1. 1 Long-term rugby practice enhances bone mass and metabolism in relation with physical fitness and playing position Mohamed Elloumi, Omar Ben Ounis, Daniel Courteix, Emna Makni, Saleheddine Sellami, Zouhair Tabka, Ge´rard Lac J Bone Miner Metab (2009) 27:713 – 720

2. 2 Introduction Physical activity is known to induce modifications to bone mass and architecture. - Groothausen J,et al. (1997). The beneficial effects of physical activity on bone mineral accrual are dependent on the type of activity. - - Rubin CT, Lanyon LE (1985)

3. 3 Rugby is a weight-bearing intermittent high- intensity exercise that includes a great number of impacts and manoeuvres. Rugby is a weight-bearing intermittent high- intensity exercise that includes a great number of impacts and manoeuvres. - Morel J, et al. (2001) In order to determine the types of sports that could lead to improved bone mineralisation, bone mineral density (BMD) and content (BMC) in participants in sports with different characteristics.

4. 4. We and others have reported increased BMD and BMC in male rugby players, particularly in forwards who are frequently engaged in physical contact. -M. Elloumi, et al -M. Elloumi, et al (2006) Previous studies have documented associations of total body muscle mass and related muscular strengths and physical fitness with total and regional BMC and BMD -Nevill A, Holder R, Stewart A (2004)

5. 5 Hypothesis (1) rugby participation could convey positive effects on bone mass and metabolic markers, osteocalcine and CTX. (1) rugby participation could convey positive effects on bone mass and metabolic markers, osteocalcine and CTX. (2) the extent to which BMD and BMC could be predicted from muscle mass, fitness and strength, and metabolic markers. (2) the extent to which BMD and BMC could be predicted from muscle mass, fitness and strength, and metabolic markers.

6. 6 Materials and methods From Tunisian national team. 22 rugby players(12 forward and 10 back players) 14 controls are students and young university teachers.

7. 7 Materials and methods

8. 8 Harpenden stadiometer (Height and weight) Harpenden stadiometer (Height and weight) Hologic QDR Delphi densitometer(BMD and BMC)→ pelvis, whole spine, and lower and upper limbs ( femur, femoral neck and lumber spine(L2 – L4). Hologic QDR Delphi densitometer(BMD and BMC)→ pelvis, whole spine, and lower and upper limbs ( femur, femoral neck and lumber spine(L2 – L4).

9. 9 Materials and methods Biochemical parameters Fasting blood samples were drawn between 7 and 9 a.m.. (Using IMRA )→osteocalcin(OC).(Using ELISA) A 24-h period of urine collection.(Using ELISA) → CTX) →Cross-linked C-telopeptides of Type I collagen (CTX)

10. 10 Materials and methods Physical performance testing Physical performance testing A) Squat jump (SJ) B) Counter movement jump (CMJ) C) hand grip (HG) The lower limbs maximal power (LLMP) was determined indirectly by the formula of Lewis. The lower limbs maximal power (LLMP) was determined indirectly by the formula of Lewis. HG strength was determined on Harpenden Dynamometer.

11. 11 Statistical analysis Statistical analysis Student ’ s unpaired t test use between different groups. Student ’ s unpaired t test use between different groups. Analysis of covariance (ANCOVA). Analysis of covariance (ANCOVA).

12. 12 Results

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15. 15 Discussion The effects of physical activity on bone mass and density have been widely documented. The effects of physical activity on bone mass and density have been widely documented. -Lima F, et al(2001) The present study demonstrated that both groups of rugby players exhibit higher total body BMD and BMC than those observed in controls. The present study demonstrated that both groups of rugby players exhibit higher total body BMD and BMC than those observed in controls. -Elloumi M,et al.(2006)

16. 16 Discussion In fact, sports like football, volleyball, or handball, which involve a large number of jumps, rapid directional changes, starts, stops, and landings, have been demonstrated to enhance BMC and BMD in young and adult athletes. In fact, sports like football, volleyball, or handball, which involve a large number of jumps, rapid directional changes, starts, stops, and landings, have been demonstrated to enhance BMC and BMD in young and adult athletes. -Vicente-Rodriguez G,et al.(2004) Although not assessed in this survey, as the players started to participate in rugby activity at a young age. Although not assessed in this survey, as the players started to participate in rugby activity at a young age. -Nebigh A, et al(2009)

17. 17 Discussion Skeletal tissue strength depends not only on BMD but also on bone content. The BMC is a combination of bone area and density. -Wittich A, etal(1998)

18. 18 The present study showed that the difference observed for BMD between both groups of rugby players (forwards and backs) and controls was more pronounced for BMC (+52% for lower limbs). The present study showed that the difference observed for BMD between both groups of rugby players (forwards and backs) and controls was more pronounced for BMC (+52% for lower limbs). -by table 2 -by table 2

19. 19 This is clearly demonstrated by higher BMD and BMC in whole spine (12 – 13%), pelvis (10 – 11%), and upper and lower limbs (9 – 18%) in forwards compared to back players. -by table 2 -by table 2 Because forwards participate in situations of contact and conflict. Because forwards participate in situations of contact and conflict.

20. 20 Scrum Ruck Maul Tackle

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22. 22 Maximal leg extension force was a major predictor of the skeleton quality in professional tennis players. Maximal leg extension force was a major predictor of the skeleton quality in professional tennis players. -Calbet et al. -Calbet et al. (1998)

23. 23 疑問 網球跟橄欖球相比，是相似類型的運動嗎 ? 網球跟橄欖球相比，是相似類型的運動嗎 ? 網球為單側型態的運動，慣用手與非慣用 手相差甚大，這樣是否比較起來會產生偏 差 ? 網球為單側型態的運動，慣用手與非慣用 手相差甚大，這樣是否比較起來會產生偏 差 ?

24. 24 Conclusion In conclusion, long-term rugby participation is associated with improvement of physical fitness, especially in forwards. In conclusion, long-term rugby participation is associated with improvement of physical fitness, especially in forwards.

25. 25 Thank you for your listening. your listening.