Osteoporosis International

, Volume 29, Issue 10, pp 2289–2298 | Cite as

Maximal strength training improves musculoskeletal health in amphetamine users in clinical treatment

  • M. NygårdEmail author
  • M.P. Mosti
  • L. Brose
  • G. Flemmen
  • A.K. Stunes
  • A. Sørskår-Venæs
  • J. Heggelund
  • E. Wang
Original Article



Amphetamine use leads to impaired skeletal health and elevated risk of osteoporosis. In the current study, we document that maximal strength training (MST), as a part of clinical treatment, works as a countermeasure, improving muscle force generating capacity, body composition, and skeletal health at sites particularly prone to osteoporotic fractures.


Amphetamine users have attenuated musculoskeletal health. MST with heavy loads, few repetitions, and emphasis on maximal mobilization in the concentric phase may increase muscle force generating capacity and skeletal health. This study investigated if MST-induced improvements in force generating capacity improved bone mineral density (BMD), trabecular bone score, and body composition in amphetamine users participating in 3-months clinical treatment.


Of 40 randomized patients, 23 completed the study: 11 in the supervised training group (TG; 8 men, 3 women, 34 ± 10 years) and 12 in the control group (CG; 9 men, 3 women, 32 ± 8 years). The TG performed hack-squat MST three times a week for 12 weeks with an intensity of ~90% of one repetition maximum (1RM). Both groups attended conventional clinical treatment. Pre-training and post-training, we assessed hack-squat 1RM and rate of force development (RFD), BMD, body composition and trabecular bone score by dual X-ray absorptiometry, and serum bone metabolism markers.


MST induced increases in 1RM (70%) and RFD (86%), and resulted in BMD improvements at lumbar spine (3.6%) and total hip (2.4%); all improvements were different from CG (p < 0.05). Both the 1RM and RFD increases were associated with BMD improvements (lumbar spine: r = 0.73 (1RM), r = 0.60 (RFD); total hip: r = 0.61 (1RM); all p < 0.05). No differences were observed in trabecular bone score or bone metabolism markers.


MST improved force generating capacity and skeletal health at sites prone to bone loss in amphetamine users, and advocate that MST should be implemented as a clinical strategy to restore the patients’ musculoskeletal health.


Addiction Bone mass One repetition maximum Rate of force development Rehabilitation Strength training 


Funding information

Mona Nygård, Mats Peder Mosti, and Astrid Kamilla Stunes were funded by a grants from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology (NTNU).

Compliance with ethical standards

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  1. 1.Department of Mental Health, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
  2. 2.Department of Mental HealthSt. Olav’s University HospitalTrondheimNorway
  3. 3.Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
  4. 4.St. Olav’s University HospitalTrondheimNorway
  5. 5.Department of Circulation and Medical Imaging, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
  6. 6.Department of Research and Development, Clinic of Substance Use and Addiction MedicineSt. Olav’s University HospitalTrondheimNorway
  7. 7.Clinic of Substance Use and Addiction MedicineSt. Olav’s University HospitalTrondheimNorway
  8. 8.Faculty of Health and Social SciencesMolde University CollegeMoldeNorway
  9. 9.Department of Internal MedicineUniversity of UtahSalt Lake CityUSA

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