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

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.