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

Is high-intensity exercise associated with vertebral fracture in middle-aged and older men with osteopenia and osteoporosis? A secondary analysis of the LIFTMOR-M trial (#49)

Amy T Harding 1 2 , Benjamin K Weeks 1 2 , 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

Purpose

Although several trials have examined exercise effects on vertebral morphology in postmenopausal women, none have done so in men. The purpose of the current analysis was to examine the prevalence and incidence of vertebral fracture (VF) following eight months of either high-intensity progressive resistance and impact training (HiRIT) or machine-based isometric axial compression exercise (IAC).

 

Methods

Men (≥ 45yrs) with low aBMD were randomised to either eight months of supervised, twice-weekly HiRIT or IAC in the Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial. VF assessment using the Genant semi-quantitative method was determined from DXA-derived lateral thoracolumbar spine morphology (Medix DR, Medilink, France). Vertebral deformities were classified by type and grade. Prevalent VFs were those identified at baseline, and incident VFs were new fractures detected at follow-up. Worsening VFs were those that showed reduced height at follow-up at the site of a prevalent fracture.

 

Results

Forty participants (HiRIT n=20, IAC n=20; 66.1±7.8yrs; lumbar spine T-score -0.1±0.8) underwent lateral thoracolumbar spine DXA and VF assessment at baseline and following completion of the intervention. Four HiRIT participants had five prevalent VFs and six IAC participants had nine prevalent VFs. Over the eight months, no incident VFs nor progression of prevalent VFs occurred for HiRIT. Five incident thoracic wedge VFs and progression of one wedge VF from grade one to grade two occurred for IAC participants.

 

Conclusions

HiRIT did not cause incident VFs or progression of prevalent VFs, but there was evidence of progression of VF severity and incident VFs for some IAC participants. Clearly, larger trials are required to confirm the observations of this exploratory analysis, however, supervised HiRIT appeared to be safe, whereas IAC may need to be applied with caution in middle-aged and older men with low bone mass if VFs are to be avoided.