Investigating the Effects of a High-Load Resistance Training Program on Bone Health in Wheelchair Users (the BoneWheel Study): Protocol for a Randomized Controlled Trial
Abstract
Background: Low mechanical loading of the bones of wheelchair users leads to low bone mineral density (BMD) and increased risk of bone fractures and associated complications. High-load resistance training of the upper body is one way to achieve mechanical loading of the lumbar spine and the hip bones. In addition, maintaining good nutritional status with key nutrients for bone remodeling, that is, vitamin D and calcium, is important for bone accrual.
Objective: This study aims to investigate the effect of 24 weeks of high-load resistance training combined with nutritional optimization on lumbar spine BMD. Secondary objectives are to investigate the effects of the intervention on (1) bone and physical health parameters, such as bone turnover blood markers, nutritional status, body composition, and maximal muscular strength, as well as (2) exercise motivation and mental health.
Methods: In this randomized controlled trial, we aimed to include 60 wheelchair users with nonprogressive impairments. Participants were randomly allocated to 24 weeks of either (1) high-load resistance training and nutrition optimization or (2) nutrition optimization only, stratified by sex and sport activity status. The training program consisted of 3 weekly sessions comprising 6 exercises periodized in low-, moderate-, and high-load phases. The nutritional optimization aimed to ensure sufficient intake of protein, vitamin D, and calcium. BMD and body composition; maximal muscular strength; and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24 participants or records.
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