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Physical activity and musculoskeletal health


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Foley, SJ 2009 , 'Physical activity and musculoskeletal health', PhD thesis, University of Tasmania.

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Population ageing is unprecedented and enduring. By 2050, the proportion of those
aged over 65 would have increased from 13% to 26%. As the population ages, the
prevalence of chronic diseases that disproportionately affect the elderly will markedly
increase. Osteoarthritis and osteoporosis, including resulting fractures are two such
diseases. Physical activity (PA) is an important risk factor for both of these diseases
but many questions remain unanswered. This thesis examines how PA and exercise
interacts with features of falls, osteoarthritis and osteoporosis.
In a population based sample of 50-80 year olds (n=850) followed over 2.6 years, self
reported functional ability and pain, and to a lesser extent stiffness (but not
radiographic osteoarthritis) have modest but independent associations with
physiological predictors of falls risk suggesting it is symptoms not radiographic
changes that increase falls risk. In addition, ambulatory activity is positively
associated with hip bone density in both sexes which appears most important in those
aged over 65 years. However, the associations for spine bone density are both weaker
and inconsistent.
In a convenience sample of 26-61 year olds (n=325) followed over two years, we
found knee cartilage volume and tibial plateau area are dynamic structures that can
respond to physical stimuli. Greater muscle strength and endurance fitness, especially
in women, protects against cartilage loss, but also results in a maladaptive
enlargement of subchondral bone in both sexes, suggesting PA may have both good
and bad effects on the knee.
1,434 children, aged 7-15 years, were measured in 1985 and approximately 20 years
later. We found childhood fitness levels, particularly in females and in the early
pubertal years, predicts adult bone mass, while BMI predicts bone mass in males only.
These results suggest that increased skeletal loading in childhood leads to an increase
in peak bone mass independent of current loading.
In 183 children examined at age 8 and 16, bone mass measured by dual x-ray
absorptiometry (DXA) is a good predictor of upper limb fracture risk during puberty.
DXA measures track moderately to strongly from childhood to adolescence. Tracking
is independent of linear growth and sex indicating bone mineralisation and growth are
under largely separate mechanistic control. Body composition is the main predictor of
altered tracking but environmental factors, such as having been breastfed, sports
participation, fitness and inhaled corticosteroid use also appear important.
In conclusion, this series of related studies shed considerable insight onto the role that
PA and exercise play in preventing osteoarthritis and osteoporosis. In particular,
childhood appears the most opportune time to prevent osteoporosis but later life is
also important while for osteoarthritis, results remain less certain for structural

Item Type: Thesis - PhD
Authors/Creators:Foley, SJ
Keywords: Musculoskeletal diseases in old age, Musculoskeletal system, Osteoarthritis, Osteoporosis, Exercise
Copyright Holders: The Author
Copyright Information:

Copyright 2009 the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s).

Additional Information:

Chapter 4 is the equivalent of a post-ptrint of an acticle published as: Foley S, Lord SR, Srikanth V, Cooley H, Jones G, 2006, Falls risk is associated with pain and dysfunction but not radiographic osteoarthritis in older adults: Tasmanian Older Adult Cohort study, Osteoarthritis Cartilage, 14(6):533-9 with the DOI: 10.1016/j.joca.2005.12.007

Chapter 5 is a non-final version of an acticle published as: Foley S, Ding C, Cicuttini F, Jones G 2007 Physical activity and knee structural change: a longitudinal study using MRI. Med Sci Sports Exerc 39(3):426-34 found at 10.1249/mss.0b013e31802d97c6

Chapter 7 appears to be in part the equivalent of the accepted version of the following article: Flynn, J., Foley, S. and Jones, G. (2007), Can BMD Assessed by DXA at Age 8 Predict Fracture Risk in Boys and Girls During Puberty?: An Eight-Year Prospective Study. J Bone Miner Res, 22: 1463–1467, which has been published in final form at 10.1359/jbmr.070509

Chapter 8 appears to be the equivalent of a pre-print of Foley S., Quinn S., Jones G., 2009, Tracking of bone mass from childhood to adolescence and factors that predict deviation from tracking, Bone, 44(5), 752-7

Chapter 9 appears to be the equivalent of a post-print article finally published as: Foley, S., Flynn, J., Jones, G. (2009), Pedometer determined ambulatory activity and bone mass: a population-based longitudinal study in older adults, Osteoporosis International, 21, (11), 1809-1816. he final publication is available at Springer via

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