Investigation of Tibial Responses to Military Training Reveals Consistency between Adaptation and Markers of Stress and Osteogenic Potential
Abstract
INTRODUCTION: Arduous military training consists of physically demanding activity that increases tibial bone formation. The intensity of these programs, however, greatly elevates the risk of bone stress injuries, especially in women. This cross-sectional study aimed to profile individuals whose tibias most and least adapted to the 10-wk Marine Officer Candidates School (OCS).
METHODS: Officer candidates ( n = 168; 49 female) included were those with the greatest (adapters; top quintile) and least (non-Adapters; bottom quintile) change in bone strength index at the distal metaphysis (4% site) of the tibia after OCS. Tibial peripheral quantitative computed tomography scans, blood draws, and demographics were taken before and after OCS. A cell culture model was utilized to measure the impact of circulating factors on osteoblast activity. Circulating markers of stress, bone turnover, and iron status were measured.
RESULTS: Analysis of tibial parameters revealed that adapters had greater changes in bone mineral density and/or strength index at each measured site (4%, 38%, and 66%) after OCS compared with non-adapters. Demographically, women were more likely to have no adaptation response. After adjusting for sex differences between groups, adapters had no stress hormone decline, unlike non-adapters, and began training at a lower body mass than non-adapting counterparts. Completion of OCS in adapters improved the osteogenic capacity of circulating factors, as evident by increased…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 168 participants or records.
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