Resistance vs Endurance Exercise for Osteoporosis

(MOVE Trial)

Overseen By Toby Wellington, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Renal impairment, Hepatobiliary disease, Thyroid dysfunction, Diabetes, Cardiovascular disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 30

Duration: 10 weeks

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine how different types of exercise affect bone health, specifically whether resistance or endurance exercise increases bone breakdown. Participants will engage in either resistance training (strength training) or endurance exercise (aerobic exercise) over a 10-week period. The study focuses on how these exercises alter blood markers related to bone health. It seeks healthy older veterans in the Denver Metro Area who are already somewhat active, such as those who enjoy cycling or walking regularly. As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance exercise recommendations for bone health.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that both strength training and endurance exercises are generally safe and can improve bone health. Strength training, such as lifting weights, strengthens bones, even in individuals with osteoporosis. These exercises are manageable and build muscle without harming bones.

Endurance exercises, like cycling, also maintain bone health safely. However, they might temporarily increase the natural bone breakdown process after a workout. This effect isn't harmful, but researchers continue to monitor it.

Both exercise types are widely used and considered safe when performed correctly. They can be part of a healthy routine, especially with guidance to ensure proper technique and intensity. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about exploring the effects of resistance and endurance exercise on osteoporosis because these methods could offer drug-free and side-effect-free alternatives to traditional treatments like bisphosphonates or hormone therapy. Resistance exercise involves using weights to strengthen muscles, which may also enhance bone density, while endurance exercise like cycling improves cardiovascular health and could indirectly support bone strength by enhancing overall fitness. This trial aims to determine how these exercises might be optimized to improve bone health, potentially offering a new approach to managing osteoporosis that is accessible and sustainable for many people.

What evidence suggests that this trial's treatments could be effective for osteoporosis?

This trial will compare the effects of two types of exercise on bone health in individuals with osteoporosis. Participants in one arm will engage in 10 weeks of supervised resistance exercise training. Research has shown that this can increase bone strength, especially in postmenopausal women, with moderate strength exercises being particularly beneficial for the lower back. In the other arm, participants will complete 10 weeks of supervised endurance exercise training, such as stationary cycling, which helps maintain bone strength in the lower back. Both types of exercise generally have similar effects on overall bone strength and can help maintain and improve bone health in people with osteoporosis. ^{2 6 7 8 9}

Who Is on the Research Team?

Sarah J Wherry, PhD

Principal Investigator

Rocky Mountain Regional VA Medical Center, Aurora, CO

Are You a Good Fit for This Trial?

This trial is for healthy older veterans aged 60+ in the Denver area who are normally active, like walking or cycling. They can't join if they have liver disease, kidney problems, anemia, diabetes, thyroid issues, abnormal calcium levels, severe high blood pressure, recent COVID-19 symptoms or diagnosis, a fracture within the last six months or heart disease.

Inclusion Criteria

I am a healthy veteran aged 60 or older living in the Denver Metro Area.

You usually do activities like riding a bike or going for walks.

Exclusion Criteria

I have had a bone break in the last 6 months.

I have a history of diabetes (type 1 or 2).

Your blood pressure is not well controlled, with a high systolic (top number) or diastolic (bottom number) reading.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo 10 weeks of supervised exercise training, either resistance training or endurance exercise, 3 times per week

10 weeks

30 visits (in-person)

Follow-up

Participants are monitored for changes in bone biomarkers and physical performance after exercise sessions

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• 10 Weeks of Supervised Endurance Exercise Training
• 10 Weeks of Supervised Resistance Exercise Training

Trial Overview The study tests how two types of exercise affect bone health markers in older adults. Participants will do either 10 weeks of supervised resistance training (like lifting weights) or endurance training (like running), to see which one is better for bones.

How Is the Trial Designed?

Group I: Resistance Exercise Experimental Treatment 1 Intervention

Participants will perform total body resistance training 3x per week for 10 weeks. Each exercise session will last approximately 1 hour.

Group II: Endurance Exercise Experimental Treatment 1 Intervention

Participants will complete 60 minutes of stationary cycling 3x per week at 70-80% of maximal heart rate for 10 weeks.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Published Research Related to This Trial

Exercise plays a crucial role in preventing and treating osteoporosis, as sedentary individuals generally have lower bone mass compared to those who exercise, although exercise alone cannot fully compensate for bone loss due to estrogen deficiency.

Moderate exercise is recommended for osteoporosis prevention and treatment, as it not only helps maintain bone mass but also improves muscle strength, coordination, and flexibility, which are important for overall bone health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bone mass and exercise. Chesnut, CH.[2019]

High-intensity, resistive strength training is the most effective exercise for increasing bone mineral density and reducing fractures in patients with osteoporosis, while posture and balance exercises mainly improve mobility.

High-force exercises do not increase the risk of fractures and are beneficial for bone health, but combining exercise with vitamin D and calcium intake is essential for optimal prevention of osteoporosis and fractures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of Exercises in Osteoporotic Fracture Prevention and Current Care Gaps. Where Are We Now? Recent Updates. Senderovich, H., Tang, H., Belmont, S.[2020]

Integrating resistance training, particularly through interval methods like cluster sets, can significantly improve health outcomes for cardiac patients, including increased muscle mass and better muscular fitness, which are not fully achieved with aerobic exercise alone.

Interval resistance training may enhance safety by reducing acute haemodynamic responses and improving exercise tolerance in cardiac patients, making it a potentially more suitable and effective option for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cluster Sets to Prescribe Interval Resistance Training: A Potential Method to Optimise Resistance Training Safety, Feasibility and Efficacy in Cardiac Patients. Way, KL., Thomas, HJ., Parker, L., et al.[2023]

A 12-week concurrent exercise training program combining sprint interval training and resistance exercise significantly improved aerobic capacity (VO2max) in 53 inactive adult women, indicating its effectiveness for cardiovascular health.

Both sprint interval training at level-grade and incline showed similar improvements in aerobic capacity, suggesting that this type of training can be beneficial for older women to enhance overall health and functionality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a Sprint Interval and Resistance Concurrent Exercise Training Program on Aerobic Capacity of Inactive Adult Women. Salom Huffman, L., Wadsworth, DD., McDonald, JR., et al.[2019]

Exercise is an effective strategy for preventing and treating osteoporosis, as shown by randomized controlled trials and meta-analyses that indicate it helps preserve bone mass and prevent fractures and falls.

Specific exercise protocols tailored to an individual's age and physical condition are crucial for safely achieving positive outcomes in osteoporosis management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Daily practice using the guidelines for prevention and treatment of osteoporosis. Effectiveness of exercise for preventing and treating osteoporosis]. Miyakoshi, N.[2008]

A 12-month Balance Training Program significantly improved the quality of life in elderly women with osteoporosis, enhancing well-being, physical function, psychological status, symptoms, and social interaction compared to a control group.

The program also led to improved functional balance and a 50% reduction in falls among participants, demonstrating its effectiveness in enhancing both safety and overall health in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: improvement of quality of life. Madureira, MM., Bonfá, E., Takayama, L., et al.[2010]

A 12-month resistance training program significantly improved muscular strength in healthy older women, with both high-intensity and low-intensity groups showing better strength compared to the control group.

However, neither high-intensity nor low-intensity resistance training led to significant changes in bone mineral density (BMD) at the lumbar spine or total hip, indicating that while strength gains are achievable, they do not necessarily translate to increased bone density.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women. Pruitt, LA., Taaffe, DR., Marcus, R.[2015]

Progressive resistance training (PRT) is beneficial for individuals at risk of fractures, as it can improve femoral neck bone mineral density (BMD), enhance health-related quality of life, and reduce pain, based on a systematic review of 53 studies involving older adults with low BMD or fracture history.

While PRT improves physical functioning, the effects on fall risk and the number of falls remain uncertain, but adverse events related to PRT are rare and typically minor.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Progressive Resistance Training for Improving Health-Related Outcomes in People at Risk of Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Ponzano, M., Rodrigues, IB., Hosseini, Z., et al.[2021]

In a 12-week study involving postmenopausal women with osteoporosis, balance and coordination exercises significantly improved balance as measured by the Timed Up and Go test and Berg Balance Scale, while strengthening exercises were more effective in reducing pain.

No patients experienced falls during the 24-week follow-up, indicating that both exercise interventions were safe and beneficial for improving quality of life in osteoporotic patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Balance-Coordination, Strengthening, and Aerobic Exercises to Prevent Falls in Postmenopausal Patients With Osteoporosis: A 6-Month Randomized Parallel Prospective Study. Dizdar, M., Irdesel, JF., Dizdar, OS., et al.[2022]

In a study of 101 postmenopausal women with abdominal obesity, endurance-strength training for 12 weeks significantly increased whole-body bone mineral density (BMD) compared to endurance training alone, suggesting it may be more beneficial for bone health.

Both endurance and endurance-strength training improved physical capacity equally, but endurance training was better at maintaining bone mineral content (BMC) in the lumbar spine, indicating different benefits of each exercise type for bone health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Endurance and Endurance-Strength Training on Bone Mineral Density and Content in Abdominally Obese Postmenopausal Women: A Randomized Trial. Jamka, M., Mądry, E., Bogdański, P., et al.[2021]

Recent studies indicate that resistance exercise, when performed at low intensities (40-60% of maximum voluntary contraction) and with high repetitions (15-20), can lead to only moderate increases in blood pressure, similar to those seen with moderate aerobic training.

Resistance training can be beneficial for certain cardiac patients, improving muscle strength, cardiovascular function, and overall quality of life, but it should be tailored to individual clinical statuses, particularly for those with high physical capacity and good myocardial function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The stakes of force perseverance training and muscle structure training in rehabilitation. Recommendations of the German Federation for Prevention and Rehabilitation of Heart-Circulatory Diseases e.v]. Bjarnason-Wehrens, B., Mayer-Berger, W., Meister, ER., et al.[2007]

Both endurance training and very low volume, high-intensity interval training improved aerobic fitness in recreationally active females, with increases in peak oxygen uptake of approximately 7% and 8%, respectively, after 4 weeks of training.

The whole-body aerobic-resistance training not only enhanced cardiovascular fitness but also significantly improved muscular endurance, with increases in various exercises ranging from 40% to 207%, while participants reported higher enjoyment and motivation to continue this type of training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Extremely low volume, whole-body aerobic-resistance training improves aerobic fitness and muscular endurance in females. McRae, G., Payne, A., Zelt, JG., et al.[2016]

Regular exercise, including aerobic, weight-bearing, and resistance training, is crucial for preventing falls and managing osteoporosis, with recommendations of at least 3 sessions per week lasting 20-30 minutes at 50-80% of maximum effort.

Proprioceptive training enhances balance and can significantly reduce the risk of falls and fractures in individuals with osteoporosis, highlighting the importance of targeting spine extensors and hip muscles in exercise interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Nonpharmacological treatment of osteoporosis]. Babić-Naglić, D.[2009]

Citations

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The Effect of Endurance and Endurance-Strength Training ... Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6323511/

The Effectiveness of Physical Exercise on Bone Density in ... Physical exercise is considered an effective means to stimulate bone osteogenesis in osteoporotic patients.

3. sciencedirect.com sciencedirect.com/science/article/pii/S235218722200465X

A comparison of different exercise intensities for improving ... Postmenopausal women with osteoporosis may achieve more significantly improved lumbar spine BMD with HiRIT than with MiRIT.

4. withpower.com withpower.com/trial/phase-osteoporosis-6-2022-fc91a

Resistance vs Endurance Exercise for Osteoporosis Research shows that exercise, including endurance and resistance training, can help maintain bone health and prevent fractures in people with osteoporosis.

5. ijbnpa.biomedcentral.com ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-01040-4

Evidence on physical activity and osteoporosis prevention for ... The aim of this review was to investigate the association between physical activity and osteoporosis prevention in people aged 65 years and above.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6279907/

Effects of Resistance Exercise on Bone Health - PMC Exercise training has been recommended as a promising therapeutic strategy to encounter the loss of bone and muscle mass due to osteosarcopenia.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10345999/

Position Statement: Exercise Guidelines for Osteoporosis ... The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2405525516300929

Osteoporosis prevention and osteoporosis exercise in ... A review of community-based public health programs for osteoporosis prevention show that programs vary in numerous ways and have mixed results.

9. frontiersin.org frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2025.1655404/epub

The effect of physical activity intervention and detraining on ... Epidemiological data show that up to one in three women over the age of 50 will suffer an osteoporotic fracture during their lifetime, which ...