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Trial registered on ANZCTR
Registration number
ACTRN12616001444471
Ethics application status
Approved
Date submitted
14/10/2016
Date registered
17/10/2016
Date last updated
19/10/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The OPTIMA-Ex trial: Osteoporosis Prevention Through Impact and Muscle-loading Approaches to Exercise
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Scientific title
A comparison of the bone response to impact loading versus resistance training: a randomised controlled trial of upper and lower limb responses in young heathy women with lower than average bone mass.
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Secondary ID [1]
290329
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None
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Universal Trial Number (UTN)
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Trial acronym
OPTIMA-Ex
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Low bone mass
300593
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Osteopenia
300595
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Osteoporosis
300596
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Condition category
Condition code
Musculoskeletal
300446
300446
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0
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Osteoporosis
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Physical Medicine / Rehabilitation
300447
300447
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study is a three-arm, single blind randomised controlled exercise intervention trial. Eligible participants are randomized to 10-month, twice-weekly, either supervised high intensity resistance training, high intensity impact training or a “sham active” control group.
Arm 1 – supervised heavy progressive resistance training.
Participants allocated to the resistance training intervention group attend twice-weekly 45 minute instructor-led sessions performed on non-consecutive days. Six compound exercises (deadlift, back squat, bench press, overhead press, bent over row and calf raise) using olympic weights will be completed each session. For each exercise, 5 sets of 3-5 repetitions, corresponding to an intensity of 85 % of 1 repetition maximum will be performed under the supervision of a physiotherapist. Measurements of 1 RM will take place every 12 weeks to ensure sufficient progression of resistance training exercises. Compliance and weight lifted is monitored via training diaries which each participant completes at the end of each session.
Arm 2 – supervised high-intensity impact loading exercise.
Participants allocated to the impact training intervention group attend twice-weekly 40 minute instructor-led high intensity impact training sessions performed on non-consecutive days. Participants will be taught three fundamental upper limb loading exercises in the form of punches (jab, cross and lead hook) as well as complete three fundamental lower limb impact exercises (jump, hop and drop jump) under the supervision of a physiotherapist. The fundamental exercises will be performed throughout the remainder of the intervention period with progressively increasing height and complexity of jumps and force of landing with participants progressing from shod to barefoot after the familiarisation phase as well as the power and complexity of punching combinations to maintain an RPE of greater than 8 out of 10. Measures of punch kinematics will take place at 2, 4, 12, 24, 36 and 44 weeks using a GymAware device to ensure that participants continue to increase the loading and speed of their punches throughout the training intervention. Compliance is monitored via training diaries which each participant completes at the end of each session.
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Intervention code [1]
296140
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Prevention
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Intervention code [2]
296141
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Lifestyle
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Comparator / control treatment
Arm 3 –
A low load, home-based unsupervised exercise program will serve as a positive control. Participants will be asked to exercise twice per week for approximately 30 minutes. The sessions consist of shadow boxing and low load and body weight exercises in a low intensity circuit training format. Participants are instructed on how to perform all exercises at the initial testing session; they are also provided with an exercise handout and have access to a private YouTube channel, as well as contacted weekly via email. Compliance is monitored via training diaries which each participant completes at the end of each session.
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Control group
Active
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Outcomes
Primary outcome [1]
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Bilateral proximal femur (femoral neck, trochanter and total hip regions of interest) bone mineral density and 3D variables determined by Dual-energy X-ray Absorptiometry.
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Assessment method [1]
299882
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Timepoint [1]
299882
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All participants, pre (baseline) and post-intervention (10 months).
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Primary outcome [2]
299883
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Lumbar spine (L2-L4) bone mineral density determined by Dual-energy X-ray Absorptiometry.
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Assessment method [2]
299883
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Timepoint [2]
299883
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All participants, pre (baseline) and post-intervention (10 months).
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Primary outcome [3]
299884
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Whole body bone mineral density determined by Dual-energy X-ray Absorptiometry .
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Assessment method [3]
299884
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Timepoint [3]
299884
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All participants, pre (baseline) and post-intervention (10 months)
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Secondary outcome [1]
328381
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Bilateral leg bone strength variables (trabecular and cortical content, density and area, bone strength index and polar section modulus) determined from peripheral Quantitative Computed Tomography .
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Assessment method [1]
328381
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Timepoint [1]
328381
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [2]
328382
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Bilateral forearms bone strength variables (trabecular and cortical content, density and area, bone strength index and polar section modulus) determined from peripheral Quantitative Computed Tomography.
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Assessment method [2]
328382
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Timepoint [2]
328382
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [3]
328383
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Bilateral leg Muscle volume and density determined from peripheral Quantitative Computed Tomography.
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Assessment method [3]
328383
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Timepoint [3]
328383
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [4]
328384
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Bilateral forearm Muscle volume and density determined from peripheral Quantitative Computed Tomography.
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Assessment method [4]
328384
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Timepoint [4]
328384
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [5]
328387
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Heel bone quality (Broadband Ultrasound Attenuation, Speed of Sound and Stiffness Index) determined by Quantitative Ultrasonometry.
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Assessment method [5]
328387
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Timepoint [5]
328387
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [6]
328389
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Body composition (lean mass, fat mass, appendicular lean mass and percentage body fat) from whole body Dual-energy X-ray Absorptiometry.
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Assessment method [6]
328389
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Timepoint [6]
328389
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [7]
328390
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Muscle force will be measured via handheld dynamometry using previously validated techniques (maximal isometric leg strength, thoracic extension muscle strength and grip strength).
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Assessment method [7]
328390
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Timepoint [7]
328390
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [8]
328391
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Relative impulse to be determined using vertical jump measure on an in-ground force plate.
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Assessment method [8]
328391
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Timepoint [8]
328391
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [9]
328392
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Physical activity enjoyment using the modified PACES questionnaires.
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Assessment method [9]
328392
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Timepoint [9]
328392
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [10]
328393
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Daily average calcium intake using the validated AusCal questionnaire.
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Assessment method [10]
328393
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Timepoint [10]
328393
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [11]
328394
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Historical bone relevant physical activity using the validated 'Bone-specific Physical Activity' (BPAQ) questionnaire.
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Assessment method [11]
328394
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Timepoint [11]
328394
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All participants, pre (baseline) and post-intervention (10 months).
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Secondary outcome [12]
328395
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Quality of life using the validated AQoL-6D questionnaire.
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Assessment method [12]
328395
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Timepoint [12]
328395
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All participants, pre (baseline) and post intervention (10 months).
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Secondary outcome [13]
328396
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Safety (adverse events and injuries) and compliance from training diaries across the whole exercise intervention period.
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Assessment method [13]
328396
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Timepoint [13]
328396
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Across the intervention period (10 months).
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Eligibility
Key inclusion criteria
Female
Apparently healthy
With lower than average bone mineral density (hip or spine BMD T-score less than or equal to 0)
Unaccustomed to resistance training and impact loading exercise
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Minimum age
18
Years
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Maximum age
30
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Musculoskeletal or medical conditions affecting the ability to perform high intensity physical activity, , medications or medical conditions known to effect bone health, cancer, uncontrolled cardiovascular disease, greater than 2 X-ray’s in the past 12 months and current participation in a regular exercise program known to influence bone or previous competitive or regular participation (more than 1 x per week for 1 year or one full season) in resistance training or boxing (including other fight sports and martial arts), gymnastics/dance sports (gymnastics, ballet, aerobics, cheerleading), court sports (volleyball, basketball, netball), ball sports (Australian rules, rugby league/union, soccer, touch) or racquet sports (badminton, squash, tennis) over the past 4 years.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random number generator by computer program
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
8/11/2016
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Actual
11/11/2016
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Date of last participant enrolment
Anticipated
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Actual
29/03/2018
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Date of last data collection
Anticipated
31/01/2019
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Actual
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Sample size
Target
100
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Accrual to date
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Final
51
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
294708
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University
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Name [1]
294708
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Griffith University
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Address [1]
294708
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School of Allied Health Sciences, Griffith University, Gold Coast campus
Parklands Drive, Southport, Gold Coast 4222, Queensland
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Country [1]
294708
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Australia
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Primary sponsor type
University
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Name
Griffith University
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Address
School of Allied Health Sciences, Griffith University, Gold Coast campus
Parklands Drive, Southport, Gold Coast 4222, Queensland
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Country
Australia
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Secondary sponsor category [1]
293556
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None
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Name [1]
293556
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Address [1]
293556
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Country [1]
293556
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296132
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Griffith University Human Research Ethics Committee
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Ethics committee address [1]
296132
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170 Kessels Road Nathan, QLD 4111
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Ethics committee country [1]
296132
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Australia
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Date submitted for ethics approval [1]
296132
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06/10/2015
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Approval date [1]
296132
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28/10/2015
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Ethics approval number [1]
296132
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GU Ref: 2015/775
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Summary
Brief summary
The skeletal response to exercise is highly dependent on the nature of the activity. The most osteogenic loads are those that induce high magnitude bone strains at high loading rates. However, debate exists as to the predominant source of the adaptive stimulus – muscle forces or gravity-derived impact loads. The determination of the most effective source of loading would provide grounds for optimal exercise prescription for bone health. The aim of this work is to compare the bone response to two known osteogenic loading methods, impact loading exercise versus muscle loading exercise in young women with lower than average bone mass.
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Trial website
www.optima-ex.com
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
69670
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Dr Benjamin Weeks
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Address
69670
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Menzies Health Institute QLD
School of Allied Health Sciences
Gold Coast campus
Griffith University
Parklands Drive
Southport, Gold Coast,
Queensland, 4222
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Country
69670
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Australia
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Phone
69670
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+61 7 5552 9336
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Fax
69670
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Email
69670
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[email protected]
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Contact person for public queries
Name
69671
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Benjamin Weeks
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Address
69671
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Menzies Health Institute QLD
School of Allied Health Sciences
Gold Coast campus
Griffith University
Parklands Drive
Southport, Gold Coast,
Queensland, 4222
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Country
69671
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Australia
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Phone
69671
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+61 7 5552 9336
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Fax
69671
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Email
69671
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[email protected]
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Contact person for scientific queries
Name
69672
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Benjamin Weeks
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Address
69672
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Menzies Health Institute QLD
School of Allied Health Sciences
Gold Coast campus
Griffith University
Parklands Drive
Southport, Gold Coast,
Queensland, 4222
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Country
69672
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Australia
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Phone
69672
0
+61 7 5552 9336
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Fax
69672
0
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Email
69672
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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