{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:57Z","timestamp":1772169057374,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.73698.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000}},{"DOI":"10.12688\/f1000research.73698.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000}}],"reference-count":32,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    To minimize fracture risk, multimodal training regimens are recommended. However, their effectiveness in community settings remains uncertain. This study evaluated the feasibility of 19-weeks of multimodal training in a local community center with emphasis on musculoskeletal health in postmenopausal women.\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    In a controlled trial, 28 postmenopausal women (53-68-years-old) were assigned to a multimodal training group (MMT, n=15) or a control group (CON, n=13). The training consisted of high- and odd-impact, resistance and balance-coordination training 1-2 hours weekly. The outcomes were attendance rate, regional and total bone mineral density (BMD), bone mineral content (BMC), bone turnover markers (BTM), body composition, functional muscle strength and power, and dynamic balance. All were determined at baseline and after 19 weeks of training. BTM was assessed after three weeks.\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Overall, 22(79%) participants (MMT, n=9; CON, n=13) completed the study, and the mean attendance rate for MMT was 65.5% of the maximum sessions (2) offered. Only right trochanter BMD increased (p&lt;0.05) by 1.0\u00b11.1% in MMT, which was higher(p&lt;0.05) than CON. While whole-body BMC was not changed at 19 weeks from baseline in MMT, it decreased (p&lt;0.05) in CON resulting in a significant difference (p&lt;0.05) in whole-body BMC delta values between the two groups. Compared to baseline, body fat percentage(%BF), fat mass(FM), and visceral adipose tissue (VAT)-mass and -volume were decreased (p&lt;0.01) in MMT, and were larger (p&lt;0.05) than CON. No significant changes were observed in BTM, muscle strength and power, and dynamic balance after 19 weeks.\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Nineteen weeks of multimodal training 1-2 hours per week in a local community had a health-enhancing effect on %BF, FM, and VAT, whereas the musculoskeletal health impact was modest. We hypothesize that the reason might be too low training volume and frequency and supposedly too low musculoskeletal training intensity for some participants.\n                    <ns4:bold>Registration:<\/ns4:bold>\n                    ClinicalTrials.gov NCT05164679 (21\/12\/2021).\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.73698.3","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T11:25:09Z","timestamp":1725449109000},"page":"51","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility Study of Community-Based Training for Musculoskeletal Health Promotion"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4489-7337","authenticated-orcid":false,"given":"Rizky Suganda","family":"Prawiradilaga","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4858-4186","authenticated-orcid":false,"given":"Magnus","family":"Bendtsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Esrup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklas Rye","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fajar Awalia","family":"Yulianto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva Wulff","family":"Helge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1137-1141","DOI":"10.1002\/jbmr.5650090802","article-title":"The diagnosis of osteoporosis.","volume":"9","author":"J Kanis","year":"1994 Aug 1","journal-title":"J Bone Miner Res."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1004-1010","DOI":"10.1007\/s00198-004-1791-2","article-title":"Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength.","volume":"16","author":"M Sinaki","year":"2005 Aug 1","journal-title":"Osteoporos Int."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"438-445","DOI":"10.1016\/j.jsams.2016.10.001","article-title":"Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the 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Extended data - Effect size of the Training Program.","author":"R Prawiradilaga","year":"2021","journal-title":"figshare."},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.16610341.v1","article-title":"CONSORT checklist, extension for Pilot and Feasibility Trials for study \u201cA Feasibility Study of Training in a Local Community Aimed Upon Health Promotion with Special Emphasis on Musculoskeletal Health Effects\u201d.","author":"R Prawiradilaga","year":"2021","journal-title":"figshare."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-51\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-51\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-51\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T04:35:23Z","timestamp":1725942923000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-51\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":32,"URL":"https:\/\/doi.org\/10.12688\/f1000research.73698.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.73698.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.73698.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.171086.r320739","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.171086.r320739","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,4]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-51\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.77367.r134828, Melanie Kistler-Fischbacher, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, 16 May 2022, version 1, 2 not approved","URL":"https:\/\/f1000research.com\/articles\/11-51\/v1#referee-response-134828","order":0,"name":"referee-response-134828","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rizky Suganda Prawiradilaga<\/b>; \n<i>Posted: 28 Feb 2023<\/i>; \n<u><b>Introduction<\/b><\/u> \n<b>P1:<\/b> We are sorry if we were mistaken. We got it from the Facts and Statistics International Osteoporosis Foundation (IOF) [cited 2017 Oct 4]. Some other references that said the same that 200 million women: COLOSTEO&nbsp;(the project has received funding from the European Union\u2019s Horizon 2020 research and innovation programme under grant agreement No. 778277)\n<sup>1<\/sup>, and de Villiers and Goldstein (2022)\n<sup>2<\/sup>.  \n<b>P2:<\/b> Thank you. We have changed the reference to: Zhang S, Huang X, Zhao X, Li B, Cai Y, Liang X,\n<i> et al.<\/i> Effect of exercise on bone mineral density among patients with osteoporosis and osteopenia: A systematic review and network meta-analysis. \n<i>J Clin Nurs<\/i>. 2022 Aug; \n<b>31<\/b>(15\u201316):2100\u201311.  \n<b>P3 &amp; 4<\/b>: We agree with you, we have changed a little bit \u201cit is hypothesized in the present study that evidence-based multimodal training as health promotion will have an osteogenic effect\u201d into \u201cit is hypothesized in the present study that training (which combined evidence-based exercise) as health promotion will have an osteogenic effect\u201d. We have revised it.&nbsp;  \n<b>P4:<\/b> We have added the references:  Watson SL, Weeks BK, Weis LJ,&nbsp;\n<i>et al.<\/i>:High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial.&nbsp;\n<i>J Bone Miner Res.<\/i>&nbsp;2018 Feb;&nbsp;\n<b>33<\/b>(2):211\u2013220.PubMed Abstract&nbsp;|&nbsp;Publisher Full Text &nbsp; Kistler-Fischbacher M, Yong JS, Weeks BK,&nbsp;\n<i>et al.<\/i>:A Comparison of Bone-Targeted Exercise With and Without Antiresorptive Bone Medication to Reduce Indices of Fracture Risk in Postmenopausal Women With Low Bone Mass: The MEDEX-OP Randomized Controlled Trial.&nbsp;\n<i>J Bone Miner Res.<\/i>&nbsp;2021;&nbsp;\n<b>36<\/b>(9):1680\u20131693.&nbsp;Publisher Full Text &nbsp; Kistler-Fischbacher M, Weeks BK, Beck BR:The effect of exercise intensity on bone in postmenopausal women (part 2): A meta-analysis.&nbsp;\n<i>Bone.<\/i>&nbsp;2021 Feb 1;&nbsp;\n<b>143<\/b>: 115697.&nbsp;Publisher Full Text &nbsp; Karinkanta S, Heinonen A, Siev&auml;nen H,&nbsp;\n<i>et al.<\/i>: A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial.&nbsp;\n<i>Osteoporos Int.<\/i>&nbsp;2007 Apr;&nbsp;\n<b>18<\/b>(4): 453\u2013462.&nbsp;PubMed Abstract&nbsp;|&nbsp;Publisher Full Text &nbsp; Shojaa M, von Stengel S , Kohl M,&nbsp;\n<i>et al.<\/i>:Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters.&nbsp;\n<i>Osteoporos Int.<\/i>&nbsp;2020 Aug;&nbsp;\n<b>31<\/b>(8):1427\u20131444.&nbsp;PubMed Abstract&nbsp;|&nbsp;Publisher Full Text&nbsp;|&nbsp;Free Full Text  \n<b>P5: <\/b>Thank you for the suggestion, We have added attendance rate as a feasibility endpoint in the Methods section. The feasibility outcome is already in the Results section.   \n<u><b>Methods<\/b><\/u> \n<b>General:<\/b> We have clarified which outcomes were primary and which ones were secondary.  \n<b>P1:<\/b> It was explained in Participants section in then Methods section. The sedentary control group was from a previous study (which hasn\u2019t been published) not a long time before the present study. The recruitment process itself was the same, via advertisement online and a local newspaper.  \n<b>P1:<\/b> Yes, we understand. The bone turnover occurs around 5 to 6 months, and we can detect the changes around that time of intervention. However, our study regarding the bone turnover marker (Prawiradilaga \n<i>et al. <\/i>(2020)\n<sup>3<\/sup>) showed that acute exercise has an acute response on bone marker (P1NP). Regarding that, we hope that we can see the change in bone turnover markers as well as the bone mineral density in only 19 months. Why only 19 months? It was the feasible range of time we can manage before everyone went to summer vacation.  \n<b>P3: <\/b>Alright, thank you. We have deleted that part.  \n<b>P4:<\/b> Sedentary is defined as someone who didn\u2019t engage in regular and systemic weight-bearing training or strength training in the last 2 years. We have added a note to distinguish active from sedentary.  No minimum age, only maximum 70. 2 years post menopause Minimum at least 1 time a week, has a goal of the training.  \n<b>P5:<\/b> We have considered your suggestion and have moved the number of participants and drop outs to the Results section.  \n<b>P5: <\/b>Thank you.  \n<b>P8:<\/b> The progressive resistance training (PRT) consisted primarily of exercises using own bodyweight, with occasional use of medicine balls, resistance bands and sandbags (5\u201315 kg), starting with 15\u201320RM and slowly progressing to 6\u201312RM, with 2\u20133 sets. We have added this in the manuscript.  \n<b>P9: <\/b>We don\u2019t think we have the information on short-term of BMD and body composition. We only measure the bone turnover markers for the short-term.  \n<b>P12\/13:<\/b> They did not want to do the test.  \n<b>P14:<\/b> Thank you for the suggestion.   \n<u><b>Results<\/b><\/u> \n<b>P1: <\/b>Our analyses were based on the delta values.  \n<b>P4: <\/b>Thank you for your suggestion. We have removed \u201cHowever, LS (1.2%) and right total femur (0.3%) tended to increase (both, p &lt; 0.1) for MMT\u201d.  \n<b>Table 2: <\/b>We think it is good information to give the reader the mean femur BMD.  \n<b>Table 2\/3: <\/b>There is significant difference between MMT and Control (CON) group. While the whole-body BMC showed decrease in CON group, the whole BMC in MMT group doesn\u2019t change. It showed that the training might inhibit the whole-body BMC to decrease in postmenopausal women. The whole-body BMD was not increased, however, the right trochanter BMD in MMT was increased compared to CON.   \n<u><b>Discussion<\/b><\/u> Thank you for the suggestion, We have added regarding the recent studies which have shown that exercise intensity is positively associated with bone changes, and that low-intensity exercise is ineffective.  Thank you for your suggestions, we have addressed other limitations.  The sample size was determined by the Author judgement based on the previous study on Bone Turnover Markers (Prawiradilaga&nbsp;\n<i>et al.&nbsp;<\/i>(2020)\n<sup>3<\/sup>. &nbsp; The posteriori power calculations were performed with Power and Sample Size Calculations version 3.0 for the paired t-test and performed with SPSS for the repeated ANOVA measurement. The results are in the link in the \u2018Extended data\u2019 section.  &nbsp;  Is the work clearly and accurately presented and does it cite the current literature?  We have cited the current literature  Is the study design appropriate and is the work technically sound?  We have added, \u201cThis is a feasibility study in a local community with a non-randomized controlled trial approach.\u201d  Are sufficient details of methods and analysis provided to allow replication by others?  We think it is sufficient since the study method and the training program were described clearly.   \n<b>References<\/b>  Osteoporosis Facts [Internet]. COLOSTEO. [cited 2022 Aug 12]. Available online&nbsp;(date last accessed: 10\/03\/2023) &nbsp; de Villiers TJ, Goldstein SR: Bone health 2022: an update. \n<i>Climacteric.<\/i> 2022 Jan 2; \n<b>25<\/b>(1):1\u20133. Publisher Full Article &nbsp; Prawiradilaga R, Madsen A, J&oslash;rgensen N,&nbsp;\n<i>et al.<\/i>: Acute response of biochemical bone turnover markers and the associated ground reaction forces to high-impact exercise in postmenopausal women.&nbsp;\n<i>Biol Sport.<\/i>&nbsp;2020;&nbsp;\n<b>37<\/b>(1): 41\u201348.&nbsp;PubMed Abstract","URL":"https:\/\/f1000research.com\/articles\/11-51\/v3#referee-comment-9398","order":1,"name":"referee-comment-9398","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.144978.r165893, Robert Wen-Wei Hsu, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Pu-Tz City, 22 Mar 2023, version 2, 1 approved, 1 approved with reservations, 1 not approved","URL":"https:\/\/f1000research.com\/articles\/11-51\/v2#referee-response-165893","order":2,"name":"referee-response-165893","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Rizky Suganda Prawiradilaga<\/b>; \n<i>Posted: 22 Apr 2023<\/i>; Dear Reviewer, We would like to say thank you for your valuable comments and suggestions that have improved the manuscript considerably.  Best Regards","URL":"https:\/\/f1000research.com\/articles\/11-51\/v3#referee-comment-9591","order":3,"name":"referee-comment-9591","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.171086.r320739, Jan Gajewski, Faculty of Physical Education, Jozef Pilsudski University of Physical Education, Warsaw, 10 Sep 2024, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/11-51\/v3#referee-response-320739","order":4,"name":"referee-response-320739","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}