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Cited by 45Bone health and osteoporosis researchBalance, Gait, and Falls PreventionPhysical Activity and Health

Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial

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Harding, Amy T., Weeks, Benjamin K., Lambert, Conor, Watson, Steven L., Weis, Lisa J., Beck, Belinda R.·2020·Bone
DOI 10.1016/j.bone.2020.115362
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Abstract

Introduction Few data exist on the effects of bone-targeted exercise on geometric and biomechanical indices of bone strength in men. The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial was designed to compare the efficacy and safety of two novel, supervised, twice-weekly, high-intensity exercise programs in middle-aged and older men with osteopenia and osteoporosis on musculoskeletal health and risk factors related to falls and fractures. The current report includes secondary outcomes of the LIFTMOR-M exercise intervention trial.Purpose Our goal was to determine the effects of two supervised, twice-weekly, high-intensity exercise programs on bone geometry and strength of the proximal femur, and distal and proximal sites of the tibia and radius in middle-aged and older men with osteopenia and osteoporosis.Methods Generally-healthy men (≥45 years), with low lumbar spine (LS) and/or proximal femur areal bone mineral density (aBMD), were recruited from the community. Eligible participants were randomised to either eight months of twice-weekly supervised high-intensity progressive resistance and impact training (HiRIT) or supervised machine-based isometric axial compression (IAC) exercise training. Intervention group outcomes were compared at baseline and eight months with a matched but non-randomised control group (CON) who self-selected to usual activities. DXA scans (Medix DR, Medilink, France) of the skeletally non-dominant proximal femur were analysed using 3D hip software (DMS Group, France) to derive femoral neck (FN) and total hip (TH) bone mineral content (BMC), volume, and volumetric bone mineral density (vBMD) for total, trabecular and cortical bone compartments. Total FN cortical thickness was determined as well as anterior, posterior, lateral and medial subregions. pQCT scans (XCT-3000, Stratec, Germany) of the 4 and 38% sites of the tibia, and 4 and 66% sites of the radius were conducted to determine a range of geometric and bone structural strength indices. Intervention effects were examined using univariate ANCOVA of percent change, and repeated measures ANCOVA of raw baseline and follow-up data, controlling for initial values, using intention-to-treat and per-protocol approaches.Results Ninety-three men (67.1 ± 7.5 yrs, 175.2 ± 6.7 cm, 82.1 ± 11.6 kg, 26.7 ± 3.5 kg/m 2) with lower than average aBMD (LS T-score -0.06 ± 1.04, FN T-score -1.58 ± 0.58, TH T-score -1.00 ± 0.58) were recruited, and designated CON (n = 26) or randomised to HiRIT (n = 34) or IAC (n = 33). Compliance to the supervised exercise programs did not differ (HiRIT 77.8 ± 16.6% versus IAC 78.5 ± 14.8%, p = 0.872). HiRIT improved medial FN cortical thickness compared with CON (5.6 ± 1.7% versus -0.1 ± 1.9%, p = 0.028) and IAC (5.6 ± 1.7% versus 0.7 ± 1.7%, p = 0.044). Distal tibia total BMC, vBMD, area and bone strength index, and trabecular BMC and bone strength index all declined for CON compared with maintenance for both HiRIT and IAC (all p < 0.05). HiRIT maintained distal tibia trabecular area compared with a loss in CON (0.2 ± 0.5% versus -1.6 ± 0.5%, p = 0.013). HiRIT and IAC maintained distal radius total BMC compared with loss in CON (-0.1 ± 0.7% versus -3.7 ± 0.8%, p = 0.001; 1.3 ± 0.7% versus -3.7 ± 0.8%, p < 0.001, respectively). HiRIT and IAC maintained distal radius total bone strength index compared with loss in CON (1.4 ± 1.4% versus -6.0 ± 1.6%, p = 0.001; 0.2 ± 1.3% versus -6.0 ± 1.6%, p = 0.004, respectively). HiRIT reduced proximal radius cortical area compared with CON (-3.1 ± 1.0% versus 1.1 ± 1.2%, p = 0.011) and IAC (-3.1 ± 1.0% versus -0.2 ± 1.0%, p = 0.042). No between-group differences were detected in any pQCT-derived bone outcome at the diaphyseal tibia 38% site.Conclusion Findings indicate that supervised HiRIT provides a positive stimulus to cortical bone at the medial FN compared with supervised IAC exercise, and both HiRIT and IAC preserve bone strength at the distal tibia and distal radius. These effects may translate into a reduced risk of lower and upper extremity fracture in middle-aged and older men with low bone mass.

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  • Most studies demonstrating the efficacy of exercise on BMD have been conducted in women between 50 and 70 years of age.

    “Overall, most studies demonstrating the efficacy of exercise on BMD have been conducted in women between 50 and 70 years of age, and it is not yet known whether the efficacy is similar in women over 80 years of age with multiple comorbidities, who have often been excluded from such trials [114,307,308].”

    From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [307]

  • Most studies demonstrating efficacy of exercise on BMD have been conducted in women between 50 and 70 years of age, and it is not yet known whether efficacy is similar in women over 80 years of age with multiple comorbidities who have often been excluded from such trials.

    “Overall, most studies demonstrating the efficacy of exercise on BMD have been conducted in women between 50 and 70 years of age, and it is not yet known whether the efficacy is similar in women over 80 years of age with multiple comorbidities, who have often been excluded from such trials [114,307,308].”

    From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [307]

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Research works printed but not linked: 1

  1. B.R. Beck, B.K. Weeks, Which limb to scan? Revisiting the relationship between funcitonal and skeletal limb dominance, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 25(S306) (2010).

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Authors
Harding, A. T., Weeks, B. K., Lambert, C., Watson, S. L., Weis, L. J., & Beck, B. R.
Affiliations
Griffith University (AU)
Corresponding author
Beck, Belinda R.
ORCID
Venue
Bone
Publisher
Elsevier BV
Published
2020-07
Volume
136
Pages
115362
ISSN
  • 1873-2763 (ISSN-L)
  • 8756-3282
DOI
10.1016/j.bone.2020.115362
OpenAlex
W3015938298
Cited by
45
References
33
Citations by year
2026: 7 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 10 · 2021: 12 · 2020: 2
FWCI
7.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Bone (publishedVersion)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion, cc-by-nc-nd)
Funders
  • Sports Medicine Australia Research Foundation
  • Osteoporosis Australia (ANZCTR12616000344493, e014951)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
high-intensity resistance training, bone geometry, bone strength, osteopenia, osteoporosis, men, middle-aged and older adults, proximal femur, tibia, radius, bone mineral density, cortical thickness, trabecular bone, fall risk, fracture risk
MeSH terms
Aged, France, Germany, Humans, Male, Middle Aged, Muscles, Osteoporosis, Radius, Tibia, Absorptiometry, Photon, Bone Density

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