The Effect of Maximal Strength Training on Muscle Strength and Bone Mineral Density in Patients with Substance Use Disorder: A randomized controlled trial
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Background: Patients with substance use disorder (SUD) experience a wide range of health problems, including reduced bone quality. Maximal strength training (MST) has shown to be effective in improving maximal strength (1RM) and rate of force development (RFD), which are associated with skeletal health. MST may therefore be an effective intervention for improving bone quality in SUD patients. Objective: The aim of the study was to confirm the observation that SUD patients experience reduced bone quality, and to investigate the effect of 16 weeks of MST on 1RM, RFD and bone mass in a group of SUD patients undergoing clinical treatment. Methods: 24 SUD patients receiving clinical treatment was randomized to either a training group (TG) or a control group (CG). The TG conducted 16 weeks of MST in the half-squat and plantar flexion exercise, while the CG followed the conventional treatment program. 6/12 and 7/12 completed the TG and CG, respectively. Results: The TG improved 1RM and RFD by 90% (p < 0.05) and 91% (p < 0.05), respectively, which led to increased bone mineral density (BMD) at the lumbar spine, trochanter, and total hip by 3.8% (p < 0.05), 4.1% (p < 0.05), and 3.4% (p < 0.05), respectively. Total body bone mineral content (BMC) and t-score at the lumbar spine and trochanter alsoincreased significantly (p < 0.05). Conclusion: The present study confirms previous reports that SUD patients experience reduced bone quality, and demonstrates that 16 weeks of lower body MST effectively improves 1RM, RFD and bone quality in SUD patients. Furthermore, it shows that MST is feasible for patients in treatment, and should be implemented as part of the treatment.