The Use of Dual-Energy X-ray Absorptiometry (DEXA) in Evaluating Recovery After Musculoskeletal Injuries in Athletes: A Scoping Review
Bibliographic record
Abstract
Background: Dual-energy x-ray absorptiometry (DEXA) is a widely used imaging modality in sports medicine and orthopaedics due to its accuracy in assessing bone mineral density (BMD) and body composition. Tracking these parameters provides valuable insights into the recovery process after musculoskeletal injuries, which are prevalent among athletes. Purpose: To evaluate how DEXA imaging has been used to guide rehabilitation in both recreational and competitive athletes by monitoring changes in BMD and body composition after musculoskeletal injuries. Study Design: Scoping review; Level of evidence, 4. Methods: A comprehensive literature search was conducted in Ovid MEDLINE, EMBASE, Cochrane Central, and SportDISCUS databases (2000-2024). Studies were included if they used DEXA to measure BMD or body composition changes in athletes after musculoskeletal injuries. Titles, abstracts, and full texts were screened independently by 2 reviewers, with discrepancies resolved through discussion. Data were synthesized qualitatively, and major trends were reported and identified. Results: Of 1132 unique records, 12 studies met inclusion criteria, involving 319 athletes (34% female) with injuries such as anterior cruciate ligament (ACL) tears, lumbar stress fractures, femoroacetabular impingement, and Achilles tendon ruptures. Athletes represented a range of sports, including soccer, basketball, cricket, and triathlon, at both competitive and recreational levels. DEXA identified significant BMD declines after injury, particularly in the affected limb. For instance, up to a 7% BMD reduction was observed in surgical limbs after ACL reconstruction, persisting for up to 2 years in some cases. Rehabilitation strategies incorporating blood flow restriction therapy or combined running and isometric exercises better preserved lean mass and BMD compared with conventional programs focused solely on closed and open kinetic chain exercises. Conclusion: The review demonstrated that DEXA imaging is a promising tool in orthopaedic sports medicine for assessing injury-related changes in BMD and body composition. It provides detailed insights into recovery processes and aids in tailoring rehabilitation strategies and return-to-sport decisions. Some studies incorporated advanced rehabilitation methods such as blood flow restriction therapy, which appeared to accelerate recovery as measured by DEXA outcomes. Future studies should explore integrating DEXA findings into athlete-specific rehabilitation protocols with validated thresholds for return to play.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.076 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.031 | 0.027 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.004 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".