Maximal Strength Training in Postmenopausal Women With Osteoporosis or Osteopenia

Abstract

Current guidelines recommend weight-bearing activities, preferably strength training for improving skeletal health in patients with osteoporosis. What type of strength training that is most beneficial for these patients is not established. Maximal strength training (MST) is known to improve 1-repetition maximum (1RM) and rate of force development (RFD), which are considered as important covariables for skeletal health. Squat exercise MST might serve as an effective intervention for patients with low bone mass. We hypothesized that 12 weeks of squat exercise MST would improve 1RM and RFD in postmenopausal women with osteoporosis or osteopenia and that these changes would coincide with improved bone mineral density (BMD) and bone mineral content (BMC), and serum markers of bone metabolism. The participants were randomized to a training group (TG, n = 10) or control group (CG, n = 11). The TG underwent 12 weeks of supervised squat exercise MST, 3 times a week, with emphasis on rapid initiation of the concentric part of the movement. The CG was encouraged to follow current exercise guidelines. Measurements included 1RM, RFD, BMD, BMC, and serum bone metabolism markers; type 1 collagen amino-terminal propeptide (P1NP) and type 1 collagen C breakdown products (CTX). At posttest, 8 participants remained in each group for statistical analyses. The TG improved the 1RM and RFD by 154 and 52%, respectively. Lumbar spine and femoral neck BMC increased by 2.9 and 4.9%. The ratio of serum P1NP/CTX tended to increase (p = 0.09), indicating stimulation of bone formation. In conclusion, squat exercise MST improved 1RM, RFD, and skeletal properties in postmenopausal women with osteopenia or osteoporosis. The MST can be implemented as a simple and effective training method for patients with reduced bone mass.

The effects of combined training on bone metabolic markers in postmenopausal women

“…Two bone markers were tested: cross-linked N-telopeptide of type I collagen and the bone alkaline phosphatase [6]. The NTX-Serum test ELISA was used for the quantitative measured of cross-linked N-telopeptide of type I collagen in human serum.…”

“…A positive effect of exercise on bone mass has been demonstrated in postmenopausal women [6][7][8][9] although the results were not always consistent due to methodological issues, namely: the age of the participants, differences between each mode of exercise (aerobic vs. resistance exercise, isometric or concentric actions, frequency of exercise, testing measures), the duration of the intervention and the markers of bone changes used.…”

“…The urinary cross-linked N-terminal telopeptides of type I collagen (NTX) is considered a specific bone resorption marker [2] and bone-alkaline phosphatase (ALP), is a recognized bone formation marker [12]. While exercise seems to be effective in lowering the risk of falls and maintain muscular performance in selected people and it should through alterations in regulation of bone metabolism prevent the deterioration [6]. It is well accepted that high-intensity aerobics and high-speed resistance training exercise seems to be more efficient to increase bone metabolism than low-to moderate-intensity activity [5,6].…”

“…While exercise seems to be effective in lowering the risk of falls and maintain muscular performance in selected people and it should through alterations in regulation of bone metabolism prevent the deterioration [6]. It is well accepted that high-intensity aerobics and high-speed resistance training exercise seems to be more efficient to increase bone metabolism than low-to moderate-intensity activity [5,6]. Thus, power training in postmenopausal women could be important for the maintenance of bone mineral density as an easily available effective exercise programs.…”

Changes in Bone Metabolism and Antioxidant Status with Combined Exercise and Honey Supplementation in Young Female Rats

“…Physical activity is reported as one of the strategies for maximizing bone mass during early age and subsequently minimizing bone loss later in life [1,2]. The effect of physical Physical activity and its relationship with elevated oxygen consumption and free radical production has been established previously [13].…”