The purpose of this study was (1) to compare the lower body strength, power, and the bone mineral density (BMD) of the proximal femur in a group of trained postmenopausal women who have been in low intensity exercise program for a long time with age-matched sedentary controls, and (2) to evaluate the magnitude of the correlation between muscle function and site-specific BMD in these postmenopausal women. Healthy postmenopausal women (n = 17) between the age of 60 and 80 were divided into two groups: 9 exercisers (mean ± SE, 74.8 ± 3.2 years) who had been in an exercise training program for at least 5 years and 8 control (mean ± SE, 71.6 ± 3.4 years) who had not been in any exercise program for at least 5 years. The exercise group performed three one hour sessions a week of aerobic and resistance training for an average of 9.9 years. The exercise training consisted of 30 minutes walking and one or two sets of twelve to fifteen repetitions focused on large muscle groups. The BMD of the proximal femoral region was assessed using dual-energy x-ray absorptiometry (DEXA). By using a Cybex Leg Press machine, 1-repetition maximum (1-RM) tests were performed for lower body strength and power of lower body were obtained by a seated chair rise. Statistical analysis demonstrated no statistical differences between the left and right region of the femur BMD for either group, with the averaged BMD being 0.858 g/cm2 for the controls and 0.853 g/cm2 for the exercisers. The trochanter BMD for the exercisers were 7 % (left) and 6 % (right) higher than the controls although these values were not statistically significant. The 1RM leg press strength ranged from 29.5 to 47.6 kg (mean ± SE, 40.21 ± 2.62 kg) in controls and from 31.8 to 61.2 kg (mean ± SE, 45.93 ± 3.72 kg) in exercisers. Although the exerciser group lifted 14.2 % more weight than the control group, the difference was not statistically significant. The results of power test ranged from 14.59 to 31.21 kg • m/sec (mean ± SE, 22.94 ± 5.67 kg • m/sec) in controls and from 13.63 to 38.60 (mean ± SE, 28.88 ± 6.81 kg • m/sec). The power did not differ significantly between the two groups. However, it is noted that between group differences approached significance at p < 0.07. Correlations between body composition and femoral neck BMD were also determined. Neither weight, nor BMI was significantly correlated with femoral neck BMD in the exercise and control group. Lower body strength and power did not correlate with the BMD of the femoral neck, Ward's triangle, or trochanter in either group. Although the BMD of the proximal femoral region did not differ between two groups the higher mean age (+ 3.2 years) of the exercise group suggested that a low intensity exercise training program can increase power and strength and maintain BMD in postmenopausal women. However, the low intensity of resistance training program utilized by the exercise group was no more effective in maintaining BMD than an active lifestyle. / School of Physical Education

A pilot clinical trial was conducted after the in-vivo and in-vitro studies: Eight subjects fulfilled the inclusion criteria were recruited. However, the liver function tests of three subjects out of eight were found to be abnormal with elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) level, which was not reported in previous toxicity test. The trial was suspended immediately and a follow-up test showed that the elevated AST and ALT level had reverted back to normal within one month after termination of OPR intake. Although we could not accomplish a RCT, the pilot study revealed potential hepatotoxicity of OPR on human beings and it would raise the safety awareness of investigators on the use of herbal remedies in future clinical studies. / After the in-vivo and in-vitro studies, a double-blinded, randomized, placebo-controlled clinical trial (RCT) was planned. Due to a lack of a Chinese version of instrument to measure osteoporosis-specific quality of life, an English version of the Osteoporosis-Targeted Quality of Life Questionnaire (OPTQoL) was translated into Chinese and linguistically validated according to the standard guideline. The newly formed Chinese OPTQoL can be used to assess the impact of new interventions on quality of life among Chinese osteoporosis patients. / Association of the incidence of postmenopausal osteoporosis and Kidney-Vacuity Syndromes in TCM was investigated with the aid of a Kidney-Vacuity Syndromes scoring questionnaire. In the study, postmenopausal women, who suffered from deficiency of kidney "qi" and kidney "essence", had a significantly higher incidence of osteoporosis. These findings strongly supported that replenishing kidney qi and kidney essence was a logical therapeutic principle in the formulation of OPR. / In conclusion, this study investigated the use of TCM on the treatment of postmenopausal osteoporosis in a systematic manner. It started from herbal formulation, basic science studies to clinical trial. It revealed beneficial effects of OPR on bones through in-vivo and in-vitro studies and demonstrated certain possible mechanism behind. On the other hand, the hepatotoxicity of OPR on human beings was also exposed and had not been reported in previous toxicity tests. The study provided valuable clinical data for other investigators on the potential hazards of herbal remedies although they had been validated as safe and effective in pre-clinical stage. / In search for safe, effective and low-priced medicine, the public have turned their attention to Traditional Chinese Medicine (TCM). Extensive experience has been accumulated in TCM regarding the diagnosis and treatment of osteoporosis, which often involves the prescription of kidney-tonifying herbs. Therefore, the aim of the study, firstly, was to explore the association of the incidence of postmenopausal osteoporosis and Kidney-Vacuity Syndromes in TCM, so as to formulate a rational kidney-tonifying herbal formula for osteoporosis research (OPR). Secondly, the effect of the formula was evaluated by in-vitro and in-vivo studies. Thirdly, the Osteoporosis-Targeted Quality of Life Questionnaire was linguistically validated from English to Chinese, which was expected to be one of the outcome measurement tools in future clinical trials. Lastly, a pilot clinical study was performed, which revealed some potential hazards of the formula on human beings which have not been shown in previous works. / Osteoporosis is a skeletal disorder which leads to an increased risk of bone fracture, disability or even death. It has become a major public health threat and the worldwide incidence of osteoporotic fracture is projected to increase two fold within the next 50 years. Postmenopausal women, being affected by a lack of estrogen, face a much higher risk of the disease. This study would therefore focus on type I osteoporosis (i.e. postmenopausal osteoporosis). Although current medications can slow down the bone deterioration process, their side effects and high cost had impaired patients' compliance with long term treatment. / The effect of OPR for the treatment of postmenopausal osteoporosis was then evaluated by in-vitro and in-vivo studies. In the in-vivo study, an osteoporosis model was established by performing ovariectomy on the four-week-old C57BL/6 mice. A high bone turnover rate was induced and OPR successfully slowed down the high turnover rate of bones by decreasing bone formation and resorption process without increasing the uterine linings. However, its beneficial effect on bones could not be detected on bone mineral density measurement. / The potential mechanism of action of OPR on bones was explored by in-vitro study. OPR was shown to induce cell proliferation and differentiation of osteoblast-like UMR 106 cells. Furthermore, the estrogenic activity of OPR was detected by MCF-7 cell line, which has been stably transfected with estrogen responsive elements (ERE). OPR was shown to possess an estrogenic activity in a dose dependent manner and was comparable to the positive control at a concentration of 200 and 1000 mug/ml. The induced estrogenic activity by OPR may be associated with the presence of phytoestrogen within the herbal formula. These findings suggested that the beneficial effect of OPR on bones might relate to its direct positive effect on osteoblast and its estrogenic-like activity. / Liong, Ching. / Adviser: Chun-tao Che. / Source: Dissertation Abstracts International, Volume: 73-03, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves ). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Studies in young women show that rowing exercise is osteogenic at the spine. However, little is known regarding rowing exercise and spine bone mineral density in older women. The aim of this study was to examine differences in spine bone mineral density (BMD) and back strength between premenopausal and postmenopausal competitive female masters rowers (n=28, 45.5 ± 4.7 yrs, n=28, 56.1 ± 5.7 years, respectively) and age-matched non-rowers (n=30, 43.3 ± 4.2 yrs; n=26, 56.8 ± 4.8 years). Competitive rowers were recruited from nine rowing clubs in the local area and compared to controls recruited from the same region who were normally active but not participating in rowing activity. Participating rowers had been engaged in competitive rowing for a minimum of one year. The average years spent rowing for the premenopausal and postmenopausal groups was 7.5 ± 6.6 yrs and 5.9 ± 6.9 yrs, respectively. BMD (g/cm²) of the third lumbar vertebrae (L3) was measured by dual-energy x-ray absorptiometry (DXA) in both the anterior-posterior and lateral views. Back strength was assessed using a standing cable tensiometer. Subjects also completed questionnaires to assess diet, physical activity, medical history and rowing history. Differences in BMD and back strength between groups were determined by analysis of covariance, controlling for lean mass. Compared to controls, postmenopausal rowers had 3.2% higher BMD at the anterior-posterior spine (p=.02) and 4.4% higher lateral spine BMD (p=.04). Furthermore, isometric back strength was 22.6% greater in these rowers than controls (p=.01). In contrast, controls had higher lateral BMD than rowers, with no differences in AP spine BMD or back strength between the premenopausal rowers and controls. Back strength was a significant predictor of AP spine BMD in premenopasual rowers and controls (R²=0.137, p=0.004) and of lateral spine BMD in postmenopausal rowers only (R²=0.153, p=0.04). There were no differences in calcium intake, age, menopausal status, weight, or lean mass between rowers and controls in either the premenopausal or postmenopausal samples. Since both increased BMD and back strength are associated with reductions in vertebral fracture risk, our results suggest that rowing exercise may be an important strategy to promote bone health and reduce vertebral fracture risk in postmenopausal women. However, the forces applied in rowing may not be great enough to alter bone mass before the onset of menopause. Therefore more research is needed examining rowing exercise in these older populations. / Graduation date: 2005

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, 2003. / Bibliyografya var.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 1999. / Includes bibliographical references (leaves 142-162).

Thesis (Ph. D.)--Texas Woman's University, 2004. / Includes bibliographical references (leaves 111-132). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (Ph. D.)--Texas Woman's University, 2004. / Includes bibliographical references (leaves 111-132).

Thesis (M.Tech.: Radiography) - Dept. of Radiography, Durban University of Technology, 2006 xxiv, 214 leaves, Annexures A-L / The aim of this research was to determine normal bone mineral density (BMD) reference ranges (means and standard deviations) for the lumbar spine, total hip and distal forearm, for Indian women of varying age groups in KwaZulu-Natal. The aim also included a comparison of the study population reference ranges with those provided by the manufacturer in order to evaluate any diagnostic implications.

A dissertation submitted in full compliance with the requirements for the M.Tech: Radiography,Durban University of Technology, 2006. / The aim of this research was to determine normal bone mineral density (BMD) reference ranges (means and standard deviations) for the lumbar spine, total hip and distal forearm, for Indian women of varying age groups in KwaZulu-Natal. The aim also included a comparison of the study population reference ranges with those provided by the manufacturer in order to evaluate any diagnostic implications. / M

INTRODUÇÃO: A diminuição da massa óssea e mudanças na composição corporal são comuns em pacientes com artrite reumatóide, particularmente nos usuários de glicocorticóide (GC). OBJETIVO: Analisar o comprometimento dos componentes da composição corporal e densidade mineral óssea (DMO) na artrite reumatóide (AR) e seus aspectos clínicos. MÉTODOS: 83 mulheres com AR realizaram densitometria óssea para análise de massa óssea total e regional e estudo da composição corporal (CC). Além disso, foram submetidas à realização laboratorial de provas inflamatórias, dosagem de fator reumatóide e aplicados questionários para avaliação da atividade da doença, classe funcional, atividade física, e inquérito alimentar. RESULTADOS: A prevalência de osteoporose nas pacientes menopausadas foi de 21,4%, 46,4% com osteopenia e 32,1% com valores normais e ocorreu de forma semelhante em coluna lombar e colo do fêmur. As mulheres na pré-menopausa apresentaram maiores valores nas médias de DMO. A idade teve efeito negativo nas medidas DMO e de CC enquanto que o índice de massa corpórea (IMC) mostrou efeito positivo nestas variáveis. A atividade física apresentou efeito positivo na DMO de fêmur total. A duração da AR teve efeito negativo na DMO de coluna lombar. O GC foi o determinante negativo na massa magra total e aumentou o percentual de gordura. CONCLUSÕES: O achado de valores reduzidos de DMO sugere que devam ser aplicadas medidas para a prevenção e tratamento de osteoporose. A doença (AR) também influenciou negativamente a DMO nestas pacientes e a utilização de GC modificou a CC, reduzindo a massa muscular e aumentando o percentual de gordura. A preservação da massa muscular é importante ao equilíbrio das pacientes, com conseqüente diminuição de quedas e futuras fraturas. / INTRODUCTION: The reduction of bone mass and changes in body compositions are usual in patients with rheumatoid arthritis specialty in users of glucocorticoid (GC). OBJECTIVE: To evaluate the bone mineral density (BMD) and body composition (BC) including its correlation to factors of rheumatoid arthritis (RA) and clinics concerns. METHODS: BMD and body composition (total and regional) were measured by densitometry in 83 patients with RA. Furthermore, it was performed laboratory exams (rheumatoid factor, inflammatory exams) and activity of disease, functional class, physical activity and alimentary data were colleted by specific questionnaires. RESULTS: The prevalence of osteoporosis in menopausal patients was 21,4%, 46,4% of osteopenia and 32,1% were normal and osteoporosis was similar in lumbar spine and femoral neck. Premenopausal women had the biggest values of BMD medias. Dose of GC was negative determinant of total lean mass and made positive effect in total fat percentual. Age made negative effect in BMD and body composition. BMI showed positive effect in all CC variables. The physical activity made positive effect in BMD in total femur. The RA duration had negative effect in BMD in lumbar spine. CONCLUSIONS: The finding of low BMD suggests a better approach to prevention and treatment. The disease (RA) also made a negative influence in BMD in these patients and the use of GC cause changes in body composition, with reduction in lean mass and improvement of total fat percentual. Recommendations to preservation of lean mass are important to reduction of falls and consequent diminution of fractures.