Qanun Medika Vol.
3 No.
Telaah Pustaka Telaah Pustaka Januari 2019 Physical Exercise and Bone Health Physical Exercise and Bone Health Meinar GadisGadis Meinar Sari Sari Physiology Department.
Faculty Medicine.
Universitas Airlangga Physiology Department.
Faculty of Medicine.
Universitas Airlangga Jl.
Prof.
Dr.
Moestopo 47.
Surabaya.
Jl.
Prof.
Dr.
Moestopo 47.
Surabaya.
Phone:Phone:
Submitted:
Desember 2018 Accepted:
Accepted:
Januari Published:
Januari Submitted:
Desember Januari Published:
Januari Submitted : Desember 2018
Accepted : Januari 2019 Published : Januari 2019
ABSTRACT
ABSTRACT
Exercise a planned and and in which there was Exercise in which therea was a movement or enhance one one or more of physical The physical on biological or enhance or more of physical The physical on biological as improving, but inbut it couldit also as improving, in certain alsoa give a as inhibiting or disturbing the level of individual, cell, and as inhibiting or disturbing the level of individual, and molecular.
Likewise the the of physical on bones, bone both and and Likewise of physical both positively negatively, among others.
the dose of physical exercise which included frequency, intensity, type and The Some The dosage of physical exercise was individual on each person.
Some studies found that on bones.
One ofOne on bones.
was affecting a had a process of proliferation and differentiation of osteoblast, which was one of bone cells Moderate function to form bone matrix.
Moderate intensity physical exercise combined with salmon calcitonin
Moderate-speed cause changes in IL-6in IL-6
Moderate-speed cause changes had had a role
in the of stem
cell differentiation into osteoprogenitor
and and a role
in process
the process
of stem
cell differentiation into osteoprogenitor
PTH
sub-acute directly affected adult osteoblasts, whereas changes in PTH serum levels in the sub-acute of phase of exercise played a role in the positive uncoupling process of bone remodeling directly.
exercise played a role in the positive uncoupling process of bone remodeling directly.
Keywords : moderate intensity physical exercise, bone health Keywords : moderate intensity physical exercise, bone health Correspondence to : gadis-m-s@fk.
Correspondence to : gadis-m-s@fk.
ABSTRAK
ABSTRAK
Olahraga adalah latihan fisik yang merupakan bagian dari aktivitas fisik yang terencana, terstruktur.
Olahraga adalah latihan fisik yang merupakan bagian dari aktivitas fisik yang terencana, terstruktur, terdapat repetisi gerakan, dan mempunyai tujuan mempertahankan atau meningkatkan salah satu atau terdapat repetisi gerakan, dan mempunyai tujuan mempertahankan atau meningkatkan salah satu atau lebih komponen kebugaran fisik.
Pengaruh latihan fisik terhadap fungsi biologis dapat memberi lebih komponen Pengaruh akan fisik pada positif yaitu bersifat fisik.
memberikan pengaruh negatif yaitu menghambat atau mengganggu baik pada tingkat individu, pula atau mengganggu sel maupun Demikian pengaruh latihan fisik terhadap baik sel maupun juga negatif, secara Demikian positif maupun lain fisik dosis latihan yang faktor fisik yang meliputi frekuensi, intensitas, jenis dan waktu melakukan latihan fisik.
Dosis latihan fisik bersifat dan waktu Dosis fisik bersifat setiap orang.
Beberapa Beberapa memberikan manfaat positif pada tulang.
Antara lain mempengaruhi proses proliferasi dan sedang manfaat yaitu Antara sel osteoblas sel tulang sel osteoblas salah satu seldengan tulang salmon yang berfungsi matriks tulang.
Latihan fisik intensitas akan meningkatkan Latihan kepadatan tulang tikus.
Latihan jalan dengan kecepatan sedang akan menyebabkan perubahan Latihan dengan kecepatan IL-6 serum yang pada proses stem cell secara kadar IL-6 serum yang berperan pada proses cell menjadi dan secara pada osteoblas sedangkan stem kadar PTH serum pada fase kadar langsung.
PTH serum pada fase berperan pada tulang secara subakut latihan berperan pada proses positive uncoupling remodeling tulang secara langsung.
Kata kunci : latihan fisik intensitas sedang, kesehatan tulang Korespondensi : gadis-m-s@fk.
INTRODUCTION
The increasing life demand nowadays causes an increase of workload.
therefore people are required to pay attention to their health in order Exercise is a planned and structured physical activity in which there is a movement repetition to maintain or enhance one or more components of physical fitness.
As well as drug administration, physical exercise also Kata kunci Korespondensi : latihan fisik intensitas sedang, kesehatan tulang : gadis-m-s@fk.
Qanun Medika Vol.
3 No.
INTRODUCTION
The increasing life demand nowadays causes an increase of workload.
therefore people are required to pay attention to their health in order to stay healthy and fit in the midst of their busy Many efforts have been done to maintain health such as consuming healthy foods, maintaining a resting pattern, and also doing exercise regularly.
Exercise is a planned and structured physical activity in which there is a movement repetition to maintain or enhance one or more components of physical fitness.
Physical exercise influences system functions of body including respiratory, cardiovascular, nervous and musculoskeletal systems.
The physical exercise on biological functions gives a positive effect such as improving, but in certain circumstances, it can also give a negative effect such as inhibiting or disturbing the level of individual, system, cell, and Likewise the effect of physical exercise on bone, recent research has revealed effects of physical exercise on bone health at the individual, system, cell and molecular levels.
Many factors affect bone both positively and negatively, among others.
the dose of physical exercise which includes frequency, intensity, type and time.
The dosage of physical exercise is individual that means each person has their own exercise dosage.
If physical exercise is carried out using the right dosage, it will give a positive effect, but on the contrary physical exercise that is carried out with high or exceeding dosage, it will give a negative effect
on organs or tissues functions, one of them is Januari 2019
DISCUSSION
Physical Exerise and Bone Metabolism Exercise is a planned and structured physical activity in which there is a movement repetition to maintain or enhance one or more components of physical fitness.
As well as drug administration, physical exercise also requires the right dosage for every human being in order to give a positive effect.
that is to fix or to improve organs function.
The dosage of physical exercise includes mild, moderate and high doses.
Calculation of physical exercise dosage is based on frequency, intensity, time and type of exercise.
Physical exercise affects the function of human cardiovascular, nervous and musculoskeletal Proper physical exercise will give a positive effect on bone metabolism.
Bone metabolism is a change of bone structure that occurs continuously throughout life including the process of resorption by osteoclasts and formation by bone osteoblasts.
Physical exercise encourages changes of bone metabolism through direct and indirect effects.
Direct effects are through mechanical force while indirect effects are through microenvironment including hormonal factors, cytokines, and vitamins.
Mechanical force applied to bone tissue forms endogenous signals captured by the mechanosensory system that will be captured by osteocytes and then transform into biochemical signals that regulate bone remodeling.
Mechanical force stimulates prostaglandin E2 (PGE.
release from gap junction.
PGE2 will bind receptors on osteocytes and stimulate protein formation that becomes bone matrix.
Physical exercise causes changes in the process of bone remodeling, whose response depends on exercise dosage (Rantalainen, 2.
The body has the ability to respond and adapt to the addition of physical exercise dosage, including frequency, intensity, time and type.
Qanun Medika Vol.
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Januari 2019 exercise stimulates growth hormone secretion (Growth Hormone.
GH), one of hormones that plays a role in bone growth.
Submaximal intensity physical exercise is a stressor that will stimulate the anterior pituitary to secrete GH.
GH will stimulate liver to produce Insulin-like Growth Factor-1 (IGF-.
which will improve the performance of osteoblast cells, while performance of osteoclast cells will decrease, thus bone formation will be higher than the process of bone resorption.
While the role of salmon calcitonin supports the process of bone-compaction.
Calcitonin works on bones through two pathways, first, in the short term that is reducing calcium transfer from bone to plasma by inhibiting osteoclast motility.
Second, it prevents the formation of new osteoclasts from osteoprogenitor cells.
Effects of Moderate Intensity Physical Exercise Many studies found that moderate intensity physical exercise can increase bone density.
Mahmudati .
showed that moderate intensity physical exercise can increase bone density through biological action of estrogen which involves estrogen receptor activity (ER).
Mechanical stimulation, in this case moderate intensity physical exercise, can activate ERK1/ 2 (Extracellular Signal Regulated Kinas.
Activation of ER and ERK1/ 2 will activate IGF-IR, thus affect the process of proliferation and differentiation of osteoblast cells, which is one of bone cells that have a function to form a bone matrix.
Other researchers have even described molecular level influences through stem cell Tinduh .
revealed that moderate-speed walking exercise is a form of osteogenic mechanical functional stimulation, which will cause changes in bone remodeling.
Activation of bone remodeling after moderate speed walking exercise mobilizes stem cells, osteoprogenitor cells in peripheral blood mononuclear cell (PBMC) which causes positive uncoupling of bone remodeling in postmenopausal women.
The role of moderate speed walking exercise also affects the dynamics of IL-6 and PTH serum which have specific patterns related to time dimension.
Changes of IL-6 serum levels in the sub-acute phase of exercise play a role in the process of stem cell differentiation into osteoprogenitor in PBMC and directly on adult osteoblasts, whereas changes of PTH serum levels in subacute phase of exercise play a role in positive uncoupling of bone remodeling directly.
Lesmana HS .
stated that submaximal physical exercise, a physical exercise with a moderate to high loading level, which is combined with salmon calcitonin increases bone density in growing white mice.
Physical Effects of High Intensity Physical Exercise Several studies have proven that high-intensity physical exercise has negative impacts especially on bone thus bone density becomes The administration of exercise dosage that exceeds threshold value of body's adaptability will be a stressor for the body.
High-intensity physical exercise will increase cortisol secretion, which is the main High glucocorticoid level can interfere body function balance resulting in pathological consequences, one of which is A study by Sari GM .
on white rats given high intensity swimming exercise.
loading of body weight in 90% of its maximum time that is carried out twice per set with a frequency of 3 times per week for 8 weeks, showed that there was a disturbance of bone It is due to an increase of glucocorticoid levels causing a decrease in osteoprotegerin levels, thereby increasing ctelopeptide levels.
Osteoprotegerin is a soluble decoy receptor released from stromal or osteoblast cells that has a binding effect on Qanun Medika Vol.
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RANK, thus it can inhibit RANKL-RANK interactions to increase osteoclastogenesis.
Glucocorticoids suppress OPG mRNA expression especially in human osteoblasts and osteoblast cell lines, inhibit OPG production, and increase production of RANKL On the other hand, an increase of glucocorticoid levels will cause a decrease of osteocalcin levels that is not through the osteoblast apoptotic pathway.
Increased ctelopeptide level and decreased osteocalcin level will increase the ratio of c-telopeptide/ osteocalcin so that there is an imbalance or disruption of bone remodeling in negative The pathway that has more role in the disruption of bone remodeling due to high intensity physical exercise is the pathway for decreasing osteoprotegerin levels which increasing c-telopeptide levels.
This study shows that exercise with improper dosage will give adverse effects on body such as disruption of organs or tissue.
This is a warning for us or all sport lovers to do sports according to the ability of our body or individual dosage.
A study by Sari GM .
on white mice showed that there was an increase in apoptosis of bone lining cells in group treated by high-dosage of glucocorticoid rather than moderate-dosage or untreated controlled group, as shown in Figure 1, 2, and This basic study illustrates that excessive glucocorticoids in the body can also occur in sportsmen/ athlete with high intensity physical activity, can cause apoptosis of lining cells that is osteoblast reserve cells originating from mesenchymal stem cells.
Januari 2019 Figure 1: Bone lining cells in controlled group (Sari GM, 2.
Figure 2: Apoptotic bone lining cells in moderate-dosage of glucocorticoids group (Sari GM, 2.
Figure 3: Apoptotic bone lining high-dosage glucocorticoids group (Sari GM.
Osteoblasts are bone-forming cells that secrete organic matrix including collagen as determining material of bone density.
osteoblasts are reduced even if lining cells as reserve cells has increased apoptosis, the process of bone formation will decrease resulting fracture risks.
Other researcher stated that glucocorticoids affect bone damage Qanun Medika Vol.
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through fat embolism.
vascular tamponade in caput femoral vein.
Manipulation will not be able to repair cells if there is a damage or Likewise in bone, if the bone lining cells, reserve cells ('resting cells of osteoblasts'), are reduced due to an increase of apoptosis process, the bone formation process will decrease with decreasing bone density that causes fracture risk.
Januari 2019 Choi Y, 2007.
Osteoimmunology.
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Galli C, 2008.
Targeted Deletion of a Distant Transcriptional Enhancer of the Receptor Activator of Nuclear FactorB Ligand Gene Reduces Bone Remodeling and Increases Bone Mass.
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Gleeson M, 2007.
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Textbook of Medical Physiology Philadelphia: Elsevier Inc, pp 987990.
Ishikawa, 1997.
Principles of Bone Biology 3th ed.
Elsevier, 2008.
CONCLUSION
The research that has been done can be a warning to the importance of the concept of exercise dosage control for health.
Everyone or athlete has different abilities that cannot be forced or generalized.
This fact is often overlooked because of the demands of target.
Therefore, exercise dosage arrangements need to be examined individually and put it in the best effort in order not to cause a counterproductive situation toward added value expected from physical exercise.
REFERENCES