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Maintenance of exercise-induced benefits in physical functioning and bone among elderly women

Osteoporosis International volume 20, pages 665–674 (2009)Cite this article

Abstract

Summary

This study showed that about a half of the exercise-induced gain in dynamic balance and bone strength was maintained one year after cessation of the supervised high-intensity training of home-dwelling elderly women. However, to maintain exercise-induced gains in lower limb muscle force and physical functioning, continued training seems necessary.

Introduction

Maintenance of exercise-induced benefits in physical functioning and bone structure was assessed one year after cessation of 12-month randomized controlled exercise intervention.

Methods

Originally 149 healthy women 70–78 years of age participated in the 12-month exercise RCT and 120 (81%) of them completed the follow-up study. Self-rated physical functioning, dynamic balance, leg extensor force, and bone structure were assessed.

Results

During the intervention, exercise increased dynamic balance by 7% in the combination resistance and balance-jumping training group (COMB). At the follow-up, a 4% (95% CI: 1–8%) gain compared with the controls was still seen, while the exercise-induced isometric leg extension force and self-rated physical functioning benefits had disappeared. During the intervention, at least twice a week trained COMB subjects obtained a significant 2% benefit in tibial shaft bone strength index compared to the controls. A half of this benefit seemed to be maintained at the follow-up.

Conclusions

Exercise-induced benefits in dynamic balance and rigidity in the tibial shaft may partly be maintained one year after cessation of a supervised 12-month multi-component training in initially healthy elderly women. However, to maintain the achieved gains in muscle force and physical functioning, continued training seems necessary.

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References

  1. Carter ND, Kannus P, Khan KM (2001) Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and evidence. Sports Med 31:427–438

    PubMed  Article  CAS  Google Scholar 

  2. Tinetti ME (2003) Preventing of falls in the elderly persons. N Engl J Med 348:42–49

    PubMed  Article  Google Scholar 

  3. Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip structure in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:814–815

    Article  Google Scholar 

  4. Sornay-Rendu E, Bountroy S, Munoz F et al (2007) Alterations of cortical and trabecular architecture are associated with fractures in postmenopausal women, partially independent of decreased BMD measured by DXA: The OFELY Study. J Bone Miner Res 22:425–433

    PubMed  Article  Google Scholar 

  5. Gillespie LD, Gillespie WJ, Robertson MC et al. (2003) Interventions for preventing falls in elderly people. The Cochrane Database of Systematic Reviews, Issue 4

  6. Bonaiuti D, Shea B, Iovine R et al. (2002) Exercise for preventing and treating osteoporosis in postmenopausal women. The Cochrane Database of Systematic Reviews, Issue 2

  7. Liu-Ambrose T, Khan KM, Eng JJ et al (2004) Resistance and agility training reduce fall risk in women aged 75 to 85 with low bone mass: A 6-month randomized, controlled trial. J Am Geriatr Soc 52:657–665

    PubMed  Article  Google Scholar 

  8. Englund U, Littbrand H, Sondell A et al (2005) A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women. Osteoporos Int 16:1117–1123

    PubMed  Article  Google Scholar 

  9. Korpelainen R, Keinänen-Kiukaanniemi S, Heikkinen J et al (2006) Effect of impact exercise on bone mineral density in elderly women with low BMD: a population-based randomized controlled 30-month intervention. Osteoporos Int 17:109–118

    PubMed  Article  Google Scholar 

  10. Korpelainen R, Keinänen-Kiukaanniemi S, Heikkinen J et al (2006) Effects of exercise on extraskeletal risk factors for hip fractures in elderly women with low BMD: A population-based randomized controlled trial. J Bone Miner Res 21:772–779

    PubMed  Article  Google Scholar 

  11. Heinonen A, Kannus P, Sievänen H et al (1999) Good maintenance of high-impact activity-induced bone gain by voluntary, unsupervised exercises: an 8-month follow-up of a randomized controlled trial. J Bone Miner Res 14:125–128

    PubMed  Article  CAS  Google Scholar 

  12. Häkkinen K, Alen M, Kallinen M et al (2000) Neuromuscular adaptation during prolonged strength training, detraining and re-strength-training in middle-aged and elderly people. Eur J Appl Physiol 83:51–62

    PubMed  Article  Google Scholar 

  13. Kontulainen S, Heinonen A, Kannus P et al. (2004) Former exercisers of an 18-month intervention display residual aBMD benefits compared with control women 3.5 years post-intervention: a follow-up of a randomized controlled high-impact trial. 15:248–251

  14. Uusi-Rasi K, Sievänen H, Heinonen A et al (2004) Effect of discontinuation of alendronate treatment and exercise on bone mass and physical fitness: 15-month follow-up of a randomized, controlled trial. Bone 35:799–805

    PubMed  Article  CAS  Google Scholar 

  15. Liu-Ambrose TY, Khan KM, Eng JJ et al (2005) The beneficial effects of group-based exercises on fall risk profile and physical activity persist 1 year postintervention in older women with low bone mass: Follow-up after withdrawal of exercise. J Am Geriatr Soc 53:1767–1773

    PubMed  Article  Google Scholar 

  16. Karinkanta S, Heinonen A, Sievänen H et al (2007) A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial. Osteoporos Int 18:453–462

    PubMed  Article  CAS  Google Scholar 

  17. Ainsworth BE, Hashell WL, Whitt MC et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498–S516

    PubMed  Article  CAS  Google Scholar 

  18. Carter ND, Khan KM, McKay HA et al (2002) Community-based exercise program reduces risk factors for falls in 65- to 75-year old women with osteoporosis: randomized controlled trial. CMAJ 167:997–1004

    PubMed  Google Scholar 

  19. Uusi-Rasi K, Kannus P, Cheng S et al (2003) Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial. Bone 33:132–143

    PubMed  Article  CAS  Google Scholar 

  20. Heinonen A, Sievänen H, Viitasalo J et al (1994) Reproducibility of computer measurement of maximal isometric strength and electromyography in sedentary middle-aged women. Eur J Appl Physiol 348:1343–1347

    Google Scholar 

  21. Hays RD, Donald Sherbourne C, Mazel RM (1993) The RAND 36-item Health Survey 1.0. Health Econ 2:217–227

    PubMed  Article  CAS  Google Scholar 

  22. Aalto AM, Aro AR, Teperi J (1999) Rand-36 as a measure of health-related quality of life. Reliability, construct validity and reference values in the Finnish general population. (In Finnish with an English summary) Research Reports, The National Research and Development Center for Welfare and Health (STAKES), Helsinki, Finland, vol 101

  23. Sievänen H, Kannus P, Nieminen V et al (1996) Estimation of various mechanical characteristics of human bones using dual energy x-ray absorptiometry: Methodology and precision. Bone 18:17S–27S

    PubMed  Article  Google Scholar 

  24. Beck TJ, Looker AC, Ruff CB et al (2000) Structural trends in the aging femoral neck and proximal shaft: analysis of third national health and nutrition examination survey dual-energy X-ray absorptiometry data. J Bone Miner Res 15:2297–2304

    PubMed  Article  CAS  Google Scholar 

  25. Nikander R, Sievänen H, Heinonen A et al (2005) Femoral neck structure in adult female athletes subjected to different loading modalities. J Bone Miner Res 20:520–528

    PubMed  Article  Google Scholar 

  26. Sievänen H, Koskue V, Rauhio A et al (1998) Peripheral quantitative computed tomography in human long bones: evaluation of in vitro and in vivo precision. J Bone Miner Res 13:871–882

    PubMed  Article  Google Scholar 

  27. Wolfson L, Whipple R, Derby C et al (1996) Balance and strength training in older adults: Intervention gains and Tai Chi maintenance. J Am Geriatr Soc 44:498–506

    PubMed  CAS  Google Scholar 

  28. Helbostad JL, Sletvold O, Moe-Nilssen R (2004) Effects of home exercises and group training on functional abilities in home-dwelling older persons with mobility and balance problems. A randomized study. Aging Clin Exp Res 16:113–121

    PubMed  Google Scholar 

  29. Toraman NF, Ayceman N (2005) Effects of six weeks of detraining on retention of functional fitness of old people after nine weeks of multicomponent training. Br J Sports Med 39:565–568

    PubMed  Article  CAS  Google Scholar 

  30. Toulette C, Thevenon A, Fabre C (2006) Effects of training and detraining on the static and dynamic balance in elderly fallers and non-fallers: A pilot study. Disabil Rehabil 28(2):125–133

    Article  Google Scholar 

  31. Lexell J, Downham DY, Larsson Y et al (1995) Heavy-resistance training in older Scandinavian men and women: short- and long-term effects on arm and leg muscles. Scand J Med Sci Sports 5:329–341

    PubMed  CAS  Google Scholar 

  32. Sforzo GA, McManis BG, Black D et al (1995) Resilience to exercise detraining in healthy older adults. J Am Geriatr Soc 43:209–215

    PubMed  CAS  Google Scholar 

  33. Taaffe DR, Marcus R (1997) Dynamic muscle strength alterations to detraining and retraining in elderly men. Clin Physiol 17:311–324

    PubMed  CAS  Google Scholar 

  34. Porter MM, Nelson ME, Fiatarone Singh MA et al (2002) Effects of long-term resistance training and detraining on strength and physical activity in older women. J Aging Phys Act 10:260–720

    Google Scholar 

  35. Trappe S, Williamson D, Godard M (2002) Maintenance of whole muscle strength and size following resistance training in older men. J Gerontol Biol Sci Med Sci 57A:B138–B143

    Google Scholar 

  36. Karlsson MK (2003) The skeleton in long-term perspective - Are exercise induced benefits eroded by time? J Musculoskel Neuron Interact 3:348–351

    CAS  Google Scholar 

  37. Dalsky GP, Stocke KS, Ehsani AA et al (1988) Weight-bearing exercise training andlumbar bone mineral content in postmenopausal women. Ann Intern Med 108:824–828

    PubMed  CAS  Google Scholar 

  38. 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 6:128–132

    PubMed  Article  CAS  Google Scholar 

  39. Sievänen H (2000) A physical model for dual-energy X-ray absorptiometry—derived bone mineral density. Invest Radiol 35:325–330

    PubMed  Article  Google Scholar 

  40. Currey JD (2001) Bone strength: what are we trying to measure? Calsif Tissue Int 68:205–210

    Article  CAS  Google Scholar 

  41. Järvinen TLN, Kannus P, Sievänen H et al (1998) Randomized controlled study of effects of sudden impact loading on rat femur. J Bone Miner Res 13:1475–1482

    PubMed  Article  Google Scholar 

  42. Adami S, Gatti D, Braga V et al (1999) Site-specific effects of strength training on bone structure and geometry of ultradistal radius in postmenopausal women. J Bone Miner Res 14:120–124

    PubMed  Article  CAS  Google Scholar 

  43. Warden SJ, Fuchs RK, Castillo AB et al (2007) Exercise when young provides lifelong benefits to bone structure and strength. J Bone Miner Res 22:251–259

    PubMed  Article  Google Scholar 

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Acknowledgments

We thank all the study participants for taking part of this study. We also thank statistician Matti Pasanen, MSc, for statistical consultation, Katriina Ojala, MSc, for physical performance measurements, and Virpi Koskue for DXA and pQCT measurements. The work was financially supported by the Finnish Ministry of Education, Medical Research Fund of the Tampere University Hospital, and the Miina Sillanpää foundation.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. The UKK Institute for Health Promotion Research, P.O. Box 30, FIN-33501, Tampere, Finland

    S. Karinkanta, A. Heinonen, H. Sievänen, K. Uusi-Rasi, M. Fogelholm & P. Kannus

  2. Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    A. Heinonen

  3. Medical School, University Tampere, Tampere, Finland

    P. Kannus

  4. Division of Orthopedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland

    P. Kannus

  5. Research Unit, Pirkanmaa Hospital District, Tampere, Finland

    S. Karinkanta

  6. Academy of Finland, Helsinki, Finland

    M. Fogelholm

Authors
  1. S. Karinkanta
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  2. A. Heinonen
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  3. H. Sievänen
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  4. K. Uusi-Rasi
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  5. M. Fogelholm
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  6. P. Kannus
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Correspondence to S. Karinkanta.

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Karinkanta, S., Heinonen, A., Sievänen, H. et al. Maintenance of exercise-induced benefits in physical functioning and bone among elderly women. Osteoporos Int 20, 665–674 (2009). https://doi.org/10.1007/s00198-008-0703-2

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  • DOI: https://doi.org/10.1007/s00198-008-0703-2

Keywords

  • Balance training
  • Bone strength
  • Maintenance
  • Physical functioning
  • Osteoporosis
  • Strength training