{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:13:06Z","timestamp":1793293986159,"version":"4.5.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sarcopenia and osteoporosis increase the likelihood of disability and caregiving burden. While progressive resistance training (PRT) is effective in mitigating these outcomes, patients often struggle to find suitable, long-term training facilities, making it difficult to adhere to exercise prescriptions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This feasibility study aimed to familiarize patients with PRT through educational training by a geriatrician, enabling them to identify a suitable long-term community-based training program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants and methods<\/jats:title><jats:p>Forty-one patients diagnosed with osteoporosis or sarcopenia at a medical center in Taiwan were enrolled via the researchers\u2019 LINE app platform. Finally, 11 participants with osteoporosis were recruited. Among them, four had vertebral compression fractures and two also met the diagnostic criteria for sarcopenia. The median age was 68 (range 63\u201369) years, DXA femoral neck T-score was \u22123.3 (\u22123.5\u2013\u22122.2), and grip strength was 22.4 (20.3\u201326.7) kg. After cardiopulmonary exercise testing (CPET), participants received up to 10 PRT sessions, with vital signs monitored. In each session, researchers focused on six key learning points of free-weight PRT, addressed difficulties hindering progress, encouraged participants to find community-based training courses, and provided training summaries to external trainers. Descriptive statistics summarized patient data and referral rates. The primary outcome was the success of referrals to community-based training. Secondary outcomes, to be reported later, included changes in grip strength, DXA bone mineral density, DXA muscle mass, CPET results after 6\u202fmonths, and sustainability of long-term resistance training (RT) in older people with osteoporosis or sarcopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The recruitment success rate was 26.8%. Baseline characteristics did not correlate to successful referrals. A total of 67 physician-guided PRT sessions were conducted for the 11 participants. On average, after 4.5 in-hospital sessions, five participants secured self-paid one-on-one RT in the community, and one joined group training, resulting in a referral success rate of 54.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This feasibility study aimed at achieving successful referral for long-term community-based RT. It provides valuable insights for future research on RT for patients with osteoporosis or sarcopenia, making exercise a sustainable and quantifiable intervention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1632960","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:09:20Z","timestamp":1755536960000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhancing resistance training adherence in older adults with sarcopenia or osteoporosis: a study on referral success 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ACSM\u2019S resources for the personal trainer","author":"Hargens","year":"2021"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e2018","DOI":"10.7717\/peerj.2018","article-title":"Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme","volume":"4","author":"Fien","year":"2016","journal-title":"Peer J"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"112193","DOI":"10.1016\/j.exger.2023.112193","article-title":"Chronic effect of resistance training on blood pressure in older adults with prehypertension and hypertension: a systematic review and meta-analysis","volume":"177","author":"Henkin","year":"2023","journal-title":"Exp Gerontol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1097\/HJH.0000000000003355","article-title":"Acute effects of high-intensity resistance training on central blood pressure parameters of elderly hypertensive women: a crossover clinical trial","volume":"41","author":"Galv\u00e3o","year":"2023","journal-title":"J Hypertens"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2338","DOI":"10.1519\/JSC.0b013e31827de07d","article-title":"The valsalva maneuver: its effect on intra-abdominal pressure and safety issues during resistance exercise","volume":"27","author":"Hackett","year":"2013","journal-title":"J Strength Cond Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e086708","DOI":"10.1136\/bmjopen-2024-086708","article-title":"Study protocol for the Rolex-DUO randomised placebo-controlled trial: Romosozumab loaded with EXercise \u2013 dual effects on bone and muscle in postmenopausal osteoporosis and osteopenia","volume":"14","author":"Kumar","year":"2024","journal-title":"BMJ Open"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.bone.2015.06.008","article-title":"Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: a 12-month randomized, clinical trial","volume":"79","author":"Hinton","year":"2015","journal-title":"Bone"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"427","DOI":"10.3233\/BMR-130402","article-title":"The effects of strengthening and high-impact exercises on bone metabolism and quality of life in postmenopausal women: a randomized controlled trial","volume":"26","author":"Basat","year":"2013","journal-title":"J Back Musculoskelet Rehabil"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"pzad 120","DOI":"10.1093\/ptj\/pzad120","article-title":"Finding the optimal resistance training intensity for your bones: protocol for a randomized controlled trial","volume":"103","author":"Giangregorio","year":"2023","journal-title":"Phys Ther"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12891-018-2021-y","article-title":"Effect of a resistance and balance exercise programme for women with osteoporosis and vertebral fracture: study protocol for a randomized controlled trial","volume":"19","author":"Stanghelle","year":"2018","journal-title":"BMC Musculoskelet Disord"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2050312119831116","DOI":"10.1177\/2050312119831116","article-title":"Effects of training with elastic resistance versus conventional resistance on muscular strength: a systematic review and meta-analysis","volume":"7","author":"Lopes","year":"2019","journal-title":"Sage Open Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1002\/jbmr.4027","article-title":"Effects of high-intensity resistance training on osteopenia and sarcopenia parameters in older men with Osteosarcopenia-one-year results of the randomized controlled Franconian osteopenia and sarcopenia trial (FrOST)","volume":"35","author":"Kemmler","year":"2020","journal-title":"J Bone Miner Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"730","DOI":"10.3389\/fpubh.2025.1507730","article-title":"Jim\u00e9nez-S\u00e1nchez Carolina benefits of musculoskeletal health promotion in school communities through service-learning: a mixed-method approach","volume":"13","author":"Calvo Sandra","year":"2025","journal-title":"Front Public Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"E803","DOI":"10.1152\/ajpendo.00213.2016","article-title":"Does the muscle protein synthetic response to exercise and amino acid-based nutrition diminish with advancing age? 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