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Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density

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Abstract

Summary

The feasibility and efficacy of home-based, impact exercise are unclear. This pilot impact exercise intervention was feasible and safe, and improved bone health and physical function in postmenopausal women with low bone density. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk.

Introduction

The feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact exercise intervention in postmenopausal women with low BMD.

Methods

Fifty community-dwelling postmenopausal women with BMD T-scores < − 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling (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

Forty-four women (mean ± SD age 64.5 ± 7.5 years) completed the intervention, with adherence of 85.3 ± 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 ± 3.76% (p = 0.048). Trabecular volumetric BMD (vBMD) increased at the total hip (2.27 ± 7.03%; p = 0.038) and femoral neck increased (3.20 ± 5.39%; p < 0.001). Distal tibia total vBMD increased by 0.32 ± 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 ± 1.54% (p = 0.034). Chair stand and stair climb time improved by 2.34 ± 1.88 s (p < 0.001) and 0.27 ± 0.49 s (p < 0.001), respectively.

Conclusion

A 16-week home-based, impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk in older populations.

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Funding

This study was funded by a Monash University Faculty of Medicine, Nursing and Health Sciences Strategic Grant (SGS16-0388) awarded to DS. DS is supported by a NHMRC RD Wright Biomedical Career Development Fellowship (GNT1123014) and a NHMRC Investigator Grant (GNT1174886).

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Author notes

  1. C.-A. Ng and L.B. McMillan contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia

    C.-A. Ng, L.B. McMillan, P.R. Ebeling & D. Scott

  2. Musculoskeletal Unit, Galgo Medical, Barcelona, Spain

    L. Humbert

  3. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia

    D. Scott

  4. Department of Medicine at Western Health, The University of Melbourne, Sunshine, Victoria, Australia

    D. Scott

Authors
  1. C.-A. Ng
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  2. L.B. McMillan
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  4. P.R. Ebeling
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  5. D. Scott
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Corresponding author

Correspondence to C.-A. Ng.

Ethics declarations

The study was approved by the Monash Health Human Research Ethics Committee (HREC/16/MonH/364) and registered with the Australian New Zealand Clinical Trials Registry (ACTRN12618000101280, www.anzctr.org.au).

Conflicts of Interest

Carrie-Anne Ng declares no conflict of interest; Lachlan McMillan, Peter Ebeling and David Scott hold a patent for a device for monitoring impact exercise (Australian Government IP Australia Innovation Patent Number 2018101099). Ludovic Humbert is a stockholder and employee of Galgo Medical.

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Ng, CA., McMillan, L., Humbert, L. et al. Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density. Osteoporos Int 32, 893–905 (2021). https://doi.org/10.1007/s00198-020-05723-3

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