Both resistance and agility training increase cortical bone density in 75- to 85-year-old women with low bone mass: a 6-month randomized controlled trial.

A randomized, controlled, single-blinded 25-wk prospective study was conducted to compare the effects of group-based resistance and agility training on bone, as measured by both dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), in older women with low bone mass. Ninety-eight community-dwelling women aged 75-85 yr were randomized to one of three experimental groups: resistance training (n = 32), agility training (n = 34), or stretching (sham exercise) (n = 32). Total hip, femoral neck, and trochanteric bone mineral density (BMD) were measured by DXA. Peripheral QCT measurements were performed at the tibia and radius. The pQCT outcome measures at the shaft regions were cortical bone content, cortical bone cross-sectional area, cortical bone density, and density-weighted polar section modulus (SSI). The pQCT outcome measures at the distal sites were total bone content, total bone cross-sectional area, and total bone density. At trial completion, the agility training group significantly increased cortical bone density by 0.5 +/- 0.2% (SE) at the tibial shaft compared with a 0.4 +/- 0.3% loss in the stretching group. The resistance training group significantly increased cortical bone density (1.4 +/- 0.6%) at the radial shaft compared, with a 0.4 +/- 0.5% loss in the agility training group. No significant between-group differences were observed in the other bone outcome measures (by DXA or pQCT). Future research is needed to determine the mechanism(s) responsible for the observed adaptation of the cortical bone to mechanical loading.

[1]  Jacques P. Brown,et al.  Research Notes: The Canadian Multicentre Osteoporosis Study (CaMos): Background, Rationale, Methods , 1999, Canadian Journal on Aging / La Revue canadienne du vieillissement.

[2]  H. Suominen,et al.  Change in bone mass distribution induced by hormone replacement therapy and high-impact physical exercise in post-menopausal women. , 2002, Bone.

[3]  J. Aloia,et al.  Effects of 17 beta-estradiol replacement and treadmill exercise on vertebral and femoral bones of the ovariectomized rat. , 1994, Bone and mineral.

[4]  J. Kanis,et al.  Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report , 1994, Osteoporosis International.

[5]  J. Aloia,et al.  Additive effect of treadmill exercise and 17β‐estradiol replacement on prevention of tibial bone loss in adult ovariectomized rat , 1993, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[6]  R. Zernicke,et al.  High-impact exercise and growing bone: relation between high strain rates and enhanced bone formation. , 2000, Journal of applied physiology.

[7]  J. Eng,et al.  Resistance and Agility Training Reduce Fall Risk in Women Aged 75 to 85 with Low Bone Mass: A 6‐Month Randomized, Controlled Trial * , 2004, Journal of the American Geriatrics Society.

[8]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[9]  J. Currey Bone Strength: What are We Trying to Measure? , 2001, Calcified Tissue International.

[10]  P. Kannus,et al.  Have the DXA‐Based Exercise Studies Seriously Underestimated the Effects of Mechanical Loading on Bone? , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[11]  J. Ferretti Peripheral Quantitative Computed Tomography for Evaluating Structural and Mechanical Properties of Small Bone , 1999 .

[12]  H. Genant,et al.  Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial. , 2003, Bone.

[13]  M. Pollock,et al.  Effect of training on the relationship between maximal and submaximal strength. , 1993, Medicine and science in sports and exercise.

[14]  R A Boileau,et al.  The physical activity scale for the elderly (PASE): evidence for validity. , 1999, Journal of clinical epidemiology.

[15]  W. Kohrt,et al.  Additive effects of weight‐bearing exercise and estrogen on bone mineral density in older women , 1995, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  M M Chen,et al.  Mechanical loading modifies ovariectomy-induced cancellous bone loss. , 1994, Bone and mineral.

[17]  A. Jette,et al.  The Physical Activity Scale for the Elderly (PASE): development and evaluation. , 1993, Journal of clinical epidemiology.

[18]  D. Raab,et al.  Bone mechanical properties after exercise training in young and old rats. , 1990, Journal of applied physiology.

[19]  D. Felsenberg,et al.  Alendronate Increases Bone Density and Bone Strength at the Distal Radius in Postmenopausal Women , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[20]  G. Breart,et al.  Fall-related factors and risk of hip fracture: the EPIDOS prospective study , 1996, The Lancet.

[21]  E. Bassey,et al.  Weight-bearing exercise and ground reaction forces: a 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. , 1995, Bone.

[22]  R. Prince,et al.  Exercise effects on bone mass in postmenopausal women are site‐specific and load‐dependent , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  D B Burr,et al.  Physical activity and bone mass: exercises in futility? , 1993, Bone and mineral.

[24]  P. Kannus,et al.  Site-Specific Skeletal Response to Long-Term Weight Training Seems to be Attributable to Principal Loading Modality: A pQCT Study of Female Weightlifters , 2002, Calcified Tissue International.

[25]  Philippa Williams,et al.  The Effect of a 12‐Month Exercise Trial on Balance, Strength, and Falls in Older Women: A Randomized Controlled Trial , 1995, Journal of the American Geriatrics Society.

[26]  S. Adami,et al.  Site‐Specific Effects of Strength Training on Bone Structure and Geometry of Ultradistal Radius in Postmenopausal Women , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[27]  C. Rubin,et al.  Suppression of the osteogenic response in the aging skeleton , 1992, Calcified Tissue International.

[28]  W. Kohrt,et al.  Effects of Exercise Involving Predominantly Either Joint‐Reaction or Ground‐Reaction Forces on Bone Mineral Density in Older Women , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[29]  M. Fiatarone,et al.  Effects of High-Intensity Strength Training on Multiple Risk Factors for Osteoporotic Fractures: A Randomized Controlled Trial , 1994 .

[30]  S. Lord,et al.  Prediction of osteoporotic fractures by postural instability and bone density. , 1993, BMJ.

[31]  D. Lieberman,et al.  Optimization of bone growth and remodeling in response to loading in tapered mammalian limbs , 2003, Journal of Experimental Biology.

[32]  O. Rutherford,et al.  Hip bone mineral density is improved by high-impact aerobic exercise in postmenopausal women and men over 50 years , 2006, European Journal of Applied Physiology and Occupational Physiology.