The Efficacy of Plyometrics to Increase Bone Mass in Men
Osteoporosis affects men, too!
Osteoporosis affects more than 2 million men in the United States today and nearly 12 million more have osteopenia. Osteoporosis is the cause of 85% of all hip fractures and 90% of vertebral fractures in men, but, nevertheless, often goes undiagnosed and inadequately treated. Unlike women who are often identified as osteopenic or osteoporotic via routine DXA scan, men are usually diagnosed with osteoporosis only after experiencing a fragility fracture, back pain or diminished stature. However, even after suffering an osteoporosis-related fracture, >90% of men remain undiagnosed and untreated. Post-fracture, men are less likely to receive follow-up care than women, including calcium and vitamin D supplementation and prescription of anti-resorptive pharmacotherapy.
Research on effective treatment of male osteoporosis is severely lacking
The majority of osteoporosis treatment and prevention studies, including pharmacologic interventions, have been conducted in female populations. Although antiresorptive medications are an FDA-approved treatment for osteoporosis in males, less than 10% of men with osteoporotic fractures are treated with bisphosphonates. Enthusiasm for use of these medications in men appears to be limited by the relative lack of long-term safety and efficacy studies in men, the especially poor treatment compliance in males, and data suggesting poor cost effectiveness of bisphosphonate treatment in men. Exercise-based interventions are an attractive alternative to medication due to the reduced cost, fewer serious side effects, e.g., severe suppression of bone turnover and gastrointestinal complications, and additional health benefits, including improved balance and fall reduction. Resistance training and structured jump-training interventions increase BMD of the spine in girls and pre- and post-menopausal women. Data supporting the efficacy of activity-based interventions to increase BMD in adult males with osteopenia are virtually non-existent. Because body composition and hormonal status modify bone response to mechanical loading, there may be sex differences in the response to exercise-based interventions. Thus, studies that aim to identify safe and effective, yet practicable, exercise-based interventions to increase BMD in adult men with osteopenia are desperately needed.
Goal of the Bone Study: Exercise-based Treatment for Low Bone Mass in Men
The overall goal of this research project is reduction in both the personal and societal costs associated with low bone density and related fractures in men. The availability of a well-defined exercise-based treatment with demonstrated effectiveness will increase overall treatment accessibility and compliance, thereby reducing both the number of incident fractures and fracture-related mortality.
This study is being done to determine if either plyometrics (jump training) or resistance training (along with calcium and vitamin D supplementation) for 12 months will increase bone mass in men with low bone mineral density who are otherwise healthy.
This study consists of two phases; the Screening Phase and the Experimental Phase.
During the Screening Phase, you will meet with the study coordinator so we can explain the study more thoroughly to you. You will also read the consent form.
IF YOU CHOOSE, YOU MAY GO HOME AND DISCUSS YOUR POTENTIAL PARTICIPATION IN THIS STUDY WITH YOUR FAMILY AND FRIENDS.
If you decide to participate, you will sign the consent form and have your bone mineral density measured by dual-energy X-ray (DXA). During the DXA scan, you will be required to lie still for approximately 10 minutes and you will be exposed to a small amount of radiation (equivalent to 1/10th of a chest x-ray). You will be provided with the results of your bone density scan. You will also fill out a medical and physical activity history questionnaire and a physical activity readiness questionnaire (PAR-Q).
If you qualify for the study, you will be randomly assigned to either the resistance training or plyometric treatment. You will also be given a diet and physical activity log to fill out for one week every three months. For the next 12 months, you will perform the prescribed training in McKee Gym under the supervision of study personnel 2-3 times per week between 6:00 AM and 7:00 PM, Monday through Friday.
During this phase, you will have a small amount (about a tablespoon) of blood drawn for measurement of markers of bone turnover and hormones. This will occur at the beginning of the study and every three months thereafter. We will also retest your bone mineral density using DXA after 6 months and at the end of the study. All procedures will be provided at no cost to you.
You will also have to fill out a diet and physical activity log for one week every three months during your participation.
You will be required to take a calcium/vitamin D supplement daily.
You will receive $1000 compensation upon completion of the study.
- Meet with study coordinator
- Learn more about study
- Read consent form
- Sign consent form
- DXA scan
- Medical and Physical Activity Questionnaire
- Physical Activity Readiness Questionnaire (PAR-Q)
If You Are Eligible:
- Random assignment to plyometrics or resistance training group
- First 7-day diet and physical activity log
For the 12 Month Intervention:
- Exercise training at McKee Gym
- Have blood drawn every 3 months
- 7-day diet and physical activity logs every 3 months
- Calcium/vitamin D supplement daily
- Continue normal exercise routine
- Receive $1000 compensation
- Receive letter containing personal results
- be a male between the ages of 25 and 60 years
- have low bone mineral density (which we will screen you for), and be otherwise apparently healthy
- participate in leisure time physical activity at least 4 hours/week for the past 24 months
- be physically able to perform resistance training or plyometrics
- be willing and able to provide accurate information about your medical history
- follow a normal sleep/wake cycle (asleep at night and awake during the day)
- be willing to take calcium/vitamin D supplements on a regular basis
You must not:
- smoke, or have quit smoking in the last 6 months
- drink excessive amounts of alcohol (more than 3 drinks per day)
- take medication that affects bone
- have a disease that affects bone
- participate regularly in plyometrics or resistance training
If you are interested in participation, you will be required to:
- Sign the consent form
- Have a DXA scan done
- Fill out a medical and physical activity history questionnaire
- Fill out a PAR-Q
- Fill out a food frequency questionnaire
If you meet the eligibility requirements for the study, you will be required to:
- Perform your assigned exercise treatment 2-3 times/week for approximately 12 months (you must perform a set number of exercise sessions based on which group you are assigned to).
- Have DXA scans taken after 6 months of participation and at the end of your participation.
- Have blood drawn every three months, starting when you begin the study. After a 10 hour overnight fast, your height and weight will be measured and a blood sample will be taken. At 0, 6, and 12 months, additional blood samples will be collected up to 1 day after your normally scheduled training.
- Fill out a diet and physical activity log for one week every three months during participation in the study
- Take a calcium/vitamin D supplement daily
- Continue with your normal exercise program in addition to the plyometrics or resistance training
There are many benefits of participation in this study, including:
- Contribution to medical knowledge
- Participation in a supervised exercise program that could directly benefit you
- Bone mineral density screening and results, at no cost to you
- Diet and physical activity analyses, at no cost to you
- Calcium and vitamin D supplements, at no cost to you
- Parking during exercise sessions, at no cost to you
- Access to McKee Gym locker room and showers, at no cost to you
- $1000 monetary compensation upon completion of all study procedures
Exercise sessions will take place in McKee Gym (on the MU campus) under the supervision of research staff. All procedures will also be performed in McKee Gym.
For more information, contact:
Peggy Nigh, Study Coordinator
Phone: (573) 882-9917
Primary Investigator: Dr. Pam Hinton, Associate Professor of Nutrition & Exercise Physiology
Study Research Coordinator: Peggy Nigh
Exercise Physiology Graduate Student: Melissa Carter
Exercise Physiology Graduate Research Assistant: Tim Sinak
Exercise Physiology Graduate Research Assistant: Jiang Jun (JJ)
Undergraduate Research Assistant: Lynn Eaton
Links to Related Research Studies from Dr. Hinton’s Lab:
- Participation in road cycling vs running is associated with lower bone mineral density in men
- Lean body mass and weight-bearing activity in the prediction of bone mineral density in physically active men
- Bone formation is increased to a greater extent than bone resorption during a cycling stage race
- Acute response of serum markers of bone turnover to a single-bout of resistance-training or plyometrics
Links to News Articles About Dr. Hinton’s Research:
Frequently Asked Questions
Q: When does the study start, and when can I come in?
Q: How long does the screening and consent meeting last?
Q: Is the DXA scan safe?
Q: When do I get to see the DXA results?
Q: Will I get copies of the study results for my personal records?
Q: I am active at my job. Does that contribute to the amount of physical activity I participate in each week?
Q: Can I still do my regular exercise?
Q: I have never done resistance training or plyometrics. Can I still participate?
Q: How often do I have to come in?
Q: How long do the exercise sessions last?
Q: Do I have to warm up before exercise?
Q: What is the intensity of the exercise sessions?
Q: Will I be supervised?
Q: Is there a place I can keep my personal belongings while exercising?
Q: Can I use the gym to work out?
Q: How much blood do you take during blood draws?
Q: Do I have to fast before testing?
Q: Do I have to change my diet during the study?
Q: How much money would I receive for participation, and when would I be paid?
Q: Is there parking available?
Q: What if I have to be out of town?
Q: What happens if I get too far behind on exercise sessions?
Q: Can I bring someone with me (e.g. spouse, child, or friend) to my exercise training sessions?