Feasibility, Safety and Efficacy of OsteoStrong© in Postmenopausal Women with Low Bone Mineral Density: A Pilot Study

OsteoStrong© is described as a high-intensity, low-volume exercise modality that targets bone health improvements by applying isometric forces at relevant anatomical sites using specific equipment during brief (~10−minute, once weekly) sessions. Evidence on adherence, safety and effectiveness is limited. In this single-arm interventional study, we determined the feasibility of 8 months of OsteoStrong© for postmenopausal women with low BMD, and measured changes in bone density, microarchitecture and strength, physical function and body composition. Forty-four postmenopausal women with low BMD (DXA−determined T-score <−1.0 but >−3.0 at total hip and/or lumbar spine) attended supervised, once−weekly 10−15−minute sessions at an OsteoStrong© clinic for 8 months. We calculated 8-month changes in areal BMD (aBMD), trabecular bone scores (TBS), HRpQCT−determined volumetric BMD (vBMD) and bone microarchitecture and strength, as well as physical function and body composition. Thirty-eight women aged 61.2±5.5 years completed the study. Two adverse events suspected to be intervention-related were recorded. Adherence was 83±28% overall and 93±9% in those who completed the study. At 8 months, there were no changes in total hip, femoral neck, and lumbar spine aBMD (all P>0.05), while TBS decreased (P<0.05). At the distal radius, total, trabecular and cortical vBMD and cortical thickness decreased (mean change: −0.007mm [95%CI: −0.012, −0.002]). At the distal tibia, cortical vBMD decreased and trabecular separation increased (mean change: 0.007mm [95%CI: 0.001, 0.012]). Chair stand time (mean change: −0.8 sec [95%CI: −1.2, −0.5]) and stair climb time (mean change: −0.1 sec [95%CI: −0.2, −0.002]) decreased, while SPPB scores increased (mean change: 0.2 [95%CI: 0.03, 0.38]). There were no changes in other bone, physical function or body composition outcomes. These findings suggest that 8 months of OsteoStrong© does not significantly improve bone density, microarchitecture, or strength in postmenopausal women with low BMD, despite good adherence and safety. However, it improves some measures of physical function.