What are the Regional Changes in Density and Microarchitecture in the Ultradistal Tibia of Female Recruits after US Army Basic Combat Training?

Research Paper Title

Regional Changes in Density and Microarchitecture in the Ultradistal Tibia of Female Recruits after U.S. Army Basic Combat Training.

Background

Musculoskeletal injuries, such as stress fracture, are responsible for over 10-million lost-duty days among US Army Soldiers. During Basic Combat Training (BCT), an 8- to 10-week programme that transforms civilians into Soldiers, women are four times more likely than men to sustain a stress fracture.

Methods

In this work, the researchers performed high-resolution peripheral quantitative computed tomography scans on the ultradistal tibia of 90 female recruits [age = 21.5 ± 3.3 (mean ± standard deviation) years] before the start of BCT and after 8 weeks into BCT.

Then, the researchers divided the scanned bone volume into four sectors-lateral, posterior, medial, and anterior-and computed the bone density and microarchitectural parameters in each of the four sectors pre- and post-BCT.

They used linear mixed models to estimate the mean difference for bone density and microarchitectural parameters, while controlling for age, race, and pre-BCT body mass index.

Results

The results revealed that the total volumetric bone mineral density, trabecular volumetric bone mineral density, and trabecular thickness increased (p < 0.05) in each of the four sectors.

In addition, cortical thickness and trabecular bone volume/total volume increased in both medial and posterior sectors (p < 0.05).

Overall, six and five out of nine parameters improved in the medial and posterior sectors, respectively, after BCT.

Conclusions

In conclusion, the heightened physical activity during BCT led to the most beneficial bone adaptation in the medial and posterior sectors of the ultradistal tibia, which is indicative of higher loading in these sectors during activities performed in the course of BCT.

Reference

Sundaramurthy, A., Xu, C., Hughes, J.M., Gaffney-Stomberg, E., Guerriere, K.I., Popp, K.L., Bouxsein, M.L., Reifman, J. & Unnikrishnan, G. (2019) Regional Changes in Density and Microarchitecture in the Ultradistal Tibia of Female Recruits After U.S. Army Basic Combat Training. Calcified Tissue International. 105(1), pp.68-76. doi: 10.1007/s00223-019-00548-7. Epub 2019 Apr 22.

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