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Effects of Exercise Training Added to Ongoing Hormone Replacement Therapy on Bone Mineral Density in Frail Elderly Women

Authors

  • Dennis T. Villareal MD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Division of Geriatrics and Gerontology, Department of Internal Medicine,
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  • Ellen F. Binder MD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Division of Geriatrics and Gerontology, Department of Internal Medicine,
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  • Kevin E. Yarasheski PhD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Division of Geriatrics and Gerontology, Department of Internal Medicine,
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  • Daniel B. Williams MD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Department of Obstetrics and Gynecology, and
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  • Marybeth Brown PhD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri; and
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  • David R. Sinacore PhD,

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri; and
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  • Wendy M. Kohrt PhD

    1. Washington University Claude Pepper Older Americans
      Independence Center,
    2. Department of Medicine, Division of Geriatric Medicine, University of Colorado Health Sciences Center, Denver,
      Colorado.
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Address correspondence to Dennis T. Villareal, MD, FACP, Washington University Older Adult Health Center, 4488 Forest Park Boulevard, St. Louis, MO 63108. E-mail: dvillare@im.wustl.edu

Abstract

OBJECTIVES: To determine whether exercise training added to ongoing hormone replacement therapy (HRT) increases bone mineral density (BMD) in physically frail elderly women.

DESIGN: Prospective controlled trial.

SETTING: University-based research center.

PARTICIPANTS: Twenty-eight women on HRT, aged 75 and older with physical frailty.

INTERVENTIONS: Participants were assigned to 9 months of supervised (EXER) or home (HOME) exercise. The EXER program started with physical therapy and gradually incorporated resistance and endurance training. The HOME program consisted of flexibility exercises.

MEASUREMENTS: Changes in BMD and body composition.

RESULTS: There were larger increases in lumbar spine BMD in response to EXER than with HOME (3.5% vs 1.5%, P = .048), with a trend for larger increases in total body BMD (1.5% vs 0.2%, P = .058). There were no significant between-group differences in hip BMD. The EXER group had decreases in weight (−2.2 ± 0.3 kg, P = .010) and fat mass (−2.7 ± 0.4 kg, P = .018) and increases in muscle strength (9–30%, P < .05).

CONCLUSION: In physically frail elderly women on HRT, relatively vigorous exercise training significantly increased lumbar spine BMD. The improved BMD and strength in response to exercise could reduce fracture risk in frail women already on HRT.

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