Watson · Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 2018 · randomized controlled trial · n=101

High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial.

Cited 445 times in the scientific literature.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 28975661 · doi:10.1002/jbmr.3284 · record verified 2026-08-26

What was done

A randomized controlled trial (LIFTMOR) evaluated the efficacy and safety of high-intensity resistance and impact training (HiRIT) in 101 postmenopausal women (mean age 65 ± 5 years) with low bone mass (T-score < -1.0) screened for conditions and medications affecting bone and physical function. Participants were randomized to 8 months of twice-weekly, 30-minute supervised HiRIT (5 sets of 5 repetitions at >85% 1-repetition maximum; n = 49) or a home-based low-intensity exercise control program (CON; n = 52). Outcomes measured pre- and post-intervention were lumbar spine and proximal femur bone mineral density (BMD), femoral neck cortical thickness, height change, functional performance measures (timed up-and-go, functional reach, 5 times sit-to-stand, back and leg strength), compliance, and adverse events.

What was found

HiRIT demonstrated superior outcomes compared to CON for lumbar spine BMD (2.9 ± 2.8% vs. -1.2 ± 2.8%, p < 0.001), femoral neck BMD (0.3 ± 2.6% vs. -1.9 ± 2.6%, p = 0.004), femoral neck cortical thickness (13.6 ± 16.6% vs. 6.3 ± 16.6%, p = 0.014), and height (0.2 ± 0.5 cm vs. -0.2 ± 0.5 cm, p = 0.004). All functional performance measures also significantly favored HiRIT (p < 0.001). Compliance was 92 ± 11% in HiRIT and 85 ± 24% in CON. Only one adverse event occurred (HiRIT group: minor low back spasm, resulting in 2 of 70 missed training sessions).

Why it matters

This trial challenges the assumption that high-intensity loading is unsafe for individuals with low bone mass, showing that brief, supervised heavy resistance and impact exercise can increase bone mineral density and physical function without major adverse events.

Limits

The study had a modest sample size (101 participants) and was restricted to otherwise healthy postmenopausal women without secondary causes of bone loss. Exercise was delivered under close professional supervision, which may limit generalizability to unsupervised settings. Clinical fracture endpoints were not directly evaluated.

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