Predicting Diaphyseal Cortical Bone Status Using Measures of Muscle Force Capacity

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Abstract

Purpose

Muscle cross-sectional area (MCSA) is often used as a surrogate for the forces applied to bones during physical activity. Although MCSA is a strong predictor of cortical bone status, its use makes assumptions about the relationship between muscle size and force that are inaccurate. Furthermore, to measure MCSA and other muscle force surrogates typically requires expensive and/or radiative laboratory equipment. Thus, this study aimed to determine whether clinical laboratory– and field-based methodologies for measuring muscular force capacity accounted for similar variance in diaphyseal cortical bone status as a commonly used muscular force surrogate, MCSA, at the midtibia in young men and women.

Methods

Healthy young adults (n = 142, 19.7 ± 0.7 yr old, 52.8% female) were assessed via peripheral quantitative computed tomography at the midtibia for cortical bone status and MCSA. Muscle force capacity was measured via Biodex dynamometer, Nottingham leg extensor power rig, and Vertec vertical jump. Regression analysis compared the independent variance predicted by each muscle force measure with that of MCSA, accounting for relevant confounders.

Results

MCSA, knee extension peak torque, and peak anaerobic power from vertical jump were independent predictors of select cortical structural outcomes (cortical thickness and area, periosteal and endosteal circumference, and estimated strength) accounting for up to 78.4% of the variance explained (all P < 0.05). However, cortical volumetric bone mineral density was unrelated to any measure or surrogate of muscle force capacity.

Conclusions

MCSA is a strong independent predictor of cortical bone structure; however, both laboratory- and field-based measures of peak torque and/or peak anaerobic power are promising alternatives, explaining similar and sometimes greater variance than MCSA.

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