Strength Training for Osteoporosis

(STOP-EM Trial)

Overseen By Charley Hasselaar

Age: 18 - 65

Sex: Female

Trial Phase: Academic

Sponsor: University of Calgary

Must not be taking: Glucocorticoids, Osteoporosis drugs

Disqualifiers: Pregnancy, Orthopaedic conditions, Cardiovascular, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 9 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the feasibility of a 9-month resistance training program for women undergoing menopause. It aims to determine if high-intensity exercise can enhance bone health, increase muscle strength, and alleviate menopausal symptoms. Participants will be divided into two groups: one will follow the exercise program, while the other will wait to try it later. Women in the early stages of menopause who are not currently engaged in resistance training may be suitable candidates. As an unphased study, this trial provides a unique opportunity to explore the benefits of exercise during menopause.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are using glucocorticoids or have been treated with osteoporosis medications, you may not be eligible to participate.

What prior data suggests that this resistance training is safe for peri- and early menopausal females?

Research shows that resistance training is generally safe and improves bone and muscle health. Studies have found that this exercise can increase bone strength, reducing the risk of osteoporosis, especially for those at risk of losing bone and muscle mass.

Other research indicates that resistance training is safe for adults, including those with heart issues, and can enhance overall heart health. While safety is crucial, most people tolerate resistance training well. Participants should follow guidelines and maintain communication with trainers to ensure safe workouts. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about resistance training for osteoporosis because it offers a drug-free alternative to strengthen bones. Unlike the standard treatments that often involve medications like bisphosphonates or hormone therapy, resistance training uses physical exercise to improve bone density. This approach minimizes potential side effects associated with drugs and empowers individuals to engage actively in their bone health. Plus, resistance training can enhance overall strength and balance, reducing the risk of falls and fractures.

What evidence suggests that resistance training might be an effective treatment for osteoporosis?

Research shows that resistance training, which participants in this trial may engage in, benefits bone health, particularly in the spine and hips. Studies suggest that lifting heavier weights increases bone mass more effectively than lifting lighter weights. Some evidence indicates that performing exercises quickly might further enhance bone strength, as measured by bone mineral density (BMD). This type of exercise is recommended to help prevent the loss of bone and muscle commonly associated with aging. ^{1 3 6 7 8}

Who Is on the Research Team?

Leigh Gabel, PhD

Principal Investigator

University of Calgary

Are You a Good Fit for This Trial?

This trial is for women aged 45-60 who are in peri- or early menopause, not currently doing resistance training, and have no recent severe fractures or conditions worsened by exercise. They shouldn't be pregnant nor planning pregnancy soon, without metabolic bone diseases, active steroid use, or low vitamin D/calcium levels.

Inclusion Criteria

I am in the early or peri-menopausal stage, within 5 years of my last period.

I am between 45 and 60 years old.

Exclusion Criteria

I have had a bone fracture due to osteoporosis in the last 5 years.

I am not pregnant nor planning to become pregnant in the next year.

Your blood test shows low levels of vitamin D or calcium.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 9-month supervised, progressive resistance training program

9 months

Twice weekly, in-person visits

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Resistance Training

Trial Overview The study tests if a high-intensity resistance training program over 9 months is practical for participants to follow. It will also look at the effects on bone health, muscle strength, and menopausal symptoms compared to a group that waits to start the program.

How Is the Trial Designed?

Group I: Exercise Experimental Treatment 1 Intervention

In-person, supervised resistance training program

Group II: Control Active Control 1 Intervention

Waitlist control group. Will be offered the exercise program following a 9-month wait.

Who Is Running the Clinical Trial?

University of Calgary

Lead Sponsor

Trials

827

Recruited

902,000+

Published Research Related to This Trial

A 12-month power-based resistance training program significantly improved bone mineral density (BMD) in a 70-year-old postmenopausal woman with osteoporosis, with increases of 24% in the lumbar spine and 29% in the femoral neck.

The training also reduced her fall risk, as indicated by a seven-point improvement in the Dynamic Gait Index, allowing her to be classified as a 'safe ambulator' after the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Power training improves bone mineral density and fall risk for a postmenopausal woman with a history of osteoporosis and increased risk of falling: A case report. Aquino, M., DiMenna, FJ., Petrizzo, J., et al.[2021]

Strength training significantly benefits adults by reducing the risk of muscle mass loss, functional decline, and fall-related injuries, especially in older adults who can achieve notable strength gains within a few months of starting a program.

Despite the health benefits, only 21.9% of men and 17.5% of women reported engaging in strength training two or more times per week in 2004, which is below the national health objective of 30% set for 2010, highlighting the need for more initiatives to promote strength training among adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trends in strength training--United States, 1998-2004. [2022]

Resistance training (RT) significantly reduces all-cause mortality and the incidence of cardiovascular disease while improving physical functioning in adults, based on an analysis of 11 systematic reviews involving over 382,000 participants.

Although adverse events were not consistently reported, serious adverse events related to RT were uncommon, suggesting that the benefits of resistance training outweigh the potential harms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resistance training and health in adults: an overview of systematic reviews. El-Kotob, R., Ponzano, M., Chaput, JP., et al.[2021]

Strength training is crucial for older adults (65 years and older) as it enhances health by improving muscular strength, endurance, and bone density, while also reducing the risk of falls and fractures.

Only about 12% of adults aged 65-74 and 10% of those aged 75 and older engage in strength training at least twice a week, highlighting the need for programs to promote strength training among older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strength training among adults aged >/=65 years--United States, 2001. [2008]

In a review of 121 trials involving 6700 older adults, most adverse events related to progressive resistance strength training were musculoskeletal issues like muscle strains and joint pain, particularly in participants with pre-existing health conditions or those engaging in high-intensity training.

Adverse events were often underreported, highlighting the need for clearer definitions and consistent reporting in future studies to better inform practitioners about the risks and benefits of strength training in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin. Liu, CJ., Latham, N.[2010]

The LIFTMOR trial demonstrated that high-intensity progressive resistance training (HiPRT) with impact loading is safe and effective for improving bone health in postmenopausal women with low bone mass, with no reported injuries during the study.

Participants in the HiPRT group showed significant improvements in bone mineral density and functional performance compared to those in a low-intensity exercise group, indicating that high-intensity training can be beneficial for osteoporosis rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Watson, SL., Weeks, BK., Weis, LJ., et al.[2018]

Citations

1. 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.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12107943/

Optimal resistance training parameters for improving bone ... The results indicate that resistance training significantly improves BMD at the LS (SMD = 0.88, 95% CI [0.21, 1.56], P = 0.01, I2 = 91%), FN ( ...

3. nature.com nature.com/articles/s41598-025-94510-3

Effect of different types of exercise on bone mineral density ... Notably, high-intensity strength training is more effective at increasing bone mass in the spine and hips than low-intensity or moderate- ...

4. frontiersin.org frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1105303/full

Comparative efficacy different resistance training protocols ... The results of the network Meta-analysis showed that moderate intensity resistance training was superior in improving lumbar spine bone mineral ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S8756328223003198

The effects of high velocity resistance training on bone ... There is growing evidence that suggests that high velocity resistance training (HVRT) has superior benefits on BMD compared to traditional resistance training ...

6. mayoclinic.org mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670

Strength training: Get stronger, leaner, healthier By stressing your bones, strength training can increase bone density and reduce the risk of osteoporosis. Manage your weight. Strength training can help you ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S2590109523000800

Exercise and Musculoskeletal Health in Men With Low ... The results suggest that regular resistance and impact training of various durations can maintain or even improve BMD in men with osteopenia or osteoporosis.

8. ahajournals.org ahajournals.org/doi/10.1161/CIR.0000000000001189

Resistance Exercise Training in Individuals With and ... Resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease.