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BioMed Research International
Volume 2013 (2013), Article ID 921830, 6 pages
Research Article

The Effect of Very High versus Very Low Sustained Loading on the Lower Back and Knees in Middle Life

1Department of Orthopaedics, The Hadassah University Hospital, Hebrew University Medical School, 91129 Jerusalem, Israel
2The Sackler School of Medicine, Tel Aviv University, 69978 Tel Aviv, Israel

Received 12 April 2013; Revised 8 June 2013; Accepted 4 August 2013

Academic Editor: Xiaodong Li

Copyright © 2013 Yael Milgrom et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


To evaluate the effect of the extremes of long term high and low physical activities on musculoskeletal heath in middle age, a historical cohort study was performed. The MRI knee and back findings of 25 randomly selected subjects who were inducted into the armed forces in 1983 and served at least 3 years as elite infantry soldiers were compared 25 years later, with 20 randomly selected subjects who were deferred from army service for full time religious studies at the same time. Both cohorts were from the same common genome. The two primary outcome measures were degenerative lumbar disc disease evaluated by the Pfirrmann score and degenerative knee changes evaluated by the WORMS score. At the 25-year follow up, the mean Pfirrmann score (8.6) for the L1 to S1 level of the elite infantry group was significantly higher than that of the sedentary group (6.7), ( ). There was no statistically significant difference between the WORMS knee scores between the two cohorts ( ). In spite of the much greater musculoskeletal loading history of the elite infantry cohort, only their lumbar spines but not their knees showed increased degenerative changes at middle age by MRI criteria.