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Osteologie 2023; 32(03): 176-182
DOI: 10.1055/a-2057-0273
Review

(Trainings-)Methodische Empfehlungen eines körperlichen Trainings zur Verbesserung der Knochenfestigkeit

Belastungskomponenten und KnochenfestigkeitRecommendations on exercise methods for bone strengthening
Simon von Stengel
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
,
Matthias Kohl
2   Department of Medical and Life Sciences, Hochschule Furtwangen - Campus Villingen-Schwenningen, Villingen-Schwenningen, Deutschland
,
Franz Jakob
3   Bernhard-Heine-Centrum für Bewegungsforschung, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
,
Katharina Kerschan-Schindl
4   Physikalische Medizin und Rehabilitation, Universität Wien, Wien, Österreich
,
Uwe Lange
5   Physikalische Medizin und Osteologie, Kerckhoff-Klinik GmbH, Bad Nauheim, Deutschland
,
Stefan Peters
6   Deutscher Verband für Gesundheitssport und Sporttherapie e.V., Erlangen, Deutschland
,
Friederike Thomasius
7   Frankfurter Hormon- und Osteoporosezentrum, Frankfurt, Deutschland
,
Michael Uder
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
,
Mahdieh Shojaa
8   Institute of Health Science, Universitätsklinikum Tübingen, Tübingen, Deutschland
,
Wolfgang Kemmler 
1   Institut für Radiologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
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Zusammenfassung

Die Belastungskomponenten bestimmen die Ausrichtung der Trainingsreize und sind somit maßgebend für die Wirkung eines Trainingsprotokolls auf die Knochenfestigkeit. In Anlehnung an die klassische Trainingswissenschaft ist eine Klassifizierung der Belastungskomponenten in Reizhöhe („strain-magnitude“), Reizrate („strain-rate“), Wiederholungsanzahl („cycle number“), Reizdauer, Reizfrequenz, Reizdichte und Trainingshäufigkeit nachvollziehbar und anwendbar. Zusammenfassend weisen intensitätsorientierte Trainingsprogramme, die mit hoher Reizhöhe und -rate und kurzer Reizdauer im dynamischen Modus mindestens zweimal/Woche appliziert werden, die höchste osteoanabole Potenz auf. Die Anzahl der Wiederholungen spielt bei der Anwendung hoher Reizintensitäten eine geringe Rolle. Reizintensitäten im Grenzbereich oder (leicht) unter der mechanischen Reizschwelle können möglicherweise über eine Erhöhung der Wiederholungsanzahl auf ein überschwelliges Niveau angehoben werden. Ähnliches gilt für die Reizfrequenz im Spektrum der willkürlichen Aktivierung (<5 Hz). Die Reizdichte bezieht ihre Relevanz aus der Desensibilisierungsproblematik des Knochens nach häufiger überschwelliger Reizsetzung. Regelmäßige Entlastungsphasen zur Resensibilisierung des Knochengewebes können im Rahmen blockperiodisierter Trainingsprogramme Raum für die Adressierung anderer relevanter Trainingsziele ohne relevante mechanische Belastung bieten.

Abstract

The optimum composition of strain parameters (or loading parameters) is crucial in designing exercise protocols with positive effects on bone strength and associated parameters. Although strain parameters related to bone adaption differ slightly from the common terminology usually applied in sport sciences, their categorization is very similar. Introducing strain parameters, (1) strain magnitude is characterized by the extent of the deformation of the bone caused by loading, while (2) strain rate represents the alteration in strain magnitude per second during the acceleration or deceleration of loading. (3) Training frequency and (4) cycle number indicate the amount of training sessions (usually per week) and the number of loading cycles/repetitions per set/session, while (5) strain duration is characterized by the length of a single loading cycle. (6) Strain frequency represents the number of loading cycles per sec (Hz) and finally (6) strain density characterizes the relationship between loading and rest periods with respect to single loading cycles, sets of cycles, training sessions or training periods (mesocycles). In summary, exercise programs applied with high strain magnitude and rate and a short cycle duration in a dynamic mode at least twice/week showed the highest osteoanabolic potency. The number of repetitions plays a minor role, at least when high exercise intensity (high strain magnitude-/rate) was applied. However, there is some evidence that stimuli around or (slightly) below bone mechanical threshold can be raised to a supra-threshold level by increasing the number of repetitions. The same might also be the case for strain frequency in the spectrum of voluntary movements (<5 Hz). The relevance of strain density is closely related to the “desensitization phenomena” of bone after repeated intense loading. Applying regular resensitization periods without relevant mechanical loading between phases of intense bone specific exercise enables other important training aims to be addressed with high emphasis during the corresponding periods.

Schlüsselworte

Trainingsempfehlungen - Belastungskomponenten - Knochendichte - Osteoporose - Reizintensität

Key words

exercise recommendation - strain parameters - bone mineral density - osteoporosis - exercise intensity


Publication History

Received: 22 February 2023

Accepted: 16 March 2023

Article published online:
19 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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