Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures

Lancet. 1996 Nov 16;348(9038):1343-7. doi: 10.1016/S0140-6736(96)04214-6.


Background: Osteoporotic fractures among the elderly are common, and without preventive measures the burden of these fractures on health-care systems will increase further. The purpose of this randomised controlled study was to evaluate, in premenopausal women, the effects of high-impact loading on several determinants osteoporotic fractures.

Methods: 98 healthy, sedentary female volunteers aged 35-45 years were randomly assigned to either a training (n = 49) or a control group (n = 49). Progressive high-impact exercises were done three times per week for 18 months. We measured bone mineral density (BMD) in specific axial and lower-limb sites, by dual-energy X-ray absorptiometry, at baseline and after 12 and 18 months. Maximum isometric strength, muscular and cardiovascular performance, and dynamic balance were also assessed.

Findings: BMD at the femoral neck, a weightbearing site, increased significantly more in the training group (mean 1.6% [95% CI 0.8-2.4]) than in the control group (0.6% [-0.2 to 1.4], p = 0.006). By contrast, at non-weightbearing sites, such as the distal radius, there was no significant difference between the training and control groups (-1.5% [-2.7 to -0.3] vs -0.7% [-1.9 to -0.5], p = 0.60). In the training group there was a significant improvement in vertical jump and predicted oxygen consumption per min at maximum exercise compared with controls.

Interpretation: High-impact exercises that load bones with a rapidly rising force profile in versatile movements improve skeletal integrity, muscular performance, and dynamic balance in premenopausal women. If done on a regular basis, this type of exercise may help decrease the risk of osteoporotic fractures in later life. Long-term studies are required to show whether these 18-month results can be translated into long-term benefit.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Density
  • Bone and Bones / physiology
  • Cardiovascular Physiological Phenomena
  • Exercise*
  • Female
  • Fractures, Bone / etiology
  • Fractures, Bone / prevention & control*
  • Humans
  • Isometric Contraction
  • Middle Aged
  • Muscles / metabolism
  • Muscles / physiology
  • Osteoporosis / complications
  • Osteoporosis / prevention & control*
  • Prospective Studies
  • Risk Factors