Home-based resistance training improves femoral bone mineral density in women on hormone therapy


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.

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Our work was supported by NIH grant no. 5P60-AG13631. We acknowledge Dr. Gail Dalsky for developing the study design. We thank Women’s Health Connecticut for help in recruitment of participants and Masonic Healthcare Center in Wallingford, Connecticut, for providing exercise space. We acknowledge Dr. Larry Raisz for his support and advice on bone turnover issues. None of the authors has a financial interest in the products that are discussed in this manuscript.

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Correspondence to James Oat Judge.

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Judge, J.O., Kleppinger, A., Kenny, A. et al. Home-based resistance training improves femoral bone mineral density in women on hormone therapy. Osteoporos Int 16, 1096–1108 (2005). https://doi.org/10.1007/s00198-004-1816-x

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  • Body composition
  • Bone turnover
  • Hormone therapy
  • Osteoporosis
  • Resistance exercise