{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:20:37Z","timestamp":1782973237252,"version":"3.54.5"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2013,6,15]],"date-time":"2013-06-15T00:00:00Z","timestamp":1371254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>\u2003<\/jats:title>\n                    <jats:p>Osteoarthritis and osteoporosis often coexist in postmenopausal women. The simultaneous effect of bone-favorable high-impact training on these diseases is not well understood and is a topic of controversy. We evaluated the effects of high-impact exercise on bone mineral content (BMC) and the estimated biochemical composition of knee cartilage in postmenopausal women with mild knee osteoarthritis. Eighty women aged 50 to 66 years with mild knee osteoarthritis were randomly assigned to undergo supervised progressive exercise three times a week for 12 months (n\u2009=\u200940) or to a nonintervention control group (n\u2009=\u200940). BMC of the femoral neck, trochanter, and lumbar spine was measured by dual-energy X-ray absorptiometry (DXA). The biochemical composition of cartilage was estimated using delayed gadolinium-enhanced magnetic resonance imaging (MRI) cartilage (dGEMRIC), sensitive to cartilage glycosaminoglycan content, and transverse relaxation time (T2) mapping that is sensitive to the properties of the collagen network. In addition, we evaluated clinically important symptoms and physical performance\u2013related risk factors of falling: cardiorespiratory fitness, dynamic balance, maximal isometric knee extension and flexion forces, and leg power. Thirty-six trainees and 40 controls completed the study. The mean gain in femoral neck BMC in the exercise group was 0.6% (95% CI, \u20130.2% to 1.4%) and the mean loss in the control group was \u20131.2% (95% CI, \u20132.1% to \u20130.4%). The change in baseline, body mass, and adjusted body mass change in BMC between the groups was significant (p\u2009=\u20090.005), whereas no changes occurred in the biochemical composition of the cartilage, as investigated by MRI. Balance, muscle force, and cardiorespiratory fitness improved significantly more (3% to 11%) in the exercise group than in the control group. Progressively implemented high-impact training, which increased bone mass, did not affect the biochemical composition of cartilage and may be feasible in the prevention of osteoporosis and physical performance\u2013related risk factors of falling in postmenopausal women. \u00a9 2014 American Society for Bone and Mineral Research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jbmr.2015","type":"journal-article","created":{"date-parts":[[2013,6,15]],"date-time":"2013-06-15T08:18:55Z","timestamp":1371284335000},"page":"192-201","source":"Crossref","is-referenced-by-count":65,"title":["Effects of High-Impact Training on Bone and Articular Cartilage: 12-Month Randomized Controlled Quantitative MRI Study"],"prefix":"10.1093","volume":"29","author":[{"given":"Juhani","family":"Multanen","sequence":"first","affiliation":[{"name":"Department of Health SciencesUniversity of Jyv\u00e4skyl\u00e4Jyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miika T","family":"Nieminen","sequence":"additional","affiliation":[{"name":"Department of RadiologyUniversity of OuluOuluFinland"},{"name":"Department of Diagnostic RadiologyOulu University HospitalOuluFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arja","family":"H\u00e4kkinen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and RehabilitationCentral Finland Central HospitalJyv\u00e4skyl\u00e4Finland"},{"name":"Department of Health SciencesUniversity of Jyv\u00e4skyl\u00e4Jyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urho M","family":"Kujala","sequence":"additional","affiliation":[{"name":"Department of Health SciencesUniversity of Jyv\u00e4skyl\u00e4Jyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"J\u00e4ms\u00e4","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Institute of BiomedicineUniversity of OuluOuluFinland"},{"name":"Department of Diagnostic RadiologyOulu University HospitalOuluFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannu","family":"Kautiainen","sequence":"additional","affiliation":[{"name":"Unit of Primary Health CareKuopio University HospitalKuopioFinland"},{"name":"Unit of Family PracticeCentral Finland Central HospitalJyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveliina","family":"Lammentausta","sequence":"additional","affiliation":[{"name":"Department of Diagnostic RadiologyOulu University HospitalOuluFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riikka","family":"Ahola","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Institute of BiomedicineUniversity of OuluOuluFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Sel\u00e4nne","sequence":"additional","affiliation":[{"name":"LIKES - Research Center for Sport and Health SciencesJyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risto","family":"Ojala","sequence":"additional","affiliation":[{"name":"Department of Diagnostic RadiologyOulu University HospitalOuluFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkka","family":"Kiviranta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and TraumatologyUniversity of Helsinki, and Helsinki University HospitalHelsinkiFinland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Department of Health SciencesUniversity of Jyv\u00e4skyl\u00e4Jyv\u00e4skyl\u00e4Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,6,15]]},"reference":[{"key":"2024020318581891500_jbmr2015-bib-0001","first-page":"1868","article-title":"Bone mineral content versus bone density in a population with osteoarthritis: a new twist to the controversy","volume":"32","author":"McDonald Blumer","year":"2005","journal-title":"J Rheumatol."},{"key":"2024020318581891500_jbmr2015-bib-0002","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1038\/nrendo.2010.70","article-title":"Physical therapy approaches to reduce fall and fracture risk among older adults","volume":"6","author":"Karinkanta","year":"2010","journal-title":"Nat Rev Endocrinol."},{"key":"2024020318581891500_jbmr2015-bib-0003","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s00198-011-1801-0","article-title":"A meta-analysis of brief high-impact exercises for enhancing bone health in premenopausal women","volume":"23","author":"Babatunde","year":"2012","journal-title":"Osteoporos Int."},{"key":"2024020318581891500_jbmr2015-bib-0004","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1136\/ard.2003.011742","article-title":"Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT)","volume":"62","author":"Jordan","year":"2003","journal-title":"Ann Rheum Dis."},{"key":"2024020318581891500_jbmr2015-bib-0005","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.joca.2007.12.013","article-title":"OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines","volume":"16","author":"Zhang","year":"2008","journal-title":"Osteoarthritis Cartilage."},{"key":"2024020318581891500_jbmr2015-bib-0006","first-page":"D004376","article-title":"Exercise for osteoarthritis of the knee","author":"Fransen","year":"2008","journal-title":"Cochrane Database Syst Rev."},{"key":"2024020318581891500_jbmr2015-bib-0007","doi-asserted-by":"crossref","first-page":"3507","DOI":"10.1002\/art.21415","article-title":"Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis","volume":"52","author":"Roos","year":"2005","journal-title":"Arthritis Rheum."},{"key":"2024020318581891500_jbmr2015-bib-0008","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/jmri.23644","article-title":"Evaluation of chondral repair using quantitative MRI","volume":"36","author":"Nieminen","year":"2012","journal-title":"J Magn Reson Imaging."},{"key":"2024020318581891500_jbmr2015-bib-0009","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/art.1780380413","article-title":"Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters","volume":"38","author":"Kujala","year":"1995","journal-title":"Arthritis Rheum."},{"key":"2024020318581891500_jbmr2015-bib-0010","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1002\/cphy.c100057","article-title":"Exercise and osteoarthritis: cause and effects","volume":"1","author":"Bennell","year":"2011","journal-title":"Compr Physiol."},{"key":"2024020318581891500_jbmr2015-bib-0011","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1136\/ard.16.4.494","article-title":"Radiological assessment of osteo-arthrosis","volume":"16","author":"Kellgren","year":"1957","journal-title":"Ann Rheum Dis."},{"key":"2024020318581891500_jbmr2015-bib-0012","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"Compendium of Physical Activities: a second update of codes and MET values","volume":"43","author":"Ainsworth","year":"2011","journal-title":"Med Sci Sports Exerc."},{"key":"2024020318581891500_jbmr2015-bib-0013","doi-asserted-by":"crossref","first-page":"17S\u201327S","DOI":"10.1016\/8756-3282(95)00376-2","article-title":"Estimation of various mechanical characteristics of human bones using dual energy X-ray absorptiometry: methodology and precision","volume":"18","author":"Siev\u00e4nen","year":"1996","journal-title":"Bone."},{"key":"2024020318581891500_jbmr2015-bib-0014","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.joca.2008.12.001","article-title":"Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla","volume":"17","author":"Multanen","year":"2009","journal-title":"Osteoarthritis Cartilage."},{"key":"2024020318581891500_jbmr2015-bib-0015","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1016\/j.joca.2009.05.011","article-title":"Topographical variation of T2 relaxation time in the young adult knee cartilage at 1.5 T","volume":"17","author":"Hannila","year":"2009","journal-title":"Osteoarthritis Cartilage."},{"key":"2024020318581891500_jbmr2015-bib-0016","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.joca.2006.05.007","article-title":"dGEMRIC as a function of BMI","volume":"14","author":"Tiderius","year":"2006","journal-title":"Osteoarthritis Cartilage."},{"key":"2024020318581891500_jbmr2015-bib-0017","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/S8756-3282(03)00082-6","article-title":"Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial","volume":"33","author":"Uusi-Rasi","year":"2003","journal-title":"Bone."},{"key":"2024020318581891500_jbmr2015-bib-0018","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s00198-006-0256-1","article-title":"A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial","volume":"18","author":"Karinkanta","year":"2007","journal-title":"Osteoporos Int."},{"key":"2024020318581891500_jbmr2015-bib-0019","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1046\/j.1365-201X.1996.461177000.x","article-title":"Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women","volume":"156","author":"Sipil\u00e4","year":"1996","journal-title":"Acta Physiol Scand."},{"key":"2024020318581891500_jbmr2015-bib-0020","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.bone.2010.01.002","article-title":"Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women","volume":"46","author":"Rantalainen","year":"2010","journal-title":"Bone."},{"key":"2024020318581891500_jbmr2015-bib-0021","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1055\/s-2000-8872","article-title":"Prediction of change in maximal aerobic power by the 2-km walk test after walking training in middle-aged adults","volume":"21","author":"Laukkanen","year":"2000","journal-title":"Int J Sports Med."},{"key":"2024020318581891500_jbmr2015-bib-0022","first-page":"1833","article-title":"Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee","volume":"15","author":"Bellamy","year":"1988","journal-title":"J Rheumatol."},{"key":"2024020318581891500_jbmr2015-bib-0023","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/S0140-6736(96)04214-6","article-title":"Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures","volume":"348","author":"Heinonen","year":"1996","journal-title":"Lancet."},{"key":"2024020318581891500_jbmr2015-bib-0024","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s00198-005-0005-x","article-title":"Intensity of exercise is associated with bone density change in premenopausal women","volume":"17","author":"Vainionp\u00e4\u00e4","year":"2006","journal-title":"Osteoporos Int."},{"key":"2024020318581891500_jbmr2015-bib-0025","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc."},{"key":"2024020318581891500_jbmr2015-bib-0026","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1016\/j.jbiomech.2010.03.021","article-title":"Daily impact score in long-term acceleration measurements of exercise","volume":"43","author":"Ahola","year":"2010","journal-title":"J Biomech."},{"key":"2024020318581891500_jbmr2015-bib-0027","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1038\/nrendo.2012.88","article-title":"Bone: impact loading-nature's way to strengthen bone","volume":"8","author":"Siev\u00e4nen","year":"2012","journal-title":"Nat Rev Endocrinol."},{"key":"2024020318581891500_jbmr2015-bib-0028","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/1741-7015-8-47","article-title":"Targeted exercise against osteoporosis: a systematic review and meta-analysis for optimising bone strength throughout life","volume":"8","author":"Nikander","year":"2010","journal-title":"BMC Med."},{"key":"2024020318581891500_jbmr2015-bib-0029","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1136\/bjsm.2008.052704","article-title":"A meta-analysis of impact exercise on postmenopausal bone loss: the case for mixed loading exercise programmes","volume":"43","author":"Martyn-St James","year":"2009","journal-title":"Br J Sports Med."},{"key":"2024020318581891500_jbmr2015-bib-0030","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1007\/BF02376766","article-title":"Hip bone mineral density is improved by high-impact aerobic exercise in postmenopausal women and men over 50 years","volume":"74","author":"Welsh","year":"1996","journal-title":"Eur J Appl Physiol Occup Physiol."},{"key":"2024020318581891500_jbmr2015-bib-0031","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1359\/jbmr.1998.13.12.1805","article-title":"Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise","volume":"13","author":"Bassey","year":"1998","journal-title":"J Bone Miner Res."},{"key":"2024020318581891500_jbmr2015-bib-0032","first-page":"1","article-title":"Effect of daily physical activity on proximal femur. Clin Biomech (Bristol","volume":"21","author":"J\u00e4ms\u00e4","year":"2006","journal-title":"Avon)."},{"key":"2024020318581891500_jbmr2015-bib-0033","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2106\/00004623-198466030-00012","article-title":"Regulation of bone formation by applied dynamic loads","volume":"66","author":"Rubin","year":"1984","journal-title":"J Bone Joint Surg Am."},{"key":"2024020318581891500_jbmr2015-bib-0034","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1016\/j.jbiomech.2010.03.046","article-title":"Loading of the knee joint during activities of daily living measured in vivo in five subjects","volume":"43","author":"Kutzner","year":"2010","journal-title":"J Biomech."},{"key":"2024020318581891500_jbmr2015-bib-0035","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1249\/MSS.0b013e31817ed272","article-title":"Risk factors and mechanisms of knee injury in runners","volume":"40","author":"Messier","year":"2008","journal-title":"Med Sci Sports Exerc."},{"key":"2024020318581891500_jbmr2015-bib-0036","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S8756-3282(98)00118-5","article-title":"Three rules for bone adaptation to mechanical stimuli","volume":"23","author":"Turner","year":"1998","journal-title":"Bone."},{"key":"2024020318581891500_jbmr2015-bib-0037","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S8756-3282(01)00574-9","article-title":"Mineral mass, size, and estimated mechanical strength of triple jumpers' lower limb","volume":"29","author":"Heinonen","year":"2001","journal-title":"Bone."},{"key":"2024020318581891500_jbmr2015-bib-0038","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/j.1469-7580.2006.00546.x","article-title":"The effects of exercise on human articular cartilage","volume":"208","author":"Eckstein","year":"2006","journal-title":"J Anat."},{"key":"2024020318581891500_jbmr2015-bib-0039","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1159\/000289816","article-title":"Effects of exercise intervention on knee morphology in middle-aged women: a longitudinal analysis using magnetic resonance imaging","volume":"192","author":"Cotofana","year":"2010","journal-title":"Cells Tissues Organs."},{"key":"2024020318581891500_jbmr2015-bib-0040","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/00003086-199210000-00046","article-title":"Articular cartilage thickness and glycosaminoglycan distribution in the canine knee joint after strenuous running exercise","volume":"283","author":"Kiviranta","year":"1992","journal-title":"Clin Orthop Relat Res."},{"key":"2024020318581891500_jbmr2015-bib-0041","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1136\/ard.55.4.253","article-title":"Decreased birefringence of the superficial zone collagen network in the canine knee (stifle) articular cartilage after long distance running training, detected by quantitative polarised light microscopy","volume":"55","author":"Arokoski","year":"1996","journal-title":"Ann Rheum Dis."},{"key":"2024020318581891500_jbmr2015-bib-0042","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/j.joca.2010.10.007","article-title":"Functional adaptation of knee cartilage in asymptomatic female novice runners compared to sedentary controls. A longitudinal analysis using delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC)","volume":"18","author":"Van Ginckel","year":"2010","journal-title":"Osteoarthritis Cartilage."},{"key":"2024020318581891500_jbmr2015-bib-0043","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1097\/01.BRS.0000065484.95996.AF","article-title":"Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in the Cochrane collaboration back review group","volume":"28","author":"van Tulder","year":"2003","journal-title":"Spine."},{"key":"2024020318581891500_jbmr2015-bib-0044","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/mrm.10389","article-title":"Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis","volume":"49","author":"Tiderius","year":"2003","journal-title":"Magn Reson Med."},{"key":"2024020318581891500_jbmr2015-bib-0045","doi-asserted-by":"crossref","first-page":"3528","DOI":"10.1002\/art.21388","article-title":"Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: findings at different radiographic stages of disease and relationship to malalignment","volume":"52","author":"Williams","year":"2005","journal-title":"Arthritis Rheum."}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjbmr.2015","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/29\/1\/192\/56565852\/jbmr2015.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/29\/1\/192\/56565852\/jbmr2015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T10:49:50Z","timestamp":1710326990000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/29\/1\/192-201\/7598959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,15]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2013,6,15]]},"published-print":{"date-parts":[[2014,1,1]]}},"URL":"https:\/\/doi.org\/10.1002\/jbmr.2015","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718026361.793482018","asserted-by":"object"}]},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2014,1,1]]},"published":{"date-parts":[[2013,6,15]]}}}