Journal of Exercise & Organ Cross Talk
Journal of Eexercise & Organ Cross Talk

The effect of exercise program combined with electrical stimulation on bone mass density (BMD) and bone turnover markers (BTMs) in postmenopausal women with osteopenia

Document Type : Original Article

Authors

Azam Zarneshan 1
Azizeh Farshbaf-Khalili 2
Yaghoub Salekzamani 2
Saeedeh Erfanniaa 3
Atena Attarana 3

1 Department of Sport Science, Azarbaijan Shahid Madani University, Tabriz, Iran.

2 Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences. Tabriz, Iran

3 Department of Sport Sciences, Faculty of Educational Sciences and Psychology, Azarbaijan Shahid Madani University Tabriz/ Iran

https://doi.org/10.22122/jeoct.2025.531569.1159
Abstract
The aim of this study was to investigate the effects of an exercise program (EP) in combination with functional electrical stimulation (FES) on bone mass density (BMD) and bone turnover markers (BTMs) in osteopenic postmenopausal women. In this semi-experimental study, 45 women aged 61.25 ± 4.1 years who were classified as osteopenic (-2.5 < T-score < -1) were divided into three groups: 1) EP + FES, 2) EP and 3) control. The EP + FES and EP groups participated in a combined aerobic (45-60% HRR) and strength program for 90 minutes three times a week for 12 weeks. In the EP + FES group, FES with a frequency of 45 Hz and a pulse width of 300 microseconds was applied to the lumbar and hip area. Blood samples were taken at the beginning of the study and again after 12 weeks to determine BMDs. BMD was measured using dual-energy X-ray absorptiometry (DXA). After 12 weeks, cross-linked type 1 collagen C-telopeptide (sCTX) (p=0.002) and pyridinoline (PYD) (p=0.001) levels decreased significantly, while vitamin D (p=0.002), PINP/PYD ratio (p=0,032), the ALP/PYD ratio (p=0.004) and the ALP/CTX-1 ratio (p=0.010) increased significantly in both the EP+FES and EP groups compared to the control group. The EP+FES group showed a significant increase in lumbar (p=0.048) and hip BMD (p=0.038) compared to the control group. Therefore, an exercise programme in combination with FES is recommended as the preferred intervention to maintain or improve bone formation, as FES has a synergistic effect on bone health in patients with osteopenia.

What is already known on this subject?

Aerobic and resistance training can positively influence bone serum metabolism and density over the long term.

 

What this study adds?

Short-term (3 months) multi-component exercise training combined with electrical stimulation can impact bone metabolism.

Keywords

Bone turnovers
BMD
Electric stimulation therapy
Exercise therapy
Osteopenia
Vitamin D

Subjects

Acknowledgements

None.

Funding

This project was supported by a research grant from …… University [grant number 1403/493]. The funder had no influence on the design and conduct of the research; the analysis, collection, management, review, and interpretation of the data; the preparation and approval of the manuscript; and the decision to submit the manuscript for publication. This work originates from a Master's thesis in exercise physiology in the Department of Sports Science.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Compliance with ethical standards

Conflict of interest The authors declare that they have no conflict of interest.

Ethical approval Participation in the study was voluntary and participants could withdraw at any time. Written informed consent was obtained and the study complied with the principles of the Declaration of Helsinki and medical ethics regulations. The ethical code IR.AZARUNIV.REC.1402.010 was registered for this study.

Informed consent Participants signed an informed consent form prior to participation in the study

Author contributions

Conceptualization: A.Z., A.F.K., Y.S., A.A., S.E.; Methodology: A.Z., A.F.K., Y.S., A.A., S.E.; Software: A.Z., A.F.K., Y.S., A.A., S.E.; Validation: A.Z., A.F.K., Y.S., A.A., S.E. Formal analysis: A.Z., A.F.K., Y.S., A.A., S.E.; Investigation: A.Z., A.F.K., Y.S., A.A., S.E; Resources: A.Z., A.F.K., Y.S., A.A., S.E.; Data curation: A.Z., A.F.K., Y.S., A.A., S.E.; Writing - original draft: A.Z., A.F.K., Y.S., A.A., S.E.; Writing–review & editing: A.Z., A.F.K., Y.S., A.A., S.E.; Visualization: A.Z., A.F.K., Y.S., A.A., S.E.; Supervision: A.Z.; Project administration: A.Z.; Funding acquisition: A.Z.

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Journal of Exercise & Organ Cross Talk
Volume 5, Issue 2
Spring 2025
Pages 48-58

  • Receive Date 28 April 2025
  • Revise Date 02 June 2025
  • Accept Date 04 June 2025

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