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A Review of Martial Arts and Bone Health Status in Young and Older Population

September 2018
Sports and Exercise Medicine - Open Journal 4(3):58-62

DOI:10.17140/SEMOJ-4-162

Authors:

Norsuriani Samsudin

Universiti Sains Malaysia

Foong Kiew Ooi

Universiti Sains Malaysia

It is well known that mechanical loading imposed on a bone is important for bone development. Therefore, one of the most effective osteoporosis prevention strategies is by adopting weight-bearing physical activity. Martial arts such as judo, silat, karate, taekwondo and kickboxing are getting popular in recent years. It is generally known that bone’s optimum response and adaptation to an applied load or strain during exercise are dependent on many factors, such as characteristics of the strain, i.e. static versus dynamic strain, strain magnitude, strain rate, strain frequency or duration, and distribution of the strain stimulus. It has been reported that martial arts are physical activities which can impose loads on the bone with their high and unusual distributed strains and subsequently increase bone health status of an individual. This article discusses the relationship between bone health and physical activity, types and characteristics of martial arts, and effects of various types of martial arts on bone health in young and older population.

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SPORTS AND EXERCISE MEDICINE

Open Journal

ISSN 2379-6375

PUBLISHERS

A Review of Martial Arts and Bone Health Status in Young

and Older Population

Samsudin Norsuriani, MSc; Foong Kiew Ooi, PhD*

Exercise and Sport Science Programmes, School of Health Science, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia

*Corresponding author

Foong Kiew Ooi, PhD

Exercise and Sport Science Programmes, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kelantan, Malaysia; E-mail: fkooi@usm.my

Article information

Received: August 19th, 2018; Revised: September 3rd, 2018; Accepted: September 7th, 2018; Published: September 7th, 2018

Cite this article

Norsuriani S, Ooi FK. A review of martial arts and bone health status in young and older population. Sport Exerc Med Open J. 2018; 4(1): 58-62. doi: 10.17140/

SEMOJ-4-162

Review

ABSTRACT

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Review | Volume 4 | Number 1|

It is well known that mechanical loading imposed on a bone is important for bone development. Therefore, one of the most ef-

fective osteoporosis prevention strategies is by adopting weight-bearing physical activity. Martial arts such as judo, silat, karate, tae-

kwondo and kickboxing are getting popular in recent years. It is generally known that bone’s optimum response and adaptation to

an applied load or strain during exercise are dependent on many factors, such as characteristics of the strain, i.e. static versus dynamic

strain, strain magnitude, strain rate, strain frequency or duration, and distribution of the strain stimulus. It has been reported that

martial arts are physical activities which can impose loads on the bone with their high and unusual distributed strains and subse-

quently increase bone health status of an individual. This article discusses the relationship between bone health and physical activity,

types and characteristics of martial arts, and effects of various types of martial arts on bone health in young and older population.

Keywords

Bone; Physical activity; Martial arts.

BONE HEALTH AND PHYSICAL ACTIVITY

Bone is a metabolically active tissue that undergoes a continuous

remodelling throughout its life cycle. The endogenic factors which

can inuence the accumulation of bone mineral in humans are he-

redity, ethnicity, gender and endocrine status. Meanwhile, the exo-

genic factors are nutrition and physical activity.1,2

Peak bone mass is attained during the second and third

decades of life. Sports participation can lead to adaptive changes

that improve bone architecture through increased density and en-

hanced geometric properties.3 Hara et al4 suggested that physical

activities are the strongest determinant of high peak bone mass

in young adults at pre-puberty and puberty. Furthermore, physical

activity begun during the teenage years could also be useful for

preventing osteoporosis and improving future quality of life of an

individual.

It has been reported that weight-bearing sport activities

are associated with a high bone mass in the lumbar spine, hip, fe-

mur, proximal tibia, and calcaneus.5,6 It has also been reported that

different types of physical activity create different strain demands

on the skeletal bones.6,7 In addition, Lanyon8 mentioned that me-

chanical loading imposes on a specic bone site should produce

high strains in unusual patterns during short periods with high rep-

etition for obtaining the greatest osteogenic effect.

According to Haapasalo et al9 loading exercises enhance

bone mass, and it is necessary to have more weight on bones than

common weights that occur in daily life. The osteogenic responses

on the skeleton are specic to the region of mechanical stress, and

the responses can be triggered by exercises.Exercise can increase

the rate of osteogenesis and subsequently increase bone mineral

density (BMD).

Robling et al10 stated that optimum response and adapta-

tion of bone to an applied load or strain during exercise depends

on many factors, which are characteristics of the strain, i.e. static

Ooi FK, et al

Sport Exerc Med Open J. 2018; 4(1): 58-62. doi: 10.17140/SEMOJ-4-162

PUBLISHERS

59 Review | Volume 4 | Number 1|

versus dynamic strain, strain magnitude, strain rate, strain frequency

or duration, and distribution of the strain stimulus. In addition,

high impact dynamic loading activities, which involve high bone

strain magnitude, rate, and with short duration of repeated bone

loading and/or versatile strain distribution can provide large osteo-

genic stimulus in humans.6 Uneven distribution of the strain seems

to have a higher potential for increasing osteogenesis.5,11 Moreover,

the adaptive response of bone decreases after a few loading cy-

cles.12

INTRODUCTION OF MARTIAL ARTS

In ancient times, martial arts were practiced for self-defence, how-

ever, nowadays they are practiced for improvement in physical t-

ness level as well.13 According to Bu et al14, there are about 200

distinct disciplines of martial arts, and different facets of disci-

plines make them unique and special. All these disciplines share a

common goal, i.e. to defend oneself from physical threat. Nowa-

days, martial arts are studied for various reasons, including tness

and self-defence enhancement, mental discipline, character devel-

opment, and as a complementary or alternative therapy for some

medical conditions.15 Martial arts is popular in many cohorts in

terms of health promotion. For example, elderly persons can gain

health benets by performing tai chi exercise.16,17

Traditional styles of martial arts can be classied as either

“soft” or “hard”. The ‘soft’ martial arts are based on redirecting

the opponent’s energy or attack and less powerful in punching and

kicking actions, whereas the ‘hard’ martial arts are based on using

blocks and punches that can crush bones or body parts of an en-

emy. Hard martial arts deliver signicantly more powerful strikes

and rigid stances.18

The term martial art is often used to describe many of

the combat arts that have been developed in eastern cultures, and

most of the martial arts practiced in the United States are those

that originated or evolved in China, Korea, and Japan.14 The mar-

tial arts of ‘wushu’ which originated in China include kungfu and

tai chi chuan. Japanese martial arts include aikido, karate, sumo and

judo. Taekwondo which was developed in Korea is a popular mar-

tial art nowadays, perhaps the most prevalent of the martial arts in

the United States. Many other forms of martial arts have evolved

throughout the world, such as silat (Malaysia), Muay Thai (Thai-

land), Pencak silat (Indonesia), Bando (Burma), Copoiera (Brazil)

and Kahli (Philippines).14

EFFECTS OF MARTIAL ARTS ON BONE HEALTH

In a study conducted by Shin et al19 which determined the effects

of taekwondo training on the bone health status of high school

female students with aged 13 to 17-years old in Korea, it was found

that the average BMD in the taekwondo group was signicantly

greater than the sedentary control group for all lumbar spine re-

gions. It was approximately 15% higher in the lumbar spine and

17% higher in the femoral neck, which identied that taekwondo

could improve bone health. Therefore, the authors mentioned that

intermittent taekwondo activity as weight-bearing exercise should

be recommended to increase BMD in adolescent females during

growth. In addition, the authors also mentioned that their study

ndings support the concept that high strain rates and high peak

stresses are more effective in enhancing bone formation than a

large number of low-force repetitions.

Kim et al20 carried out a study to determine the effects

of judo practice on the bone health status of high school male

students with mean age of 17.2-years old in Korea. In this previ-

ous study, the boys who had engaged in judo practice had greater

BMD in their lumbar, femur, and wrist regions when compared

with their non-active subjects. According to the results of this

study, the BMD was approximately 22.7% higher in the lumbar

spine, 24.5% higher in the femur and 18.3% higher in the forearm

of judo players when compared to sedentary control group. The

authors mentioned that judo involves both high intensity and high

strain rates, which strongly stimulate bone formation. Specically,

unusual strain distribution and versatile loading patterns, both are

involved in the practice of judo for promoting bone mineralization

with greater effects compared to exercises involve regular load-

ing patterns. Therefore, the authors suggested that judo activity is

strongly recommended to improve bone health and prevent osteo-

penia in young Korean males.

A previous study has been carried out by Ito et al21 to

investigate the relationship between martial art practice of judo,

karate and kungfu with bone mineral density in adolescents with

age between 11 to 17-years-old in both sexes. Their study showed

that adolescents engaged in judo practice exhibited higher values

of BMD in the arms compared to karate and kungfu participants.

The authors also mentioned that muscle mass and biological matu-

ration have been veried as important factors in bone mass and

geometry gain.

A recent study conducted by Norsuriani and Ooi22 ex-

amined bone health status of Malay adolescent female silat and

taekwondo practitioners with age ranged from 15 to 19-years-old.

They found that there were no signicant differences in quantita-

tive ultrasound measurement of the bone speed of sound (SOS)

of dominant and non-dominant arms and legs of young females

among sedentary control, silat and taekwondo groups. In this

study, the average age of the participants was 17-years-old, all the

participants were Malay females, and their average duration of in-

volvement in martial arts was 2 to 3-years. It is speculated that

differences in gender, age, ethnicity, duration of involvement in

martial art training may have caused the inconsistent results of this

study compared to the aforementioned previous studies.

Drozdzowska et al23 examined skeletal status assessed by

quantitative ultrasound measurement (QUS) at the hand phalanges

in 226 karate male practitioners between 7 to 61-years of age, who

had been training karate for at least 6-months. The results showed

that there were signicant differences in bone mineral density of

karate athletes compared with control subjects. The authors men-

tioned that longer duration, higher frequency, and early involve-

Ooi FK, et al

Sport Exerc Med Open J. 2018; 4(1): 58-62. doi: 10.17140/SEMOJ-4-162

PUBLISHERS

Review | Volume 4 | Number 1|

ment in physical training positively inuenced the skeletal status.

They concluded that karate is a sport which can elicit a positive

inuence on the skeletal status, with the most signicant benets

occurring in adults.

Andreoli et al24 investigated the effects of different sports

including martial arts on bone density and muscle mass in high-

ly trained athletes. In their study, participants consisted of judo

(n=21), karate (n=14), and water polo (n=24) men athletes with

age ranged between 18 to 25-years-old who competed at national

and international levels, and age-matched non-athletic individuals

were served as the control group. Their study found that athletes

had signicantly greater BMD than the non-athletes of similar age

and in particular, the judo athletes, who practicing a high-intensity

weight-bearing sport, had higher values of BMD compared to oth-

er athletes. Therefore, the authors highlighted that physical activ-

ity appears to have a benecial effect on bone mass, with greater

mechanical loading appears to result in a greater bone mass, and

these appeared to be a site-specic skeletal response to the type of

loading at each BMD site.

Agostinete et al25 investigated the effect of karate, judo,

soccer and basketball on bone mineral density (BMD) accrual

among male adolescents with age ranged from 11 to 17-years-

old. In this previous study, it was observed that karate and judo

groups exhibited higher BMD than soccer, basketball and control

groups. Their ndings are consistent with results of previous stud-

ies26,27 which showed that impact sports could enhance bone health

among adolescents. The authors mentioned that it is an indicator

of responsive loaded sites to the signicant amount of mechanical

loads induced by martial arts training. The authors also mentioned

that during punching, kicking, blocking and striking in martial arts,

loading bones are under tensile, compressive, shear, bending, and

torsional stress, which produces high strain stimulus for eliciting

benecial effects on bone.

A study was conducted by Platen et al28 to determine bone

mineral density in top-level male athletes of different sports, i.e.

athletics, cycling, team sport, judo and wrestling. The participants

of this study aged between 18 to 31-years. Among 173 athletes par-

ticipants, 104 were athletes of runners (n=21), cyclists(n=12), tri-

athletes (n=18), heavy athletes such as judo and wrestling (n=28),

and team sport athletes (handball, soccer, basketball, volleyball,

n=25); 44 were not specically trained sport students and 25 were

untrained controls. This previous study found that at most sites,

BMD was highest in heavy athletes (judo and wrestling) followed

by athletes in team sports and sports students, and lowest in cyclists

and untrained controls. An explanation for these results is that the

strain imposed on bone is mainly determined by mechanical forces,

and dynamic forces depend on the body mass and acceleration.

In judo and wrestling, movements correspond to high maximal

muscular strength and power. Besides forces induced by muscular

activation, high accelerations and therefore high forces, as well as

varied patterns of strain, occur when falling in judo and wrestling.

Furthermore, special strength training with heavy weights is a typi-

cal and regular training method in these sports. Therefore, high

bone formation rate can be expected by involvement in judo and

wrestling.

Soo bahk do (SBD; also known as tang soo do) empha-

sises a combination of hard styles of karate and tae kwon do with

the soft style of the Chinese martial arts. Their system of action

and the characteristic use of bare hands and feet as striking weap-

ons are different from other martial art systems. A study carried

out by Douris et al29 examined tness levels of middle-aged martial

art practitioners in both genders from 40 to 60-years of age. The

study found that the SBD practitioners were higher in bone health

status compared to sedentary participants. The authors mentioned

that SBD can be considered an excellent form of exercise for the

promotion of tness in middle-aged population.

Ving T sun (VT) is a traditional Chinese martial art that

has the potential to be developed into a new form of health-

maintenance exercise to prevent bone loss in the elderly. Fong et

al30 compared bone strength, lower limb muscular strength, func-

tional balance performance, and balance self-efcacy between VT

martial art practitioners and non-practitioners with mean age of

62.7- years-old in both sexes. In their study, it was found those VT-

trained older adults had the signicantly higher bone strength than

the control group. VT training includes many striking movements

using the forearms, for example, sandbag workouts, sticking-hand

exercises, and wooden dummy training, and therefore the authors

concluded that these movements repetitively load the forearm

bones including the radius with high impact forces, resulting in

remodeling and strengthening of these bones to withstand the ex-

ternal loads or stress.

Tai Chi is a traditional Chinese mind-body exercise and

benets on health outcome, particularly middle-aged and elderly

people. A study conducted by Hui et al31 which determined the ef-

fects of Tai chi on bone mineral density (BMD) in both genders of

Chinese adults with aged from 36 to 60-years-old. The study found

that there was no signicant change in BMD of both groups, i.e.

Tai Chi and control groups. These authors concluded that short-

term Tai Chi exercise, e.g., 12-weeks may not provide sufcient

training stimulation in improving bone health, and may can only

be acted as a protective factor for bone loss in older population.

CONCLUSION

Previously published research studies on martial arts mentioned in

this article provide evidence that involvement in training and com-

petition of martial arts such as taekwondo, judo, karate, wrestling,

soo bahk do, Ving T sun and Tai Chi could elicit benecial effects

on bone health in young and older population. Thus, it can be con-

cluded that engagement in martial arts is one of the effective ways

to enhance bone health.

CONFLICT OF INTEREST

The authors declare that they have no conicts of interest.

Ooi FK, et al

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PUBLISHERS

61 Review | Volume 4 | Number 1|

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Apr 2022

Background Sarcopenia and osteoporosis are important health issues faced by older people. These are often associated with each other and share common risk factors and pathologic mechanisms. In the recently revised consensus of the European Working Group on Sarcopenia in Older People, low muscle strength has been defined as the first characteristic of sarcopenia rather than a loss in muscle mass, and walking speed has been stated as an indicator of the severity of sarcopenia. It is believed that these markers of muscle function can be potentially reversed via exercise-based interventions. The purpose of this study was to evaluate the effects of kickboxing exercise training on the parameters of sarcopenia and osteoporosis in community-dwelling adults. Methods In total, one hundred eligible subjects were randomized into an intervention group ( n = 50) with 76% women and control group ( n = 50) with 86% women. Both the intervention and control groups were provided with classroom lectures and personal consultations pertaining to sarcopenia and osteoporosis, whereas a 12-week kickboxing exercise training was arranged only for the intervention group. All anthropometric, physical performance, body composition, and bone mineral density measurements along with participant completed questionnaires were conducted before and after the training period. Results After 12 weeks, 41 participants in the intervention group and 34 participants in the control group completed the final assessments. There was no difference between the intervention and control groups in terms of basic demographic data. The BMI (+1.14%) of the control group increased significantly during the study period. The waist circumference (−6.54%), waist-to-height ratio (−6.57%), waist–to–hip ratio (−4.36%), total body fat (−1.09%), and visceral fat area (−4.6%) decreased significantly in the intervention group. Handgrip strength (+5.46%) and gait speed (+5.71%) improved significantly in the intervention group. The lean body mass increased by 0.35% in the intervention group and by 0.9% in the control group. The femoral neck bone mineral density (−1.45%) and T score (−3.72%) of the control group decreased significantly. The intervention group had more improvement in the status of sarcopenia (OR 1.91) and osteoporosis over the control group. Finally, the intervention group had less deterioration in the status of sarcopenia (OR 0.2) and osteoporosis (OR 0.86) compared with the control group. Conclusion Our study demonstrated that a 12-week kickboxing exercise training program is effective for improving sarcopenic parameters of muscle strength and function, but not muscle mass in adults, aged 50–85 years. Furthermore, markers of osteoporosis also showed improvement. These findings suggest that a 12-week kickboxing program is effective for muscle and bone health among community-dwelling older individuals.

Basketball Affects Bone Mineral Density Accrual in Boys More Than Swimming and Other Impact Sports: 9-mo Follow-Up

Article

Full-text available

May 2016
J CLIN DENSITOM

The objective of this study was to analyze the effect of different sports on bone mineral density (BMD) accrual among male adolescents during a 9-mo follow-up. The sample was composed of 82 boys (control [n = 13], basketball [n = 14], karate [n = 9], soccer [n = 18], judo [n = 12], and swimming [n = 16]) who were followed up for 9 mo (from October 2013 to August 2014). BMD (gram per square centimeter) was assessed at baseline and follow-up using a dual-energy X-ray absorptiometry scanner, whereas somatic maturation was estimated through the use of the peak height velocity. Vitamin D consumption was assessed by questionnaire. After 9 mo of follow-up, all groups (including the control group) presented significant BMD accrual (overall sample: 4.5% in the whole body). On the other hand, the basketball group presented higher BMD accrual in the upper limbs (17.6%) than the control group (7.2%). A similar difference was observed in whole-body BMD (control group: 4.1% vs basketball group: 7.1%). The basketball group had significantly higher BMD gains than the control group and other sports groups.

Beneficial effects of judo training on bone mineral density of high-school boys in Korea

Article

Full-text available

Dec 2013

Bone mineralization is strongly stimulated by weight-bearing exercise during growth and development. Judo, an Olympic combat sport, is a well-known form of strenuous and weight-bearing physical activity. Therefore, the primary goal of this study was to determine the effects of Judo practice on the bone health of male high school students in Korea. The secondary goal of this study was to measure and compare the bone mineral density (BMD) of the hands of Judo players and sedentary control subjects. Thirty Judo players (JDP) and 30 sedentary high school boys (CON) voluntarily participated in the present study, and all of the sedentary control subjects were individually matched to the Judo players by body weight. BMD was determined by using dual-energy X-ray absorptiometry (Hologic, Bedford, MA, USA). The lumbar spine, femur and forearm BMD in the JDP group were significantly greater by 22.7%, 24.5%, and 18.3%, respectively, than those in the CON group. In addition, a significant difference in the CON group was observed between the dominant hand (DH) radius (0.710 ± 0.074 g/cm(2)) and the non-dominant hand (NDH) radius (0.683 ± 0.072 g/cm(2)), but this was not observed in the JDP group (DH = 0.819 ± 0.055 g/cm(2); NDH = 810 ± 0.066 g/cm(2)) (P < 0.05). Therefore, the results of this study suggest that Judo practice during the growth period significantly improves bone health in high school male students. In addition, it seems that Judo practice could eliminate the effect of increased BMD in the dominant hand.

An Investigation Of Leg And Trunk Strength And Reaction Times Of Hard-Style Martial Arts Practitioners

Article

Full-text available

Jul 2006
J SPORT SCI MED

The purpose of this study was to investigate trunk and knee strength in practitioners of hard-style martial arts. An additional objective was to examine reaction times in these participants by measuring simple reaction times (SRT), choice reaction times (CRT) and movement times (MT). Thirteen highlevel martial artists and twelve sedentary participants were tested under isokinetic and isometric conditions on an isokinetic dynamometer. Response and movement times were also measured in response to simple and choice auditory cues. Results indicated that the martial arts group generated a greater body-weight adjusted peak torque with both legs at all speeds during isokinetic extension and flexion, and in isometric extension but not flexion. In isokinetic and isometric trunk flexion and extension, martial artists tended to have higher peak torques than controls, but they were not significantly different (p > 0.05). During the SRT and CRT tasks the martial artists were no quicker in lifting their hand off a button in response to the stimulus [reaction time (RT)] but were significantly faster in moving to press another button [movement time (MT)]. In conclusion, the results reveal that training in a martial art increases the strength of both the flexors and extensors of the leg. Furthermore, they have faster movement times to auditory stimuli. These results are consistent with the physical aspects of the martial arts.

Influence of Sports Participation on Bone Health in the Young Athlete: A Review of the Literature

Article

Full-text available

Sep 2011

Peak bone mass is attained during the second and third decades of life. Sports participation during the years that peak bone mass is being acquired may lead to adaptive changes that improve bone architecture through increased density and enhanced geometric properties. A review of the literature evaluating sports participation in young athletes, ages 10-30 years, revealed that sports that involve high-impact loading (eg, gymnastics, hurdling, judo, karate, volleyball, and other jumping sports) or odd-impact loading (eg, soccer, basketball, racquet games, step-aerobics, and speed skating) are associated with higher bone mineral composition, bone mineral density (BMD), and enhanced bone geometry in anatomic regions specific to the loading patterns of each sport. Repetitive low-impact sports (such as distance running) are associated with favorable changes in bone geometry. Nonimpact sports such as swimming, water polo, and cycling are not associated with improvements in bone mineral composition or BMD, and swimming may negatively influence hip geometry. Participating in sports during early puberty may enhance bone mass. Continued participation in sports appears to maintain the full benefits of increased peak bone mass, although former athletes who do not maintain participation in sports may retain some benefits of increased BMD. Long-term elite male cycling was reported to negatively influence bone health, and female adolescent distance running was associated with suppressed bone mineral accrual; confounding factors associated with participation in endurance sports may have contributed to those findings. In summary, young men and women who participate in sports that involve high-impact or odd-impact loading exhibit the greatest associated gains in bone health. Participation in nonimpact sports, such as swimming and cycling, is not associated with an improvement in bone health.

Effects of taekwondo training on bone mineral density of high school girls in Korea

Article

Sep 2011

The incidence of bone fractures has increased in the current decade due to osteoporosis. Bone mineral density (BMD), or the amount of mineralized bone, is an important determinant of risk for bone fractures. Bone mineralization is strongly stimulated by weight-bearing exercise during growth and development. Taekwondo, a Korean martial art, is a well-known form of strenuous and weight-bearing physical activity. Therefore, the primary goal of this study was to determine the effects of taekwondo training on the bone health of female high school students in Korea. The secondary goal of this study was to clarify the relationships between body weight and BMD in this sample. Thirty taekwondo players (TKD) and 30 sedentary high school girls (CON) voluntarily participated in the present study and were split into three groups by weight: light weight (L) under 51 kg; middle weight (M) between 51 and under 57 kg; and heavy weight (H) over 57 kg. BMD was determined from dual-emission X-ray absorptiometry (DEXA), and percent body fat was measured by the skin-fold method. Lumbar spine and femoral BMD were not significantly different between light, middle and heavy body weight groups. However, the average BMD in the TKD group was significantly greater than in the CON group for all lumbar spine regions (P<0.05). The results of this study suggest that taekwondo training during growth significantly improved bone health in all weight groups.

Bone mineral density in top level male athletes of different sports

Article

Dec 2001

The purpose of this study was to determine the influence of muscle strength, trainingspecific and anthropometric parameters on bone mineral density (BMD) in male top athletes of different sports in comparison to untrained controls. BMD was measured by dual energy X-ray absorptiometry in 173 males, aged 18 to 31 years. Of these, 104 were athletes (runners, n = 21; cyclists, n = 12; triathletes, n = 18), heavy athletes (HA, judo and wrestling, n = 28), and team sport athletes (TS, handball, soccer, basketball, volleyball, n = 25); 44 were unspecifically trained sport students (STU); and 25 were untrained controls (UT). Sport- and group-specific differences were found in anthropometric but not strength parameters. Marked sport- and group-specific differences were found for BMD at lumbar spine (LSP) and the femoral sites (FEM). Group-specific effects on BMD were clearest when calculating percentual differences between BMD of athletes and UT: In group I (HA, TS, and STU), BMD at LSP and FEM were significantly (p < .01) higher compared to UT; in group II (R and TRI), BMD at FEM but not at LSP was higher compared to UT (p

Skeletal Mass in Adolescent Male Athletes and Nonathletes: Relationships with High-Impact Sports

Article

Nov 2011
J STRENGTH COND RES

Dias Quiterio, AL, Canero, EA, Baptista, FM, and Sardinha, LB. Skeletal mass in adolescent male athletes and nonathletes: relationships with high-impact sports. J Strength Cond Res 25(12): 3439-3447, 2011-This study examined the relationships between the practice of different categories of sports (high-impact vs. nonimpact) and bone status in adolescent male athletes and investigated differences from an age-matched control group. A total of 54 adolescent male athletes and 26 adolescent nonathletes were evaluated. Bone mineral density, bone mineral content (BMC), and bone area at the whole-body, limbs, and lumbar spine were determined by dual-energy x-ray absorptiometry, along with total and regional fat-free mass and body fat. The high-impact group included 34 athletes: 9 gymnasts, 18 basketball players, and 7 handball players (age: 15.7 ± 1.6 years; weight: 72.0 ± 15.0 kg; height: 178.5 ± 12.5 cm). The nonimpact group consisted of 20 swimmers (age: 16.4 ± 2.5 years; weight: 66.9 ± 10.4 kg; height: 173.7 ± 10.9 cm). The nonathletic control group included 26 male adolescents (age: 15.9 ± 2.8 years; weight: 64.7 ± 16.3 kg; height: 168.6 ± 15.1 cm). No differences were observed between the nonimpact and the control group in all bone variables, before and after adjustments for maturation level, body weight, and height (p > 0.05). After adjustments for these variables, the high-impact group displayed greater bone mass in most of the measured sites when compared to the other 2 groups (p < 0.001). Subjects in the nonimpact group showed lower values of BMC, particularly in the lower limbs, than both the high-impact and the nonathletic control groups (p < 0.05) after adjustments for maturation, high, and fat-free mass. This study reinforces the positive associations between high-impact physical activities and skeletal health in adolescent boys.

Effects of martial arts on health status: A systematic review

Article

Nov 2010

To systematically summarize the evidence for the effects of martial arts on health and fitness, to show the strengths of different types of martial arts, and to get a more complete picture of the impacts of martial arts on health, and also to provide a basis for future research on martial arts as an exercise prescription in exercise therapy. We searched for "martial arts"health" and "random" in eight databases (n= 5432). Randomized controlled trials and controlled clinical trials on the health effects of martial arts were included in the study. The final analysis included 28 papers (one general martial arts, one kung fu, sixteen tai chi, six judo, three karate, and one taekwondo). Among the disciplines of martial arts, tai chi was the most well-studied, followed by judo, karate, and taekwondo. Research topics varied widely, and included health, injuries, competition, morals and psychology, and herbal medicine. Most found positive effects on health. Tai chi is no-contact, low-impact, soft body and mindfulness exercise, which has been widely adopted by elderly people and proven to be a beneficial health promotion exercise. Research on judo, karate, and taekwondo mainly focused on improvements to athletes' competitive abilities, rather than on health effects. We did not find any published randomized controlled trials or controlled clinical trials on aikido, kendo, sumo, kyudo, qi gong, or other disciplines. Since martial arts are widely practiced, their effects on physiology, morphology, immunology, and neurology should be further studied in order to help people to select the best discipline or style to accomplish their purposes. This necessitates categorizing and classifying the disciplines and styles according to their effects on different body systems and levels of contact, as well as standardizing evaluation criteria for martial arts. Martial arts as an exercise prescription can then move from an experience-based to an evidence-based treatment.

Skeletal Status Assessed by Quantitative Ultrasound at the Hand Phalanges in Karate Training Males

Article

Feb 2011

The aim of the study was to assess the influence of regularly exercised karate on the skeletal status. The study comprised a group of 226 males (the mean age: 25.64 ± 12.3 years, range 7-61 years), exercising for 61.9 ± 68.4 months, with the mean frequency of 3.12 ± 1.4 times per week, and 502 controls, matched for age and body size. The skeletal status was assessed by quantitative ultrasound, using a DBM Sonic 1200 (IGEA, Italy) sonographic device, which measures amplitude-dependent speed of sound (Ad-SoS [m/s]) at hand phalanges. Ad-SoS, T-score, Z-score were significantly higher in the examined karatekas than in controls. Up to age 18, there had been no difference between the study subjects and controls, while afterwards, up to age 35, the difference increased to stabilize again after age 35. Longer duration, higher frequency and earlier start of physical training positively influenced the skeletal status. In conclusion, karate is a sport with a positive influence on the skeletal status with the most significant benefits occurring in adults.

Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly

Article

Oct 2009

Bone mass is a key determinant of fracture risk. Maximizing bone mineral mass during childhood and adolescence may contribute to fracture risk reduction during adolescence and possibly in the elderly. Although more than 60% of the variance of peak bone mass (PBM), the amount of bone present in the skeleton at the end of its maturation process, is genetically determined, the remainder is likely influenced by factors amenable to positive intervention, such as adequate dietary intake of dairy products as a natural source of calcium and proteins, vitamin D, and regular weight-bearing physical activity. Low calcium and vitamin D intakes are associated with negative effects on bone, including suboptimal PBM acquisition. As suggested by intervention studies, regular intake of dairy products may have positive and possibly sustained effects on bone mineral mass gain, contributing thereby to fracture risk reduction. Further evidence from intervention studies suggests that weight-bearing physical activities, such as jumping, may contribute to bone mineral mass gain in children. Optimizing PBM acquisition through dietary and physical exercise measures may represent a valuable primary method for the prevention of fractures.