Citation

Gianoudis J, Bailey CA, Ebeling PR, Nowson CA, Sanders KM, Hill KD, Daly RM. J. Bone Miner. Res. 2014; 29(1): 182-191.

Affiliation

NorthWest Academic Centre, University of Melbourne, Western Health, Melbourne, Australia; Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.

Copyright

(Copyright © 2014, American Society for Bone and Mineral Research)

DOI

10.1002/jbmr.2014

PMID

23775701

Abstract

Multi-modal exercise programs incorporating traditional progressive resistance training (PRT), weight-bearing impact and/or balance training are recommended to reduce risk factors for falls and fracture. However, muscle power, or the ability to produce force rapidly, has emerged as a more crucial variable to functional decline than muscle strength or mass. The aim of this 12-month community-based randomised controlled trial, termed Osteo-cise: Strong Bones for Life, was to evaluate the effectiveness and feasibility of a multi-modal exercise program incorporating high-velocity (HV)-PRT, combined with an osteoporosis education and behavioural change program, on bone mineral density (BMD), body composition, muscle strength and functional muscle performance in older adults. Falls incidence was evaluated as a secondary outcome. 162 older adults (mean ± SD; 67 ± 6 years) with risk factors for falls and/or low BMD were randomised to the Osteo-cise program (n = 81) or a control group (n = 81). Exercise consisted of fitness centre-based HV-PRT, weight-bearing impact and challenging balance/mobility activities performed three times weekly. After 12 months, the Osteo-cise program led to modest but significant net gains in femoral neck and lumbar spine BMD (1.0-1.1%, P < 0.05), muscle strength (10-13%, P < 0.05), functional muscle power (timed stair climb, 5%, P < 0.05) and dynamic balance (four-square step test 6%, P < 0.01; sit-to-stand, 16%, P < 0.001) relative to controls. There was no effect on total body lean mass or mobility (timed-up-and-go), and no difference in falls rate (incidence rate ratio [IRR] 1.22; 95% CI, 0.72, 2.04). In conclusion, this study demonstrates that the Osteo-cise: Strong Bones for Life community-based, multi-modal exercise program represents an effective approach to improve multiple musculoskeletal and functional performance measures in older adults with risk factors for falls and/or low BMD. Although this did not translate into a reduction in the rate of falls, further large-scale trials are needed to evaluate the efficacy of this multi-modal approach on reducing falls and fracture.

Language: en