J Bone Miner Res. 2020 Apr 9. doi: 10.1002/jbmr.4027. [Epub ahead of print]
Dynamic resistance exercise (DRT) might be the most promising agent for fighting sarcopenia in older people. However, the positive effect of DRT on osteopenia/osteoporosis in men has still to be confirmed. In order to evaluate the effect of low volume/high intensity (HIT)-DRT on bone mineral density (BMD) and skeletal muscle mass index (SMI) in men with osteosarcopenia, we initiated the Franconian Osteopenia and Sarcopenia Trial (FrOST). Forty-three sedentary community dwelling older men (73-91 years) with osteopenia/osteoporosis and SMI-based sarcopenia were randomly assigned to a HIT-RT exercise (EG: n=21) or a control group (CG, n=22). HIT-RT provided a progressive, periodized single set DRT on machines with high intensity, effort and velocity twice a week, while CG maintained their lifestyle. Both groups were adequately supplemented with whey protein, Vit-D and calcium. Primary study endpoint was integral lumbar spine (LS) BMD as determined by quantitative computed tomography. Core secondary study endpoint was skeletal muscle mass index (SMI) as determined by dual-energy-x-ray absorptiometry. Additional study endpoints were BMD at the total hip and maximum isokinetic hip-/leg-extensor strength (leg press). After 12 months of exercise, LS-BMD was maintained in the EG and decreased significantly in the CG, resulting in significant between group differences (p<.001, standardized mean difference (SMD): .90). In parallel, SMI increased significantly in the EG and decreased significantly in the CG (p<.001, SMD: 1.95). Total hip BMD changes did not differ significantly between the groups (p=.064, SMD=0.65), while changes in maximum hip-/leg-extensor strength were much more prominent (p<.001, SMD=1.92) in the EG. Considering dropout (n=2), attendance rate (95%) and unintended side effects/injuries (n=0), we believe our HIT-RT protocol to be feasible, attractive and safe. In summary, we conclude that our combined low-threshold HIT-RT/protein/Vit-D/calcium intervention was feasible, safe and effective for tackling sarcopenia and osteopenia/osteoporosis in older men with osteosarcopenia.