The BMD response to ONERO exercise is driven by load magnitude and the BMD response to bone medication is enhanced by ONERO — ASN Events
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  3. The BMD response to ONERO exercise is driven by load magnitude and the BMD response to bone medication is enhanced by ONERO

The BMD response to ONERO exercise is driven by load magnitude and the BMD response to bone medication is enhanced by ONERO (#14)

Belinda R Beck 1 2 , Tyler Collings 1
  1. Griffith University, QLD, Australia
  2. The Bone Clinic, Brisbane, QLD, Australia

BACKGROUND: Long term monitoring of a real-world clinical dataset has shown that bone-targeted exercise (ONERO) reduces risk for osteoporotic fracture by improving BMD, muscle, posture and function in patients with low bone mass. Determining the factors influencing patient response to ONERO will provide opportunities to optimise patient care. 

AIM: To assess the effect of bone medications on the BMD response of individuals adhering to ONERO exercise. 

METHODS: A total of 537 women (age 61.1 ± 6.7 yrs; Ht 162.8 ± 5.9 cm; Wt 62.3 ± 10.9 kg; total hip BMD T-score −1.6 ± 0.6) undertaking 11.9 ± 1.6 months of supervised ONERO exercise with a minimum of 50% adherence were examined in 4 groups: CON (no ONERO, no meds), CON+MEDS, ONERO-ALONE, ONERO+MEDS. Outcomes were absolute lumbar spine (LS), total hip (TH) and femoral neck (FN) BMD change. Group differences were estimated using multivariable linear regression models, adjusted for baseline BMD, age, BMI, time between scans, calcium intake, glucocorticoid use, years since menopause, clinical comorbidity, and fracture history. 

RESULTS: Within-group adjusted analyses revealed LS BMD increased in CON+MEDS (15.4 mg/cm², p = 0.019), ONERO-ALONE (18.3 mg/cm², p = 0.005) and ONERO+MEDS (22.1 mg/cm², p < 0.001). ONERO+MEDS also increased TH (20.1 mg/cm², p = 0.002) and FN BMD (19.2 mg/cm², p < 0.001). There were no significant BMD changes at any site in CON. Between-group adjusted contrasts revealed there was no difference in BMD improvement between CON+MEDS versus ONERO-ALONE at LS (−3.0 mg/cm², p = 0.749), TH (−3.9 mg/cm², p = 0.663) or FN (−2.6 mg/cm², p = 0.740), but a trend for greater improvement in ONERO-ALONE. CON+MEDS did not improve BMD significantly more than CON at any site, but ONERO+MEDS improved BMD more than CON at LS (19.8 mg/cm², p = 0.033), TH (18.7 mg/cm², p = 0.039) and FN (19.7 mg/cm², p = 0.011).

CONCLUSIONS: There is a consistent, strong, positive load-related dose response of BMD to ONERO exercise in older women at risk of osteoporotic fracture. ONERO improved BMD as much as bone medications and bone medications only improved hip BMD significantly when combined with ONERO exercise.