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This trial explored 18-weeks combined rehabilitation and endurance and resistance training (Intervention,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200917) compared with standard-of-care (Control,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200914) on areal bone mineral density (aBMD), tibial bone, and patella tendon properties in postpartum UK Servicewomen. Intervention received standard care plus pelvic floor and core strength exercises from week 1 to 18 (week 6 to 24 postpartum), and combined high-intensity interval and resistance training from week 6 to 18 (week 12 to 24 postpartum). Control received standard care. Whole-body DXA and tibial HRpQCT scans (4% and 30% sites) were taken at week 1 and 18. Patella tendon properties at rest and during isometric contractions were measured by ultrasound at weeks 1, 6, and 18. There was no effect of training on aBMD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2265 0.100) but trunk (\u20131.6%) and spine (\u20132.3%) aBMD decreased from week 1 to 18, irrespective of group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2264 0.021). There was no effect of training on tibial bone (\n                    <jats:italic>p<\/jats:italic>\n                    \u2265 0.151) or patella tendon properties (\n                    <jats:italic>p<\/jats:italic>\n                    \u2265 0.185). An 18-week rehabilitation and endurance and resistance training programme had no effect on bone or tendon properties in postpartum Servicewomen.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-51411-3","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:24:26Z","timestamp":1777706666000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone and tendon adaptations to 18-weeks rehabilitation and endurance and resistance training in postpartum British Servicewomen: a non-randomised controlled trial"],"prefix":"10.1038","volume":"16","author":[{"given":"Thomas J.","family":"O\u2019Leary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L.","family":"Bostock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie L.","family":"Wardle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty J.","family":"Elliott-Sale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Sale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P.","family":"Greeves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"51411_CR1","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1152\/physrev.00027.2015","volume":"96","author":"CS Kovacs","year":"2016","unstructured":"Kovacs, C. 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CS has current research funding from Myositis UK, Balchem Inc, and Iovate Health Sciences Inc. CS has previously received research funding from Vision is Sport Foundation (for ADIDAS), UK Ministry of Defence, Birmingham City University, Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo, Natural Alternatives Inc, Irish Research Council, Enterprise Partnership Scheme, Coventry University, English Institute of Sport, Ci\u00eancia sem Fronteiras, GlaxoSmithKline High Performance Laboratory, NOW Foods Ltd, Santander Research Mobility Grant, NHS Nottingham City, Deltex Medical, EAS Sports Nutrition, and Cytodine Technologies. CS is also a paid member of the Myprotein Performance Advisory Board and is Editor-in-Chief of The Journal of Nutritional Physiology, for which he receives an honorarium from The Physiological Society. CS has in the past received payment\/honoraria\/support in kind (predominantly for the production and delivery of lecture material) from Natural Alternatives Inc, PepsiCo (GSSI), GlaxoSmithKline, English Institute of Sport, Dairy Council, Dairy Council Northern Ireland, FSI Nutrition, Guru Performance Ltd, Institute of Performance Nutrition, Sportsoracle, WE Nutrition, ISSN, Nutrition X, and Leaders in Performance. CS has attempted to list all potentially relevant interests, current and historical, but acknowledges that some might have been unintentionally missed. KES certifies that they have no current affiliations with any organisation or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript. KES has received honoraria and educational grants from the following organisations: Women\u2019s Tennis Association, European Club Association, Ministry Of Defence, Arsenal Women\u2019s Football Club, Manchester Thunder Netball Club, UK Sports Institute, More Than Equal, GlaxoSmithKline, National Institute for Health Research, Santander Research Mobility Grant, British Horseracing Federation, Natural Alternatives International, Adidas, National Strength And Conditioning Association, Erasmus Plus, Balchem Inc, Optimum Nutrition, Science in Sport, FIFPRO, BIA Formulations, England and Wales Cricket Board, London City Lionesses, PepsiCo, CPSDA, Bristol Bears, European Athletics, Lawn Tennis Association, German Athletics Association, Always, Mayo Amateur Ladies\u2019 Gaelic Football, GAA, UK Strength and Conditioning Association, Football Science Institute, Rangers Women\u2019s Football Club, TUS, UEFA, Sportsoracle, Cycling Alliance, Sheffield United Women\u2019s Team, Institute of Performance Nutrition, Netball New Zealand. KES has attempted to list all potentially relevant interests, current and historical, but acknowledges that some might have been unintentionally missed.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20308"}}