Duckham2012 - risk factors.pdf (220.79 kB)
Download fileRisk factors for stress fracture in female endurance athletes: a cross-sectional study
journal contribution
posted on 14.08.2014, 12:06 authored by Rachel Duckham, Nicholas Peirce, Caroline Meyer, Gregory D. Summers, Noel Cameron, Katherine Brooke-WavellKatherine Brooke-WavellObjective: To identify psychological and physiological
correlates of stress fracture in female endurance
athletes.
Design: A cross-sectional design was used with a
history of stress fractures and potential risk factors
assessed at one visit.
Methods: Female-endurance athletes (58 runners and
12 triathletes) aged 26.0±7.4 years completed
questionnaires on stress fracture history, menstrual
history, athletic training, eating psychopathology and
exercise cognitions. Bone mineral density, body fat
content and lower leg lean tissue mass (LLLTM) were
assessed using dual-x-ray absorptiometry. Variables
were compared between athletes with a history of
stress fracture (SF) and those without (controls; C)
using χ², analysis of variance and Mann-Whitney
U tests.
Results: Nineteen (27%) athletes had previously been
clinically diagnosed with SFs. The prevalence of
current a/oligomenorrhoea and past amenorrhoea was
higher in SF than C (p=0.008 and p=0.035,
respectively). SF recorded higher global scores on the
eating disorder examination questionnaire (p=0.049)
and compulsive exercise test (p=0.006) and had higher
LLLTM (p=0.029) compared to C. These findings
persisted with weight and height as covariates. In
multivariate logistic regression, compulsive exercise,
amenorrhoea and LLLTM were significant independent
predictors of SF history (p=0.006, 0.009 and 0.035,
respectively).
Conclusions: Eating psychopathology was associated
with increased risk of SF in endurance athletes, but
this may be mediated by menstrual dysfunction and
compulsive exercise. Compulsive exercise, as well as
amenorrhoea, is independently related to SF risk.
Funding
This research was funded by Loughborough University School of Sport, Exercise and Health Sciences and East Midlands Universities Association.
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