Oral Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

A comparison of bone-targeted exercise strategies to reduce fracture risk in middle-aged and older men with osteopenia and osteoporosis: The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men trial (#57)

Amy T Harding 1 2 , Benjamin K Weeks 1 2 , Lisa J Weis 3 , Conor Lambert 1 2 , Steven L Watson 1 2 , Belinda R Beck 1 2 3
  1. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
  2. School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
  3. The Bone Clinic, Brisbane, QLD, Australia

Aim:

To compare the effects of two novel, bone-targeted exercise programs on bone strength and risk factors for falls and fracture in middle-aged and older men with low BMD.

 

Methods:

Men with low BMD were randomised to 8-months of twice-weekly, supervised, high-intensity resistance and impact training (HiRIT) or bioDensity machine-based isometric exercise. A matched sample of men who self-selected to no intervention acted as controls. Outcomes included: anthropometry; body composition; DXA-derived lumbar spine (LS), total hip (TH), femoral neck (FN) and trochanter BMD; QUS-derived calcaneal broadband ultrasound attenuation (BUA); vertical jump impulse; back (BES) and leg muscle strength (LES); and compliance. Intervention effects were examined with univariate ANOVA of percent change (intention-to-treat) controlling initial values.

 

Results:

Ninety-three men (67.1±7.5yrs; 82.1±11.6kg; 175.2±6.7cm; FN T-score -1.58±0.58) were designated control (n=26) or randomised to HiRIT (n=34) or bioDensity (n=33). Compliance was high (HiRIT 77.8±16.6%; bioDensity 78.5±14.8%, p=0.872). There were no between-group differences in percent change for anthropometrics or body composition, except lean mass which increased for HiRIT (1.5±0.8% versus -2.4±0.9%, p=0.002) and bioDensity (0.8±0.8% versus -2.4±0.9%, p=0.013) over control. HiRIT exhibited improved LS BMD (4.1±0.7% versus 0.9±0.8%, p=0.003), trochanteric BMD (2.8±0.8% versus -0.1±0.9%, p=0.024), and BUA (2.2±0.7% versus -0.8±0.9%, p=0.009) compared to control. HiRIT improved LS BMD more than bioDensity (4.1±0.7% versus 2.0±0.7%, p=0.039). There were no between-group differences in percent change for TH or FN BMD. HiRIT improved BES (26.0±5.1% versus 4.1±5.8%, p=0.006), LES (25.1±3.8% versus 9.3±4.4%, p=0.008) and impulse (3.2±2.0% versus -4.2±2.3%, p=0.017) versus control.

 

Conclusion:

High-intensity resistance and impact training, but not isometric bioDensity training, improved bone and risk factors for fracture in middle-aged and older men with low bone mass. High compliance suggests the regime is acceptable and feasible. Findings of the trial will facilitate the development of an optimal exercise program for men at risk of osteoporotic fracture.