The aim of the LIFTMOR (Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation) trial is to determine the safety and efficacy of brief, bone-targeted, high-intensity progressive resistance training (HiPRT) with impact loading for postmenopausal women with low bone mass. Preliminary findings indicate the LIFTMOR program is safe and effective.
Despite a lack of notable efficacy, exercise guidelines for osteoporosis typically recommend moderate-intensity exercises, owing to a perceived risk of fracture from high-intensity loading. Indeed, safety concerns alone have prevented the well-recognised preferential response of bone tissue to high-intensity loads from being applied to those who stand to benefit the most. To progress from this therapeutic stalemate, a challenge to conventional wisdom was required. Our goal was to examine the safety and efficacy of HiPRT and impact loading for risk factors of osteoporotic fracture in postmenopausal women with low to very low bone mass.
Participants have been randomised to either 8 months of twice-weekly 30-min supervised HiPRT and impact loading or a low-intensity home-based exercise program of the same duration and dose. Testing at baseline and follow-up has included anthropometry; bone, muscle, and fat mass; and functional performance.
Twenty-eight women (66.1 ± 4.8 years, mean lumbar spine T-score −2.15 ± 0.72) have completed the study. HiPRT and impact loading (n = 12) improved height (0.4 ± 0.2 cm vs −0.3 ± 0.1 cm, p = 0.003), femoral neck bone mineral density (0.3 ± 0.5 % vs −2.5 ± 0.8 %, p = 0.016), lumbar spine bone mineral density (1.6 ± 0.9 % vs −1.7 ± 0.6 %, p = 0.005), and functional performance (p < 0.05), compared to controls (n = 16). Compliance has been >87 %. There have been no injuries.
Brief supervised HiPRT with impact loading is a safe and effective exercise therapy for postmenopausal women with low to very low bone mass.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37(4):411–417
O’Connor JA, Lanyon LE, MacFie H (1982) The influence of strain rate on adaptive bone remodelling. J Biomech 15(10):767–781
Rubin CT, McLeod KJ (1994) Promotion of bony ingrowth by frequency-specific, low-amplitude mechanical strain. Clin Orthop Relat Res 298:165–174
Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66(3):397–402
Bocalini DS, Serra AJ, dos Santos L, Murad N, Levy RF (2009) Strength training preserves the bone mineral density of postmenopausal women without hormone replacement therapy. J Aging Health 21(3):519–527
Maddalozzo GF, Widrick JJ, Cardinal BJ, Winters-Stone KM, Hoffman MA, Snow CM (2007) The effects of hormone replacement therapy and resistance training on spine bone mineral density in early postmenopausal women. Bone 40(5):1244–1251
Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ (1994) Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. A randomized controlled trial. JAMA 272(24):1909–1914
von Stengel S, Kemmler W, Kalender WA, Engelke K, Lauber D (2007) Differential effects of strength versus power training on bone mineral density in postmenopausal women: a 2-year longitudinal study. Br J Sports Med 41(10):649–655, discussion 655
Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR, American College of Sports M (2004) American college of sports medicine position stand: physical activity and bone health. Med Sci Sports Exerc 36(11):1985–1996
Giangregorio LM, Papaioannou A, Macintyre NJ, Ashe MC, Heinonen A, Shipp K, Wark J, McGill S, Keller H, Jain R, Laprade J, Cheung AM (2014) Too Fit to fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25(3):821–835
Palombaro KM (2005) Effects of walking-only interventions on bone mineral density at various skeletal sites: a meta-analysis. J Geriatr Phys Ther 28(3):102–107
Sherrington C, Tiedemann A, Fairhall N, Close J, Lord SR (2011) Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. N S W Public Health Bull 22:78–83
Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G (2011) Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 7:CD000333
Cussler EC, Lohman TG, Going SB, Houtkooper LB, Metcalfe LL, Flint-Wagner HG, Harris RB, Teixeira PJ (2003) Weight lifted in strength training predicts bone change in postmenopausal women. Med Sci Sports Exerc 35(1):10–17
Harding A, Little A, Weeks BK, Horan SA, Watson SL, Beck BR A fresh approach to back extensor muscle strength testing with handheld dynamometry. (2015) In: Sports Medicine Australia, Queensland Branch Conference, Brisbane, QLD, 16th May 2015
Podsiadlo D, Richardson S (1991) The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148
Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49(2):M85–94
Duncan PW, Weiner DK, Chandler J, Studenski S (1990) Functional reach: a new clinical measure of balance. J Gerontol 45(6):M192–197
Beck B, Weeks B, Weis L, Harding A, Horan S, Watson S (2015) Restoring standing height: yet another benefit of exercise for osteoporosis. Proceedings of the ASBMR, Seattle, 9-15 October
Mosti MP, Kaehler N, Stunes AK, Hoff J, Syversen U (2013) Maximal strength training in postmenopausal women with osteoporosis or osteopenia. J Strength Cond Res 27(10):2879–2886
Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone 30(6):836–841
Itoi E, Sinaki M (1994) Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. Mayo Clin Proc 69(11):1054–1059
The authors wish to acknowledge the Sports Medicine Australia for their support for exercise equipment and Griffith University for Postgraduate Research Scholarship support of Mr. Watson.
Conflict of interest
About this article
Cite this article
Watson, S.L., Weeks, B.K., Weis, L.J. et al. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporos Int 26, 2889–2894 (2015). https://doi.org/10.1007/s00198-015-3263-2