Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal women with low bone mineral density

The feasibility and efficacy of home-based, impact exercise are unclear. This pilot impact exercise intervention was feasible and safe, and improved bone health and physical function in postmenopausal women with low bone density. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk. Introduction The feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact exercise intervention in postmenopausal women with low BMD. Methods Fifty community-dwelling postmenopausal women with BMD T-scores < - 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D modelling (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical performance was assessed by repeated chair stand time and stair climb time. Results Forty-four women (mean +/- SD age 64.5 +/- 7.5 years) completed the intervention, with adherence of 85.3 +/- 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 +/- 3.76% (p = 0.048). Trabecular volumetric BMD (vBMD) increased at the total hip (2.27 +/- 7.03%; p = 0.038) and femoral neck increased (3.20 +/- 5.39%; p < 0.001). Distal tibia total vBMD increased by 0.32 +/- 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 +/- 1.54% (p = 0.034). Chair stand and stair climb time improved by 2.34 +/- 1.88 s (p < 0.001) and 0.27 +/- 0.49 s (p < 0.001), respectively. Conclusion A 16-week home-based, impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such interventions can reduce fracture risk in older populations.