Aims: To assess the effectiveness of high-velocity progressive resistance training (PRT) interventions with regard to exercise parameters in enhancing bone mass among individuals at risk of bone loss or with osteoporosis.
Methods: The review protocol was registered with PROSPERO (CRD42024558168). Seven databases were searched for PRT interventions on bone mineral density (BMD). Two reviewers independently screened records for eligibility. PRT interventions included land-based exercises using progressive overload. Primary outcome was BMD at fracture-relevant sites, measured by DEXA.
Results: Of 1,652 screened records, 8 studies met the inclusion criteria. Three studies investigated postmenopausal women (n=336). A 13-month study employing PRT at different velocities noted BMD gains within the group and against the control group. Two moderate-velocity (2s/0s/2s) programs (12 and 24 months) demonstrated reduced mean BMD at bone-relevant sites. The 24-month study revealed significant BMD increases in 23%, 36% and 28% of the participants at the femoral neck (FN), total hip (TH), and lumbar spine (LS) compared to the least significant change. However, the program did not prevent significant bone loss in most participants at these sites. Four interventions examined elderly men (n=173). Two 12-month studies employed an explosive concentric phase, resulting in BMD increases at 4 or 6 months across all bone-relevant sites. However, only one showed BMD increases at 12-months, while the other showed decreases. One 18-month intervention utilizing mixed velocities increased LS BMD and preserved TH BMD, while the control group experienced BMD decreases. A 12-month intervention applying moderate velocity (2s/0s/2s) resulted in unchanged TH BMD, a slight LS BMD increase, and FN BMD loss.
Conclusion: Further research is needed to identify the optimal movement velocity for enhancing bone health. Individualization appears crucial, as responses to programs vary, prompting questions about underlying differences. Considering osteoporosis may involve defective mechanotransduction, factors beyond known confounders may influence the intervention's effectiveness.