High-intensity dynamic resistance training helps to maintain lumbar spine bone mineral density (BMD) and increase skeletal muscle mass index (SMI) in older men with osteopenia and sarcopenia, according to the results of a randomized controlled trial published in the Journal of Bone and Mineral Research.
The effect of resistance exercise on osteopenia and osteoporosis in men has not yet been determined. In addition, many previous studies have had limitations to dynamic resistance training protocols and none has focused on individuals with osteosarcopenia.
To determine the effect of isolated resistance exercise training on lumbar spine BMD and SMI in older community-dwelling men with osteosarcopenia, data from 43 men aged ≥72 years were analyzed. Included individuals had a baseline SMI of ≤7.26 kg/m2, baseline osteopenia or osteoporosis, no secondary osteoporosis, and no history of hip fracture. Individuals were excluded if they were receiving osteoanabolic or antiresorptive treatment or had received >7.5 mg/d of glucocorticoid therapy in the prior 2 years, had a disease or health problem that prevented dynamic resistance training, had participated in regular resistance training in the prior 5 years, consumed >60 g/d of ethanol, had problems attending the gym, or did not attend >2 weeks of the intervention period.
Individuals were stratified by SMI (<6.70 kg/m2, 6.70-7.00 kg/m2, or >7.00 kg/m2) and members of each stratum were randomly assigned to either the exercise group (mean age, 77.8±3.6 years) or the control group (mean age, 79.2±4.7 years). Individuals in the exercise group participated in 2 supervised exercise sessions each week at a centrally located gym. All major and minor muscle groups were targeted through various single-set, high-intensity, machine-assisted resistance exercises. The initial 4 weeks were spent learning exercise techniques followed by 8 weeks of conditioning, and the remainder of the 12-month program consisted of high-intensity exercise. All individuals in both groups were provided with whey protein powder, calcium supplements, and vitamin D supplementation based on baseline serum levels.
Lumbar spine BMD decreased significantly from baseline in the control group (-2.5%±4.7%; P =.029). There was a nonsignificant increase in lumbar spine BMD from baseline in the exercise group (1.6%±4.3%) and the between-group difference in BMD change was significant (P =.006). SMI decreased significantly from baseline in the control group (-1.2%±1.9%; P =.03) and increased significantly from baseline in the exercise group (3.6%±3.0%; P <.001). The between-group difference was significant (P <.001). Maximum hip and leg extensor strength also increased significantly from baseline in the exercise group (27%±15%; P <.001) and was maintained in the control group, with the between-group difference being significant (P <.001).
Taken together, these findings indicated that twice-weekly high-intensity dynamic resistance training over a period of 12 months was a time-efficient, safe, and effective intervention for men aged ≥72 years with osteopenia or osteoporosis to improve BMD, SMI, and muscle strength parameters.
One limitation to the study was the difficulty of enforcing effort requirements for exercise exertion. Upon review of the training logs, the researchers noted that up to one-third of the exercises were possibly conducted with inadequate effort. Although this affected adherence to the study, the positive results demonstrated the enduring effect of dynamic resistance training despite this limitation.
Kemmler W, Kohl M, Fröhlich M, et al. Effects of high-intensity resistance training on osteopenia and sarcopenia parameters in older men with osteosarcopenia—one-year results of the randomized controlled Franconian Osteopenia and Sarcopenia Trial (FrOST) [published online April 9, 2020]. J Bone Miner Res. doi:10.1002/jbmr.4027