High Impact Physical Activity and Bone Health of Lower Extremities in Childhood Cancer Survivors: A Cross-sectional Study of SURfit.

Zürcher, Simeon J; Jung, Ruedi; Monnerat, Sophie; Schindera, Christina; Eser, Prisca; Meier, Christian; Rueegg, Corina S; von der Weid, Nicolas X; Kriemler, Susi (2020). High Impact Physical Activity and Bone Health of Lower Extremities in Childhood Cancer Survivors: A Cross-sectional Study of SURfit. International journal of cancer, 147(7), pp. 1845-1854. Wiley-Blackwell 10.1002/ijc.32963

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Childhood cancer survivors (CCS) are at risk of reduced bone health and premature osteoporosis. As physical activity with high impact loading (IL-PA) is known to promote bone health, we compared bone densitometry and microstructure between groups of CCS who performed different amounts of physical activities in their daily life. We used baseline data of a single-centre PA trial including 161 CCS from the Swiss Childhood Cancer Registry, aged <16 at diagnosis, ≥16 at study, and ≥ 5 years since diagnosis. Lower body bone health was assessed with peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA). Daily IL-PA (duration in activities >2 g acceleration and numbers of vertical impacts/h > 2 g) was captured using hip-worn accelerometers (1-3 weeks). For both IL-PA approaches, we formed low, middle, and high activity groups based on tertiles. Bone health of the high and middle active groups were compared to the low active group. 63% of CCS had indication of at least one bone mineral density z-score ≤ -1 measured by pQCT or DXA. The high IL-PA group performing 2.8 min/day or 19.1 impact peaks/h > 2 g (median) showed about 3-13% better microstructural and densitometric bone health as compared to the low IL-PA group with 0.38 min/day or 0.85 peaks/h > 2 g. Just a few minutes and repetitions of high IL-PA as easily modifiable lifestyle factor may be sufficient to improve bone health in adult CCS. Future longitudinal research is needed to better understand pattern and dosage of minimal impact loading needed to strengthen bone in growing and adult CCS. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Schindera, Christina, Eser, Prisca Christina


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services








Andrea Flükiger-Flückiger

Date Deposited:

18 Mar 2020 11:59

Last Modified:

02 Mar 2023 23:33

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

DXA accelerometry bone bone health bone mineral density childhood cancer survivors densitometry high impact load pQCT physical activity





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