Efficacy and safety of simple exercise interventions for men with osteoporosis – a prospective randomized controlled trial

Abstract

Background: Aging is associated with progressive loss of musculoskeletal performance. Exercise interventions can improve physical function in the elderly but there is a paucity of comparative assessments in order to understand what specific goals can be achieved particularly with less demanding exercise interventions readily accessible for untrained men. Methods: Prospective randomized, controlled, single center trial to compare efficacy and feasibility of four distinct exercise interventions for 6 months in men at risk for osteoporosis aged 65-90 years. Primary endpoint was change in isometric one repetition maximum force trunk strength for extension (TSE) and flexion (TSF) compared to baseline, secondary endpoints covered key parameters of geriatric functional assessment, including Handgrip Strength (HS), Chair-Rise-Test (CRT) Usual Gait Speed (UGS) and Timed-Up-and-Go (TUG).Results: Altogether 47 men (mean age 77 +/-6.1years) were randomized to Resistance Training (RT, n=11), Whole Body Vibration Exercise (WBV, n=13), Qi Gong (QG, n=10) and wearing a Spinal Orthosis (SO, n=13). RT lead to significant improvements for TSE (p=0.009) and TSF (p=0.013). Vibration exercise caused sign. Progress in TSE (p=0.014) and CRT (p=0.005), the Spinal Orthosis improved CRT (p=0.003) and Gait Speed (p=0.027), while the QG Group did not attain any sig. developments. Subgroup analyses revealed most pronounced musculoskeletal progress in vulnerable patients (age ≥80years, pre-sarcopenia, multimorbidity ≥3chronic diseases). Irrespective of the type of exercise, participants ≥80years experienced significant gain in TSE (p=0.029) and CRT (p=0.017). Presarcopenic subjects (Skeletal muscle Index (SMI) ≤10.75 kg/m²) improved in TSE (p=0.003), CRT (p=0.001) and UGS (p=0.016). Multimorbid participants achieved sig. gains in TSE (p<0.001), TSF (p=0.002), UGS (p=0.036) and HS (p=0.046).Conclusions: Simple exercise interventions are feasible in elderly men with specific efficacy, i.e. improvements are attained in those tasks addressed with the training. Consequently, exercise strategies in elderly men should comprise multiple modalities to comprehensively cover various deficits. For vulnerable patients, any simple training appears beneficial.