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HomeSport and Exercise MedicineHiRIT safe for post-menopausal women with low bone mass

HiRIT safe for post-menopausal women with low bone mass

Contrary to current opinion, High-intensity resistance and impact training (HiRIT) was efficacious and induced no adverse events for otherwise healthy post-menopausal women with low to very low bone mass.

Exercise is known to be beneficial to bone health but there is reluctance to use high intensity programmes in older women with low bone mass because of the risk of fracture or other injury. A study found that only 30 minutes twice a week of high intensity resistance and impact training improved functional performance and bone density, structure, and strength in postmenopausal women with low bone mass, without adverse effects.

The results of the LIFTMOR trial indicate that closely supervised exercise training interventions of this type are effective and safe for bone.

"We were delighted to find that even women with very low bone mass could tolerate the high loading required to increased bone mineral density as long as it was introduced gradually with close attention to technique," said Dr Belinda Beck, senior author of the study from the School of Allied Health Sciences, Griffith University, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia and The Bone Clinic Brisbane.

"The simultaneous improvement in functional performance suggests our exercise program provides dual protection from osteoporotic fracture by also preventing falls."

Abstract
Optimal osteogenic mechanical loading requires the application of high-magnitude strains at high rates. High-intensity resistance and impact training (HiRIT) applies such loads but is not traditionally recommended for individuals with osteoporosis because of a perceived high risk of fracture. The purpose of the LIFTMOR trial was to determine the efficacy and to monitor adverse events of HiRIT to reduce parameters of risk for fracture in postmenopausal women with low bone mass. Postmenopausal women with low bone mass (T-score < –1.0, screened for conditions and medications that influence bone and physical function) were recruited and randomized to either 8 months of twice-weekly, 30-minute, supervised HiRIT (5 sets of 5 repetitions, >85% 1 repetition maximum) or a home-based, low-intensity exercise program (CON). Pre- and post-intervention testing included lumbar spine and proximal femur bone mineral density (BMD) and measures of functional performance (timed up-and-go, functional reach, 5 times sit-to-stand, back and leg strength). A total of 101 women (aged 65 ± 5 years, 161.8 ± 5.9 cm, 63.1 ± 10.4 kg) participated in the trial. HiRIT (n = 49) effects were superior to CON (n = 52) for lumbar spine (LS) BMD (2.9 ± 2.8% versus –1.2 ± 2.8%, p < 0.001), femoral neck (FN) BMD (0.3 ± 2.6% versus –1.9 ± 2.6%, p = 0.004), FN cortical thickness (13.6 ± 16.6% versus 6.3 ± 16.6%, p = 0.014), height (0.2 ± 0.5 cm versus –0.2 ± 0.5 cm, p = 0.004), and all functional performance measures (p < 0.001). Compliance was high (HiRIT 92 ± 11%; CON 85 ± 24%) in both groups, with only one adverse event reported (HiRIT: minor lower back spasm, 2/70 missed training sessions). Our novel, brief HiRIT program enhances indices of bone strength and functional performance in postmenopausal women with low bone mass. Contrary to current opinion, HiRIT was efficacious and induced no adverse events under highly supervised conditions for our sample of otherwise healthy postmenopausal women with low to very low bone mass.

Authors
Steven L Watson, Benjamin K Weeks, Lisa J Weis, Amy T Harding, Sean A Horan, Belinda R Beck

[link url="https://www.sciencedaily.com/releases/2017/10/171004084937.htm"]Wiley material[/link]
[link url="http://onlinelibrary.wiley.com/doi/10.1002/jbmr.3284/abstract"]Journal of Bone and Mineral Research abstract[/link]

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