Resistance training prevents vertebral osteoporosis in lung transplant recipients.
BACKGROUND
Osteoporosis and vertebral fractures are a consequence of glucocorticoid immunosuppression therapy in lung transplant recipients (LTR). The purpose of this study was to determine the therapeutic efficacy of a 6-month program of specific resistance exercise designed to reverse glucocorticoid-induced vertebral osteoporosis.


METHODS
Sixteen lung transplant candidates were randomly and prospectively assigned to a group (n=8) that performed 6 months of exercise on a lumbar extensor machine or to a control group (n=8). Resistance exercise was initiated at 2 months after transplantation. Bone mineral density (BMD) of the lumbar vertebra (L2-3) was assessed using a dual-energy X-ray absorptiometer (DXA). DXA scans were performed before and 2 months after transplantation and after 6 months of lumbar extensor training or control period.


RESULTS
Lumbar BMD did not differ (P>0.05) between the two groups at study entry. Both the trained (0.63 to 0.54 g/cm2 of hydroxyapatite) and control groups (0.62 to 0.53 g/cm2 of hydroxyapatite) lost significant and comparable amounts (-14.5%) of BMD between study entry and 2 months posttransplantation. The control group lost further (P<or=0.05) lumbar BMD between 2 and 8 months posttransplantation (0.53 to 0.50 g/cm2 of hydroxyapatite), decreasing to values that were 19.5% less than pretransplantation baseline. Lumbar BMD in the trained group increased significantly (+9.2%) after 6 months (0.54 to 0.60 g/cm2 of hydroxyapatite) and returned to values that were within 5% of pretransplantation baseline.


CONCLUSIONS
Mechanical loading associated with progressive resistance exercise, using a specific exercise that isolated the lumbar spine, was efficacious in preventing steroid-induced osteoporosis in LTR.
Mitchell
Matthew J
MJ
University of Florida, Gainesville, FL 32611, USA.
Baz
Maher A
MA
Fulton
Michael N
MN
Lisor
Clem F
CF
Braith
Randy W
RW
D015502:Absorptiometry, Photon; D015992:Body Mass Index; D017886:Durapatite / Q000032:analysis; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008159:Lumbar Vertebrae; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000517:prevention & control*; D011183:Postoperative Complications; D011446:Prospective Studies; D013122:Spinal Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D013314:Stress, Mechanical
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D017886:Durapatite