Postmenopausal Women With Low Bone Mass Enjoy Bone-targeted, High-intensity Resistance Training: LIFTMOR Trial Observations

Abstract

PURPOSE: The LIFTMOR trial improved bone and function with high-intensity progressive resistance and impact training (HiRIT) in postmenopausal women with low to very low bone mass. While efficacious in a research setting, a comprehensive evaluation of participant perception of HiRIT was required to inform implementation in the ‘real world’. Therefore, the aim of the current work was to examine physical activity enjoyment, quality of life (QOL), and participant perception of the HiRIT program undertaken in the LIFTMOR trial. METHODS: Postmenopausal women with low bone mass were randomized to either 8 months of 30-minute, twice-weekly supervised HiRIT (n=49) or unsupervised, low-intensity, home-based exercise (CON; n=52). At baseline and follow-up, all participants completed physical activity enjoyment (PACES-8) and QOL (WHOQOL-BREF) questionnaires (Kruskal-Wallis and Friedman’s test). At follow-up, 17 HiRIT and 15 CON participants completed an exit survey relating to their experiences, scored using a 5-point Likert scale. Of those, 14 participants from the HiRIT program underwent semi-structured interviews to facilitate qualitative analysis (Leximancer v4.50) of their experiences undertaking the HiRIT program. RESULTS: Participants who undertook the HiRIT program reported improvements in PACES-8 (3.3±1.0 vs -1.6±0.9, p<0.001), and on the exit survey, HiRIT were happier with their group allocation (4.8±0.6 vs 4.0±1.2, p=0.03), more enthusiastic about undertaking training sessions (4.4±0.5 vs 3.7±1.1, p=0.03) and more likely to participate in the LIFTMOR trial again given the chance (3.8±0.9 vs 2.9±1.3, p=0.028), than CON (p<0.05). Qualitative analysis revealed current bone health status as the most common motivator for enrolling in the LIFTMOR trial, time was an important barrier to previous physical activity participation and supervised group exercise sessions were perceived as positive. All HiRIT participants would recommend the program to a friend. No differences in QOL were observed (p>0.05). CONCLUSIONS: Supervised HiRIT was more enjoyable than a low-intensity home exercise program. The combination of high acceptability and the osteogenic nature of the LIFTMOR program suggests supervised HiRIT is an effective and appealing therapy for postmenopausal women at risk of fracture.