The Influence of Lower Extremity Biomechanics on Biochemical Markers of Bone Turnover During Army Cadet Basic Training

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  • March 21, 2019
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  • Mauntel, Timothy
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Curriculum in Human Movement Science
Abstract
  • Lower extremity stress fracture rates are high among military personnel, result in substantial lost duty time, and inhibit military readiness. Stress fracture risk factors include aberrant biomechanics, previous musculoskeletal injury, physical fitness, and anthropometric measurements. It is unknown how these risk factors influence bone formation and resorption (turnover) biomarkers. Elucidating the relationships between stress fracture risk factors and bone turnover biomarkers will provide insight into how these factors influence bone health. Our primary aim was to characterize the effects of stress fracture risk factors on bone turnover biomarkers. Our secondary aim was to validate an automated markerless motion capture system. We hypothesized the presence of stress fracture risk factors would result in bone biomarker profiles indicative of high turnover rates. We also hypothesized the markerless motion capture system would provide valid kinematic measurements. Army cadets completing Cadet Basic Training (CBT) were assessed via a jump-landing assessment and other stress fracture risk factors were recorded. Bone turnover biomarkers were measured post-CBT. Linear regression models were used to determine the extent to which stress fracture risk factors influenced bone turnover biomarkers. Kinematic measures calculated by the markerless motion capture system during a jump-landing assessment were compared against a stereophotogrammetric motion capture system. Lower extremity stress fracture risk factors predicted post-CBT bone turnover biomarkers. Overall movement quality was not predictive, but variables associated with sagittal plane displacement and foot position at initial ground contact did predict post-CBT bone turnover biomarkers. Injury during CBT, physical fitness test performance, and mass also predicted post-CBT bone turnover biomarkers. Moderate agreement was observed between the markerless and stereophotogrammetric motion capture systems. Better agreement was observed for sagittal than frontal plane joint angles and for maximum and displacement angles than initial ground contact joint angles. Our findings provide important information regarding how stress fracture risk factors affect bone health. The markerless motion capture system was limited in identifying minute changes in trunk and lower extremity joint angles but can accurately identify gross movement patterns. These findings will guide interventions to reduce stress fracture risks and guide the use of automated movement assessments for identifying injury risks.
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  • In Copyright
Advisor
  • Marshall, Stephen
  • Cameron, Kenneth
  • Padua, Darin A.
  • Pietrosimone, Brian
  • Hackney, Anthony
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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