From this study:

Maximal strength training in postmenopausal women with osteoporosis or osteopenia. (2013)

Current guidelines recommend weight-bearing activities, preferably strength training for improving skeletal health in patients with osteoporosis. What type of strength training that is most beneficial for these patients is not established.

Maximal strength training (MST) is known to improve 1-repetition maximum (1RM) and rate of force development (RFD), which are considered as important co-variables for skeletal health. Squat exercise MST might serve as an effective intervention for patients with low bone mass. We hypothesized that 12 weeks of squat exercise MST would improve 1RM and RFD in postmenopausal women with osteoporosis or osteopenia and that these changes would coincide with improved bone mineral density (BMD) and bone mineral content (BMC), and serum markers of bone metabolism.

The participants were randomized to a training group (TG, n = 10) or control group (CG, n = 11). The TG underwent 12 weeks of supervised squat exercise MST, 3 times a week, with emphasis on rapid initiation of the concentric part of the movement. The CG was encouraged to follow current exercise guidelines.

At posttest, 8 participants remained in each group for statistical analyses. The TG improved the 1RM and RFD by 154 and 52%, respectively. Lumbar spine and femoral neck BMC increased by 2.9 and 4.9%.

My comments:

This is a great study! It has a pretty good review of strength training for reversing osteoporosis and then had the patients perform only one exercise: a squat machine for 2 warm-up sets of 8-12 reps (at ~50% of the person’s max) then 4 sets of 3-5 reps at 85-90% of their max.

The exercises were done 3 times per week for 12 weeks, and the result was an increase in hip (femoral neck) bone mineral content of 4.9% (that’s a lot in osteoporosis studies) and an increase in lumbar spine bone mineral content of 2.9%. Strength improved 154%.

It’s worth talking more about how they did the reps, which was explosively, with the subjects exploding upwards with the weights as fast as they could. They called this “Maximal Strength Training” (MST), which is a new term for me but sounds identical to Compensatory Acceleration Training (CAT) coined by Fred Hatfield back in the 80s. Either way, I expect exploding with the weights throughout the concentric (upward) motion is a better way to train.

I recall studies from the 90s showing it increased strength better than conventional weightlifting exercises, with college students being the subjects. When I was doing Olympic weightlifting at NAU, pretty much all our reps were explosive. So it’s cool to see explosive training with weights being applied to and helping elderly women with osteoporosis. It goes to show, yet again, that the best techniques for physical therapy come out of the weight room rather than the classroom.