The Osteogenic Effect of Impact-Loading and Resistance Exercise on Bone Mineral Density in Middle-Aged and Older Men: A Pilot Study

Abstract

Background: Regular exercise has been recommended as a potential strategy to counteract the age-related bone loss experienced by men; however, the optimal exercise prescription is not known. Objective: To perform a pilot study to examine the osteogenic effect, safety and feasibility of a combined program of upper body resistance exercise and two doses of impact-loading exercise on bone mineral density (BMD) of middle-aged and older men. Methods: Forty-two community-dwelling men aged 50-74 years were randomly assigned to either an exercise program of combined upper body resistance exercise and either high-dose impact-loading (HI; 80 jumps per session) or moderate-dose impact-loading (MOD; 40 jumps per session) or a control (CON) group. The 9-month intervention involved 4 sessions each week: 2 supervised clinic-based and 2 home-based. BMD of the lumbar spine, femoral neck, total hip, trochanter and whole body as well as lean and fat mass were assessed at baseline and 9 months by dual-energy X-ray absorptiometry. Bone turnover markers, hormone levels, physical function and muscle strength were also assessed. Results: Following 9 months of training, significant differences in BMD among groups were found at the total hip (p = 0.010) and trochanter (p = 0.047) with BMD in the MOD group decreasing relative to the HI group. Although not significant, the HI group consistently preserved BMD, whereas BMD of the MOD and CON groups declined at the hip sites. Mean change for all groups at all skeletal sites was approximately within ±1%. There was no change in bone turnover markers. There were no adverse events as a result of the intervention; however, overall attendance for the HI and MOD groups was 53% (clinic: 68%, home: 38%) and 65% (clinic: 74%, home: 55%), respectively. Conclusions: This study indicates that while impact-loading exercise can be safely undertaken in middle-aged and older men, the current combined program did not elicit significant improvements in BMD.

The effect of 4 months exercise training on systemic biomarkers of cartilage and bone turnover in hip osteoarthritis patients

“…Several studies have investigated the effect of exercise on bone turnover markers in serum in non‐OA individuals, however, with varying results . In agreement with our study, resistance exercise combined with or without impact loading was without effect on CTX and PINP, However, soccer training increased PINP and CTX levels in non‐OA individuals suggesting that the type of exercise is relevant for the effect on bone turnover. The lack of effect of exercise on PINP and CTX in our study could therefore be due to the type or duration of exercise but could also be the result of altered bone turnover in OA patients.…”

Effects of a 20-week high-intensity strength and sprint training program on tibial bone structure and strength in middle-aged and older male sprint athletes: a randomized controlled trial

“…As in some previous studies [15,[37][38][39][40]] the lack of training-induced improvements in BMD could be attributable to normal or high pretraining BMD values. Another possible reason for the unchanged BMD in this study is the short duration of the intervention (20 weeks).…”

Aging and Mechanoadaptive Responsiveness of Bone

“…Measurement of bone-specific alkaline phosphatase, carboxyterminal cross-linked type I collagen telopeptide (CTX), and serum Sclerostin levels before and immediately after a single exercise intervention revealed significant decreases only in serum CTX levels, suggesting that such regimes can exert direct bone mechanoadaptive responses in aged individuals [104]. Bolam et al (2016) also sought to identify optimal exercise strategies to counteract age-related bone loss. They examined the scale of the osteogenic effect on BMD and evaluated safety and feasibility of a program of upper body resistance exercise combined with either of two regimes of impact-loading (high/moderate, 80/40 jumps/session) in middle-aged and older men.…”