@article{ref1,
title="Effects of a targeted multi-modal exercise program incorporating high speed power training on falls and fracture risk factors in older adults: A community-based randomised controlled trial",
journal="Journal of bone and mineral research",
year="2014",
author="Gianoudis, Jenny and Bailey, Christine A. and Ebeling, Peter R. and Nowson, Caryl A. and Sanders, Kerrie M. and Hill, Keith D. and Daly, Robin M.",
volume="29",
number="1",
pages="182-191",
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.<p /> <p>Language: en</p>",
language="en",
issn="0884-0431",
doi="10.1002/jbmr.2014",
url="http://dx.doi.org/10.1002/jbmr.2014"
}