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Osteoporosis International

, Volume 19, Issue 2, pp 177–183 | Cite as

Physical training preserves bone mineral density in postmenopausal women with forearm fractures and low bone mineral density

  • I. BergströmEmail author
  • BM. Landgren
  • J. Brinck
  • B. Freyschuss
Original Article

Abstract

Summary

One hundred and twelve postmenopausal women with low bone mineral density (BMD) and forearm fractures were randomized to physical training or control group. After one year the total hip BMD was significantly higher in the women in the physical training group. The results indicate a positive effect of physical training on BMD in postmenopausal women with low BMD.

Introduction

The fivefold increase in hip fracture incidence since 1950 in Sweden may partially be due to an increasingly sedentary lifestyle. Our hypothesis was that physical training can prevent bone loss in postmenopausal women.

Methods

One hundred and twelve postmenopausal women 45 to 65 years with forearm fractures and T-scores from −1.0 to −3.0 were randomized to either a physical training or control group. Training included three fast 30-minute walks and two sessions of one-hour training per week. Bone mineral density (BMD) was measured in the hip and the lumbar spine at baseline and after one year.

Results

A per protocol analysis was performed, including 48 subjects in the training group and 44 subjects in the control group. The total hip BMD increased in the training group +0.005 g/cm2 (±0.018), +0.58%, while it decreased −0.003 g/cm2 (±0.019), −0.36%, (p = 0.041) in the control group. No significant effects of physical training were seen in the lumbar spine. A sensitivity intention to treat analysis, including all randomized subjects, showed no significant effect of physical training on BMD at any site.

Conclusions

The results indicate a small but positive effect of physical exercise on hip BMD in postmenopausal women with low BMD.

Keywords

Bone mineral density Forearm fracture Physical training Postmenopausal women 

Notes

Acknowledgements

Friskis och Svettis, Stockholm, AFA Sweden, Trygg Hansa Sweden, Nycomed Sweden, Center for Gender Medicine; Karolinska Institutet, Stockholm.

References

  1. 1.
    Kanis JA (1993) The incidence of hip fracture in Europe. Osteoporos Int 3(Suppl 1):10–15PubMedCrossRefGoogle Scholar
  2. 2.
    Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, De Laet C (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporosis Int 11:669–674CrossRefGoogle Scholar
  3. 3.
    Kannus P, Neime S, Parkkari J, Palvanen M, Vuori I, Järvinen M (2006) Nationwide decline in incidence of hip fracture. J Bone Mineral Res 21:1836–1838CrossRefGoogle Scholar
  4. 4.
    Obrant KJ, Begner U, Johnell O, Nilsson BE, Sembo I (1998) Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 44:157–162CrossRefGoogle Scholar
  5. 5.
    Beck BR, Schaw J, Snow CM (2001) Physical activity and osteoporosis. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis. Academic Press, San Diego, pp 701–717CrossRefGoogle Scholar
  6. 6.
    Rubin CT, Judex S, McLeod KJ, Qin YX (2001) Inhibition of osteopenia by biophysical intervention. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis. Academic Press, San Diego1, pp 489–503CrossRefGoogle Scholar
  7. 7.
    Smith EL (2003) Role of physical activity in regulation and maintenance of bone. In: Favus MJ (ed) Primer on the metabolic bone disease and disorders of mineral metabolism, fifth edition. Am Soc Bone Mineral Res, pp 323–326Google Scholar
  8. 8.
    Sinaki M (1995) Musculoskeletal Rehabilitation. In: Riggs L, Melton LJ (eds) Osteoporosis. Lippincott-Raven, New York, p 435Google Scholar
  9. 9.
    Grove KA, Londeree BR (1992) Bone density in postmenopausal women: high impact vs low impact exercise. Medicine and Science in Sports and Exercise :1190–1194Google Scholar
  10. 10.
    Hatori M, Hasegawa A, Adachi H, Shinozaki A, Hayashi R, Okano H, Mizunuma H, Murata K (1993) The effect of walking at an anaerobic threshold on vertebral bone loss in postmenopausal women. Calcif Tissue Int 52:411–414PubMedCrossRefGoogle Scholar
  11. 11.
    Iwamoto J, Takeda T, Otani T, Yabe Y (1998) Effect of increased physical activity on bone mineral density in postmenopausal osteoporotic women. Keio J Med 147:157–161Google Scholar
  12. 12.
    Iwamoto J, Takeda T, Ichimura S (2001) Effect of exercise training and detraining on bone mineral density in postmenopausal women with osteoporosis. J Orthop Sci 6:128–132PubMedCrossRefGoogle Scholar
  13. 13.
    Martin D, Notelovitz M (1993) Effects of aerobic training on bone mineral density of postmenopausal women. JBMR 8:931–936Google Scholar
  14. 14.
    Revel M, Mayoux-Benhamou MA, Rabourdin JP, Bagheri F, Roux C (1993) One-year psoas training can prevent lumbar bone loss in postmenopausal women: a randomized controlled trial. Calcified Tissue 53:307–311CrossRefGoogle Scholar
  15. 15.
    Kerr D, Morton M, Dick I, Prince R (1996) Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res 11:218–225PubMedCrossRefGoogle Scholar
  16. 16.
    Kerr D, Ackland T, Maslen B, Morton A, Prince R (2001) Resistance training over 2 years increases bone mass in calcium-replete postmenopausal women. JBMR 16:175CrossRefGoogle Scholar
  17. 17.
    Korpelainen R, Keinänen-Kiukaanniemi, Heikkinen J, Väänänen K, Korpelainen J (2006) Effect of impact exercise on bone mineral density in elderly women with low bone mineral density: a population-based randomized controlled 30-month intervention. Osteoporosis Int 21:1–7Google Scholar
  18. 18.
    Snow CM, Shaw JM, Winters KM, Witzke KA (2000) Long-term exercise using weighted vest prevents hip bone loss in postmenopausal women. J Gerontol 9:489–491Google Scholar
  19. 19.
    Ebrahim S, Thompson PW, Baskaran V, Evans (1997) Randomized placebo-controlled trial of brisk walking in the prevention of postmenopausal osteoporosis. Age and Ageing 26:253–2603PubMedCrossRefGoogle Scholar
  20. 20.
    Bravo G, Gauthier P, Roy PM, Payette H, Gaulin P, Harvey M, Pélequin L, Dubois MF (1996) Impact of a 12-month exercise program on the physical and psychological health of osteopenic women. JAGS 44:756–762Google Scholar
  21. 21.
    Heinonen A, Oja P, Sievänen H, Pasanen M, Vouri I (1998) Effect of two training regimens on bone mineral density in healthy perimenopausal women: a randomized controlled trial. JBMR 13:483–490CrossRefGoogle Scholar
  22. 22.
    Kemmler W, Engelke K, Weineck J, Hensen J, Kalender WA (2003) The Erlangen fitness osteoporosis prevention study: a controlled exercise trial in early postmenopausal women with low bone density—first year results. Arch Phys Med Rehabil 84:673–682PubMedGoogle Scholar
  23. 23.
    Kerr D, Ackland T, Maslen B, Morton A, Prince R (2001) Resistance training over 2 years increases bone mass in calcium-replete postmenopausal women. JBMR 16:175CrossRefGoogle Scholar
  24. 24.
    Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans JE (1994) Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA 27(2):1909–1914CrossRefGoogle Scholar
  25. 25.
    Prince R, Devine A, Dick J, Criddle A, Kerr D, Kent N, Price R, Randell A (1995) The effects of calcium supplementation (milk powder or tablets) and exercise on bone density in postmenopausal women. JBMR 10:1068–1075Google Scholar
  26. 26.
    Pruitt LA, Jackson RD, Bartels RL, Lehnhard HJ (1992) Weight-training effects on bone mineral density in early postmenopausal women. JBMR 7:179–185Google Scholar
  27. 27.
    Krolner B, Toft B, Pors Nielsen S, Tondevold E (1983) Physical exercise as prophylaxis against involutional vertebral bone loss: a controlled trial. Clin Sci 64:541–546PubMedGoogle Scholar
  28. 28.
    Csuka M, McCarty DJ (1985) Physical rehabilitation outcome measures II(PROMII). Book Measure Review Template. Milwaukee, Wisconsin, USAGoogle Scholar
  29. 29.
    Kirk RE (1995) Experimental design: procedures for the behavioral sciences. Brooks/Cole Publishing Company, Pacific Grove, CA, USAGoogle Scholar
  30. 30.
    Croonenborg JJ, Kemper HC, Kostense PJ, Twisk JW (1999) The effect of exercise training programs on bone mass: a meta analysis of published controlled trials in pre- and postmenopausal women. Osteoporos Int 9:1–12PubMedCrossRefGoogle Scholar
  31. 31.
    Ehrlich PJ, Lanyon L (2002) Mechanical strain and bone cell function: a review. Osteoporosis Int 13:688CrossRefGoogle Scholar
  32. 32.
    Skerry TM FRVC (2005) ThesisGoogle Scholar
  33. 33.
    Haapasalo H, Kannus P, Sievanen H, Pasanen M, Uusi-Rasi K, Heinonen A, Oja P, Vuori I (1998) Effect of long-term unilateral activity on bone mineral density of female junior tennis players. J Bone Miner Res 13:10–19CrossRefGoogle Scholar
  34. 34.
    Lanyon LE, Hampson WG, Goodship AE, Shah JS (1975) Bone deformation recorded in vivo from strain gauges attached to the human tibial shaft. Acta Orthop Scand 46:256–268PubMedCrossRefGoogle Scholar
  35. 35.
    Ashley JM, St Jeor ST, Perumean-Chaney S, Schrage J, Bovee V (2001) Meal replacement in weight intervention. Obes Res 9:3125–3205CrossRefGoogle Scholar
  36. 36.
    Cumming RG (1990) Calcium intake and bone mass: a quantitative review of evidence. Calcif Tissue Int 47:194–201PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • I. Bergström
    • 1
    • 3
    Email author
  • BM. Landgren
    • 2
  • J. Brinck
    • 1
  • B. Freyschuss
    • 1
  1. 1.Center for Metabolism and EndocrinologyKarolinska Institutet at Karolinska University, Karolinska University Hospital HuddingeStockholmSweden
  2. 2.Department of Obstetrics and GynecologyKarolinska Institutet at Karolinska University, Karolinska University Hospital HuddingeStockholmSweden
  3. 3.Karolinska University Hospital HuddingStockholmSweden

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