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Effects of physical exercise on bone mass, balance skill and aerobic capacity in women and men with low bone mineral density, after one year capacity in women and men with low bone mineral density, after one year: a prospective study
Linköping University, Department of Department of Health and Society.
Research and Development Unit, Primary Health Care, BorÅs, Sweden.
1998 (English)In: Scandinavian journal of medicine & science in sports, ISSN 0905-7188 (print) 1600-0838 (online), Vol. 8, no 5 Pt 1, 290-298 p.Article in journal (Refereed) Published
Abstract [en]

Vadstena is a small community in the county of Ostergötland, Sweden, where a project began in 1989 to prevent osteoporosis and to lower the expected incidence of osteoporotic fractures. Persons aged 40-70 years who had a low bone mineral density (BMD) value at screening of the distal radius by single-photon absorptiometry (SPA) were invited to participate in a training study during one year. The definition of low BMD was a densitometry value below -1 SD (standard deviation) from a sex- and age-specific reference value (z-score). Fifteen persons wanted to exercise in a group and 15 persons wanted to become a control group. All participants answered a questionnaire about lifestyle, occupation, diseases, medication and heredity. Clinical tests were made regarding mobility of the joints and muscles, balance and physical fitness. BMD for the hip and the lumbar spine were assessed by dual-energy X-ray absorptiometry (DXA) before and after the investigation period. The training programme was carried out for 60 min twice a week during one year and had the intention to improve bone mass, muscle strength and flexibility, balance skill and aerobic capacity. After the training period there was a significant increase in BMD at the greater trochanter (P < 0.01), in balance skill (standing on one leg with closed eyes and "ski step"-test) (P < 0.05) and in oxygen uptake capacity (P < 0.05) in the exercise group. In the control group, there was a significant increase in BMD at the lumbar spine (P < 0.05). However, these results should be judged with caution because several participants were over the age of 60, and at that age degenerative changes in the lumbar spine may increase to a greater or lesser extent. Regular weight-bearing exercises during one year seem to influence BMD at the greater trochanter in a training group comprising both women and men. However, our study was small in number and further training studies are needed to assess the effect of weight-bearing training on bone mass in different sex- and age-specific groups.

Place, publisher, year, edition, pages
1998. Vol. 8, no 5 Pt 1, 290-298 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13678OAI: diva2:21150
Available from: 2003-05-19 Created: 2003-05-19
In thesis
1. Community-based osteoporosis prevention: Physical activity in relation to bone density, fall prevention, and the effect of training programmes: The Vadstena Osteoporosis Prevention Project
Open this publication in new window or tab >>Community-based osteoporosis prevention: Physical activity in relation to bone density, fall prevention, and the effect of training programmes: The Vadstena Osteoporosis Prevention Project
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is based on studies of the ten-year community-based intervention programme entitled, the Vadstena Osteoporosis Prevention Project (VOPP). The specific aims of the research were to describe the effects of physical activity and training programmes on bone mass and balance performance in adults, to determine whether a fall risk prevention programme could motivate personal actions among the elderly, to ascertain whether the intervention programme could reduce the incidence of forearm and hip fractures.

Two studies addressed training programmes for middle-aged and old people. First, VOPP participants who were aged 40–70 years and had low forearm bone mineral density (BMD) values were invited to take part in a one-year weight-bearing training study. Thirty of those individuals were included in the investigation. Additional bone mass measurements were performed at the hip and the lumbar spine, and balance and aerobic capacity were also tested. The training programme was performed twice a week (I). In the second study, healthy persons aged 70–75 years were invited to participate in a balance-training study. Fifteen persons joined an exercise group, and another fifteen were controls. The training programme comprised specific balance exercises and was carried out twice a week for nine weeks (II). The association between forearm BMD values and several lifestyle factors was explored in random samples of the population aged 20–72 years (n=880) in a cross-sectional study (III). Another study explored the association between calcaneal stiffness, forearm BMD, and lifestyle factors amongst participants aged 20–79 years (n=956) at the final registration of the VOPP (V). Effects of the VOPP interventions directed at environmental risk factors for falls and the promotion of physical activity were examined in people aged ≥ 65 years (IV). The incidence of forearm and hip fractures was studied amongst middle-aged and elderly individuals in the intervention and the control communities during the study period 1987–2001 (VI).

The exercise group (n=15) in the weight-bearing training study showed increases in BMD at the greater trochanter (p<0.01), one-leg stance balance with the eyes closed and coordination tests (p<0.05), and aerobic capacity (p<0.05). No significant difference was found when the groups were compared concerning changes in the different tests during the intervention period (I). In the balance-training study, the exercise group showed post-training improvement in the following tests: standing on the right leg with eyes closed (p<0.01), standing on the right leg (p<0.01) and on the left leg (p<0.05) while turning the head, and walking 30 metres (p<0.01). There were significant differences between the groups in these tests when changes were compared at the post-intervention test (II). Age (p<0.0001) and body mass index (p≤.0001) were associated with forearm BMD in both sexes. Reported moderate physical activity levels in men were positively associated with forearm BMD (p<0.05) (III). In both sexes, reported moderate (p<0.05) and high (women p<0.05 and men p<0.001) physical activity levels were positively associated with calcaneal stiffness. The correlation coefficient between forearm BMD and calcaneal stiffness was 0.58 in women and 0.34 in men (V). Persons aged ≥ 65 years at the follow-up in 1994 reported more use of shoe/cane spikes

and moderate physical activity levels compared to controls (IV). There was no change in the general incidence of forearm and hip fractures between the communities for the study period. However, there was a tendency towards decreasing incidence of forearm and trochanteric hip fracture in both sexes during the late intervention period in the intervention community (VI).

A community-based intervention programme aimed at reducing the incidence of osteoporotic fractures must be regarded as a long-term project and should preferably be monitored over an extended post-intervention period.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2003. 50 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 788
Vadstena Osteoporosis Prevention Project (VOPP), weight-bearing training study, physical activity, training programmes, elderly, forearm bone mineral density (BMD), balance-training
National Category
urn:nbn:se:liu:diva-5212 (URN)91-7373-547-7 (ISBN)
Public defence
2003-05-08, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
On the day of the public defence the statuses of articles IV and V were Submitted and VI was ManuscriptAvailable from: 2003-05-19 Created: 2003-05-19 Last updated: 2013-09-05Bibliographically approved

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