Improving bone health in wheelchair users by a long-term intervention combining bone-specific exercise and nutrition
Wheelchair users are especially at risk of low bone mineral density due to low mechanical stimuli on the bone, and thus at an increased risk of fractures. Fractures in this population often come with complications, reduced independence, and life quality. What effect do strength training and optimization of nutrition have on bone health, muscular strength and function in wheelchair users?
This project will investigate the health effects of a bone-specific strength training intervention and nutrition optimization in wheelchair users. With a randomized controlled study design, the participants will be randomized to a training group or a control group and followed for 24 weeks. Repeated testing will be performed with DXA, maximal strength, rate of force development, function and nutritional status and intake at baseline, 12 and 24 weeks will test the differences between the groups and the effects of the intervention.
This project is divided into two parts, screening and exercise intervention. After screening, measurement of bone density will be analyzed and the participants will be invited to take part in the intervention, if they meet the inclusion criteria. These include having low normal to low bone density in the spine, as well as satisfactory function to carry out the strength training programme.
The participants are tested again including blood samples (baseline). Diet interviews are also carried out (3x during the two weeks around the baseline) which, together with blood analyses, lay the foundation for nutritional optimisation.
In the exercise intervention, participants are randomly drawn to a training and nutrition group who will take part in structured strength training over 6 months, or to a nutrition group that continues with their normal physical activity. All participants will receive a dietary supplement (protein, vitamin D and calcium) and advice on optimizing nutrition related to bone health. The training group participates in supervised strength training for 4 weeks before continuing the training at their own location, with digital and on-site follow-up over the next 5 months.
Testing is repeated halfway through and after the end of the intervention. In addition, some of the participants from the training group will be invited to focus interviews after the study. The participants from the nutrition group are invited to the same 4-week guided training as in the intervention