Author Identifiers

Mark Jenkins

ORCID ID: 0000-0003-4542-1768

Date of Award

2018

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

School of Medical and Health Sciences

First Advisor

Associate Professor Sophia Nimphius

Second Advisor

Dr Nicolas Hart

Third Advisor

Dr Paola Chivers

Fourth Advisor

Dr Timo Rantalainen

Fifth Advisor

Professor Robert Newton

Field of Research Code

1103, 1106

Abstract

This research encompasses four studies exploring bone adaptation, fracture incidence, and preventative measures to decrease fracture risk and increase bone health. Study one was a clinical audit exploring incidence rates for appendicular fractures in children in Western Australia over ten years. Diagnostic and remedial approaches were explored in studies two, three and four by examining the between-day reliability of upper limb scans; reliability of the osteogenic index (OI) for upper-body strength and power exercises; and the diagnostic value or utility of using pQCT in disease profiling, respectively. Fracture rates in the limbs of children were found to be increasing each year, particularly in the forearm, and regardless of gender, between 2005 and 2015, similar to international trend data. pQCT was established as a reliable tool for quantifying upper limb diaphyseal measurements. The OI had varying reliability depending on the equation used, exercise type and exercise intensity when measured using accelerometers at multiple locations. Lastly, paediatric populations with low motor competence and/or neuromuscular disorders were disease profiles which had a measurably negative influence on bone when compared to unaffected controls. The increase in fracture incidence in Western Australia is a concerning trend for bone health in children and adolescents that requires lifestyle and population-based interventions to arrest this incremental problem. pQCT may be a valuable tool for disease profiling with area measurements for bone and some muscle variables more reliable than volumetric measurements in the upper limbs. The OI is a more reliable tool when measuring strength exercises than power exercises; and individuals with a greater risk of weaker bones should apply more daily load to increase their overall bone health. Interventions should be put into place to rehabilitate individuals with already weaker bones, such as targeted and well-designed exercise programs supported by good nutritional practices.

Access Note

Last 2 appendices (news stories) are not included in this version of the thesis.

Available for download on Saturday, October 19, 2019

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