Mini-trampoline training programme for osteopenia

...is it an effective tool to improve balance, functional mobility, fear of falling and bone mineral density?

Aging is characterised by a loss of muscle (mass, strength, power, flexibility), balance and impaired motor control. This may lead to further disorders affecting daily life performances and increasing fear of falling. The latter in its turn can imply less movement, less physical function and again higher risk of falling through a vicious circle which negatively affects the quality of life and increases morbidity as well as mortality.

Older women suffering from osteoporosis and osteopenia are particularly at stake with high risks of fractures. Physical activity is one of the key preventative tools for these conditions, especially exercises involving high-impacts on the skeleton as they have shown benefits in bone modeling, remodeling and maintaining mineralisation. There is no consensus on an optimal physical activity programme to reduce the effects of osteoporosis and osteopenia. Clinicians usually use combination of techniques to improve strength, balance, functional control, gait speed or fear of falling. 

In this study, the authors specifically investigated the effects of a combined balance, strength and jumping exercise programme on a mini-trampoline on these various aspects of health and the metabolism of bone mineral density in older women with osteopenia. They concluded that such an intervention seems to be highly effective in improving the above parameters in this population.

The authors found that participants who performed the mini-trampoline exercise programme showed significant improvements compared to the control group in terms of postural control, functional mobility, strength, gait speed and fear of falling. However, no significant differences were found in regard to bone mineral density. They concluded that the combined intervention with the mini-trampoline was an effective tool in order to improve these parameters for patients with osteopenia.

> From: Posch, Clin Interv Aging 14 (2019) 2281-2293 . All rights reserved to The Author(s). Click here for the online summary.

Expert opinion

The significant changes in balance, functional mobility, strength, gait speed and fear of falling highlighted by the present study are clinically interesting as they improve various elements often at stake in older people, and particularly in women with osteopenia. They indeed help in reducing risk of falling or disabilities while being in favour of a higher independence in activities of daily living (walking, carrying groceries, personal care activities, transfers, etc.).

The mini-trampoline intervention appears to be very encouraging as it is one of the rare activities that increases various parameters at the same time, while reducing the risk of falling. Nevertheless, we must bear in mind that only short-term effects were assessed here and that additional studies should focus on long-term benefits of such techniques.

Although no significant changes were found in bone mineral density, it seems that further studies should be carried out before drawing any conclusions, as the duration of the intervention may remain short to see any benefit on bones according to the authors. Another reason might be the fact that a low-impact training device was used in the present study (mini-trampoline) while earlier studies assessing the effects of jumping on bone mineral density changes were based on high-impact jumping exercises (i.e., on the floor). Additionally, the current study targeted women with osteopenia while earlier studies focused on healthy premenopausal (i.e., younger) women.

A question that may arise when reading the present study is: are there risks involved in such mini-trampoline intervention? It is true that this technique is not without any risk, but the authors’ position is, that physical activity in general may present some risks for older people. Moreover, they minimised these risks with the presence of a specialised and experienced instructor as well as with the use of a mini-trampoline. In any case, clinicians should be aware of the potential risks of such intervention and assess its opportunity case by case.

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