The erlangen fitness osteoporosis prevention study: a controlled exercise trial in early postmenopausal women with low bone density—first-year results

Abstract

Kemmler W, Engelke K, Weineck J, Hensen J, Kalender WA. The Erlangen Fitness Osteoporosis Prevention Study: a controlled exercise trial in early postmenopausal women with low bone density—first-year results. Arch Phys Med Rehabil 2003;84:673-82. Objective: To investigate the effect of a 2-year vigorous, combined high-impact, strength, and endurance training program on bone mineral density (BMD) determined by dual-energy x-ray absorptiometry (DXA), quantitative computed tomography (QCT), and ultrasound in early postmenopausal women with osteopenia. Design: Nonrandomized controlled trial, reporting 1-year data. Setting: Community. Participants: Early postmenopausal (1–8y postmenopausal) osteopenic women (DXA T score at lumbar spine or total hip between −1 and −2.5 standard deviations). The exercise group (n=59; mean age, 55.1±3.4y) and control group (n=41; mean age, 55.9±3.1y) were recruited from community registers. Intervention: Fourteen months of exercise training, with 2 joint sessions and 2 additional home training sessions. Exercise and control groups were supplemented individually with calcium and cholecalciferol up to 1500mg of calcium and 500IU of vitamin D per day. Main Outcome Measures: BMD at the lumbar spine and total hip measured by DXA, isometric maximum strength, and maximal oxygen consumption (V̇ o 2max) during a stepwise running test to exhaustion. Results: Bone density increased significantly at the lumbar spine for the exercise group (1.3%, P<.001) and decreased in the control group (−1.2%, P<.01). Differences at the total hip (−0.3%, not significant vs −0.8%, P<.05) and the femoral neck (−0.8%, P<.05 vs −1.8%, P<.001) were nonsignificant. Changes in isometric maximum strength were significant for each region (grip strength, trunk flexors and extensors, hip flexors, leg adductors and abductors, arm flexors and extensors) in the exercise group (11%–39%) compared with nonrelevant changes (−1.1% to 3.9%) in the control group. Between-group differences were significant ( P<.01–.001) for all strength parameters. V̇ o 2max increased significantly by 11% ( P<.001) in the exercise group but decreased in the control group by 4% ( P<.05) while showing significant between-group differences. Conclusion: High-intensity exercise training can have a positive influence on bone density in early postmenopausal osteopenic women.