Monitored Impact Loading of the Hip: Initial Testing of a Home-Use Device

Abstract

Many studies have been done involving exercise, impact loading, and the effect on BMD. In some of these studies, particularly those involving outpatient activity, compliance and the specific parameters of an individual's impact loading have been difficult to monitor effectively. In this study, an individual, home-use platform was used to record daily, specific, and reproducible impact forces generated during a heel drop exercise. At three centers over 24 months, we conducted a randomized, prospective study of 157 osteoporotic and osteopenic women, aged 60-85 years. A total of 99 patients used the home Osteocare device (OrthoGenesis Incorporated, Northborough, Massachusetts USA) to generate a reproducible and specific daily impact program (active group). Controls (32) performed a similar motion on the unit but without trying to trigger an impact force (sham group), and 26 patients did no prescribed heel drop exercise (control group). All groups had the same calcium and vitamin D supplementation. Hip DXA was performed at baseline and every 6 months during the entire study duration. Compliance with the 3-5 min routine was high, and patients were able to consistently achieve the specific targeted impact range. Pooled BMD results showed no significant differences between groups in overall BMD measurements. However, a classification model that looked at individual site-specific BMD changes showed that more than 75% of the active group responded (versus 62% for both the sham and the control groups) by maintaining or increasing site-specific hip BMD over the 2-year trial. In fact, at the end of the study, 45% of the actives were gainers versus 12% and 22% in the sham and control groups, respectively. This study suggests that hip BMD may be maintained through a brief, safe, at-home, monitored impact loading program.

Long-Term Exercise and Bone Mineral Density Changes in Postmenopausal Women—Are There Periods of Reduced Effectiveness?

“…Unfortunately, only the latter study provided intermittent assessments over a longer period. Other exercise studies with postmenopausal cohorts that applied regular follow-up assessments (32)(33)(34)(35)(36)(37)(38)(39)(40) were too short ( 3 years) to allow meaningful comparison with the data of the present exercise trial. Although our rather ambitious hypothesis that significant group differences of BMD changes at the LS and total hip were observable within each of the four 4-year periods failed, BMD group differences increased consistently during the complete study period.…”

Effectiveness of a Theory‐Driven Nutritional Education Program in Improving Calcium Intake among Older Mauritian Adults

“…The importance of fruits and vegetables was also highlighted since they contained equally protective nutrients like potassium, magnesium, vitamins A, K, E, and C, and carotene in the prevention of chronic diseases and for bone health. Likewise, simple osteoporosis prevention exercise, developed by Hans et al [27], was demonstrated to maximise retention of calcium in the bone. Simple exercises like daily brisk walking for ten to fifteen minutes and climbing the stairs at home were also covered.…”

Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials

“…The effect of an exercise intervention on BMD or bone strength was assessed in 11 RCT's [28, 32-35, 37, 38, 41, 44-48], of which ten RCT's compared an exercise group with an inactive control group or a sham intervention [28,32,33,37,38,41,[44][45][46][47][48]. In four of these RCT's, the duration of the intervention was less than a year [38,41,44,48].…”

“…One year of vibration training had no effect on lumbar spine BMD of participants with osteoporosis [45]. Hans et al studied the effects of an intervention in which heel drops were performed in participants with osteoporosis and osteopenia [47]. Participants were divided in three groups.…”