The Ultimate Workout for Osteoporosis? A PhD Study on Osteoanabolic Exercises

The Ultimate Workout for Osteoporosis? A PhD Study on Osteoanabolic Exercises

Last Updated: July 27, 2025

For the millions of postmenopausal women managing osteoporosis, the advice is clear: exercise is crucial. But with so many options, what is the best type of exercise to improve bone density, enhance balance, and reduce the terrifying fear of falling? A groundbreaking 2019 PhD thesis from Ziauddin University provides a compelling answer, introducing a powerful protocol known as “osteoanabolic exercises.” This study scientifically tested a combined exercise regimen against traditional aerobic and resistance training, offering new hope and clear guidance. This article breaks down the key findings and details the exact exercise plan that yielded the most significant results.

This research offers a detailed look at a powerful, structured approach to combating the effects of osteoporosis.

The Challenge: Beyond Just “More Exercise”

Osteoporosis is a progressive disease characterized by decreased Bone Mineral Density (BMD), making bones fragile and susceptible to fractures. While exercise is a cornerstone of management, the specific type, frequency, and intensity are critical for success. The study notes that simply recommending “exercise” is not enough; a tailored protocol is needed to address the multifaceted challenges of osteoporosis, which include:

• Decreased Bone Mineral Density (BMD): The primary concern that leads to fracture risk.
• Impaired Gait and Balance: An unsteady walk and poor balance significantly increase the likelihood of falls.
• Fear of Falling (FOF): This psychological barrier can lead to a sedentary lifestyle, ironically worsening the condition.

To tackle these issues head-on, researcher Amna Aamir Khan designed a 3-arm randomized controlled trial to compare the effectiveness of three distinct 12-week exercise programs for osteoporotic females. The most novel of these was the “Osteoanabolic” protocol.

What Are Osteoanabolic Exercises for Osteoporosis?

The term “osteoanabolic” refers to the process of building new bone tissue. The exercise protocol designed in this study is a combination of aerobic and resistance training, structured to maximize this bone-building effect. The goal was to create a regimen that elicits a strain on the bones exceeding the threshold required for bone metabolism, activating osteoblasts (bone-building cells) and enhancing mechanical load.

The study’s Osteoanabolic group (Group C) followed a rigorous 6-day-per-week schedule that alternated between aerobic and resistance conditioning.

The Science-Backed Osteoanabolic Protocol Revealed

The 12-week Osteoanabolic training protocol was divided into two distinct, alternating phases, meticulously designed according to American College of Sports Medicine (ACSM) guidelines.

Phase 1: Aerobic Conditioning (3 Days/Week)

This phase focused on cardiovascular health and weight-bearing activity, which is crucial for stimulating bone.

• Frequency: 3 days per week (on alternate days).
• Intensity: 55%-75% of Maximum Heart Rate (MHR). The MHR was calculated as 220 minus the participant’s age, with the target heart rate zone determined using the Karvonen method.
• Time: 30 to 60 continuous minutes.
• Type: Walking on a treadmill.
• Progression: Participants’ perceived exertion was monitored using the Borg RPE scale, with the intensity gradually increased to maintain the target heart rate.

Phase 2: An-Aerobic (Resistance) Conditioning (3 Days/Week)

This phase was designed to build muscle strength, which pulls on bones and stimulates growth.

• Frequency: 3 days per week (on the alternate days from aerobic training).
• Intensity: Approximately 60% of 1 Repetition Maximum (1RM) for three sets of 10-15 repetitions. As participants successfully completed the reps, the weight was increased.
• Time: 45-60 minutes.
• Type: Dumbbells and barbells targeting major muscle groups.
• Exercises Included: Biceps Curls, Triceps Extensions, Pectoralis Lifts (e.g., bench press), Deltoid (Shoulder) Lifts, Latissimus Dorsi (Back) exercises like lunges with a dumbbell row, Abdominal Crunches, Back Extensions, Hamstring Curls, Quadriceps Extensions, and Calf Raises.

The Results: How Did Osteoanabolic Exercises Compare?

After 12 weeks, the results were clear and statistically significant. While all three exercise groups (aerobic, resistance, and osteoanabolic) showed improvement, the Osteoanabolic group demonstrated superior results across every key metric.

• Bone Mineral Density (BMD): The Osteoanabolic group showed the highest improvement in median T-score, significantly more than the aerobic or resistance-only groups.
• Gait Velocity and Cadence: This group saw the most significant increase in walking speed and steps per minute, crucial indicators of functional mobility.
• Dynamic Balance (Timed Up and Go Test): Participants in the osteoanabolic program significantly improved their time on the TUG test, indicating better balance and a lower risk of falls.
• Fear of Fall (FOF): The osteoanabolic group reported the greatest reduction in their fear of falling, achieving a 30% reduction in future fall risk compared to a 10% reduction in the aerobic group. The resistance-only group actually saw a slight increase in their perceived risk.

Conclusion: A Combined Approach is Best

This rigorous PhD study provides strong evidence that osteoanabolic exercises for osteoporosis, which strategically combine weight-bearing aerobic activity and progressive resistance training, are more effective than either modality alone for postmenopausal women. The combination protocol not only improved physical metrics like bone density and balance but also addressed the critical psychological barrier of fear, empowering participants with confidence and security.

For those seeking the most comprehensive and impactful exercise plan to manage osteoporosis, this science-backed, combined approach offers a clear and effective path forward.

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Author Bio

Dr. Amna Aamir Khan holds a Doctor of Philosophy (PhD) in Physical Therapy from the College of Rehabilitation Sciences at Ziauddin University. Her research focuses on the effects of targeted exercise interventions on functional parameters in clinical populations.

Source & Citations

Thesis Title: EFFECTS OF OSTEOANABOLIC EXERCISES ON GAIT, BALANCE AND FEAR OF FALL AMONG OSTEOPOROTIC FEMALES
Researcher: Amna Aamir Khan (DPT, MSc)
Guide (Supervisor): Prof. Dr. Pirzada Qasim Raza Siddiqui
University: Ziauddin University, Karachi, Pakistan
Year of Compilation: 2019
Excerpt Page Numbers: 1, 23, 26, 52, 61-66, 78, 82, 85, 88, 92, 96, 100, 103, 107, 115, 118, 121

Disclaimer

“Disclaimer: Some sentences have been lightly edited for SEO and readability. For the full, original research, please refer to the complete thesis PDF linked in the section above.”

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