High-Impact Exercise Increased Femoral Neck Bone Density With No Adverse Effects on Imaging Markers of Knee Osteoarthritis in Postmenopausal Women

Abstract

High‐impact exercise can improve femoral neck bone mass but findings in postmenopausal women have been inconsistent and there may be concern at the effects of high‐impact exercise on joint health. We investigated the effects of a high‐impact exercise intervention on bone mineral density (BMD), bone mineral content (BMC), and section modulus (Z) as well as imaging biomarkers of osteoarthritis (OA) in healthy postmenopausal women. Forty‐two women aged 55 to 70 years who were at least 12 months postmenopausal were recruited. The 6‐month intervention consisted of progressive, unilateral, high‐impact exercise incorporating multidirectional hops on one randomly assigned exercise leg (EL) for comparison with the contralateral control leg (CL). Dual‐energy X‐ray absorptiometry (DXA) was used to measure BMD, BMC, and Z of the femoral neck. Magnetic resonance imaging (MRI) of the knee joint was used to analyze the biochemical composition of articular cartilage using T2 relaxometry and to analyze joint pathology associated with OA using semiquantitative analysis. Thirty‐five participants (61.7 ± 4.3 years) completed the intervention with a mean adherence of 76.8% ± 22.5%. Femoral neck BMD, BMC, and Z all increased in the EL (+0.81%, +0.69%, and +3.18%, respectively) compared to decreases in the CL (−0.57%, −0.71%, and −0.75%: all interaction effects p < 0.05). There was a significant increase in mean T2 relaxation times (main effect of time p = 0.011) but this did not differ between the EL and CL, indicating no global effect. Semiquantitative analysis showed high prevalence of bone marrow lesions (BML) and cartilage defects, especially in the patellofemoral joint (PFJ), with no indication that the intervention caused pathology progression. In conclusion, a high‐impact exercise intervention that requires little time, cost, or specialist equipment improved femoral neck BMD with no negative effects on knee OA imaging biomarkers. Unilateral high‐impact exercise is a feasible intervention to reduce hip fracture risk in healthy postmenopausal women. © 2019 American Society for Bone and Mineral Research.

High-impact exercise stimulated localised adaptation of microarchitecture across distal tibia in postmenopausal women

“…The participants were recruited from a cohort of postmenopausal women completing a randomized controlled trial of a six-month high-impact, unilateral exercise (registered at clinicaltrials.gov: NCT03225703: The Effect of High-Impact Exercise on Bone and Articular Cartilage in Postmenopausal Women). The study design, methods, and main findings of the trial have been published [16], but key methods are summarised below A subgroup of participants from this study volunteered to have HR-pQCT scans for the current study.…”

“…The exercise intervention was a six-month unilateral hopping protocol, completed on the same randomly assigned EL to be compared with the contralateral CL [5] [16]. The intervention was individually progressed for the first ten weeks, leading to the final protocol of 50 multidirectional hops daily for all participants in weeks 11-26.…”

Effects of Low Energy Availability on Bone Health in Endurance Athletes and High-Impact Exercise as A Potential Countermeasure: A Narrative Review

“…However, both effect sizes were moderate implying that there is a degree of individual variability in the response to loading, or that the study lacked statistical power. Furthermore, a 6-month low repetition hopping intervention significantly increased femoral neck BMD in postmenopausal women despite estrogen deficiency [71]; female athletes with FHA also demonstrate estrogen deficiency [72]. In overweight (and otherwise sedentary) individuals, BMD was significantly reduced following 12 months of caloric restriction-induced weight loss but was maintained during weight bearing exercise-induced weight loss of a similar magnitude and duration [73].…”

The Key Research of Sports in Maintaining Human Health

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