Emeritus Faculty, Acad Council, Medicine - Endocrinology, Gerontology, & Metabolism
RETIRED in 2008, do not conduct research
Tibial stress fractures increasingly affect athletes and military recruits, with few known effective management options. Electrical stimulation enhances regular fracture healing, but the effect on stress fractures has not been definitively tested.Capacitively coupled electric field stimulation will accelerate tibial stress fracture healing.Randomized controlled trial; Level of evidence, 1.Twenty men and 24 women with acute posteromedial tibial stress fractures were referred from local clinicians. Subjects were randomly assigned active or placebo capacitively coupled electric field stimulation to be applied for 15 hours per day until healed, given supplemental calcium, and instructed to rest from provocative training. Healing was confirmed when hopping to 10 cm for 30 seconds could be achieved without pain.No difference in time to healing was detected between treatment and placebo groups. Women in the treatment group healed more slowly than did the men (P = .05). Superior treatment compliance was associated with reduced time to healing (P = .003). Rest noncompliance was associated with increased time to healing (P = .05).Whole-group analysis did not detect an effect of capacitively coupled electric field stimulation on tibial stress fracture healing; however, greater device use and less weightbearing loading enhanced the effectiveness of the active device. More severe stress fractures healed more quickly with capacitively coupled electric field stimulation.Although the use of capacitively coupled electric field stimulation for tibial stress fracture healing may not be efficacious for all, it may be indicated for the more severely injured or elite athlete/recruit whose incentive to return to activity may motivate superior compliance.
View details for DOI 10.1177/0363546507310076
View details for Web of Science ID 000253374000016
View details for PubMedID 18055921
Bone mass at any time of life reflects the totality of events that have impinged on the skeleton to that point. For adults, these events include those that have influenced the acquisition of bone during years of growth, resulting in the achievement of skeletal maturity, or "peak bone mass," as well as those that have subsequently influenced bone losses. For each limb of this trajectory, physical activity has been implicated as a powerful and independent factor. This article reviews current evidence regarding the relation of habitual physical activity to bone acquisition and maintenance, the skeletal consequences of exercise training, and the clinical value of exercise for patients with skeletal frailty.
View details for Web of Science ID 000167685100007
View details for PubMedID 11285991
View details for Web of Science ID A1994BB55L00011
Although age-related bone loss due to remodeling is basically a normal, predictable phenomenon, it is one that may be accelerated, at times quite dramatically, by dietary factors, hormonal insufficiency, or lack of exercise. Recent data regarding the long-term prophylactic efficacy of calcium supplementation, estrogen replacement therapy, and exercise are evaluated.
View details for Web of Science ID A1989U131700016
View details for PubMedID 2538489