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The relation between stress fractures and bone mineral density: evidence from active-duty Army women. Arch Phys Med Rehabil 2000 Jan;81(1):73-9

Date

01/19/2000

Pubmed ID

10638880

DOI

10.1016/s0003-9993(00)90225-9

Scopus ID

2-s2.0-0033988132 (requires institutional sign-in at Scopus site)   94 Citations

Abstract

OBJECTIVE: To determine if bone mineral density (BMD) is associated with the probability of stress fractures in premenopausal women.

DESIGN: Case-control study.

SETTING: Large Army post, Fort Lewis, WA.

PARTICIPANTS: Twenty-seven active duty Army women with documented stress fractures within the last 2 years and 158 female controls.

METHODS AND MAIN RESULTS: All subjects were examined and interviewed. BMD of the femoral neck and posteroanterior lumbar spine (L2-L4) was measured using dual energy X-ray absorptiometry. Univariate comparisons revealed no significant differences in BMD of the femoral neck or lumbar spine between groups. Women with stress fractures had a significantly higher exercise intensity (428 vs 292 minutes per week, p<.05) and were more likely to be entry-level enlisted soldiers (63% vs. 44%, p<.05) than those without stress fractures. Multivariate analyses revealed a strong negative association between femoral neck BMD and the probability of stress fractures (lower BMD, higher risk). Exercise intensity and body mass index had a significant positive effect on BMD of the femoral neck and lumbar spine, yet both were associated with an increased probability of stress fractures.

CONCLUSIONS: Femoral neck BMD was significantly associated with the probability of stress fractures. Optimal training programs should balance the beneficial indirect effect of increased exercise (through increased BMD) with its detrimental direct effect on stress fractures.

Author List

Lauder TD, Dixit S, Pezzin LE, Williams MV, Campbell CS, Davis GD

Author

Liliana Pezzin PhD, JD Professor in the Institute for Health and Humanity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Bone Density
Case-Control Studies
Exercise
Female
Fractures, Stress
Health Behavior
Humans
Military Personnel
Multivariate Analysis
Premenopause
Probability
United States