Influence of high impact loading on ultrasound bone measurements in children: a cross-sectional report

Evidence suggests that weight-bearing exercise during the growing years may enhance peak bone mass. The purpose of this study was to compare ultrasound bone measurements, serum alkaline phosphatase (S-ALP), serum osteocalcin (S-OC), and dietary calcium in highly active and normal healthy male children. Subjects were 33 elite and subelite male gymnasts and 40 normoactive controls matched for age (9.4 +/- 1.1 years), height (133.9 +/- 5.9 cm), and weight (30.1 +/- 3.8 kg). Measurements of broadband ultrasound attenuation (dB/MHz) through the calcaneus (CBUA) and ultrasound velocity (m/s) through the calcaneus (CVOS), distal radius (RVOS), and proximal phalanx of the index finger (PVOS) were performed using a Contact Ultrasonic Bone Analyzer (CUBA Research). Gymnasts had significantly greater CVOS (P < 0.001), RVOS (P < 0.0001), and PVOS (P < 0.05). There were no differences in CBUA, S-ALP, or S-OC between groups. RVOS correlated significantly with dietary calcium intake in all subjects (P < 0.05) and training time in the gymnasts (P < 0.05). Though gymnasts had significantly greater calcium intakes than controls (P < 0.05), whose mean value was below the RDA, after controlling for calcium intake in the gymnasts alone, RVOS was still significantly correlated with training time (P < 0.05). These preliminary results suggest that the heavy musculoskeletal loading inherent in gymnastics training produces positive adaptive responses in the growing skeleton. Furthermore, ultrasound appears to provide a safe, noninvasive means of comparing the skeletal status of exercising and normal healthy children, whereas single samples of biochemical markers did not discriminate between the groups.