Oral Presentation 30th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2020

Feasibility, safety and effectiveness of a pilot 16-week home-based, high-impact exercise intervention in post-menopausal women with low bone mineral density (#36)

Carrie-Anne Ng 1 , Lachlan B McMillan 1 , Ludovic Humbert 2 , Peter R Ebeling 1 , David Scott 1 3 4
  1. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  2. Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
  3. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
  4. Department of Medicine at Western Health, The University of Melbourne, Sunshine, Victoria, Australia

OBJECTIVE: High-impact exercise is recommended to improve bone health, but the feasibility and efficacy of home-based exercise in postmenopausal women with low bone mineral density (BMD) is unclear. We aimed to determine feasibility, safety and changes in BMD, bone microarchitecture and physical function following a pilot 16-week home-based high-impact exercise intervention in
postmenopausal women with osteopenia or osteoporosis.
METHODS: 50 community-dwelling postmenopausal women with BMD T-scores <-1.0 participated in 16 weeks of home-based exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and total hip dual-energy X-ray absorptiometry (DXA), 3D modelling algorithms (3D-SHAPER) of hip DXA scans, and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical performance was assessed by repeated chair stand time and stair climb time.
RESULTS: 44 (88%) women (mean±SD age 64.5±7.5 years) completed the intervention, with adherence to exercise sessions of 84.7±18.0%. Six (12%) women withdrew from the study due to related soreness (n=2), unrelated injury (n=1) and loss of interest (n=3). Femoral neck areal BMD significantly increased by 1.13±3.76% (p=0.048). Trabecular volumetric BMD of the total hip and femoral neck estimated by 3D-SHAPER significantly increased by 2.27±7.03% (p=0.038) and 3.20±5.39% (p<0.001), respectively. Additionally, femoral neck integral (trabecular plus cortical) volumetric BMD increased by 1.81±4.33% (p=0.010). At the distal tibia, total volumetric BMD significantly increased by 0.32±0.88% (p=0.032) and cortical cross-sectional area significantly increased by 0.55±1.54% (p=0.034). Chair stand and stair climb time significantly improved by 2.3±1.88s (p<0.001) and 0.27±0.49s (p<0.001), respectively.
CONCLUSION: A home-based 16-week high-impact exercise intervention was feasible and effective in improving femoral neck areal BMD, total hip and distal tibial volumetric BMD, and physical function in postmenopausal women. Home-based high-impact exercise interventions may reduce risk factors for fracture in older populations with limited access to clinic- or gym-based programs.