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[PMID]: 29461218 [Au] Autor: Barrack MT; Fredericson M; Tenforde AS; Nattiv A [Ad] Endereço: California State University, Long Beach, Long Beach, California, USA. [Ti] Título: Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes. [So] Source: Br J Sports Med;51(3):200-205, 2017 Feb. [Is] ISSN: 1473-0480 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Limited research has evaluated risk factors for low bone mineral density (BMD) in male adolescent athletes. AIMS/OBJECTIVES: To evaluate predictors of low BMD (defined as BMD Z-score <-1.0) in a sample of male adolescent distance runner and non-runner athletes. METHODS: Male adolescent athletes completed a survey characterising sports participation, nutrition, stress fracture history, dual energy X-ray absorptiometry (DXA)-measured BMD and body composition. Independent t-tests and analysis of covariance (ANCOVA) evaluated group differences; logistic regression evaluated low BMD risk factors. RESULTS: Runners (n=51) exhibited a lower body weight (p=0.02), body mass index (BMI) (kg/m ) (p=0.02), per cent expected weight (p=0.02) and spine BMD Z-score (p=0.002) compared with non-runners (n=18). Single risk factors of low BMD included <85% expected weight (OR=5.6, 95% CI 1.4 to 22.5) and average weekly mileage >30 in the past year (OR=6.4, 95% CI 1.5 to 27.1). The strongest two-variable and three-variable risk factors included weekly mileage >30+ stress fracture history (OR=17.3, 95% CI 1.6 to 185.6) and weekly mileage >30+<85% expected weight + stress fracture history (OR=17.3, 95% CI 1.6 to 185.6), respectively. Risk factors were cumulative when predicting low BMD (including <85% expected weight, weekly mileage >30, stress fracture history and <1 serving of calcium-rich food/day): 0-1 risk factors (11.1%), 2 risk factors (42.9%), or 3-4 risk factors (80.0%), p<0.001). CONCLUSIONS: Male adolescent runners exhibited lower body weight, BMI and spine BMD Z-score values. The risk of low BMD displayed a graded relationship with increasing risk factors, highlighting the importance of using methods to optimise bone mass in this population. [Mh] Termos MeSH primário: Atletas Índice de Massa Corporal Densidade Óssea Corrida [Mh] Termos MeSH secundário: Absorciometria de Fóton Adolescente Composição Corporal Peso Corporal Estudos Transversais Fraturas de Estresse Seres Humanos Masculino Estado Nutricional Fatores de Risco [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180221 [St] Status: MEDLINE [do] DOI: 10.1136/bjsports-2016-096698

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[PMID]: 29209416 [Au] Autor: Pritchard NS; Smoliga JM; Nguyen AD; Branscomb MC; Sinacore DR; Taylor JB; Ford KR [Ad] Endereço: Department of Physical Therapy, High Point University, High Point, NC USA. [Ti] Título: Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual-energy x-ray absorptiometry (DXA). [So] Source: J Foot Ankle Res;10:52, 2017. [Is] ISSN: 1757-1146 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Background: Metatarsal fractures, especially of the fifth metatarsal, are common injuries of the foot in a young athletic population, but the risk factors for this injury are not well understood. Dual-energy x-ray absorptiometry (DXA) provides reliable measures of regional bone mineral density to predict fracture risk in the hip and lumbar spine. Recently, sub-regional metatarsal reliability was established in fresh cadaveric specimens and associated with ultimate fracture force. The purpose of this study was to assess the reliability of DXA bone mineral density measurements of sub-regions of the second and fifth metatarsals in a young, active population. Methods: Thirty two recreationally active individuals participated in the study, and the bone density of the second (2MT) and fifth (5MT) metatarsals of each subject was measured using a Hologic QDR x-ray bone densitometer. Scans were analyzed separately by two raters, and regional bone mineral density, bone mineral content, and area measurements were calculated for the proximal, shaft, and distal regions of the bone. Intra-rater, inter-rater, and scan-rescan reliability were then determined for each region. Results: Proximal and shaft bone mineral density measurements of the second and fifth metatarsal were reliable. ICC's were variable across regions and metatarsals, with the distal region being the poorest. Conclusions: Bone mineral density measurements of the metatarsals may be a better indicator of fracture risk of the metatarsals than whole body measurements. A reliable method for measuring the regional bone mineral densities of the metatarsals was found. However, inter-rater reliability and scan-rescan reliability for the distal regions were poor. Future research should examine the relationship between DXA bone mineral density measurements and fracture risk at the metatarsals. [Mh] Termos MeSH primário: Absorciometria de Fóton/métodos Densidade Óssea/fisiologia Pé/diagnóstico por imagem Ossos do Metatarso/diagnóstico por imagem [Mh] Termos MeSH secundário: Adolescente Adulto Feminino Pé/patologia Traumatismos do Pé/diagnóstico por imagem Fraturas Ósseas/diagnóstico por imagem Fraturas de Estresse Seres Humanos Masculino Ossos do Metatarso/metabolismo Ossos do Metatarso/patologia Reprodutibilidade dos Testes Fatores de Risco Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180205 [Lr] Data última revisão: 180205 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171207 [St] Status: MEDLINE [do] DOI: 10.1186/s13047-017-0234-1

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[PMID]: 29193921 [Au] Autor: Rivera Rosado E; Santaella Sante B; Corderob PM; Rivera JJ; Otero Lopez F [Ti] Título: An Isolated Gluteus Minimus Tendon Tear with Stress Fracture of the Iliac Wing in a Marathon Runner: A case report. [So] Source: Bol Asoc Med P R;108(1):65-8, 2016. [Is] ISSN: 0004-4849 [Cp] País de publicação: Puerto Rico [La] Idioma: eng [Ab] Resumo: Stress fractures and muscle strains are common in marathon runners. Most stress fractures occur in lower extremities and tibia stress fractures comprise almost half. Iliac wing stress fractures are not commonly found in runners and are usually related to osteoporosis. There have been 4 previous reports of iliac stress fractures in marathon runners none reported an associated isolated gluteus minimus tendon tears. We will report a case of a female marathon runner with iliac wing stress fracture with associated isolated gluteus minimus tendon tear. [Mh] Termos MeSH primário: Fraturas de Estresse/diagnóstico Ílio/lesões Corrida/lesões Traumatismos dos Tendões/diagnóstico [Mh] Termos MeSH secundário: Feminino Fraturas de Estresse/patologia Seres Humanos Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171214 [Lr] Data última revisão: 171214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171202 [St] Status: MEDLINE

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[PMID]: 28687543 [Au] Autor: Gescheit DT; Cormack SJ; Duffield R; Kovalchik S; Wood TO; Omizzolo M; Reid M [Ad] Endereço: School of Exercise Science, Australian Catholic University, Fitzroy, Victoria, Australia. [Ti] Título: Injury epidemiology of tennis players at the 2011-2016 Australian Open Grand Slam. [So] Source: Br J Sports Med;51(17):1289-1294, 2017 Sep. [Is] ISSN: 1473-0480 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIM: To examine the epidemiology and in-event treatment frequency of injury at the 2011-2016 Australian Open tournaments. METHODS: Injury incidence was defined as a medical consultation by a tournament physician and in-event treatment frequency as the mean total number of follow-up medical/physiotherapy consultations (2013-2016 tournaments only). Data were collated by sex, injury region and type and reported as frequencies per 10 000 game exposures. Incidence rate s± 95% CI and rate ratios were used to test effects for injury, sex and year. RESULTS: Female players experienced more injuries than male players (201.7 vs 148.6). The shoulder (5.1±1.1 injuries per year), foot (3.2±1.1), wrist (3.1±1.5) and knee (3.1±1.1) were the most commonly injured regions among females. Knee (3.5±1.6), ankle (2.3±1.3) and thigh (2.3±1.5) were the most prevalent male injuries. Upper arm injuries and in-event treatment frequency increased by ≥2.4 times in both sexes over the 5-year period. Muscle injuries were most frequent. There was a greater than twofold increase in men and women with stress fractures over the 5-year period. The torso region, including the neck, thoracic spine, trunk and abdominal, lumbar spine, hip and groin, pelvis/buttock, attracted high in-event treatment frequencies in both sexes. CONCLUSION: Investigation of injury at the Australian Open suggests that females are more commonly injured than males. Upper and lower extremity injuries affected females while lower limb injuries were more prominent in males. There was an increasing rate of in-event treatments of upper limb and torso injuries as well as stress fractures during the observation period. [Mh] Termos MeSH primário: Traumatismos em Atletas/epidemiologia Tênis/lesões [Mh] Termos MeSH secundário: Austrália Feminino Fraturas de Estresse/epidemiologia Seres Humanos Incidência Traumatismos da Perna/epidemiologia Masculino Músculo Esquelético/lesões Tronco/lesões Extremidade Superior/lesões [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170824 [Lr] Data última revisão: 170824 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170709 [St] Status: MEDLINE [do] DOI: 10.1136/bjsports-2016-097283

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[PMID]: 28578345 [Au] Autor: Liu L; Li H; Cui Y; Li R; Meng F; Ye Z; Zhang X [Ad] Endereço: Logistical College of Chinese People's Armed Police Forces, Tianjin, China. [Ti] Título: Calcium Channel Opening Rather than the Release of ATP Causes the Apoptosis of Osteoblasts Induced by Overloaded Mechanical Stimulation. [So] Source: Cell Physiol Biochem;42(2):441-454, 2017. [Is] ISSN: 1421-9778 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: BACKGROUND: Stress fracture is one of the most common overuse injuries in athletes. Overloaded mechanical stimulation is an important factor affecting stress fractures, but the mechanism is unclear. METHODS: MC3T3-E1 cells and a polycaprolactone (PCL) scaffold were co-cultured, and finite element analysis (FEA) was used to analyze the load-carrying capability. Cell proliferation was investigated with CCK-8 assays. An alkaline phosphatase (AKP) activity assay was used to evaluate cell differentiation. Cell apoptosis was analyzed using Hoechst/ PI double-labeling, Caspase-3 activity and lactate dehydrogenase (LDH) activity assays. Realtime PCR and Western blotting were used to examine the gene and protein expression, respectively, of Caspase-3 and Caspase-9. Assays of the intracellular calcium with fluorescent probe technique and extracellular ATP with fluorometric assay kit were used to analyze the changes in the intracellular calcium concentration induced by calcium channel opening and the release of ATP, respectively, at different operation times. RESULTS: When the apparent strain reached 10000 µÎµ, the strain scope of fber at levels greater than 4000 µÎµ was 60%. Overloading for 4 days and operation times of 0.5 h and 2 h increased the cell number and AKP secretion. However, apoptosis genes were activated at the same time, and the operation time of 2 h had a significantly greater effect than 0.5 h. At 8 days, the cell numbers were greater for the operation time of 0.5 h than for 2 h, and the 2-h groups had the fastest apoptosis rate. Overloading for 1 day increased intracellular calcium levels and ATP release. The increase in intracellular calcium could be blocked by the addition of N-ethylmaleimide (NEM) or Hank's medium. Overloading for 8 days increased intracellular calcium levels but decreased extracellular ATP, and verapamil blocked the increase in intracellular calcium. CONCLUSION: We found that a simultaneous 'double effect' on osteoblasts was induced by overloading, which promoted cell proliferation, differentiation and apoptosis. Short-term overloading could open the cell membrane calcium channels and release calcium stores to elevate intracellular calcium levels, thereby promoting the proliferation and differentiation of cells to a greater extent than the effect of apoptosis. For long-term overloading, calcium channel opening in the membrane could lead to overloading of intracellular calcium levels, inducing an apoptosis effect that is greater than the effect on proliferation and differentiation. [Mh] Termos MeSH primário: Canais de Cálcio/metabolismo Diferenciação Celular/genética Fraturas de Estresse/genética Estresse Mecânico [Mh] Termos MeSH secundário: Trifosfato de Adenosina/metabolismo Fosfatase Alcalina/genética Fosfatase Alcalina/metabolismo Apoptose/genética Atletas Cálcio/metabolismo Proliferação Celular/genética Etilmaleimida/metabolismo Fraturas de Estresse/patologia Seres Humanos Osteoblastos/metabolismo Osteoblastos/patologia Poliésteres/farmacologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Calcium Channels); 0 (Polyesters); 24980-41-4 (polycaprolactone); 8L70Q75FXE (Adenosine Triphosphate); EC 3.1.3.1 (Alkaline Phosphatase); O3C74ACM9V (Ethylmaleimide); SY7Q814VUP (Calcium) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170804 [Lr] Data última revisão: 170804 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170605 [St] Status: MEDLINE [do] DOI: 10.1159/000477592

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[PMID]: 28439058 [Au] Autor: Yagishita K [Ad] Endereço: Clinical Center for Sports Medicine and Sports Dentistry Tokyo Medical and Dental University/Hyperbaric Medical Center, Japan. [Ti] Título: [Calcium and bone metabolism across women's life stages. Stress fracture in female athletes.] [So] Source: Clin Calcium;27(5):699-706, 2017. [Is] ISSN: 0917-5857 [Cp] País de publicação: Japan [La] Idioma: jpn [Ab] Resumo: Stress fractures are common overuse injuries in athletes, especially in long-distance runner, jumping sports and gymnastics in female athletes. The pathology of stress fracture mainly includes repeated biomechanical loading, which leads to bone micro-damage and failure of bone structure. Female athlete triad(FAT), which includes low energy availability with or without an eating disorder, functional hypothalamic amenorrhea, and osteoporosis, is a serious healthcare concern in female athletes. For prevention and treatment of stress fracture, management of biomechanical factors modifying the load applied to a bone is important, and especially in female athletes, management for FAT is one of the important factors. This report outlines the current knowledge on the epidemiology, diagnosis, treatment and prevention of stress fracture, relating to FAT in female athletes. [Mh] Termos MeSH primário: Atletas Osso e Ossos/metabolismo Cálcio/metabolismo Fraturas de Estresse [Mh] Termos MeSH secundário: Fenômenos Biomecânicos Feminino Fraturas de Estresse/diagnóstico Fraturas de Estresse/terapia Seres Humanos Fatores de Risco [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: SY7Q814VUP (Calcium) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171006 [Lr] Data última revisão: 171006 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170426 [St] Status: MEDLINE [do] DOI: CliCa1705699706

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[PMID]: 28418950 [Au] Autor: Burgess MD; Johnston MJ; Silverman ED [Ad] Endereço: From the *Department of Radiology, Naval Medical Center San Diego, San Diego, CA. [Ti] Título: Sacral Fatigue Fracture in a Military Recruit. [So] Source: Clin Nucl Med;42(6):e319-e321, 2017 Jun. [Is] ISSN: 1536-0229 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: A 19-year-old male military recruit presented with 3 weeks of persistent left hip and groin pain after abnormally twisting his hip during a hike. Initial radiographs were interpreted as negative. He subsequently underwent a bone scan which revealed linear left sacral uptake along or paralleling the sacroiliac joint. Differential diagnostic considerations included unilateral sacroiliitis and sacral fracture. SPECT/CT was performed which confirmed left sacral fatigue stress fracture. Transitional lumbosacral anatomy was evident on radiographs with pseudoarticulation of the transitional left S1 transverse process with the sacrum. We postulate this predisposed the recruit to sacral fracture. [Mh] Termos MeSH primário: Fraturas de Estresse/diagnóstico por imagem Militares Articulação Sacroilíaca/diagnóstico por imagem [Mh] Termos MeSH secundário: Fraturas de Estresse/complicações Fraturas de Estresse/patologia Seres Humanos Masculino Tomografia Computadorizada com Tomografia por Emissão de Pósitrons Sacroileíte/complicações Adulto Jovem [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171113 [Lr] Data última revisão: 171113 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170419 [St] Status: MEDLINE [do] DOI: 10.1097/RLU.0000000000001666

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[PMID]: 28412162 [Au] Autor: Tamaki Y; Nagamachi A; Inoue K; Takeuchi M; Sugiura K; Omichi Y; Tamaki S; Chikawa T; Sairyo K; Adachi K [Ad] Endereço: Department of Orthopedics, Mitoyo General Hospital, 708 Himehama, Kanonji, Kagawa 769-1695, Japan. Electronic address: tamaki-yasuaki@takamatsu.jrc.or.jp. [Ti] Título: Incidence and clinical features of sacral insufficiency fracture in the emergency department. [So] Source: Am J Emerg Med;35(9):1314-1316, 2017 Sep. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. MATERIALS AND METHODS: The study participants comprised 250 patients (132 male, 118 female; mean age 58.6years) with pelvic trauma. SIF was identified on computed tomography or MRI. The incidence, initial symptoms, and time delay between the first visit and an accurate diagnosis of SIF were recorded. RESULTS: We detected 11 cases of SIF. Initial symptoms of SIF were low back pain (36.4%), gluteal pain (63.6%), and coxalgia (18.2%). Two patients complained of both low back pain and gluteal pain. The mean delay between the first visit and an accurate diagnosis of SIF was 23.9days. This time interval was significantly longer than in patients with other types of pelvic fracture. Four patients underwent MRI targeting the lumbar spine to investigate their symptoms. In all 4 patients, the signal intensity on T1-weighted and fat-suppressed images of the second sacral segment was low and high, respectively. CONCLUSION: This study demonstrates that accurate diagnosis of SIF may be delayed because of difficulties in detecting this type of fracture on plain X-ray and the non-specific nature of the presenting complaints. Emergency physicians should keep SIF in mind when investigating patients who complain of low back pain or gluteal pain. Findings at the second sacral segment on MRI targeting the lumbar spine may aid early diagnosis of this type of pelvic fracture. [Mh] Termos MeSH primário: Diagnóstico Tardio Fraturas de Estresse/diagnóstico por imagem Vértebras Lombares/lesões Sacro/lesões Fraturas da Coluna Vertebral/diagnóstico por imagem [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Serviço Hospitalar de Emergência Feminino Seres Humanos Japão Dor Lombar/etiologia Vértebras Lombares/diagnóstico por imagem Imagem por Ressonância Magnética Masculino Osteoporose/complicações Estudos Retrospectivos Sacro/diagnóstico por imagem Tomografia Computadorizada por Raios X [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170907 [Lr] Data última revisão: 170907 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170417 [St] Status: MEDLINE

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[PMID]: 28332986 [Au] Autor: Ramlov A; Pedersen EM; Røhl L; Worm E; Fokdal L; Lindegaard JC; Tanderup K [Ad] Endereço: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: anraml@rm.dk. [Ti] Título: Risk Factors for Pelvic Insufficiency Fractures in Locally Advanced Cervical Cancer Following Intensity Modulated Radiation Therapy. [So] Source: Int J Radiat Oncol Biol Phys;97(5):1032-1039, 2017 Apr 01. [Is] ISSN: 1879-355X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC). METHODS AND MATERIALS: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin and underwent external beam radiation therapy with 45 Gy in 25 fractions (node-negative patients) or 50 Gy in 25 fractions with a simultaneous integrated boost of 60 Gy in 30 fractions (node-positive patients). Pulsed dose rate magnetic resonance imaging guided adaptive brachytherapy was given in addition. Follow-up magnetic resonance imaging was performed routinely at 3 and 12 months after the end of treatment or based on clinical indication. PIF was defined as a fracture line with or without sclerotic changes in the pelvic bones. D and V were calculated for the os sacrum and jointly for the os ileum and pubis. Patient- and treatment-related factors including dose were analyzed for correlation with PIF. RESULTS: The median follow-up period was 25 months. The median age was 50 years. In 20 patients (20%), a median of 2 PIFs (range, 1-3 PIFs) were diagnosed; half were asymptomatic. The majority of the fractures were located in the sacrum (77%). Age was a significant risk factor (P<.001), and the incidence of PIF was 4% and 37% in patients aged ≤50 years and patients aged >50 years, respectively. Sacrum D was a significant risk factor in patients aged >50 years (P=.04), whereas V of the sacrum and V of the pelvic bones were insignificant (P=.33 and P=.18, respectively). A dose-effect curve for sacrum D in patients aged >50 years showed that reduction of sacrum D from 40 Gy to 35 Gy reduces PIF risk from 45% to 22%. CONCLUSIONS: PIF is common after treatment of LACC and is mainly seen in patients aged >50 years. Our data indicate that PIFs are not related to lymph node boosts but rather to dose and volume associated with irradiation of the elective pelvic target. Reducing the prescribed elective dose from 50 to 45 Gy may reduce the risk of PIF considerably. [Mh] Termos MeSH primário: Fraturas de Estresse/epidemiologia Ossos Pélvicos/lesões Complicações Pós-Operatórias/epidemiologia Radioterapia Conformacional/estatística & dados numéricos Neoplasias do Colo do Útero/epidemiologia Neoplasias do Colo do Útero/radioterapia [Mh] Termos MeSH secundário: Adulto Distribuição por Idade Idoso Idoso de 80 Anos ou mais Causalidade Comorbidade Dinamarca/epidemiologia Radioterapia Hipofracionada Relação Dose-Resposta à Radiação Feminino Fraturas de Estresse/prevenção & controle Seres Humanos Incidência Meia-Idade Ossos Pélvicos/efeitos da radiação Complicações Pós-Operatórias/prevenção & controle Estudos Retrospectivos Fatores de Risco Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170713 [Lr] Data última revisão: 170713 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170324 [St] Status: MEDLINE

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[PMID]: 28330449 [Au] Autor: Xu C; Silder A; Zhang J; Reifman J; Unnikrishnan G [Ad] Endereço: Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Materiel Command, Fort Detrick, Maryland, USA. [Ti] Título: A cross-sectional study of the effects of load carriage on running characteristics and tibial mechanical stress: implications for stress-fracture injuries in women. [So] Source: BMC Musculoskelet Disord;18(1):125, 2017 Mar 23. [Is] ISSN: 1471-2474 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Load carriage is associated with musculoskeletal injuries, such as stress fractures, during military basic combat training. By investigating the influence of load carriage during exercises on the kinematics and kinetics of the body and on the biomechanical responses of bones, such as the tibia, we can quantify the role of load carriage on bone health. METHODS: We conducted a cross-sectional study using an integrated musculoskeletal-finite-element model to analyze how the amount of load carriage in women affected the kinematics and kinetics of the body, as well as the tibial mechanical stress during running. We also compared the biomechanics of walking (studied previously) and running under various load-carriage conditions. RESULTS: We observed substantial changes in both hip kinematics and kinetics during running when subjects carried a load. Relative to those observed during running without load, the joint reaction forces at the hip increased by an average of 49.1% body weight when subjects carried a load that was 30% of their body weight (ankle, 4.8%; knee, 20.6%). These results indicate that the hip extensor muscles in women are the main power generators when running with load carriage. When comparing running with walking, finite element analysis revealed that the peak tibial stress during running (tension, 90.6 MPa; compression, 136.2 MPa) was more than three times as great as that during walking (tension, 24.1 MPa; compression, 40.3 MPa), whereas the cumulative stress within one stride did not differ substantially between running (15.2 MPa · s) and walking (13.6 MPa · s). CONCLUSIONS: Our findings highlight the critical role of hip extensor muscles and their potential injury in women when running with load carriage. More importantly, our results underscore the need to incorporate the cumulative effect of mechanical stress when evaluating injury risk under various exercise conditions. The results from our study help to elucidate the mechanisms of stress fracture in women. [Mh] Termos MeSH primário: Fraturas de Estresse/etiologia Corrida/fisiologia Estresse Mecânico Tíbia/fisiologia Fraturas da Tíbia/etiologia Caminhada/fisiologia [Mh] Termos MeSH secundário: Adulto Articulação do Tornozelo/fisiologia Fenômenos Biomecânicos Estudos Transversais Eletromiografia Feminino Análise de Elementos Finitos Quadril/anatomia & histologia Seres Humanos Articulação do Joelho/fisiologia Militares Músculo Esquelético/fisiologia Suporte de Carga [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170926 [Lr] Data última revisão: 170926 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170324 [St] Status: MEDLINE [do] DOI: 10.1186/s12891-017-1481-9

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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