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 Some researchers and clinicians specializing in bone health caution,
however, that the evidence for patients with osteoporosis to engage
in these types of exercises is insufficient to go against the
current osteoporosis exercise guidelines, which recommend only
moderate-intensity exercises because heavy training might be
hazardous to fragile osteoporotic bones.
“Certainly, this study demonstrated some signal for bone that HiRIT
may well make a difference, but this study was not rigorous enough
(nor) had a sufficient number of participants to alter in any way
the current guidelines,” said D. Lee Alekel, director of the
Osteoporosis and Metabolic Disorders of Bone Program at the U.S.
National Institute of Arthritis and Musculoskeletal and Skin
Diseases Medicine in Bethesda, Maryland, in an email.
For the new study, researchers analyzed data from the larger Lifting
Intervention for Training Muscle and Osteoporosis Rehabilitation (LIFTMOR)
Trial on 101 postmenopausal women age 58 or older. For eight months,
half of the women did twice-weekly 30-minute sessions of supervised
HiRIT that included deadlifts, overhead presses, squats and jumping
chin ups with drop landings.
The other half formed a comparison group, and for eight months they
did unsupervised, twice-weekly 30-minute low-intensity exercise at
home.
All the participants had bone mineral density testing with a special
type of X-ray called a DXA scan before and after the eight-month
training program to assess changes in their bone mineral density (BMD),
or bone health, at the spine and the femoral head at the very top of
the thigh bone that meets the hip.
“I was very pleasantly surprised by our novel and very positive
outcomes,” senior study author Belinda Beck told Reuters Health in
an email. “I had concerns that heavy loading might be hazardous to
an osteoporotic spine, but it wasn’t,” said Beck, who directs The
Bone Clinic at Griffith University’s Menzies Health Institute in
Queensland, Australia.
By the end of the study, the HiRIT participants increased BMD in
their spines by an average of about 3 percent and increased hip BMD
by 2.2 percent. In the comparison group, women lost an average 1.2
percent of spinal BMD and lost more than 2 percent at the hip,
researchers report in the Journal of Bone and Mineral Research.
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The benefits of bone density improvements at the femoral neck
translate into stronger hips, Beck said. Women in the resistance
group also had a 40 percent improvement in back and leg extensor
strength, which Beck said helped improve their posture and reduce
their risk of falls.
Ethel Siris, director of the Toni Stabile Osteoporosis Center of
Columbia University Medical Center and New York Presbyterian
Hospital, who was not involved in the research, said the benefit of
exercise is that it makes people physically stronger so they can
prevent falls.
She cautioned that patients with osteoporosis or osteopenia should
do highly individualized exercise based upon their overall condition
that is safe.
“You don’t want someone with poor bone health to overdo repetitions
because they can get a stress fracture,” Siris said in a phone
interview.
Bones naturally deteriorate with age, but 10 million Americans, 80
percent of whom are women, have osteoporosis, a debilitating
condition in which their BMD is significantly lower than normal.
Their bones become so weak and brittle they can break during a fall,
or in extreme cases, from even a sneeze or minor jolt. People with
osteopenia have thinning bones and are at risk for osteoporosis.
HiRIT training should be supervised by adequately trained
professionals to ensure correct technique and appropriate
progressions, as well as to minimize injuries, Beck said.
“I think this study warrants follow-up using HiRIT because it may
well provide sufficient stimulus to evoke a bone response, but this
would need to be tested in a larger sample with more rigorous study
design,” Alekel said.
SOURCE http://bit.ly/2kqlSYJ Journal of Bone and Mineral Research,
online October 4, 2017.
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