Buddies Bone Up

How research, group therapy and human touch can change lives and tackle osteoporosis.

So this is how it should work--exciting research results translated to everyday life. Three institutions in Oregon--including Oregon State University, the OSU Benton County Extension Office and Linn-Benton Community College--cooperated to make the following events happen.

It all started when Janet Shaw, then a graduate student in the Bone Research Laboratory in the College of Health and Human Performance at OSU, performed a doctoral study on the benefits of weighted-vest exercises for older women.[1] She wanted to know if there was a way to reduce the risk of falls and hip fractures all too common for this age group.

Then and Now

Shaw and others have found that osteoporosis is not a foregone conclusion--it isn't inevitable that an older woman will fall and break a hip. Now we know we can slow the natural loss of bone later in life, and even increase bone mass, with the right kind of exercise.

It's long been thought that as we age, our bones become more fragile, muscle mass and strength decrease and balance deteriorates. However, women in the exercise group of Shaw's study increased muscular strength (primarily in their hips and legs) by 16 percent to 33 percent. In addition, they increased muscular power by 13 percent and improved lateral balance (shifting body weight from side to side more quickly and accurately).

Bone mass did not change in neither the exercisers nor the controls, which was a disappointment to Shaw. However, a follow-up study did show a small increase in bone mass in premenopausal women[2]. Another study showed long-term weighted-vest exercise preserves hip bone mineral density in postmenopausal women[3]. Small increases are important because an increase in bone mass of 3 percent to 5 percent reduces fracture risk by 20 percent to 30 percent.

Demographics

The 44 women in Shaw's initial study were non-smokers ages 50 to 75. All were at least five years past menopause and most were not on estrogen replacement therapy. They exercised for nine months, three times a week for about one hour. Besides a warm-up, cool-down and stretches, they performed seven exercises emphasizing the lower body--rising from a chair, bench stepping, jumping without a vest, squats, forward and side lunges and rising on their toes. As their physical fitness increased, they gradually added weight to the pockets of their specially designed blue vests. A control group similar to the exercise group maintained normal activity patterns.

"I sought to develop a program of exercises that would transfer to activities of daily living, and hopefully impact bone mass as well," Shaw explains. "Along with those practical considerations, I wanted the program to be progressive and not `gentle and easy'--a phrase often used to describe exercise programs for the retirement crowd. The idea was reinforced by my mentor, Dr. Christine Snow, Director of the Bone Research Laboratory."

Group Unity

Shaw was excited her control group showed increased strength and balance, but she found one result of the study more difficult to quantify. "The group began to do things together socially," she says. "They took photos of each other and passed them around. I think it had to do with the fact that they were doing something positive for their health as a group. Something obviously clicked for them because many of them were still doing it more than five years later."

Donna Gregerson, a participant in Shaw's initial study, played an important role in keeping the group together. As the Home Economics Extension Agent for Benton County, not only did Gregerson want to continue the exercises herself, but she wanted to make this valuable program accessible to everyday people. She says, "This was the perfect role for us in Extension because our motto is `from land grant to the public.'"

The Class

Knowing that a group setting worked best, Gregerson partnered up with Linn-Benton Community College, which already has a good outreach classroom structure. She worked with Theresa Knight, Benton Center Senior Exercise Coordinator and instructor at LBCC, to develop a class that Knight would teach. Students could sign up on the college's quarter system for 10 weeks, meeting for three days per week to do the same set of exercises established in Shaw's study.

The course catalog listed the class as Osteoporosis Risk Reduction. Although it doesn't sound very exciting, so many people signed up it had to be closed at 30 students. New sections have been added, one most recently at the senior center. To train more instructors, Shaw, Gregerson, Knight and Snow took the program statewide to fitness directors and other practitioners in a seminar accredited by the American College of Sports Medicine (ACSM).

A visit to Knight's morning class at the Benton Center gym, an outreach center of the community college, finds about 30 women in their 40s to 80s filtering in and visiting in small clusters before starting. Some of them wear whimsical tan T-shirts decorated with Knight's oft-repeated instructions, "hold your head high," "wear that vest" and "toes to ceiling."