Search Filters

  • Presentation Format
  • Media Type
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

Identification of Predictive Risk Factors for the Development of a Stress Fracture within 6 Months in Female Elite Long-distance Runners


Harukazu Tohyama, MD, PhD
JAPAN

Identification of Predictive Risk Factors for the Development of a Stress Fracture within 6 Months in Female Elite Long-distance Runners

Tomoya Ishida, PhD, JAPAN Harukazu Tohyama, MD, PhD, JAPAN

Hokkaido University Faculty of Health Sciences, Sapporo, Hokkaido, JAPAN

2021 Congress   Award Winner   5 minutes   rating (1)

 

Sports Medicine

Orthopaedic Sports Medicine Preventative Sports Medicine Sport Specific Injuries

Patient Populations

Female Athletes Gender Specific Sport Specific Population

Diagnosis Method

MRI Bone Scan CT-Scan

This media is available to current ISAKOS Members, Global Link All-Access Subscribers and Webinar/Course Registrants only.
Log inSubscription Options

Summary: Lumbar bone mineral density (BMD) < 81.1% of the young adult mean (YAM) predicted a prospective stress fracture within 6 months with 74% specificity and 88% sensitivity in female elite long-distance runners.

Background

Female runners have a higher risk of stress fractures than male runners. Literature about best practices for preventing stress fractures in female long-distance runners is lacking. We aimed to identify which factors predict the risk of stress fractures within 6 months in female elite long-distance runners.

Study design: Cohort study.

Methods

We measured bone mineral densities (whole body and lumbar spine) and body composition using dual-energy X-ray absorptiometry (DXA) in elite female long-distance runners aged 18 to 37 years old (N = 21) who belonged to a women's track team. We followed participants prospectively for 6-month periods. Stress fractures were confirmed with bone scan, magnetic resonance imaging, and/or computed tomography findings. We used univariate logistic regression and stepwise multivariate logistic regression with the receiver operating characteristics curve to examine the ability of bone mass and body composition parameters alone or in combination to predict the occurrence of a stress fracture.

Results

We performed 118 DXA measurements. Stress fractures (four sacral, three tibial, three calcaneal, two pubic, two femoral neck, one rib, one cuboid, and one metatarsal) occurred in nine runners within 6 months. Bone mineral densities (whole body and lumbar spine), total bone mineral content, lean body mass, and percentage total bone mineral content (relative to total body mass) were significantly associated with a stress fracture developing. The multivariate analysis showed that bone mineral density of the lumbar spine alone was the strongest predictive factor. Bone mineral density of the lumbar spine <81.1% of the young adult mean predicted the occurrence of a stress fracture within 6 months, with and 88% sensitivity and 74% specificity.

Conclusion

Female elite long-distance runners with lumbar spine bone mineral density <81.1% are at increased risk of a stress fracture within 6 months and should reduce their high-impact sports activities to avoid developing a stress fracture.

Clinical relevance: The present study provides meaningful information that suggests a possible useful application of DXA measurement as a screening tool in regular medical examinations for predicting stress fractures in female long-distance runners.

More 2021 Congress Sports Medicine Abstract Presentations

More ISAKOS 2021: Global Content