KRISTIN MOYSTAD MICHELET: Physical exercise with static compared to dynamic loading; experiences and effects on bone, muscles and balance

Project description

Osteoporosis is a systemic skeletal disease characterized by low bone density and altered microarchitecture, leading to fragile bones and an increased risk of fractures. Physical exercise as part of osteoporosis treatment is strongly recommended in international guidelines and has been shown to preserve, and possibly increase, bone density. However, the impact of physical activity on other aspects of bone quality, such as microarchitecture and blood biomarkers of bone health, has been less studied. The evidence underlying current national and international guidelines on physical activity in osteoporosis does not include recommendations for static muscle-strengthening training. Recently, the private training concept OsteoStrong® has marketed itself as exercise for osteoporosis, but large randomized studies on the effects of this training method on the skeleton are still lacking. 

Aim

This doctoral project is part of the BONEMORE study, with the aim of comparing experiences and effects of static training with OsteoStrong® and dynamic training according to national recommendations for osteoporosis. The study measures effects on bone, balance, muscle strength, and biochemical bone markers during a nine-month randomized controlled trial (RCT). 

Method

The doctoral project uses quantitative (studies 1, 3, and 4) and qualitative (study 2) methodology.

In study 1 we examined how bone strength measured with OsteoProbe®, blood bone markers, and bone density measured with DXA were affected in study participants after nine months of training. 

In study 2 we interviewed participants after completing nine months of training, asking about their perceptions and experiences of the exercise. The interviews were analyzed using qualitative content analysis, where we also compared the two different training interventions. 

In study 3, the plan is to investigate associations between the presence of vertebral compressions assessed with VFA (vertebral fracture assessment) and the level of physical activity measured with an accelerometer. 

In study 4, the plan is to examine correlations between balance measures from the BTrackS balance plate and other clinically well-established measures of balance, muscle strength, and fall risk. 

Relevance

By studying both the biological effects and participants’ own experiences of the training, the research can provide a more complete picture of how different forms of exercise affect people with osteoporosis. The hope is that these studies will contribute to increased knowledge about how different types of loading strengthen bone and balance, provide scientific evidence for training methods that are currently marketed but not yet sufficiently studied, and lead to more individualized recommendations for exercise in patients with osteoporosis.