Category Archives: Weight-Bearing Exercise

Weight Belt Walking Maintains Bone

Abstract

An aerobic weight-loaded pilot exercise intervention for breast cancer survivors: bone remodeling and body composition outcomes.

Weight gain and bone loss are commonly reported in breast cancer survivors. The purpose of this pilot study is to assess feasibility and explore the effect of an aerobic weight-loaded exercise intervention on bone remodeling, weight, and body composition.
A one-group pre-posttest design was used to test a 16-24-week supervised walking exercise intervention among women within 2 years of menopause. Through Weeks 1-4, time and weight were progressively increased. By Week 5 and through the end of the intervention, a waist belt was loaded with 5 lb and participants spent 45 min on the treadmill 3 times/week. Bone remodeling was measured by serum biomarkers (N-terminal propeptides of type I collagen [NTX] and serum osteocalcin). Dual-energy absorptiometry scans assessed body composition. Data were collected at baseline and 16 and 24 weeks.
The majority of the 26 participants were married, well educated, and employed, with a mean age of 51.3 years (SD = 6.2). The high adherence (M = 88.2%, SD = 6.8) demonstrated feasibility. There were no significant changes in serum osteocalcin (p = .67), serum NTX (p = .31), lean muscle mass (p = .08), or percent fat mass for the group as a whole (p = .14), but fat mass increased for women on adjuvant endocrine therapy (p = .04). The women maintained their weight.
This novel exercise intervention for breast cancer survivors was feasible, and women otherwise at high risk for weight gain and bone loss maintained their weight and bone mass.

Knobf MT, Insogna K, DiPietro L, Fennie C…
Biol Res Nurs Jul 2008
PMID: 18705153

GH + Exercise No Benefit Over Exercise Alone

Abstract

Effect of resistance exercise and growth hormone on bone density in older men.

The purpose of this study was to evaluate whether 16 weeks of heavy resistance exercise training combined with daily growth hormone administration (GH) increases bone mineral density in 64-75-year-old men greater than resistance exercise training without GH supplementation.
Eighteen healthy, elderly men (67 +/- 1 year) followed a 16-week progressive resistance training programme (75-90% maximum strength, 5-10 repetitions/set, 4 sets/day, 4 days/week) after double-blind, random assignment to either a GH (12.5 or 18 micrograms/kg/day, equivalent to 25 or 36 mU/kg/day, n = 7) or placebo (n = 11) group.
Before and at the end of 16 weeks of resistance exercise with or without GH administration, body composition, whole body and regional bone mineral density (BMD) were determined by dual-energy X-ray absorptiometry. Serum osteocalcin and IGF-I were determined by radioimmunoassay before, during and at the end of treatment.
Increments in fat-free mass and training-specific maximum voluntary muscle strength were similar in both groups after training. Serum insulin-like growth factor-I (IGF-I) and osteocalcin levels were increased (P < 0.05) after exercise training plus GH. In comparison to initial measures, bone mineral density (g/cm2) of the proximal femur (Ward’s triangle) was increased (P < 0.05) after 16 weeks of exercise training plus placebo treatment. Sixteen weeks of exercise training plus GH treatment did not increase whole body, spine or hip (femoral neck, trochanter, Ward’s triangle) bone mineral density more than exercise plus placebo treatment.
These findings suggest that in these older men with normal bone mineral density, short-term resistance exercise training increased regional bone mineral density, but the addition of daily GH administration did not enhance whole body or regional bone mineral density despite GH-induced increments in serum IGF-I and osteocalcin. This implies that GH administration during a 16-week resistance exercise training programme may increase bone turnover without increasing bone mineral accumulation.

Yarasheski KE, Campbell JA, Kohrt WM
Clin. Endocrinol. (Oxf) Aug 1997
PMID: 9302398

Review: Exercise & Bones

Abstract

The effect of physical activity and its interaction with nutrition on bone health.

Physical activity (PA) is a popular therapy for the prevention and treatment of bone loss and osteoporosis because it has no adverse side effects, it is low cost, and it confers additional benefits such as postural stability and fall prevention. Bone mass is regulated by mechanical loading, and is limited but not controlled by diet. The mechanism by which strain thresholds turn bone remodelling ‘on’ and ‘off’ is known as the mechanostat theory. Research in animals has shown that optimal strains are dynamic, with a high change rate, an unusual distribution and a high magnitude of strain, but the results of randomized controlled trials in human subjects have been somewhat equivocal. In the absence of weight-bearing activity nutritional or endocrine interventions cannot maintain bone mass. Biochemical markers of bone turnover predict bone mass changes, and findings from our research group and others have shown that both acute and chronic exercise can reduce bone resorption. Similarly, Ca intervention studies have shown that supplementation can reduce bone resorption. Several recent meta-analytical reviews concur that changes in bone mass with exercise are typically 2-3%. Some of these studies suggest that Ca intake may influence the impact of PA on bone, with greater effects in Ca-replete subjects. Comparative studies between Asian (high PA, low Ca intake) and US populations (low PA, high Ca intake) suggest that PA may permit an adaptation to low Ca intakes. Whether Ca and PA interact synergistically is one of the most important questions unanswered in the area of lifestyle-related bone health research.

Murphy NM, Carroll P
Proc Nutr Soc Nov 2003
PMID: 15018482

Running Improves Calcium Balance in Rats

Abstract

Hypokinesia-induced negative net calcium balance reversed by weight-bearing exercise.

Negative calcium balance and bone loss occurring with immobilization and hypokinesia have been attributed to a lack of weight bearing on bones. The effects of weight-bearing exercise for promotion of calcium balance after hypokinesia were examined. Rats were randomly assigned to either hypokinetic suspension for 28 d or to a control sedentary group, free to move about their cages at will. After 28 d, the rats in each group were randomly subdivided to either post-hypokinetic forced running (HR), post-hypokinetic sedentary (HS), control forced running (CR), or control sedentary (CS) groups. Net calcium balance was then determined for 25 consecutive days. Net calcium balance of HR was negative for the first 5-d period of recovery and then became positive; that of HS was negative for 25 d; that of CR and CS remained essentially positive. Net calcium absorption paralleled net calcium balance. Forced running was effective in reestablishment of positive net calcium balance after 28 d of decreased weight bearing.

Lutz J, Chen F, Kasper CE
Aviat Space Environ Med Apr 1987
PMID: 3579816

Exercise + HRT = Bone Synergy

Abstract

Additive effects of weight-bearing exercise and estrogen on bone mineral density in older women.

The separate and combined effects of weight-bearing exercise and hormone replacement therapy (HRT) on bone mineral density (BMD) were studied in 32 women, 60 to 72 years of age. HRT consisted of continuous conjugated estrogens 0.625 mg/day and trimonthly medroxyprogesterone acetate 5 mg/day for 13 days. Exercise consisted of 2 months of low-intensity exercise followed by 9 months of more vigorous weight-bearing exercise approximately 45 minutes/day, > or = 3 days/week, at 65-85% of maximal heart rate. Lumbar spine and proximal femur BMD were significantly increased in response to exercise and to HRT, and total body BMD was significantly increased in response to HRT; neither exercise nor HRT had an effect on wrist BMD. The combination of exercise + HRT resulted in increased BMD at all sites except the wrist, with effects being additive for the lumbar spine and Ward’s triangle and synergistic for the total body. Based on reductions in serum osteocalcin levels, it appears that increases in BMD in response to HRT and exercise + HRT were due to decreased bone turnover. The lack of change in serum osteocalcin and IGF-I in response to exercise alone suggests that increases in BMD were due to decreased bone resorption and not increased formation. Results indicate that weight-bearing exercise + HRT may be effective in preventing and/or treating osteoporosis. It is likely that the additive effects of weight-bearing exercise and HRT on bone mineral accretion, coupled with other adaptations to the exercise (i.e., increased strength and functional capacity), could effectively reduce the incidence of falls and osteoporotic fractures.

Kohrt WM, Snead DB, Slatopolsky E, Birge SJ
J. Bone Miner. Res. Sep 1995
PMID: 7502701