Role of intensive training in the growth and maturation of artistic gymnasts

Sports Medicine

Volumn 43, Issue 9, 2013, Pages 783-802

  Malina, Robert M ^a,b,m   Baxter Jones, Adam D G ^c   Armstrong, Neil ^d   Beunen, Gaston P ^e   Caine, Dennis ^f   Daly, Robin M ^g   Lewis, Richard D ^h,i   Rogol, Alan D ^j,k   Russell, Keith ^c,l  

^a UNIVERSITY OF TEXAS AT AUSTIN   (United States)

^b TARLETON STATE UNIVERSITY   (United States)

^c UNIVERSITY OF SASKATCHEWAN   (Canada)

^d UNIVERSITY OF EXETER   (United Kingdom)

^e UNIVERSITY OF LEUVEN   (Belgium)

^f UNIVERSITY OF NORTH DAKOTA   (United States)

^g DEAKIN UNIVERSITY   (Australia)

^h UNIVERSITY OF GEORGIA   (United States)

ⁱ UNIVERSITY OF GEORGIA   (United States)

^j INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

^k UNIVERSITY OF VIRGINIA   (United States)

^l Federation Internationale de Gymnastique (FIG)   (Switzerland)

^m not available   (United States)

more..

Author keywords

[No Author keywords available]

Indexed keywords

HORMONE;

ADOLESCENT; ADOLESCENT DEVELOPMENT; BLOOD; BODY HEIGHT; BODY WEIGHT; CHILD; CHILD DEVELOPMENT; EXERCISE; FEMALE; GROWTH, DEVELOPMENT AND AGING; HUMAN; LEG; MALE; NUTRITIONAL STATUS; PHYSICAL EDUCATION; PHYSIOLOGY; PUBERTY; SEXUAL MATURATION; TRUNK; REVIEW;

ADOLESCENT; ADOLESCENT DEVELOPMENT; BODY HEIGHT; BODY WEIGHT; CHILD; CHILD DEVELOPMENT; FEMALE; GYMNASTICS; HORMONES; HUMANS; LOWER EXTREMITY; MALE; NUTRITIONAL STATUS; PHYSICAL CONDITIONING, HUMAN; PHYSICAL EXERTION; PUBERTY; SEXUAL MATURATION; TORSO;

EID: 84883228691     PISSN: 01121642     EISSN: 11792035     Source Type: Journal    
DOI: 10.1007/s40279-013-0058-5     Document Type: Review

References (127)

1. Malina RM. Physical growth and biological maturation of young athletes. Exerc Sport Sci Rev. 1994;22:389-433.
2. Malina RM. Growth and maturation of elite female gymnasts: is training a factor? In: Zemel B, Eveleth PB, Johnston FE, editors. Human growth in context. London: Smith-Gordon; 1999. p. 291-301.
3. Beunen GP, Malina RM, Thomis M. Physical growth and maturation of female gymnasts. In: Johnston FE, Zemel B, Eveleth PB, editors. Human growth in context. London: Smith-Gordon; 1999. p. 281-9.
4. Claessens AL. Elite female gymnasts: a kinanthropometric overview. In: Johnston FE, Zemel B, Eveleth PB, editors. Human growth in context. London: Smith-Gordon; 1999. p. 273-80.
5. Malina RM, Bouchard C, Bar-Or O. Growth, maturation, and physical activity. 2nd ed. Champaign: Human Kinetics; 2004.
6. Claessens AL. Growth and maturity status of elite female gymnasts: state of the art. In: Proceedings of the 10th sport kinetics conference (lecture), Belgrade; 2007.
7. Official Website of the Beijing 2008 Olympic Games. Female artistic gymnasts; 2008. http://en.beijing2008.cn/ (Accessed 26 Feb 2009).
8. Ziemilska A. Wpływ Intensywnego Treningu Gimnastycznego na Rozwój Somatyczny i Dojrzewanie Dzieci. Warsaw: Akademia Wychowania Fizycznego; 1981.
9. Ziemilska A. Effects of intensive gymnastics training on growth and maturation of children. Biol Sport. 1985;8:279-94.
10. Jost-Relyveld A, Sempé M. Analyse de la croissance et de la maturation squelettique de 80 jeunes gymnastes internationaux. Pediatrie. 1982;37:247-62.
11. Jahreis G, Kauf E, Frohner G, et al. Influence of intensive exercise on insulin-like growth factor I, thyroid and steroid hormones in female gymnasts. Growth Regul. 1991;1:95-9.
12. Theintz GE, Howald H, Weiss U, et al. Evidence for a reduction of growth potential in adolescent female gymnasts. J Pediatr. 1993;122:306-13.
13. Lindholm C, Hagenfeldt K, Ringertz B-M. Pubertal development in elite juvenile gymnasts: effects of physical training. Acta Obstet Gynecol Scand. 1994;73:269-73.
14. Tofler IR, Stryer BK, Micheli LJ, Herman LR. Physical and emotional problems of elite female gymnasts. N Eng J Med. 1996;335:281-3.
15. Georgopolous NA, Markou KB, Theodoropoulou A, et al. Growth, pubertal development, skeletal maturation and bone mass acquisition in athletes. Hormones. 2004;3:233-43.
16. Georgopolous NA, Theodoropoulou A, Leglise M, et al. Growth and skeletal maturation in male and female artistic gymnasts. J Clin Endocrinol Metab. 2004;89:4377-82.
17. Markou KB, Mylonas P, Theodoropoulou A, et al. The influence of intensive physical exercise on bone acquisition in adolescent elite female and male artistic gymnasts. J Clin Endocrinol Metab. 2004;89:4383-7.
18. Theodoropoulou A, Markou KB, Vagenakis GA, et al. Delayed but normally progressed puberty is more pronounced in artistic compared with rhythmic elite gymnasts due to the intensity of training. J Clin Endocrinol Metab. 2005;90:6022-7.
19. Caine D, Lewis R, O'Connor P, et al. Does gymnastics training inhibit growth of females? Clin J Sports Med. 2001;11:260-70.
20. Caine D, Bass S, Daly R. Does elite competition inhibit growth and delay maturation in some gymnasts? Quite possibly. Pediatr Exerc Sci. 2003;15:360-72.
21. Daly RM, Caine D, Bass SL, et al. Growth of highly versus moderately trained competitive female artistic gymnasts. Med Sci Sports Exerc. 2005;37:1053-60.
22. Baxter-Jones ADG, Maffulli N, Mirwald RL. Does elite competition inhibit growth and delay maturation in some gymnasts? Probably not. Pediatr Exerc Sci. 2003;15:373-82.
23. Georgopoulos NA, Markou KB, Theodoropoulou A, et al. Growth retardation in artistic compared with rhythmic elite female gymnasts. J Clin Endocrinol Metab. 2002;87:3169-73.
24. Hartley GL. A comparative view of talent selection for sport in two socialist states - the USSR and the DDR - with particular reference to gymnastics. In: The growing child in competitive sport: proceedings of the BANC International Congress; 1987, Cardiff: The National Coaching Foundation; 1988. p. 50-6.
25. Baxter-Jones ADG, Helms PJ. Effects of training at a young age: a review of the Training of Young Athletes (TOYA) study. Pediatr Exerc Sci. 1996;8:310-27.
26. Rowley S. Training of Young Athletes study: TOYA and intensive training. London: The Sports Council; 1993.
27. USA Gymnastics. Coaching elite athletes, no date. http://www.usa- gymnastics.org/pages/women/pages/coaching-elite-athletes.html (Accessed 3 Feb 2011).
28. Ridley K, Ainsworth BE, Olds S. Development of a compendium of energy expenditures for youth. Int J Behav Nutr Phys Act. 2008;5:45-52.
29. Ridley K, Olds TS. Assigning energy costs to activities in children: a review and synthesis. Med Sci Sports Exerc. 2008;40:1439-46.
30. Laing EM, Wilson AR, Modlesky CM, et al. Initial years of recreational artistic gymnastics training improves lumbar spine bone mineral accrual in 4- to 8-year-old females. J Bone Miner Res. 2005;20:509-19.
31. Daly RM, Rich PA, Klein R. Hormonal responses to physical training in high-level peripubertal male gymnasts. Eur J Appl Physiol. 1998;79:74-81.
32. Daly RM, Rich PA, Klein R, et al. Effects of high-impact exercise on ultrasonic and biochemical indices of skeletal status: a prospective study in young male gymnasts. J Bone Miner Res. 1999;14:1222-30.
33. Caine D, Caine D, Cochrane B, et al. An epidemiologic investigation of injuries affecting young competitive female gymnasts. Am J Sports Med. 1989;17:811-20.
34. Bouchard C, Malina RM, Perusse L. Genetics of fitness and physical performance. Champaign: Human Kinetics; 1997.
35. O'Kane JW, Levy MA, Pietila K, et al. Survey of injuries in Seattle area level 4-10 club gymnasts. Clin J Sports Med. 2011;21:486-92.
36. Erlandson MC, Kontulainen SA, Chilibeck PD, et al. Bone mineral accrual in 4- to 10-year-old precompetitive, recreational gymnasts: a 4-year longitudinal study. J Bone Miner Res. 2011;26:1313-20.
37. Peltenburg AL, Erich WBM, Bernink MJE, et al. Biological maturation, body composition, and growth of female gymnasts and control groups of schoolgirls and girl swimmers, aged 8 to 14 years: a cross-sectional survey of 1064 girls. Int J Sports Med. 1984;5:36-42.
38. Theintz GE, Howald H, Allemann Y, et al. Growth and pubertal development of young female gymnasts and swimmers: a correlation with parental data. Int J Sports Med. 1989;10:87-91.
39. Peltenburg AL, Erich WBM, Zonderland ML, et al. A retrospective growth study of female gymnasts and girl swimmers. Int J Sports Med. 1984;5:262-7.
40. Damsgaard R, Bencke J, Matthiesen G, et al. Is prepubertal growth adversely affected by sport? Med Sci Sports Exerc. 2000;32:1698-703.
41. Keller E, Fröhner G. Growth and development of boys with intensive training in gymnastics during puberty. In: Laron Z, Rogol AD, editors. Hormones and sport. New York: Raven Press; 1989. p. 11-20.
42. Erlandson MC, Sherar LB, Mirwald RL, et al. Growth and maturation of adolescent female gymnasts, swimmers, and tennis players. Med Sci Sports Exerc. 2008;40:34-42.
43. Baxter-Jones ADG, Helms P, Maffulli N, et al. Growth and development of male gymnasts, swimmers, soccer and tennis players: a longitudinal study. Ann Hum Biol. 1995;22:381-94.
44. Tönz O, Stronski SM, Gmeiner CYK. Wachstum und Pubertät bei 7- bis 16 jahrigen Kunstturneirinnen: eine prospektive Studie. Schweiz med Wschr. 1990;120:10-20.
45. USA Gymnastics. Do you know your stats? Indianapolis: USA Gymnastics; 2009. p. 32-4.
46. Claessens AL, Lefevre J. Morphological and performance characteristics as drop-out indicators in female gymnasts. J Sports Med Phys Fitness. 1998;38:305-9.
47. Council of Europe, Committee for the Development of Sport. EUROFIT: handbook for the EUROFIT tests of physical fitness. Rome: Council of Europe; 1998.
48. Lindner KJ, Caine DJ, Johns DP. Withdrawal predictors among physical and performance characteristics of female competitive gymnasts. J Sports Sci. 1991;9:259-72.
49. Roche AF, Davila GH. Late adolescent growth in stature. Pediatrics. 1972;50:874-80.
50. Khamis HJ, Roche AF. Growth outcome of "normal" short children who are retarded in skeletal maturation. J Pediatr Endocrinol Metab. 1995;8:85-96.
51. Kozieł SM. Combined effects of the tempo of maturation and midparent height on the shape of individual growth curves. Am J Hum Biol. 1997;9:555-63.
52. Rekers-Mombarg LTM, Cole TJ, Massa GG, et al. Longitudinal analysis of growth in children with idiopathic short stature. Ann Hum Biol. 1997;24:569-83.
53. Brämswig JH, Fasse M, Holthoff M-L, et al. Adult height in boys and girls with untreated short stature and constitutional delay of growth and puberty: accuracy of five different methods of height prediction. J Pediatr. 1990;117:886-91.
54. Jancarik A, Salmela JH. Longitudinal changes in physical, organic and perceptual factors in Canadian male gymnasts. In: Petiot B, Salmela JH, Hoshizaki TB, editors. World identification systems for gymnastic talent. Montreal: Sport Psyche Editions; 1987. p. 151-9.
55. Bielicki T, Szklarska A, Welon Z, et al. Niero ci społeczne w Polsce: antropologiczne badania poborowyczh w trzydziestoleciu 1965-1995. Monographs of the Institute of Anthropology, No 16. Wroclaw: Polish Academy of Sciences; 1997.
56. Bielicki T, Malina RM, Waliszko H. Monitoring the dynamics of social stratification: statural variation among Polish conscripts in 1976 and 1986. Am J Hum Biol. 1992;4:345-52.
57. Buckler JMH, Brodie DA. Growth and maturity characteristics of schoolboy gymnasts. Ann Hum Biol. 1977;4:455-63.
58. Thomis M, Claessens AL, Lefevre J, et al. Adolescent growth spurts in female gymnasts. J Pediatr. 2005;146:239-44.
59. Caldarone G, Leglise M, Giampietro M, et al. Anthropometric measurements, body composition, biological maturation and growth predictions in young female gymnasts of high agonistic level. J Sports Med. 1986;26:263-73.
60. Caldarone G, Leglise M, Giampietro M, et al. Anthropometric measurements, body composition, biological maturation and growth predictions in young male gymnasts of high agonistic level. J Sports Med. 1986;26:406-15.
61. Claessens AL, Lefevre J, Beunen GP, Malina RM. Maturity-associated variation in the body size and proportions of elite female gymnasts 14-17 years of age. Eur J Pediatr. 2006;165:186-92.
62. Bass S, Bradney M, Pearce G, et al. Short stature and delayed puberty in gymnasts: influence of selection bias on leg length and the duration of training on trunk length. J Pediatr. 2000;136:149-55.
63. Daly RM, Rich PA, Klein R, et al. Short stature in competitive prepubertal and early pubertal male gymnasts: the results of selection bias or intense training. J Pediatr. 2000;137:510-6.
64. Roche AF, Malina RM. Manual of physical status and performance in childhood, vol. 1. Physical status. New York: Plenum; 1983.
65. Malina RM. Skeletal age and age verification in youth sport. Sports Med. 2011;41:925-47.
66. Bass S, Pearce G, Bradney M, et al. Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res. 1998;13:500-7.
67. Duvallet A, Leglise M, Auberge T, et al. Étude radiologique des lésions osseuses du poignet du sportif: a propos de 98 radiographies du poignet et de la main gauche chez le gymnaste junior Européen de haut niveau. Cinésiologie. 1983;22:157-62.
68. Rich PA, Fulton A, Ashton J, et al. Training and testosterone in elite young gymnasts. Aust J Sci Med Sport. 1992;24:68-72.
69. Weimann E, Witzel C, Schwidergall S, et al. Peripubertal perturbations in elite gymnasts caused by sport specific training regimes and inadequate nutritional intake. Int J Sports Med. 2000;21:210-5.
70. Zemel BS, Johnston FE. Applications of the Preece-Baines growth model to cross-sectional data: problems of validity and interpretation. Am J Hum Biol. 1994;6:563-70.
71. Mirwald RL, Baxter-Jones ADG, Bailey DA, et al. An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc. 2002;24:689-94.
72. Nurmi-Lawton JA, Baxter-Jones AD, Mirwald RL, et al. Evidence of sustained skeletal benefits from impact-loading exercise in young females: a 3-year longitudinal study. J Bone Miner Res. 2004;19:314-22.
73. Irurtia Amigo A, Busquets Faciabén A, Evrard MM, et al. Height, weight, somatotype and body composition in elite Spanish gymnasts from childhood to adulthood. Apunts Med Esport. 2009;161:18-28.
74. Tanner JM. Growth at adolescence. 2nd ed. Oxford: Blackwell Scientific Publications; 1962.
75. Geithner CA, Woynarowska B, Malina RM. The adolescent spurt and sexual maturation in girls active and not active in sport. Ann Hum Biol. 1998;25:415-23.
76. Gurd B, Klentrou P. Physical and pubertal development in young male gymnasts. J Appl Physiol. 2003;95:1011-5.
77. Malina RM, Ryan RC, Bonci CM. Age at menarche in athletes and their mothers and sisters. Ann Hum Biol. 1994;21:417-22.
78. Baxter-Jones ADG, Helms P, Baines-Preece J, et al. Menarche in intensively trained gymnasts, swimmers and tennis players. Ann Hum Biol. 1994;21:407-15.
79. Theintz G. Endocrine adaptation to intensive physical training during growth. Clin Endocrinol. 1994;41:267-72.
80. Loucks AB. The response of luteinizing hormone pulsatility to 5 days of low energy availability disappears by 14 years of gynecological age. J Clin Endocrinol Metab. 2006;91:3158-64.
81. Loucks AB, Thuma JR. Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. J Clin Endocrinol Metab. 2003;88:297-311.
82. Shackleton C. Clinical steroid mass spectrometry: a 45-year history culminating in HPLA-MS/MS becoming an essential tool for patient diagnosis. J Steroid Biochem Mol Biol. 2010;121:481-90.
83. Stanczyk FZ, Clarke NJ. Advantages and challenges of mass spectrometry assays for steroid hormones. J Steroid Biochem Mol Biol. 2010;121:491-5.
84. Peltenburg AL, Erich WBM, Thijssen JJH, et al. Sex hormone profiles of premenarcheal athletes. Eur J Appl Physiol. 1984;52:385-92.
85. De Ridder CM, Zonderland ML, Thijssen JJH, et al. The onset of puberty and the availability of sex steroids in female gymnasts. Am J Hum Biol. 1993;5:251-7.
86. Soliman AT, Hassan AEHI, Aref MK, et al. Serum insulin-like growth factors (IGF) I and II concentrations and GH and insulin responses to arginine in children with protein-energy malnutrition before and after nutritional rehabilitation. Pediatr Res. 1986;20:1122-30.
87. Weimann E. Gender-related differences in elite gymnasts: the female athlete triad. J Appl Physiol. 2002;92:2146-52.
88. Press A. Old too soon, wise too late? Newsweek (10 Aug), 1992. p. 22-4. http://www.thedailybeast.com/newsweek/1992/08/09/old-too-soon-wise-too-late. html (Accessed 4 Apr 2013).
89. Prieser U. Faszinierende Artistik oder "Kindersmiβbrauch" - wie jung dürfen Kunstturnerinnen sein? Die Hochleistungskinder. Die Zeit. 1992; Dec 11; p. 22.
90. Becker D, Brown B. USA gymnastics, IOC try to tackle eating disorders. USA Today. 1995;21:10C.
91. Ryan J. Little girls in pretty boxes: the making and breaking of elite gymnastics and figure skaters. New York: Doubleday; 1995.
92. O'Connor PJ, Lewis RD, Boyd A. Health concerns of artistic women gymnasts. Sports Med. 1996;21:321-5.
93. Schwidergall S, Weimann E, Witzel C, et al. Ernährungsverhalten bei weiblichen und männlichen Hochleistungsturnern. Wien Med Wochenschr. 1998;148:243-4.
94. Davies PSW, Feng J-Y, Crisp JA, et al. Total energy expenditure and physical activity in young Chinese gymnasts. Pediatr Exerc Sci. 1997;9:243-52.
95. Lindholm C, Hagenfeldt K, Hagman U. A nutrition study of juvenile elite gymnasts. Acta Paediatr. 1995;84:273-7.
96. Deutz RC, Bernadot D, Martin DE, et al. Relationship between energy deficits and body composition in elite female gymnasts and runners. Med Sci Sports Exerc. 2000;32:659-68.
97. Cole TJ, Flegal KM, Nicholls D, et al. Body mass index cut offs to define thinness in children and adolescents: international survey. Br Med J. 2007;335:194-201.
98. Freedman DS, Wang J, Maynard LM, et al. Relation of BMI to fat and far-free mass among children and adolescents. Int J Obes. 2005;29:1-8.
99. Associated Press. Earlier state media report listed gymnast He's age as 13; 2008. http://sports.espn.go.com/oly/summer08/gymnastics/news/story?id= 3534544 (Accessed 14 Aug 2008).
100. Associated Press. Chinese gymnasts cleared, but two from 2000 games still eyed; 2008. http://sports.espn.go.com/oly/gymnastics/news/story?id=3619325 (Accessed 1 Oct 2008).
101. Macur J. A visit to the athletes' village to see the (perhaps underage) Chinese gymnasts. New York Times; 2008. http://beijing2008.blogs.nytimes.com/ 2008/08/03/a-visit-to-the-athletes-village-to-see-the-perhaps-underage-chinese- gymnasts/?scp=1&sq= Macur%20A%20visit%20to%20the%20athletes%20village%203%20%22August%202008%22& st=cse (Accessed 12 Aug 2008).
102. Roche AF, Himes JH. Incremental growth charts. Am J Clin Nutr. 1980;33:2041-52.
103. Lindsay R, Feldkamp M, Harris D, et al. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatr. 1994;125:29-35.
104. Baumgartner RN, Roche AF, Himes JH. Incremental growth tables: supplementary to previously published charts. Am J Clin Nutr. 1986;43:711-22.
105. Prader A, Largo RH, Molinari L, et al. Physical growth of Swiss children from birth to 20 years of age: First Zurich Longitudinal Study of Growth and Development. Helvet Paediatr Acta. 1989;Suppl 52:1-125.
106. Ellis BJ. Timing of pubertal maturation in girls: an integrated life history approach. Psychol Bull. 2004;130:920-58.
107. Ackland T, Elliott B, Richards R. Growth in body size affects rotational performance in women's gymnastics. Sports Biomech. 2003;2:163-76.
108. Cumming SP, Eisenmann JC, Smoll FL, et al. Body size and perceptions of coaching behaviors by adolescent female athletes. Psychol Sport Exerc. 2005;6:693-705.
109. Cumming SP, Smith RE, Grossbard JR, et al. Body size, coping strategies, and mental health in adolescent female athletes. Int J Sports Sci Coach. 2012;7:515-26.
110. Theintz G, Ladame F, Kehre E, et al. Prospective study of psychological development of adolescent female athletes: initial assessment. J Adolesc Health. 1994;15:258-62.
111. Claessens AL, Lefevre J, Beunen G, Malina RM. The contribution of anthropometric characteristics to performance scores in elite female gymnasts. J Sports Med Phys Fitness. 1999;39:355-60.
112. Claessens AL, Veer FM, Stijnen V, et al. Anthropometric characteristics of outstanding male and female gymnasts. J Sports Sci. 1991;9:53-74.
113. Malina RM, Katzmarzyk PT, Bonci CM, et al. Family size and age at menarche in athletes. Med Sci Sports Exerc. 1997;29:99-106.
114. De Garay AL, Levine L, Carter JEL. Genetic and anthropological studies of Olympic athletes. New York: Academic Press; 1974.
115. Malina RM, Bouchard C, Shoup RF, et al. Age, family size and birth order in Montreal Olympic athletes. In: Carter JEL, editor. Physical structure of Olympic athletes: part I. The Montreal Olympic Games Anthropological Project. Basel: Karger; 1982. p. 13-24.
116. Ellis BJ, Essex MJ. Family environments, adrenarche, and sexual maturation: a longitudinal test of a life history model. Child Dev. 2007;78:1799-817.
117. Kantrowitz B, Starr M, Wilson DJ. Living with training. Newsweek; 1992. p. 24-5. http://www.thedailybeast.com/newsweek/1992/08/10/living-with-training. html (Accessed 4 Apr 2013).
118. Beech J. The price of gold. Time Magazine Asia; 2004. http://www.time.com/time/magazine/article/0,9171,678686-3,00.html (Accessed 22 Apr 2013).
119. Prokopec M. Die Bedeutung der Körperhöhe der Eltern für die richtige Bewertung des Kinderwachstums. Arztl. Jugendkd. 1977;68:70-6.
120. Claessens AL, Malina RM, Lefevre J, et al. Growth and menarcheal status of elite female gymnasts. Med Sci Sports Exerc. 1992;24:755-63.
121. Kirchner EM, Lewis RD, O'Connor PJ. Bone mineral density and dietary intake of female college gymnasts. Med Sci Sports Exerc. 1995;27:543-9.
122. Pollock NK, Laing EM, Modlesky CM, et al. Former college artistic gymnasts maintain higher BMD: a nine-year follow-up. Osteoporos Int. 2006;17:1691-7.
123. Faria IE, Faria EW. Relationship of the anthropometric and physical characteristics of male junior gymnasts to performance. J Sports Med Phys Fitness. 1989;29:369-78.
124. Österback LL, Viitasalo J. Growth selection of young boys participating in different sports. In: Rutenfranz J, Mocellin R, Klimt F, editors. Champaign: Human Kinetics; 1986. p. 373-80.
125. Beunen G, Claessens A, Wellens R, et al. Biological maturity status of Belgian athletes. In: Proceedings of the international congress on child and sport. Urbino: School of Sport of the Italian National Olympic Committee; 1984.
126. Malina RM, Bouchard C, Shoup RF, et al. Growth and maturity status of Montreal Olympic athletes less than 18 years of age. Med Sport. 1982;16:117-27.
127. World Health Organization. Physical status: the use and interpretation of anthropometry. Geneva: World Health Organization, Technical Report Series, No. 854; 1995.