Table 2:
Summary of the characteristic of studies included in the present review
| Reference | Subjects | Methodology | Results | Remark | |
|---|---|---|---|---|---|
| Welten et. al. (1994) (25) Longitudinal Amsterdam Growth and Health Longitudinal Study (AGAHLS) |
182 (84 ♂ & 98 ♀) Age at base-line: 13 yr Follow-up: 14 yr Country: Netherlands |
PA Measurement Cross-check interview was used. Activities were limited to a minimal of 4 METs with minimum of 5 min. The average of weekly time spent in 3 categories: light (4–7 METs), medium heavy (7–10 METs), and heavy (>I0 METs) were collected. The total activity score per week was the summation of the time spent per level of intensity (light:1, medium:2, heavy:3). Only WB activities were selected. The mean for adolescence period age 13–17 were calculated. |
Bone Measurement BMD of the LS (L2–L4) was determined at age 27 by DEXA (DXA; Norland XR-26). |
In ♂, WB activity was a significant predictor of LS BMD. In ♀, WB activity was not a significant predictor of LS BMD. |
Regular WB activity in adolescence is importance in reaching the highest lumbarPBM in ♂but not in ♀. |
| Reference | Subjects | Methodology | Results | Remark | |
| Lloyd et. al. (2000) (26) Longitudinal Penn State Young Women’s Health Study |
81 ♀. Age at base-line: 11.9± 0.5 yr Follow up: 6 yr Country: USA |
PA Measurement Sport–exercise questionnaire was used. Cumulative sport-exercise score is the arithmetic sum of scores using different ranges of values (ages 12–18 yr) were obtained from questionnaire which listed 28 activities: school based activities, outside of school organized activities and individual activities. |
Bone Measurement TB BMD gain (TB bone gain during ages 12–18 yr). BMD of the PF (hip) at age 18 yr was measured by using DEXA (Hologic Corporation, Waltham, MA) |
The cumulative sport-exercise score was positively associated with the Hip BMD at age 18 yr but not with TB bone mineral gain between ages 12–18 yr. The cumulative Sport-exercise was a significant predictor for hip BMD at ages of 18 yr. |
♀ who participate in sport-exercise during adolescence is related to a significant increase in peak hip BMD but not with TB bone mineral gain. |
| Reference | Subjects | Methodology | Results | Remark | |
| Van Langendonck et al. (2003) (6) Longitudinal Leuven Longitudinal Study of Lifestyle, Fitness and Health (LLSLFH) |
154 ♂ Age at base-line: 13 yr Follow up: 6yr Country: Belgium |
PA measurement Sports participation inventory was used: Types of sports and time spent per week were obtained. The mean score for 6 yr (ages 13–18 yr) was calculated to obtain: Time spent in sports activities during adolescence and impact score. PS scores (0–3) for all activities according to GRF were summed. |
Bone Measurement BMD of the LS and TB was measured by using DEXA (Hologic QDR-4500A; Hologic, Inc., Bedford, Massachusetts) |
Time spent in sports activities during adolescence and Impact scores during adolescence were not predictors of adult TB BMD and LS BMD. | Sports participation during adolescence did not result in a better bone status (BMD) in adulthood. |
| Reference | Subjects | Methodology | Results | Remark | |
| Barnekow-Bergkvist et al. (2006) (27) Longitudinal |
36 ♀ Age: 15–17 yr. Follow-up:20yr Country: Sweden |
PA measurement Standardized questionnaire on participation in PA was used: (1) leisure-time sports activity (yes/no), (2) membership of a sports club (yes/no; MSC16), (3) kind of activity/ies |
Bone Measurement BMD of the TB, arms, legs, LS, right FN and TR was measured by using DEXA (Lunar Co., Madison, Wisconsin, USA). |
♀ who were members of a sports club (MSC16) at baseline had significantly higher adult BMD values at all skeletal sites except for the arms compared with those women who were not physically active at baseline. | Membership in a sport club during adolescence contributes to higher adult BMD. |
| Reference | Subjects | Methodology | Results | Remark | |
| McKay et al. (2011) (30) Cross-sectional Healthy Bones (HBS) III study |
278 (146 ♂ and 132 ♀) Age: 15–20 yr. Country: Canada |
PA measurement PAQ-A was used to assessed Moderate to vigorous PA. The outcomes were Impact-loading PA time (ImpactPA, min/wk) and non-impact loading PA time (NoimpactPa, min/wk). e.g. of impact loading PA: all activities that involve running. Non-impact loading PA: cycling and swimming. |
Bone measurement Bone density (Tt.Dn, Ct.Dn, Tb.Dn), Bone architecture (Tt.Ar = BA, Ct.Th, Tb.N, Tb.Th), Bone strength (Imin & Imax) of the non-dominant tibia were measured using HR-pQCT (XtremeCT; Scanco Medical AG, Switzerland). |
Impact PA had significantly positive relation with Imin & Imax in ♂only. Impact PA had significantly association with Bone density variables in ♀ except Ct.Dn and ♂. Impact PA had positive association with Tb.N in ♀ and Tt.Arin ♂. |
Impact PA was associated with Bone strength and Bone Area in ♂. Impact PA was associated with Bone density and Bone Architecture in ♀. |
| Reference | Subjects | Methodology | Results | Remark | |
| Sayers et. al. (2011) (31) Cross-sectional analysis based on the Avon Longitudinal Study of Parents and children (ALSPAC). |
1748 (778 ♂, 970 ♀) Age: 15.5 yr. Country: UK |
PA Measurement MTI Actigraph accelerometer was worn for 7 consecutive d. Individual Accumulated PA was categorized into different intensities (cpm) by using cut-point (sedentary:0–199 cpm, light:200–3599 cpm, moderate:3600–6199 cpm and vigorous and 6200+ cpm). These cut-points are associated with METs (validated). |
Bone Measurement Cortical BMC (BMCc), cortical BMD (BMDc), cortical BA (BAc), PC, EC and SSI of the mid (50%) right tibia were obtained using pQCT (Stratec XCT 2000L, Stratec, Pforzheim, Germany). |
Vigorous PA had the highest association with BMCc and BAc Only light and vigorous PA showed positive association with PC. All intensities of PA showed negative association with BMDc and endosteal circumference adjusted for periosteal circumference. |
Vigorous day-to-day PA was associated with cortical BMC, BA and PC as well as SSI. |
| Reference | Subjects | Methodology | Results | Remark | |
| Farr et al. (2011) (32) Cross-sectional Jump-In: Building Better Bones Study |
465 ♀ Age: 8–13yr Country: USA |
PA Measurement PYPAQ was used. A list of 41 activities in the past year outside of PE class. Duration and frequency were obtained. PYPAQ score = ∑1−n (duration (average min/session) × frequency ([months/12] × d/wk) × load (=PS score). Load (PS score) values were assigned to each activity based on GRF. Jumping PA (3), involve changing directions quickly and sprinting PA (2), Low-impact PA (1.5), Non-WB (0.5). PYPAQ score were divided into groups: low, moderate and high. |
Bone Measurement vBMD, bone structure (Ct.Ar, EC, PC, Ct.Th) and bone strength (BSI & SSI) at the distal metaphyseal (4% femur, tibia) and diaphyseal (20% femur, 66% tibia) sites of the non-dominant leg were assessed using pQCT (XCT 3000; stratec Medizintechnik GmbH, Pforzheim, Germany, Division of Orthometrix; White Plains, NY). |
High PA ♀ had higher bone geometric and bone strength than low PA ♀, except for 4% femur BSI, diaphyseal Ct.Ar and diaphyseal Ct.Th, High PA had similar bone parameters with moderate PA except for 66% tibia EC. Moderate PA had higher bone parameters compared with inactive ♀, except for 4% femur BSI, diaphyseal Ct.Ar, diaphyseal Ct.Th, and 66% tibia EC. |
Active ♀ had higher values on bone geometry (EC, PC) and bone strength (BSI, SSI) at metaphyseal and diaphyseal sites of the femur and tibia compared with less active girls. |
| Reference | Subjects | Methodology | Results | Remark | |
| Jackowski et al. (2014) (28) Longitudinal Pediatric Bone Mineral Accrual Study (PBMAS) |
104 (55 ♂, 49♀) Age at base-line: 8–15 yr Follow-up: more than 7 yr. Country: Canada |
PA Measurement PAQ-C and A were used. Nine items scored on a five-point Likert-type scale. Final PA scores range from: lowest (1) to highest (5). An age and sex-specific Z score was determined and individualswere ranked into three quartiles: Highest (active), middle three (average), andlowest (inactive). |
Bone Measurement Bone geometric strength: CSA and Z at the NN, IT, and S sites of the PF were assessed from FN using DXA (Hologic QDR-2000; Hologic, Bedford, MA). |
PA during adolescence was positively related with adolescent bone CSA and Z of the PF. Active adolescents had significantly greater adjusted adult bone geometric measures at the PF than participants who were classified as inactive during adolescence. |
Being active during adolescence provides greater adolescent geometric strength at the PF. |
| Reference | Subjects | Methodology | Results | Remark | |
| Tolonen et al. (2015) (29) Longitudinal The Cardiovascular Risk inYoung Finns Study |
1884 (1135 ♂, 1174 ♀) Age:9–18 yr old Follow-up:28yr. Country: Finland |
PA Measurement Total PA sum indices based on PA index (PAI). PAI includes intensity (breathlessness and sweating during exercise), leisure-time PA (at least half an hour/session), participation in sport club, competitions (yes/no), and common leisure-time activity coded as 1=inactivity, 2=intermediate and 3=frequent or vigorous PA. The PA sum indices were divided into: very low, low, intermediate and frequent according to the cut-off values: <8, <9 and <10 in ♀ and <9, <10 and <11 in ♂. |
Bone Measurement BMC, Tt.ar, Tb.Dn and BSI at the distal tibia (5%) and Tt.Ar, Cortical CSA, Ct.Dn, BMC, SSI and CSI at the tibial shaft (30%) of the left leg were were obtained using pQCT (Stratec XCT 2000R, Stratec, Medizintechnik GmbH, Pforzheim, Germany). |
In ♀, frequent PA was associated with higher adult BSI at the distal tibia, Tt.Ar and Cortical CSA, BMC, CSI and SSI at the tibial shaft. In ♂, frequent PA was associated with higher adult Tt.Ar at distal tibia, and Cortical CSA and CSI at the tibial shaft. No association between frequent PA and tibial bone density in both gender. |
Frequent habitual PAin adolescence was associated with greater bone size, mineral content and strength at the weight-bearing tibia inadulthood. |
♀= (female), ♂= (male)
Bone Indices: Bone Mineral Density (BMD), Bone Mineral Content (BMC), volumetric Bone Mineral Density (vBMD), Total Bone Density (Tt.Dn), Cortical Density (Ct.Dn), Trabecular Density (Tb.Dn), Bone Area (BA), Cortical Area (Ct.Ar), Total Bone Area (Tt.Ar), Periosteal Circumference (PC), Endosteal Circumference (EC), Cross-Sectional Area (CSA), Cortical Thickness (Ct.Th), Trabecular No. (Tb.N), Trabecular Thickness (Tb.Th), Minimum & Maximum Cross-Sectional Of Inertia (Imin & Imax), Bone Strength Index (BSI), Strength-Strain Index (SSI), Section Modulus (Z), Cortical Strength Index (CSI)
Skeletal Site: Total Body (TB), Lumbar Spine (LS), Proximal Femur (PF), Femoral Neck (FN), Trochanter (TR), Narrow Neck (NN), Intertrochanter (IT), Femoral Shaft (S)
Bone Densitometry: Dual Energy X-Ray Absorptiometry (DEXA), Peripheral Quantitative Computed Tomography (pQCT)
PBM, Peak Strain (PS), Physical Activity (PA), Physical Education (PE), Ground Reaction Force (GRF),
PA Questionnaire for adolescents (PAQ-A), PA Questionnaire for children (PAQ-C), Past Year PA Questionnaire (PYPAQ