A Comparison of Bone‐Targeted Exercise Strategies to Reduce Fracture Risk in Middle‐Aged and Older Men with Osteopenia and Osteoporosis: LIFTMOR‐M Semi‐Randomized Controlled Trial

ABSTRACT The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR‐M) trial examined efficacy and safety of two novel exercise programs in older men with low BMD. Men with low hip and/or LS BMD were randomized to high‐intensity progressive resistance and impact training (HiRIT) or machine‐based isometric axial compression (IAC) and compared to a nonrandomized matched control (CON). Outcomes included: hip and LS BMD; calcaneal ultrasound parameters; anthropometry; body composition; function (timed up‐and‐go [TUG], five‐times sit‐to‐stand [FTSTS]); back extensor strength (BES); leg extensor strength (LES); compliance and adverse events. Ninety‐three men (67.1 ± 7.5 years; 82.1 ± 11.6 kg; 175.2 ± 6.7 cm; FN T‐score −1.6 ± 0.6) were randomized to HiRIT (n = 34) or IAC (n = 33), or allocated to CON (n = 26). HiRIT improved trochanteric BMD (2.8 ± 0.8%; −0.1 ± 0.9%, p = .024), LS BMD (4.1 ± 0.7%; 0.9 ± 0.8%, p = .003), BUA (2.2 ± 0.7%; −0.8 ± 0.9%, p = .009), stiffness index (1.6 ± 0.9%; −2.0 ± 1.1%, p = .011), lean mass (1.5 ± 0.8%; −2.4 ± 0.9%, p = .002), TUG, FTSTS, BES, and LES (p < .05) compared with CON. IAC improved lean mass (0.8 ± 0.8%; −2.4 ± 0.9%, p = .013) and FTSTS (−4.5 ± 1.6%; 7.5 ± 2.0%, p < .001) compared with CON. HiRIT improved LS BMD (4.1 ± 0.7%; 2.0 ± 0.7%, p = .039), stiffness index (1.6 ± 0.9%; −1.3 ± 0.9%, p = .025), and FTSTS (−10.7 ± 1.6%; −4.5 ± 1.7%, p = .010) compared with IAC. Exercise compliance was high (HiRIT 77.8 ± 16.6%; IAC 78.5 ± 14.8%, p = .872). There were five minor adverse events (HiRIT, 2; IAC, 3). HiRIT was well‐tolerated and improved bone, function and fracture risk more than CON or IAC. © 2020 American Society for Bone and Mineral Research.