Investigating the bone-muscle interaction during growth and development in children
The purpose of this dissertation was to assess functional changes in the muscle-bone unit during normal growth and maturation in peri-pubertal children, and determine if changes in muscle strength are directly related to changes in bone properties. The first part of this work was a systematic review of literature on the effect of physical activity on bone development in children. It was found the best time to see large improvements in bone properties may be during the peri-pubertal years. It was not clear the best type of activity, nor which loading characteristic, should be utilized. This led to the second part of this work, where a non weight-bearing bone, the radius, was investigated in order to separate the influence of muscle properties on bone from ground reaction forces. Children and adolescents (n=172), between the ages of 8-16 years, were examined over a 2-year period. Measurements of somatic maturity, anthropometry, grip strength, bone properties (reflected by speed of sound (SOS)), physical activity (accelerometery), nutrition (24-hour recall), and bone resorption (NTX) were taken. Materials and procedures were identical between studies allowing for both a cross-sectional and longitudinal examination of the muscle-bone unit. Cross-sectionally, results demonstrated relative grip strength, maturity, dietary calcium and NTX explained 21% of the variance in radial SOS (p<0.05). Calcium intake was found to be a significant predictor only after NTX was accounted for, suggesting its effects on the muscle-bone unit may be modulated through bone resorption. In boys, the primary explanatory variables of radial SOS was NTX, followed by grip strength and maturity; where as in girls, it was maturity and dietary calcium. Longitudinally, maturity was found to have indirect effects on radial SOS mediated by grip strength. The influence of maturity on grip strength was similar between sexes, with the effect of grip strength on radial SOS being significantly greater in girls than boys (14.26 vs. 6.60; p<0.05); implying female bones maybe more responsive to muscle forces. Together, these studies provide an overview of muscle-bone unit development during peri-pubertal maturation, demonstrating radial bone properties to be appropriately adapted to muscle function and force independent of physical activity.