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Effect of high-intensity resistance exercise on cardiometabolic health in older men with osteosarcopenia: the randomised controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)
  1. Wolfgang Kemmler1,
  2. Matthias Kohl2,
  3. Simon von Stengel1,
  4. Daniel Schoene1
  1. 1Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
  2. 2Faculty Medical and Life Sciences, Furtwangen University of Applied Sciences, Furtwangen, Germany
  1. Correspondence to Professor Wolfgang Kemmler; wolfgang.kemmler{at}


Objectives Sarcopenia is related to the metabolic syndrome (MetS), a cluster of cardiometabolic risk-factors (CRF). Most exercise trials apply aerobic rather than resistance exercise to address CRF, while the strategy for maintaining muscle and bone is the opposite. However, there is considerable evidence that resistance exercise positively affects CRF. In the present study, we determined the effect of high-intensity resistance exercise training (HIT-RT) on CRF represented by the MetS in older men.

Methods Forty-three osteosarcopenic and predominately obese older men (>72 years) living independently in Erlangen-Nürnberg, Germany were randomly assigned to two study arms. The HIT-RT group (n=21) conducted a periodised high intensity/effort protocol dedicated to muscle and bone mass and function two times per week, while the control group (CG: n=22) maintained their habitual physical activities. Both groups were supplemented with protein, cholecalciferol and calcium. Study outcomes presented here were the MetS-Z (MetSZ) score and its underlying risk-factors.

Results After 18 months of intervention, we observed significant effects for the MetSZ score (p<0.001), with significant improvements in the HIT-RT and significant worsening in the CG. In detail, all parameters constituting the MetS contributed to this result, however, only waist-circumference, HDL-cholesterol and mean arterial blood pressure revealed significant effects. No adverse events were reported and high adherence was determined for the HIT-RT-protocol.

Conclusion Continuously supervised HIT-RT is an effective, attractive, feasible and safe method to address cardiometabolic risk factors in community-dwelling men aged 72 years and older. Further, considering the proven effects on musculoskeletal risk factors, the present results indicate a more prominent role for HIT-RT within non-pharmacological prevention strategies of older adults.

Trial registration number NCT03453463.

  • exercise physiology
  • exercise rehabilitation
  • sports rehabilitation programmes
  • old
  • cardiovascular

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  • Contributors WK, MK, SvS and DS designed the study, carried out data analysis and/or interpretation, drafted the manuscript and revised the manuscript. WK accepts responsibility for the integrity of the data sampling, analysis and interpretation.

  • Funding The study was funded by the Institute of Medical Physics (IMP), Friedrich-Alexander University of Erlangen-Nürnberg, with support from the non-profit organizationorganisation “Netzwerk Knochengesundheit e.V.”, a local health sport club closely associated with the IMP, FAU.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The project was planned and initiated by the Institute of Medical Physics, University of Erlangen-Nürnberg (FAU), Germany. The FAU University Ethics Committee (number 67_15b and 4464b) and the Federal Bureau of Radiation Protection (BfS, number Z 5-2246212-2017-002) approved the trial. The study fully complies with the Declaration of Helsinki ‘Ethical Principles for Medical Research Involving Human Subjects’. All study participants gave their written informed consent after receiving detailed information.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. The anonymised data used to support the findings of this study are available from the corresponding author upon request.