Introduction: The LIFTMOR trial demonstrated high-intensity resistance and impact training (HiRIT) is safe and improves bone, muscle and function in postmenopausal women with low bone mass under RCT conditions. We subsequently established an osteoporosis clinic to translate the LIFTMOR program into practice with systematic longitudinal monitoring of bone, muscle, function, falls and fractures to determine effectiveness and feasibility of HiRIT as an osteoporosis intervention in the ‘real world’. The aim of the current report is to present 4-year outcomes from the clinic.
Methods: Clients undergo comprehensive testing for height, weight, spine(LS), hip(TH) and femoral neck(FN) BMD, lean and fat mass, back extensor strength(BES), functional performance, falls and fracture, at their baseline visit to the Clinic, then annually. Twice-weekly supervised HiRIT with balance training is provided. Compliance and injuries are recorded. In the absence of a control group, effectiveness is determined from two-sample T-tests of baseline and follow up measures, and one-sample T-tests of percent change.
Results: We report outcomes from 415 clients completing a minimum of 12 months HiRIT (63.4±7.7yrs, 162.4±6.7cm, 61.4±10.7kg, LS T-score -1.9±1.2, FN T-score -2.0±0.7, compliance 60.4±42.4%). 107 were on bone medications at baseline and 29 at follow-up. Improvement was observed in weight (1.0±4.0%, P<0.0001), LS (3.0±4.8%, P<0.0001), TH (1.2±3.5%, P<0.0001) and FN BMD (1.8±4.6%, P<0.0001), lean mass (2.3±5.1%, P<0.0001), fat percent (-4.2±10.2%, P<0.0001), functional reach (7.5±15.2%, P<0.0001), timed up and go (10.3±14.6%, P<0.0001), tandem walk (18.8±33.9%, P<0.0001), sit to stand (11.7±18.1%, P<0.0001), BES (20.2±34.7%, P<0.0001), and kyphosis (7.1±55.5%, P<0.011). Clients increased dietary calcium 19% (P<0.008) and reduced supplementation 16% (P<0.0001). Previous 12-month falls decreased 51% (P<0.01). Fractures decreased 78% (P<0.001). Fourteen injuries were sustained in a total of 44,742 training sessions.
Conclusions: We continue to demonstrate in clinical practice that targeted, supervised exercise is a highly effective osteoporosis intervention in postmenopausal women with low bone mass.