DOSE RESPONSE OF RISK FACTORS FOR OSTEOPOROTIC FRACTURE TO THERAPEUTIC EXERCISE

BACKGROUND: We previously conducted randomised controlled trials in older women and men with low bone mass and showed that high intensity resistance and impact training (HiRIT) can markedly reduce the risk of osteoporotic fracture by improving bone, muscle, posture and function. We then rolled the program out into a bespoke translational research clinical practice (The Bone Clinic, Brisbane, Australia) so we could continue to rigorously monitor the effects of the program (now called ONERO®) under real-world circumstances in a large patient cohort. We have found ONERO® to be equally effective in clinical practice as in our clinical trials, with added cardiovascular, psychosocial and quality of life benefits. Ten years of continuous comprehensive data collection has grown our patient sample sufficiently to examine ONERO® dose response. The aim of the current analysis was to examine whether there is a training frequency and/or intensity dose response of ONERO® on risk factors for osteoporotic fracture including BMD and functional performance. METHODS: In this longitudinal cohort study, 1020 women (age=61.7±7.9yrs, 163.2±6.7cm, 63.0±10.8kg, lumbar spine (LS) T score -2.2±1.1, total hip (TH) T score -1.6±0.7) who had attended The Bone Clinic for at least two years were examined. All patients are tested for risk factors for osteoporotic fracture (biometrics, BMD, functional performance, posture, etc.) at baseline and annually thereafter. Twice-weekly supervised ONERO® is recommended but dose is self-selected by patients. Some patients do not attend ONERO® classes at all thus creating an ersatz control. The dose parameters of ONERO® attendance (adherence) and load magnitude were monitored, along with adverse events. The relationships between dose and changes in all outcome variables were analysed and moderating variables of those relationships were determined. RESULTS: Older women undertaking long term consistent ONERO® showed a significant dose-related improvement in femoral neck (FN) bone mineral density (BMD) (p