{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T02:07:58Z","timestamp":1773281278020,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Erasmus+ Sport","award":["N2017-2128\/001-001"],"award-info":[{"award-number":["N2017-2128\/001-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Adherence is important for an exercise program\u2019s efficacy. This study aims at investigating whether the COVID-19 lockdown had different consequences on the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or gym group training (GGT). At the start of the lockdown, which imposed the temporary closure of any gym activities, GGT participants were invited to continue to exercise at home. IHT participants continued to exercise at home as usual. Adherence was recorded via logs and measured as the percentage of exercise sessions actually performed out of the total number of scheduled sessions in three 1-month periods: one before (PRE) and two after (M1 and M2) the beginning of lockdown. Before lockdown, IHT (66.8% \u00b1 26.6) and GGT (76.3% \u00b1 26.6) adherence were similar. During lockdown, IHT participation increased (M1: 81.5% \u00b1 31.0; M2: 88.0% \u00b1 28.3), while that of GGT showed no statistical differences (M1: 79.4% \u00b1 34.2; M2: 80.6% \u00b1 36.4). Exercise protocols based on supervised gym practice must consider the possibility of disruptive events, which could cause a sudden interruption of gym activity and include educational initiatives to instruct participants to exercise effectively and safely without a trainer\u2019s direct supervision.<\/jats:p>","DOI":"10.3390\/ijerph18052441","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:36:37Z","timestamp":1614681397000},"page":"2441","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of COVID-19 Lockdown on Adherence to Individual Home- or Gym-Based Exercise Training among Women with Postmenopausal Osteoporosis"],"prefix":"10.3390","volume":"18","author":[{"given":"Erika","family":"Pinelli","sequence":"first","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-4269","authenticated-orcid":false,"given":"Giuseppe","family":"Barone","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7025-4271","authenticated-orcid":false,"given":"Sofia","family":"Marini","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Benvenuti","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3482-3323","authenticated-orcid":false,"given":"Marie H.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Centre for Exercise Medicine Physical Activity and Health, Ulster University, Newtownabbey, Co Antrim BT37 0QB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Julin","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Laurea University of Applied Sciences, 02650 Espoo, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3515-0669","authenticated-orcid":false,"given":"Wolfgang","family":"Kemmler","sequence":"additional","affiliation":[{"name":"Institute of Medical Physics, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91052 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Von Stengel","sequence":"additional","affiliation":[{"name":"Institute of Medical Physics, Friedrich-Alexander-University Erlangen-N\u00fcrnberg, 91052 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Di Paolo","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7555-9659","authenticated-orcid":false,"given":"Laura","family":"Dallolio","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Science, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-0532","authenticated-orcid":false,"given":"Pasqualino","family":"Maietta Latessa","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Zinno","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-2300","authenticated-orcid":false,"given":"Laura","family":"Bragonzoni","sequence":"additional","affiliation":[{"name":"Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d\u2019Augusto 237, 47921 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0749-0690(18)30494-4","article-title":"Preventing Frail Health","volume":"8","author":"Buchner","year":"1992","journal-title":"Clin. Geriatr. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/j.1532-5415.1994.tb06221.x","article-title":"Understanding the Relationship Between Disease and Disability","volume":"42","author":"Guralnik","year":"1994","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"M262","DOI":"10.1093\/gerona\/57.5.M262","article-title":"Exercise Comes of Age: Rationale and Recommendations for a Geriatric Exercise Prescription","volume":"57","author":"Singh","year":"2002","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.12927\/hcpap.2009.21219","article-title":"Community exercise: A vital component to healthy aging","volume":"10","author":"Stuart","year":"2008","journal-title":"Healthcarepapers"},{"key":"ref_5","unstructured":"World health organization (2020). Guidelines on Physical Activity and Sedentary Behaviour, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/0002-9343(93)90218-E","article-title":"Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis","volume":"94","author":"Peck","year":"1993","journal-title":"Am. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00198-007-0426-9","article-title":"The care gap in diagnosis and treatment of women with a fragility fracture","volume":"19","author":"Bessette","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_8","unstructured":"Group WS (1994). Prevention and management of osteoporosis. WHO Technical Report Series, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1007\/s11136-012-0332-2","article-title":"Effect of changes in moderate or vigorous physical activity on changes in health-related quality of life of elderly British women over seven years","volume":"22","author":"Choi","year":"2013","journal-title":"Qual. Life Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jsams.2016.10.001","article-title":"Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis","volume":"20","author":"Beck","year":"2017","journal-title":"J. Sci. Med. Sport"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.bjpt.2018.11.011","article-title":"Exercise for the prevention of osteoporosis in postmenopausal women: An evidence-based guide to the optimal prescription","volume":"23","author":"Daly","year":"2019","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12966-020-01040-4","article-title":"Evidence on physical activity and osteoporosis prevention for people aged 65+ years: A systematic review to inform the WHO guidelines on physical activity and sedentary behaviour","volume":"17","author":"Pinheiro","year":"2020","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_13","first-page":"2333721418823604","article-title":"Adherence to Exercise Programs in Older Adults: Informative Report","volume":"5","author":"Fahey","year":"2019","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Morgan, F., Battersby, A., Weightman, A.L., Searchfield, L., Turley, R., Morgan, H., Jagroo, J., and Ellis, S. (2016). Adherence to exercise referral schemes by participants\u2013what do providers and commissioners need to know? A systematic review of barriers and facilitators. Bmc Public Health, 16.","DOI":"10.1186\/s12889-016-2882-7"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/AJP.0b013e318226c411","article-title":"Adherence to a Community-based Exercise Program Is a Strong Predictor of Improved Back Pain Status in Older Adults: An Observational Study","volume":"28","author":"Hicks","year":"2012","journal-title":"Clin. J. Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jphys.2014.06.012","article-title":"Adherence to exercise programs for older people is influenced by program characteristics and personal factors: A systematic review","volume":"60","author":"Picorelli","year":"2014","journal-title":"J. Physiother."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1016\/j.ijnurstu.2008.02.012","article-title":"Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: A discussion paper","volume":"45","author":"Lee","year":"2008","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1123\/jpah.9.6.857","article-title":"Predictors of Adherence to Supervised and Unsupervised Exercise in the Alberta Physical Activity and Breast Cancer Prevention Trial","volume":"9","author":"Courneya","year":"2012","journal-title":"J. Phys. Act. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1159\/000442087","article-title":"Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial","volume":"62","author":"Lacroix","year":"2016","journal-title":"Gerontology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1136\/jech-2011-200354","article-title":"Levels and predictors of exercise referral scheme uptake and adherence: A systematic review","volume":"66","author":"Pavey","year":"2012","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bragonzoni, L., Barone, G., Benvenuti, F., Canal, V., Ripamonti, C., Marini, S., and Dallolio, L. (2020). A Randomized Clinical Trial to Evaluate the Efficacy and Safety of the ACTLIFE Exercise Program for Women with Post-menopausal Osteoporosis: Study Protocol. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17030809"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00198-013-2523-2","article-title":"Too Fit to Fracture: Exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture","volume":"25","author":"Giangregorio","year":"2014","journal-title":"Osteoporos. Int."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Marini, S., Leoni, E., Raggi, A., Sanna, T., Malavolta, N., Angela, B., Latessa, P.M., and Dallolio, L. (2019). Proposal of an Adapted Physical Activity Exercise Protocol for Women with Osteoporosis-Related Vertebral Fractures: A Pilot Study to Evaluate Feasibility, Safety, and Effectiveness. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16142562"},{"key":"ref_24","unstructured":"American College of Sport Medicine (2018). Exercise Testing and Prescritions, Walter Kluver. [5th ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"M221","DOI":"10.1093\/gerona\/55.4.M221","article-title":"Lower Extremity Function and Subsequent Disability: Consistency Across Studies, Predictive Models, and Value of Gait Speed Alone Compared with the Short Physical Performance Battery","volume":"55","author":"Guralnik","year":"2000","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: Association with self-repoted disability and prediction of mortality and nursing home admuission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J. Gerontol. Med. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ageing\/afi196","article-title":"Development and initial validation of the Falls Efficacy Scale-International (FES-I)","volume":"34","author":"Yardley","year":"2005","journal-title":"Age Ageing"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.archger.2009.09.031","article-title":"Validation of the Italian version of the falls efficacy scale international (FES-I) and the short FES-I in community-dwelling older persons","volume":"49","author":"Ruggiero","year":"2009","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1477-7525-2-41","article-title":"The ECOS-16 questionnaire for the evaluation of health related quality of life in post-menopausal women with osteoporosis","volume":"2","author":"Badia","year":"2004","journal-title":"Heal. Qual. Life Outcomes"},{"key":"ref_30","first-page":"390","article-title":"Validity and reliability of the Italian version of the ECOS-16 questionnaire in postmenopausal women with prevalent vertebral fractures due to osteoporosis","volume":"25","author":"Salaffi","year":"2007","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1006\/pmed.2002.1134","article-title":"Controlled Comparison of Retention and Adherence in Home- vs Center-Initiated Exercise Interventions in Women Ages 40\u201365 Years: The S.W.E.A.T. Study (Sedentary Women Exercise Adherence Trial)","volume":"36","author":"Cox","year":"2003","journal-title":"Prev. Med."},{"key":"ref_32","first-page":"72","article-title":"Disease-related factors associated with exercise adherence in postmenopausal women with osteoporosis","volume":"5","year":"2020","journal-title":"J. Frailtysarcopenia Falls"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00198-016-3793-2","article-title":"Facilitators and barriers to exercise adherence in patients with osteopenia and osteoporosis: A systematic review","volume":"28","author":"Rodrigues","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.numecd.2020.05.020","article-title":"Quarantine during COVID-19 outbreak: Changes in diet and physical activity increase the risk of cardiovascular disease","volume":"30","author":"Mattioli","year":"2020","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Schwartz, H., Har-Nir, I., Wenhoda, T., and Halperin, I. (2021). Staying physically active during the COVID-19 quarantine: Exploring the feasibility of live, online, group training sessions among older adults. Transl. Behav. Med.","DOI":"10.1093\/tbm\/ibaa141"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Suzuki, Y., Maeda, N., Hirado, D., Shirakawa, T., and Urabe, Y. (2020). Physical Activity Changes and Its Risk Factors among Community-Dwelling Japanese Older Adults during the COVID-19 Epidemic: Associations with Subjective Well-Being and Health-Related Quality of Life. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186591"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.amepre.2007.02.041","article-title":"Website-Delivered Physical Activity Interventions","volume":"33","author":"Vandelanotte","year":"2007","journal-title":"Am. J. Prev. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.amepre.2007.05.007","article-title":"A Review of eHealth Interventions for Physical Activity and Dietary Behavior Change","volume":"33","author":"Norman","year":"2007","journal-title":"Am. J. Prev. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ypmed.2010.06.004","article-title":"A meta-analysis of computer-tailored interventions for health behavior change","volume":"51","author":"Krebs","year":"2010","journal-title":"Prev. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12966-016-0454-y","article-title":"Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: A systematic review","volume":"13","author":"Schoeppe","year":"2016","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Pennucci, F., De Rosis, S., Murante, A.M., and Nuti, S. (2019). Behavioural and social sciences to enhance the efficacy of health promotion interventions: Redesigning the role of professionals and people. Behav. Public Policy, 1\u201321.","DOI":"10.1017\/bpp.2019.19"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2441\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:31:26Z","timestamp":1760160686000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,2]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["ijerph18052441"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18052441","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,2]]}}}