Abstract：
To compare the effects of high-intensity resistance and impact training (HiRIT) to low-intensity, Pilates-based exercise (LiPBE) on proximal femur geometry and explore the influence of antiresorptive medication on those effects. Postmenopausal women with low bone mass, on or off antiresorptive bone medications were randomly allocated, stratified on medication intake, to eight months of twice-weekly, supervised HiRIT (Onero™) or LiPBE (Buff Bones®). 3D hip software was used to analyse proximal femur DXA scans. Outcomes included femoral neck (FN) and total hip (TH), volumetric (e.g. vBMC, vBMD) and geometric (e.g. cortical thickness, cross-sectional area [CSA], section modulus [Z]) indices of bone strength. Data were analysed using analysis of variance. Scans of 102 women were examined: LiPBE, 43; HiRIT, 37; LiPBE-med, 11; HiRIT-med, 11. HiRIT improved TH trabecular vBMC and vBMD (3.1 ± 1.1% versus - 1.2 ± 1.2%, p = 0.008; and 1.5 ± 1.0% versus - 1.6 ± 1.2%, p = 0.042, respectively) and FN and TH total vBMC (2.0 ± 0.8% versus - 0.2 ± 0.7%, p = 0.032; and 0.7 ± 0.4% versus - 0.8 ± 0.6%, p = 0.032, respectively), compared to losses in LiPBE. HiRIT also increased Z while LiPBE did not (p = 0.035). The combination of HiRIT and medication achieved greater improvements in FN total and trabecular vBMD, total BMC, CSA and Z than HiRIT alone. HiRIT improved geometric parameters of proximal femur strength, while LiPBE exercise was largely ineffective. Medication may enhance some HiRIT effects. Findings suggest reduced hip fracture risk in response to HiRIT.Trial registration number ACTRN12617001511325.
摘要：
为了比较高强度阻力和冲击训练（HIRIT）与低强度训练的效果，基于普拉提的运动（LiPBE）对股骨近端几何形状的影响，并探讨抗再吸收药物对这些影响的影响。绝经后低骨量妇女，抗骨吸收药物是随机分配的，根据药物摄入量进行分层，到八个月的每周两次，监督HIRIT(Onero™)或LiPBE(BuffBones®)。使用3D髋关节软件分析股骨近端DXA扫描。结果包括股骨颈（FN）和全髋关节（TH），体积(例如，vBMC，vBMD)和几何(例如皮质厚度，横截面积[CSA]，截面模量[Z])骨强度指数。使用方差分析对数据进行分析。对102名妇女进行了检查：LiPBE，43;HiRIT,37;LiPBE-med，11；HiRIT-med，11.HIRIT改善了TH小梁vBMC和vBMD（3.1±1.1％对-1.2±1.2％，p=0.008；1.5±1.0%对-1.6±1.2%，p分别=0.042）以及FN和TH总vBMC（2.0±0.8％对-0.2±0.7％，p=0.032；和0.7±0.4%对-0.8±0.6%，p=0.032，分别），与LiPBE的损失相比。HIRIT也增加Z,而LiPBE不增加(p=0.035)。HIRIT和药物的组合在FN总和小梁vBMD方面取得了更大的改善，总BMC,CSA和Z比单独的HiRIT。HIRIT改良股骨近端强度的几何参数，而LiPBE运动基本上无效。药物治疗可能会增强一些HIRIT效应。研究结果表明，应对HIRIT的髋部骨折风险降低。试验注册号ACTRN126170015111325。
