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Title: Risk factors for stress fracture in female endurance athletes: a cross-sectional study
Authors: Duckham, Rachel
Peirce, Nicholas
Meyer, Caroline
Summers, Gregory D.
Cameron, Noel
Brooke-Wavell, Katherine S.F.
Issue Date: 2012
Publisher: BMJ Publishing Group (© The authors)
Citation: DUCKHAM, R. ... et al., 2012. Risk factors for stress fracture in female endurance athletes: a cross-sectional study. BMJ Open, 2, e001920, 7pp.
Abstract: Objective: 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.
Description: This article was published in BMJ Open following peer review and can also be viewed on the journal’s website at http://bmjopen.bmj.com. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
Sponsor: This research was funded by Loughborough University School of Sport, Exercise and Health Sciences and East Midlands Universities Association.
Version: Published
DOI: 10.1136/bmjopen-2012-001920
URI: https://dspace.lboro.ac.uk/2134/15543
Publisher Link: http://dx.doi.org/10.1136/bmjopen-2012-001920
ISSN: 2044-6055
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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