Table 2. Descriptive characteristics of included studies with artistic gymnasts.
Study Participants Training Data
source		 Measured areas Outcome QA
Number Sex Age
(yrs)		 Tanner
stage		 History
(yrs)		 Volume
(hours/week)
Zanker et al.
(2003)		 AG (10)
UC (10)		 M
M		 8.1±0.2
7.6±0.1		 I
I		 1-2 4-6 DXA Whole body, lumbar spine. AG had similar measured bone values with UC. 4/7
Zanker et al.
(2003)		 AG (10)
UC (10)		 F
F		 8.1±0.1
7.6±0.1		 I
I		 3-4 8-10 DXA Whole body, lumbar spine. AG had higher LS aBMD and compared to UC. 4/7
Cassell et al.
(1996)		 AG (14)
UC (17)		 F
F		 8.8±0.2
8.3±0.2		 I
I		 ≥1 13.9 DXA Whole body. AG had higher WB aBMD compared to UC. 5/7
Dyson et al. (1997) AG (16)
UC (16)		 F
F		 9.8±0.9
9.9±0.8		 I
I		 3-7 16-23 DXA,
pQCT		 Whole body, lumbar spine, femoral region, radius. AG had higher LS aBMD and FN aBMD; and total, trabecular and cortical distal radius aBMD compared to UC 4/7
Courteix et al. (1998) AG (18)
UC (13)		 F
F		 10.4±1.3
10.7±1.0		 I
I		 ≥3 10-15 DXA Lumbar spine, femur, radius. AG had higher LS aBMD, FN aBMD and FA aBMD compared to UC.
4/7
Dowthwaite et al. (2006) AG (12)
UC (10)		 F
F		 10.0±1.0
10.4±0.9		 I
I		 ≥2 10.3±2.4 DXA Lumbar spine, femoral neck, forearm. AG had higher LS aBMD, FN aBMD, FA aBMD, LS BMC, FA BMC and FA BA compared to UC. 4/7
Nickols-Richardson et al. (1999*) AG (9)
UC (9)		 F
F		 11.0±0.3
11.1±0.3		 I
I		 7.1±0.6 15.7±1.6 DXA Whole body, lumbar spine, femoral region. AG had higher WB aBMD, LS aBMD, FN aBMD compared to UC. 4/7
Lehtonen-Veromaa et al. (2000a) AG (16)
UC (14)		 F
F		 11.2±0.7
10.9±0.9		 I
I		 ≥4 ≥7.5 DXA Lumbar spine, femoral neck, forearm. AG had similar measured bone values with UC. 4/7
Burt et al.
(2012)		 AG (30)
UC (29)		 F
F		 8.9 (6-11)
8.6 (6-11)		 26/4/0/0/0
24/5/0/0/0		 2.6-3.5 9.2-12.0 pQCT Radius. AG had higher FA BMC, distal radius BMC, distal radius aBMD and proximal radius BA compared to UC. 4/7
Vicente-Rodriguez et al. (2007) AG (13)
UC (13)		 F
F		 9.7±1.5
9.9±0.7		 3/10/0/0/0
2/11/0/0/0		 3.4±2.8 ≥12 DXA Whole body, lumbar spine, femoral region. AG had higher FA aBMD compared to UC. 4/7
Dowthwaite et al. (2006) AG (16)
UC (18)		 F
F		 11.4±0.9
11.0±0.8		 II
II		 ≥2 14.7±5.3 DXA Lumbar spine, femoral neck, forearm. AG had higher FN aBMD, FA aBMD, FN BMC, FA BMC and FA BA compared to UC. 4/7
Erlandson et al. (2012a) AG (25)
UC (22)		 F
F		 11.6±1.9
11.9±1.7		 I-V
I-V		 ≥2 ≥15 DXA Whole body, lumbar spine, femoral neck. AG had higher FN aBMD compared to UC. 4/7
Nurmi-Lawton et al. (2004) AG (45)
UC (52)		 F
F		 11.3±2.3
11.3±1.9		 I-V
I-V		 6.5±2.4 20.9±4.5 DXA Whole body, lumbar spine. AG had higher WB aBMD, LS aBMD, WB BMC and LS BMC compared to UC. 4/7
Pikkarainen et al. (2009) AC (52)
UC (44)		 F
F		 13.0±1.7
13.0±1.7		 I-V
I-V		 6.4±2.9 N/A DXA Lumbar spine, femoral neck. AG had higher LS BMC, FN BMC and FN BA compared to UC. 4/7
Lehtonen-Veromaa et al. (2000a) AG (50)
UC (46)		 F
F		 13.3±1.5
13.8±1.3		 II-V
II-V		 ≥6 ≥9 DXA Lumbar spine, femoral neck, forearm. AG had higher LS aBMD, FN aBMD, LS BMC and FN BMC compared to UC. 4/7
Maimoun et al. (2011*) AG (23)
UC (23)		 F
F		 13.4±2.2
13.2±2.2		 6/1/3/1/12
5/5/3/0/11		 ≥8 19.9±4.1 DXA Whole body, lumbar spine, femoral region, radius. AG had higher WB aBMD, LS aBMD, FN aBMD and FA aBMD compared to UC. 4/7
Maimoun et al. (2013a*) AG (20)
UC (20)		 F
F		 13.8±2.0
13.7±2.0		 4/1/2/1/12
2/3/3/1/11		 ≥5 20.3±4.2 DXA Whole body, lumbar spine, femoral region, radius. AG had higher WB aBMD, LS aBMD, FN aBMD and FA aBMD compared to UC. 4/7
Greene et al.
(2012)		 AG (28)
UC (28)		 F
F		 13.7±1.8
14.3±1.1		 2.0±0.3a
3.2±0.8a		 N/A 14.0±5.2 pQCT Tibia, radius. AG had higher cortical and trabecular BMC, cortical and trabecular vBMD at the tibia and radius compared to UC 4/7
Dowthwaite et al. (2011) AG (60)
UC (54)		 F
F		 14.2
13.8		 21/10/5/19
19/12/4/6/13		 ≥1 10.5 DXA Lumbar spine region. AG had higher LS aBMD, LS BMC and LS BA compared to UC. 4/7
Tanner stage: when presented by Roman numbers, it represents what Tanner stages participants were, without specifying the number of participants in each Tanner stage; when presented by Arabic numbers, it represents the number of participants in each Tanner stage acoordingly: I/II/III/IV/VaTanner stage given as an average value by the authors.* These studies have also measured bone turnover values. AG artistic gymnasts, aBMD areal bone mineral density, BA bone area, BMC bone mineral content, DXA dual-energy X-ray absorptiometry, F female, FN femoral neck, FA forearm, LS lumbar spine, M male, N/A not available, pQCT peripheral quantitative computed tomography, QA quality assessment, UC untrained controls, vBMD volumetric bone mineral density, WB whole body.