John Carlson

Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density, and bone strength: a controlled prospective study

Cross‐sectional studies of elite athletes suggest that growth is an opportune time for exercise to increase areal bone mineral density (BMD). However, as the exercise undertaken by athletes is beyond the reach of most individuals, these studies provide little basis for making recommendations regarding the role of exercise in musculoskeletal health in the community. To determine whether moderate exercise increases bone mass, size, areal, and volumetric BMD, two socioeconomically equivalent schools were randomly allocated to be the source of an exercise group or controls. Twenty boys (mean age 10.4 years, range 8.4–11.8) allocated to 8 months of 30‐minute sessions of weight‐bearing physical education lessons three times weekly were compared with 20 controls matched for age, standing and sitting height, weight, and baseline areal BMD. Areal BMD, measured using dual‐energy X‐ray absorptiometry, increased in both groups at all sites, except at the head and arms. The increase in areal BMD in the exercise group was twice that in controls; lumbar spine (0.61 ± 0.11 vs. 0.26 ± 0.09%/month), legs (0.76 ± 0.07 vs. 0.34 ± 0.08%/month), and total body (0.32 ± 0.04 vs. 0.17 ± 0.06%/month) (all p < 0.05). In the exercise group, femoral midshaft cortical thickness increased by 0.97 ± 0.32%/month due to a 0.93 ± 0.33%/month decrease in endocortical (medullary) diameter (both p < 0.05). There was no periosteal expansion so that volumetric BMD increased by 1.14 ± 0.33%/month, (p < 0.05). Cortical thickness and volumetric BMD did not change in controls. Femoral midshaft section modulus increased by 2.34 ± 2.35 cm3 in the exercise group, and 3.04 ± 1.14 cm3 in controls (p < 0.05). The growing skeleton is sensitive to exercise. Moderate and readily accessible weight‐bearing exercise undertaken before puberty may increase femoral volumetric BMD by increasing cortical thickness. Although endocortical apposition may be a less effective means of increasing bone strength than periosteal apposition, both mechanisms will result in higher cortical thickness that is likely to offset bone fragility conferred by menopause‐related and age‐related endocortical bone resorption.

Prospective ten-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass.

Enhancement of bone mineral acquisition during growth may be a useful preventive strategy against osteoporosis. The aim of this study was to explore the lean mass, strength, and bone mineral response to a 10‐month, high‐impact, strength‐building exercise program in 71 premenarcheal girls, aged 9–10 years. Lean body mass, total body (TB), lumbar spine (LS), proximal femur (PF), and femoral neck (FN) bone mineral were measured using the Hologic QDR 2000+ bone densitometer. Strength was assessed using a grip dynamometer and the Cybex isokinetic dynamometer (Cybex II). At baseline, no significant difference in body composition, pubertal development, calcium intake, physical activity, strength, or bone mineral existed between groups. At completion, there were again no differences in height, total body mass, pubertal development, calcium intake, or external physical activity. In contrast, the exercise group gained significantly more lean mass, less body fat content, greater shoulder, knee and grip strength, and greater TB, LS, PF, and FN BMD (exercise: TB 3.5%, LS 4.8%, PF 4.5%, and FN 12.0%) compared with the controls (controls: TB 1.2%, LS 1.2%, PF 1.3%, and FN 1.7%). TB bone mineral content (BMC), LS BMC, PF BMC, FN BMC, LS bone mineral apparent density (BMAD), and FN bone area also increased at a significantly greater rate in the exercise group compared with the controls. In multiple regression analysis, change in lean mass was the primary determinant of TB, FN, PF, and LS BMD accrual. Although a large proportion of bone mineral accrual in the premenarcheal skeleton was related to growth, an osteogenic effect was associated with exercise. These results suggest that high‐impact, strength building exercise is beneficial for premenarcheal strength, lean mass gains, and bone mineral acquisition.

Physiological issues surrounding the performance of adolescent athletes.

More than ever, many young athletes are being encouraged to train intensely for sporting competitions from an early age. Compared with studies in adults, less is known about the physiological trainability of adolescents. The velocity of physical growth during the adolescent years makes research with a group of young athletes particularly difficult. The purpose of this review is to discuss a number of physiological issues that surround the performances of the adolescent athlete. Research has highlighted the role of growth hormone (GH) in the abrupt acceleration of linear growth that occurs during adolescence. In addition, GH has been shown to be sensitive to exercise following short term intervention studies. The reduced anaerobic power of the adolescent athlete compared with that of an adult athlete has been attributed to the intrinsic properties of the muscle that are yet to be fully understood. Resistance training studies in male adolescents, and to a lesser extent female adolescents, highlight the substantial relative strength gains that can be obtained. Aerobic trainability in young boys appears to improve markedly during the adolescent years. One of the most plausible explanations for this observation is the ‘trigger hypothesis’ which links increased aerobic improvements in adolescence with hormonal changes and substantial growth of the cardiorespiratory and musculoskeletal systems. Studies of aerobic trainability in adolescent girls are too scarce to be conclusive. An understanding of the impact of long term intensive training on adolescent athletes is difficult to ascertain because physical stresses vary both between and within sports. There is, however, limited evidence to suggest that ‘intense’ training does not impair normal growth, development or maturation. Adolescent athletes who experience rapid growth as well as large increases in training volumes may be vulnerable to overuse injuries.

The Yo-Yo Intermittent Recovery Test (Level 1) to discriminate elite junior Australian football players

The Yo-Yo Intermittent Recovery (IR) Test is currently used to assess endurance performance in team sport athletes. However, to date, no data has been presented on its application to an elite junior Australian football (AF) playing group. Therefore, the aim of this study was to evaluate the Yo-Yo Intermittent Recovery Test Level 1 (IR1) ability to discriminate between junior AF players at two different playing standards and a group of non-athletic healthy males. Sixty age matched participants (16.6+/-0.5 years) spread over three groups (20 per group): elite junior footballers; sub-elite junior footballers; and non-athletic healthy males participated in this study. Participants undertook a single Yo-Yo test performance on an indoor basketball court for each group. A one-way ANOVA with Scheffes post hoc analysis revealed the elite junior footballers covered a significantly greater total distance (p<0.001) and completed a significantly greater number of high-intensity efforts (p<0.001) in comparison to their sub-elite counterparts, whilst both AF groups performed significantly better (p<0.001) than the non-athletic healthy males. This study demonstrates the ability of the Yo-Yo IR1 to discriminate endurance performance between elite and sub-elite AF players, whilst further distinguishing AF players from a non-athletic healthy control group.

Wearing a sports compression garment on the performance of visuomotor tracking following eccentric exercise: A pilot study

Clinical compression garments have been shown to improve functional control in patients with motor impairments, however, investigation in functional control has not been observed whilst wearing sports compression garments. This pilot study assessed motor control changes in the bicep brachii muscle following a bout of eccentric exercise designed to induce delayed onset muscle soreness for intervals up to 14 days after exercise. Eight male participants performed 35 maximal isokinetic eccentric extensions at 90 degrees s(-1). Participants where then randomly divided into one of two groups to perform a one-dimensional elbow flexion/extension visuomotor tracking task; one group wore a sports compression garment during the task, the other acted as control (no garment). The group who wore the compression garment performed the tracking task significantly better immediately post-exercise, and at days 1, 2 and 3 post-exercise (p < or = 0.05). Non-significant but large and moderate effects sizes (ES), in tracking, were found between the two groups on day 5 (ES = 1.3) and day 7 (ES = 0.7), respectively. Further research is necessary to elucidate these preliminary findings, however, the results suggest that the wearing of sports compression garments post-eccentric exercise has a positive effect on functional motor control.

Accumulated oxygen deficit measurements during and after high-intensity exercise in trained male and female adolescents.

Abstract The purpose of this study was to compare accumulated oxygen deficits and markers of anaerobic metabolism [plasma ammonia (NH3) and lactate (La−) concentrations] in anaerobically trained male [n = 8, age 14.8 (0.5) years; maximal oxygen consumption V˙O2max 61.74 (2.23) ml ·  kg−1 · min−1] and female [n = 8, age 14.5 (0.2) years; V˙O2max 49.62 (3.52) ml · kg−1 · min−1] adolescents. The exercise protocol consisted of runs to exhaustion at speeds predicted to represent 120% and 130% of V˙O2max. Arterialised blood samples were obtained from a pre-warmed hand via a catheter inserted into a forearm vein. Samples were taken at rest and after 1, 3, 5, 7, 10, 15 and 20 min of recovery. The high-intensity exercise resulted in mean accumulated oxygen deficits that were less (P < 0.05) in females (52.3 ml · kg−1) than in males (68.6 ml · kg−1). Lower (P < 0.05) plasma concentrations of NH3 and La−1, and a higher pH were evident in females compared with males during various stages of the 20-min recovery period. The increase in anaerobic performance in the male adolescent athletes when compared with their female counterparts was associated with an increased plasma concentration of selected plasma and blood metabolites. The observed results may reflect well-established differences between the sexes in the morphology and metabolic power of muscle.