI 5 to 16%; CST vs CON: 9%, 95% CI 3 to 15%, p<0.05). No between-group differences were observed for sprint performance or LBM (p>0.05). Conclusions In conclusion, 3×40 min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8–10 years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children. Trial registration number NCT02000492, post results.

Fitness Effects of 10-Month Frequent Low-Volume Ball Game Training or Interval Running for 8–10-Year-Old School Children

We investigated the exercise intensity and fitness effects of frequent school-based low-volume high-intensity training for 10 months in 8–10-year-old children. 239 Danish 3rd-grade school children from four schools were cluster-randomised into a control group (CON, n = 116) or two training groups performing either 5 × 12 min/wk small-sided football plus other ball games (SSG, n = 62) or interval running (IR, n = 61). Whole-body DXA scans, flamingo balance, standing long-jump, 20 m sprint, and Yo-Yo IR1 childrens tests (YYIR1C) were performed before and after the intervention. Mean running velocity was higher (p < 0.05) in SSG than in IR (0.88 ± 0.14 versus 0.63 ± 0.20 m/s), while more time (p < 0.05) was spent in the highest player load zone (>2; 5.6 ± 3.4 versus 3.7 ± 3.4%) and highest HR zone (>90% HRmax; 12.4 ± 8.9 versus 8.4 ± 8.0%) in IR compared to SSG. After 10 months, no significant between-group differences were observed for YYIR1C performance and HR after 2 min of YYIR1C (HRsubmax), but median-split analyses showed that HRsubmax was reduced (p < 0.05) in both training groups compared to CON for those with the lowest aerobic fitness (SSG versus CON: 3.2%  HRmax [95% CI: 0.8–5.5]; IR versus CON: 2.6%  HRmax [95% CI: 1.1–5.2]). After 10 months, IR had improved (p < 0.05) 20 m sprint performance (IR versus CON: 154 ms [95% CI: 61–241]). No between-group differences (p > 0.05) were observed for whole-body or leg aBMD, lean mass, postural balance, or jump length. In conclusion, frequent low-volume ball games and interval running can be conducted over a full school year with high intensity rate but has limited positive fitness effects in 8–10-year-old children.

Short Duration Small Sided Football and to a Lesser Extent Whole Body Vibration Exercise Induce Acute Changes in Markers of Bone Turnover

We aimed to study whether short-duration vibration exercise or football sessions of two different durations acutely changed plasma markers of bone turnover and muscle strain. Inactive premenopausal women (n = 56) were randomized to complete a single bout of short (FG15) or long duration (FG60) small sided football or low magnitude whole body vibration training (VIB). Procollagen type 1 amino-terminal propeptide (P1NP) was increased during exercise for FG15 (51.6 ± 23.0 to 56.5 ± 22.5 μg·L−1, mean ± SD, P < 0.05) and FG60 (42.6 ± 11.8 to 50.2 ± 12.8 μg·L−1, P < 0.05) but not for VIB (38.8 ± 15.1 to 36.6 ± 14.7 μg·L−1, P > 0.05). An increase in osteocalcin was observed 48 h after exercise (P < 0.05), which did not differ between exercise groups. C-terminal telopeptide of type 1 collagen was not affected by exercise. Blood lactate concentration increased during exercise for FG15 (0.6 ± 0.2 to 3.4 ± 1.2 mM) and FG60 (0.6 ± 0.2 to 3.3 ± 2.0 mM), but not for VIB (0.6 ± 0.2 to 0.8 ± 0.4 mM) (P < 0.05). Plasma creatine kinase increased by 55 ± 63% and 137 ± 119% 48 h after FG15 and FG60 (P < 0.05), but not after VIB (26 ± 54%, NS). In contrast to the minor elevation in osteocalcin in response to a single session of vibration exercise, both short and longer durations of small sided football acutely increased plasma P1NP, osteocalcin, and creatine kinase. This may contribute to favorable effects of chronic training on musculoskeletal health.