{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T05:03:43Z","timestamp":1791090223901,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[1998,2,1]],"date-time":"1998-02-01T00:00:00Z","timestamp":886291200000},"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":[[1998,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>High peak bone mass in early adulthood is an important protective factor against osteoporotic fractures in later life, but little is known about the effects of exercise on growing bone. The purpose of this cross-sectional study was to determine at which state of maturity (Tanner stage), the areal bone mineral density (BMD) differences between the playing and nonplaying arms of junior tennis players become obvious, and to clarify in each developmental stage which training and background variables, if any, could explain the interindividual differences in bones' response to mechanical loading. Ninety-one 7- to 17-year-old female tennis players and 58 healthy female controls were measured. In each Tanner stage, differences in BMD in playing and nonplaying (dominant and nondominant) arms (proximal humerus, humeral shaft, and distal radius) and BMD of the lumbar spine and nondominant distal radius were compared between the controls and players. Within each Tanner stage of players, the associations between training and background variables and BMD differences were analyzed with Spearman rank correlation coefficients. In players, BMD differences between the playing and nonplaying arms were significant (P &amp;lt; 0.05\u2013 &amp;lt; 0.001) in all Tanner stages, with the mean difference ranging from 1.6 to 15.7%. In controls, these dominant-to-nondominant arm differences were clearly smaller (ranging from \u22120.2 to 4.6%), but significant at some measured sites. In comparison with the relative side-to-side arm differences between the players and controls (i.e., examination of the training effect), the mean difference was not obvious and significant until the adolescent growth spurt (i.e., the girls in Tanner stage III with a mean age of 12.6 years). In the lumbar spine, significant BMD differences between players and controls were not found until Tanner stage IV (mean age 13.5 years; 8.7%, P &amp;lt; 0.05) and V (mean age 15.5 years; 12.4%, P &amp;lt; 0.05). In a nonloaded site of the skeleton (nondominant distal radius), no significant BMD differences were found between the players and controls in any Tanner stage. In the correlation analysis, the Tanner I and II players (mean ages 9.4 and 10.8 years) showed no significant associations between any of the predictive variables and the side-to-side BMD differences, while in Tanner stages III, IV, and V, such associations could be found; the total amount of training hours during the playing career and the number of training sessions per week showed a significant and systematic correlation (rs ranging from 0.43 to 0.80) with the side-to-side BMD differences in several measured bone sites. In conclusion, this study suggests that in a majority of female junior tennis players, the benefit of unilateral activity on bone density does not become clearly evident until the adolescent growth spurt or Tanner stage III. The total amount of training during the player's career and the current training frequency (sessions per week) seem to best explain the training effect on bone tissue, leaving, however, room for speculation on the still unknown factors that modulate the loading response of a growing bone.<\/jats:p>","DOI":"10.1359\/jbmr.1998.13.2.310","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T00:17:25Z","timestamp":1146097045000},"page":"310-319","source":"Crossref","is-referenced-by-count":233,"title":["Effect of Long-Term Unilateral Activity on Bone Mineral Density of Female Junior Tennis Players"],"prefix":"10.1093","volume":"13","author":[{"given":"Heidi","family":"Haapasalo","sequence":"first","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"Kannus","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Siev\u00e4nen","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Pasanen","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsti","family":"Uusi-Rasi","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"Oja","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkka","family":"Vuori","sequence":"additional","affiliation":[{"name":"Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2009,12,4]]},"reference":[{"key":"2024020713325238800_bib1","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1007\/BF01623435","article-title":"Peak bone mass, bone loss and risk of fracture","volume":"1","author":"Johnston","year":"1994","journal-title":"Osteoporos Int"},{"key":"2024020713325238800_bib2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jbmr.5650080102","article-title":"Heritable and lifestyle determinants of bone mineral density","volume":"8","author":"Krall","year":"1993","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib3","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/bmj.309.6949.230","article-title":"Exercise, smoking, and calcium intake during adolescence and early adulthood as determinants of peak bone mass","volume":"309","author":"V\u00e4lim\u00e4ki","year":"1994","journal-title":"Br Med J"},{"key":"2024020713325238800_bib4","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1002\/jbmr.5650100903","article-title":"Vitamin D receptor gene alleles and osteoporosis: An affirmative view","volume":"10","author":"Eisman","year":"1995","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1002\/jbmr.5650100308","article-title":"Bone density in young women is associated with body weight and muscle strength but not dietary intakes","volume":"10","author":"Henderson","year":"1995","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib6","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1210\/jcem-73-3-555","article-title":"Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence","volume":"73","author":"Bonjour","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"2024020713325238800_bib7","first-page":"1060","article-title":"Longitudinal monitoring of bone mass accumulation in healthy adolescents: Evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects","volume":"75","author":"Theinz","year":"1992","journal-title":"J Clin Endocrinol Metab"},{"key":"2024020713325238800_bib8","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1172\/JCI117034","article-title":"Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis","volume":"93","author":"Matkovic","year":"1994","journal-title":"J Clin Invest"},{"key":"2024020713325238800_bib9","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1002\/jbmr.5650111119","article-title":"Development of mass, density, and estimated mechanical characteristics of bones in Caucasian females","volume":"11","author":"Haapasalo","year":"1996","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib10","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1002\/jbmr.5650090520","article-title":"Reduced femoral neck bone density in the daughters of women with hip fractures: The role of low peak bone density in the pathogenesis of osteoporosis","volume":"9","author":"Seeman","year":"1994","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib11","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1651-2227.1995.tb13857.x","article-title":"Late consequences of a low peak bone mass","volume":"411","author":"Ribot","year":"1995","journal-title":"Acta Paediatr Suppl"},{"key":"2024020713325238800_bib12","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/8756-3282(96)00102-0","article-title":"Low peak bone mass and fast rate of bone loss at menopause. Equal risk factors for future fracture: A 15-year follow up study","volume":"19","author":"Riis","year":"1996","journal-title":"Bone"},{"key":"2024020713325238800_bib13","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1007\/BF01623431","article-title":"Optimizing peak bone mass: What are the therapeutic possibilities?","volume":"1","author":"Adami","year":"1994","journal-title":"Osteoporos Int"},{"key":"2024020713325238800_bib14","first-page":"179","article-title":"Bone density in athletes","volume":"77","author":"Nilsson","year":"1971","journal-title":"Clin Orthop"},{"key":"2024020713325238800_bib15","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/jor.1100020404","article-title":"Bone density in women: College athletes and older athletic women","volume":"2","author":"Jacobson","year":"1984","journal-title":"J Orthop Res"},{"key":"2024020713325238800_bib16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/8756-3282(95)00151-3","article-title":"Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton","volume":"17","author":"Heinonen","year":"1995","journal-title":"Bone"},{"key":"2024020713325238800_bib17","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.2106\/00004623-198668070-00018","article-title":"Effects of intense physical activity on the bone mineral content in the lower limbs of young adults","volume":"68A","author":"Margulies","year":"1986","journal-title":"J Bone Joint Surg"},{"key":"2024020713325238800_bib18","doi-asserted-by":"crossref","first-page":"824","DOI":"10.7326\/0003-4819-108-6-824","article-title":"Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women","volume":"108","author":"Dalsky","year":"1988","journal-title":"Ann Intern Med"},{"key":"2024020713325238800_bib19","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":"2024020713325238800_bib20","doi-asserted-by":"crossref","first-page":"204","DOI":"10.2106\/00004623-197759020-00012","article-title":"Humeral hypertrophy in response to exercise","volume":"59A","author":"Jones","year":"1977","journal-title":"J Bone Joint Surg"},{"key":"2024020713325238800_bib21","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1001\/jama.1980.03310100025022","article-title":"Bone mass in lifetime tennis athletes","volume":"244","author":"Huddleston","year":"1980","journal-title":"JAMA"},{"key":"2024020713325238800_bib22","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/8756-3282(94)90289-5","article-title":"The site-specific effects of long-term unilateral activity on bone mineral density and content","volume":"15","author":"Kannus","year":"1994","journal-title":"Bone"},{"key":"2024020713325238800_bib23","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1152\/jappl.1990.68.1.130","article-title":"Bone mechanical properties after exercise training in young and old rats","volume":"68","author":"Raab","year":"1990","journal-title":"J Appl Physiol"},{"key":"2024020713325238800_bib24","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1007\/BF00301627","article-title":"Suppression of the osteogenic response in the aging skeleton","volume":"50","author":"Rubin","year":"1992","journal-title":"Calcif Tissue Int"},{"key":"2024020713325238800_bib25","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0169-6009(08)80012-8","article-title":"Physical activity and bone mass: Exercises in futility?","volume":"21","author":"Forwood","year":"1993","journal-title":"Bone Miner"},{"key":"2024020713325238800_bib26","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1007\/BF01622201","article-title":"The two faces of growth: Benefits and risks to bone integrity","volume":"4","author":"Parfitt","year":"1994","journal-title":"Osteoporos Int"},{"key":"2024020713325238800_bib27","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/BF00295946","article-title":"Long-term unilateral loading and bone mineral density and content in female squash players","volume":"54","author":"Haapasalo","year":"1994","journal-title":"Calcif Tissue Int"},{"key":"2024020713325238800_bib28","doi-asserted-by":"crossref","first-page":"27","DOI":"10.7326\/0003-4819-123-1-199507010-00003","article-title":"Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players","volume":"123","author":"Kannus","year":"1995","journal-title":"Ann Intern Med"},{"key":"2024020713325238800_bib29","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0169-6009(08)80021-9","article-title":"High intensity activities in young women: Site specific bone mass effects among female figure skaters","volume":"20","author":"Slemenda","year":"1993","journal-title":"Bone Miner"},{"key":"2024020713325238800_bib30","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/jech.49.3.299","article-title":"Physical activity, calcium intake, and bone mineral content in children in the Netherlands","volume":"49","author":"VandenBergh","year":"1995","journal-title":"J Epidemiol Community Health"},{"key":"2024020713325238800_bib31","first-page":"122","article-title":"Estimation of calcium and riboflavin intake by a short diary","volume":"38","author":"Uusi-Rasi","year":"1994","journal-title":"Scand J Nutr"},{"key":"2024020713325238800_bib32","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF02088471","article-title":"Validation of a self-administered instrument to assess stage of adolescent development","volume":"9","author":"Morris","year":"1980","journal-title":"J Youth Adolesc"},{"key":"2024020713325238800_bib33","doi-asserted-by":"crossref","first-page":"S17","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":"2024020713325238800_bib34","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0169-6009(08)80004-9","article-title":"Precision of dual-energy x-ray absorptiometry in the upper extremities","volume":"20","author":"Siev\u00e4nen","year":"1993","journal-title":"Bone Miner"},{"key":"2024020713325238800_bib35","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1056\/NEJM198408023110501","article-title":"Bone mineral content of amennorrheic and eumenorrheic athletes","volume":"311","author":"Drinkwater","year":"1984","journal-title":"N Engl J Med"},{"key":"2024020713325238800_bib36","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1249\/00005768-199310000-00004","article-title":"Bone mineral density in elite junior olympic weightlifters","volume":"25","author":"Conroy","year":"1993","journal-title":"Med Sci Sports Exerc"},{"key":"2024020713325238800_bib37","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1249\/00005768-199410000-00007","article-title":"The effects of gymnastics training on bone mineral density","volume":"26","author":"Nichols","year":"1994","journal-title":"Med Sci Sports Exerc"},{"key":"2024020713325238800_bib38","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1002\/jbmr.5650110918","article-title":"The effect of weight-bearing exercise on bone mineral density: A study of female ex-elite athletes and the general population","volume":"11","author":"Etherington","year":"1996","journal-title":"J Bone Miner Res"},{"key":"2024020713325238800_bib39","first-page":"245","volume-title":"Bone Mechanics","author":"Meade","year":"1991"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1359%2Fjbmr.1998.13.2.310","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/13\/2\/310\/56598878\/5650130219.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/13\/2\/310\/56598878\/5650130219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T14:56:15Z","timestamp":1710341775000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/13\/2\/310-319\/7514570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,2,1]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2009,12,4]]},"published-print":{"date-parts":[[1998,2,1]]}},"URL":"https:\/\/doi.org\/10.1359\/jbmr.1998.13.2.310","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1998,2,1]]},"published":{"date-parts":[[1998,2,1]]}}}