title: Home-based resistance training improves femoral bone mineral density in women on hormone therapy.
abstract: This study tested whether moderate resistance training would improve femoral bone mineral density (BMD) in long-term users of hormone therapy with low BMD. The study was a 2-year randomized, controlled, trial (RCT) of moderate resistance training of either the lower extremity or the upper extremity. Eighty-five women participated in a 6-month observation period. The setting was center-based and home-based training. The participants were 189 women aged 59-78 years, with total femur T-scores from -0.8 to -2.8 and on hormone therapy (HT) for a minimum of 2 years (mean 11.8 years); 153 completed the trial. Lower extremity training used weight belts (mean 7.8 kg) in step-ups and chair rises; upper extremity training used elastic bands and dumbbells. Measurements were BMD and body composition [dual-energy X-ray absorptiometry (DXA)], bone turnover markers. Total femoral BMD showed a downward trend during the observation period: 0.35%+/-0.18% (P=0.14). The response to training was similar in the upper and lower groups in the primary outcomes. At 2 years, total femoral BMD increased 1.5% (95% CI 0.8%-2.2%) in the lower group and 1.8% (95% CI 1.1%-2.5%) in the upper group. Trochanter BMD increased 2.4% (95% CI 1.3%-3.5%) in the lower group and 2.5% (95% CI 1.4%-3.6%) in the upper group (for both analyses time effect P<0.001). At 1 year, a bone resorption marker (C-telopeptide) decreased 9% (P=0.04). Bone formation markers, bone-specific alkaline phosphatase, decreased 5% (P<0.001), and N-terminal type I procollagen peptide decreased 7% (P=0.01). Body composition (percent lean and percent body fat) was maintained in both groups. We concluded that long-term moderate resistance training reversed bone loss, decreased bone turnover, increased femur BMD, and maintained body composition. The similarity of response in upper and lower groups supports a systemic response rather than a site-specific response to moderate resistance training.
authors.affiliation: University of Connecticut School of Medicine, Farmington, Connecticut 01032, USA. jamesjudge@comcast.net
authors.forename: James Oat
authors.initials: JO
authors.lastname: Judge
authors.forename: Alison
authors.initials: A
authors.lastname: Kleppinger
authors.forename: Anne
authors.initials: A
authors.lastname: Kenny
authors.forename: Jo-Anne
authors.initials: JA
authors.lastname: Smith
authors.forename: Brad
authors.initials: B
authors.lastname: Biskup
authors.forename: Glenn
authors.initials: G
authors.lastname: Marcella
mesh_terms: D000368:Aged; D000886:Anthropometry; D001823:Body Composition; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology; D002136:Calcium, Dietary / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005081:Exercise Therapy; D005260:Female; D005269:Femur / Q000502:physiology*; D006699:Home Care Services; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010349:Patient Compliance; D017698:Postmenopause; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D