Effects of progressive multimodal resistance training with varied muscle actions and range of motion on bone mineral density in osteopenic older women: a pilot study

Background Resistance training improves bone health in patients with osteopenia, but high-load programs may not be ideal for everyone. This pilot study examined the effect of a progressive multimodal resistance training program on bone mineral density (BMD) in osteopenic women. Methods Twenty older women (65.3 [3.23] years; 1.58 [0.08] m; 69.3 [12.9] kg) diagnosed with osteopenia were non-randomly assigned to experimental ( n = 10) or control ( n = 10) groups. After obtaining ethics approval and informed consent, experimental participants completed a 16-week multimodal resistance training program with varying muscle actions and range of motion (ROM). Lumbar spine and femoral neck BMD were assessed pre- and post-intervention by DXA. Estimation, robust, and Bayesian statistics were employed. Results The experimental group showed BMD increases at the lumbar spine (Δ=+0.05 (0.04) [95% CI: 0.03, 0.08] g·cm -2 ; d unb =0.20; p=0.026) and the femoral neck (Δ=+0.05 (0.03) [95% CI: 0.02, 0.07] g·cm -2 ; d unb =0.35; p=0.003), exceeding the predefined MCID threshold (+0.03 g·cm -2 ). No changes were found in control. Between-group comparisons favored the experimental group (lumbar: p=0.003; femoral: p=0.010). Bayesian ANCOVA provided strong support treatment effects (BF m >10 7 ; P(M|data)>0.96), consistent with frequentist ANCOVA findings (η²p>0.48). Conclusion This non-randomized pilot intervention study found preliminary evidence that multimodal resistance training improved BMD in osteopenic older women. Findings are limited by sample size and support a future definitive trial.