Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
J Bone Miner Res. 2021 Sep;36(9):1680-1693. doi: 10.1002/jbmr.4334. Epub 2021 May 25.
The goal of the MEDEX-OP trial was to compare the efficacy of a known effective high-intensity resistance and impact training (HiRIT) with a low-intensity exercise control (Buff Bones® [BB]), alone or in combination with antiresorptive bone medication, on indices of fracture risk (bone mass, body composition, muscle strength, functional performance), compliance, and safety. Primary study outcomes were 8-month change in lumbar spine (LS) and total hip (TH) bone mineral density (BMD). Healthy postmenopausal women with low bone mass (T-score ≤ -1.0) on or off stable doses (≥12 months) of antiresorptive medication were recruited. A total of 115 women (aged 63.6 ± 0.7 years; body mass index [BMI] 25.5 kg/m ; femoral neck [FN] T-score -1.8 ± 0.1) were randomly allocated to 8-month, twice-weekly, 40-minute HiRIT (5 sets of 5 repetitions, >80% to 85% 1 repetition maximum) or BB (low-intensity, Pilates-based training), stratified by medication intake, resulting in four groups: HiRIT (n = 42), BB (n = 44), HiRIT-med (n = 15), BB-med (n = 14). HiRIT improved LS BMD (1.9 ± 0.3% versus 0.1 ± 0.4%, p < 0.001) and stature (0.2 ± 0.1 cm versus -0.0 ± 0.1 cm, p = 0.004) more than BB. Both programs improved functional performance, but HiRIT effects were larger for leg and back muscle strength and the five times sit-to-stand test (p < 0.05). There was a positive relationship between maximum weight lifted and changes in LS BMD and muscle strength in the HiRIT groups. Exploratory analyses suggest antiresorptive medication may enhance exercise efficacy at the proximal femur and lumbar spine. Exercise compliance was good (82.4 ± 1.3%) and both programs were well tolerated (7 adverse events: HiRIT 4; BB 3). HiRIT improved indices of fracture risk significantly more than Buff Bones®. More trials combining bone medication and bone-targeted exercise are needed. © 2021 American Society for Bone and Mineral Research (ASBMR).
MEDEX-OP 试验的目的是比较已知有效的高强度阻力和冲击训练（HiRIT）与低强度运动对照（Buff Bones®[BB]）在骨折风险指数（骨量、身体成分、肌肉力量、功能表现）、依从性和安全性方面的疗效。主要研究结果是 8 个月时腰椎（LS）和全髋（TH）骨矿物质密度（BMD）的变化。招募了服用或未服用稳定剂量（≥12 个月）抗吸收药物的绝经后低骨量（T 评分≤-1.0）的健康女性。共有 115 名女性（年龄 63.6±0.7 岁；体重指数 [BMI] 25.5kg/m；股骨颈 [FN] T 评分-1.8±0.1）被随机分配到 8 个月、每周两次、40 分钟的 HiRIT（5 组，每组 5 次重复，>80%至 85%的 1 次最大重复）或 BB（低强度，基于普拉提的训练），按药物摄入分层，结果分为四组：HiRIT（n=42）、BB（n=44）、HiRIT-药物（n=15）、BB-药物（n=14）。HiRIT 改善 LS BMD（1.9±0.3%比 0.1±0.4%，p<0.001）和身高（0.2±0.1cm 比-0.0±0.1cm，p=0.004）均优于 BB。两种方案均改善了功能表现，但 HiRIT 对腿部和背部肌肉力量以及五次坐站测试的影响更大（p<0.05）。HiRIT 组的最大举重重量与 LS BMD 和肌肉力量的变化呈正相关。探索性分析表明，抗吸收药物可能增强股骨近端和腰椎的运动疗效。运动依从性良好（82.4±1.3%），两种方案均耐受良好（7 例不良事件：HiRIT 4 例；BB 3 例）。HiRIT 改善骨折风险指数的效果明显优于 Buff Bones®。需要更多将骨药物与骨靶向运动相结合的试验。 © 2021 美国骨骼与矿物质研究协会（ASBMR）。
