Associations of accelerometer-estimated free-living daily activity impact intensities with 10-year probability of osteoporotic fractures in adults

Aleksi Leviäkangas; Raija Korpelainen; Pekka Pinola; Jonatan Fridolfsson; Laura Nauha; Timo Jämsä; Vahid Farrahi

doi:10.1016/j.gaitpost.2024.05.002

Associations of accelerometer-estimated free-living daily activity impact intensities with 10-year probability of osteoporotic fractures in adults

Gait Posture. 2024 May 5:112:22-32. doi: 10.1016/j.gaitpost.2024.05.002. Online ahead of print.

Authors

Aleksi Leviäkangas¹, Raija Korpelainen², Pekka Pinola³, Jonatan Fridolfsson⁴, Laura Nauha⁵, Timo Jämsä⁶, Vahid Farrahi⁷

Affiliations

¹ Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
² Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Oulu Deaconess Institute Foundation sr., Department of Sports and Exercise Medicine, Finland.
³ Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
⁴ Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.
⁵ Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland; Oulu Deaconess Institute Foundation sr., Department of Sports and Exercise Medicine, Finland.
⁶ Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁷ Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Institute for Sport and Sport Science, Division of Data Analytics, TU Dortmund University, Dortmund, Germany. Electronic address: Vahid.Farrahi@tu-dortmund.de.

PMID: 38723392
DOI: 10.1016/j.gaitpost.2024.05.002

Abstract

Purpose: Accelerometers are used to objectively measure physical activity; however, the relationship between accelerometer-based activity parameters and bone health is not well understood. This study examines the association between accelerometer-estimated daily activity impact intensities and future risk estimates of major osteoporotic fractures in a large population-based cohort.

Methods: Participants were 3165 adults 46 years of age from the Northern Finland Birth Cohort 1966 who agreed to wear a hip-worn accelerometer during all waking hours for 14 consecutive days. Raw accelerometer data were converted to resultant acceleration. Impact magnitude peaks were extracted and divided into 32 intensity bands, and the osteogenic index (OI) was calculated to assess the osteogenic effectiveness of various activities. Additionally, the impact peaks were categorized into three separate impact intensity categories (low, medium, and high). The 10-year probabilities of hip and all major osteoporotic fractures were estimated with FRAX-tool using clinical and questionnaire data in combination with body mass index collected at the age of 46 years. The associations of daily activity impact intensities with 10-year fracture probabilities were examined using three statistical approaches: multiple linear regression, partial correlation, and partial least squares (PLS) regression.

Results: On average, participants' various levels of impact were 8331 (SD = 3478) low; 2032 (1248) medium; and 1295 (1468) high impacts per day. All three statistical approaches found a significant positive association between the daily number of low-intensity impacts and 10-year probability of hip and all major osteoporotic fractures. In contrast, increased number of moderate to very high daily activity impacts was associated with a lower probability of future osteoporotic fractures. A higher OI was also associated with a lower probability of future major osteoporotic fractures.

Conclusion: Low-intensity impacts might not be sufficient for reducing fracture risk in middle-aged adults, while high-intensity impacts could be beneficial for preventing major osteoporotic fractures.

Keywords: Accelerometry; Bone health; Impact exercise; Movement behavior; Osteoporotic fractures; Physical activity.