Resistance training for musculoskeletal health and the prevention of disability in postmenopausal women

Ageing is characterised by a deterioration in musculoskeletal structure and function; specifically a decrease in muscle strength, a reduction in skeletal muscle mass, and a loss of bone density. These changes greatly affect the lives of elderly individuals through reducing functional performance necessary for independent living and contribute to frailty, falls, fragility fractures, and physical disability. Although men are affected by such changes, women are at much greater risk of experiencing poor musculoskeletal health and physical disability with advancing age due to the large, rapid change in the level of serum sex hormones that occurs during menopause. Resistance training has been demonstrated to be a safe and highly effective exercise intervention to improve or maintain musculoskeletal integrity and prevent or delay physical disability in the elderly. This chapter reviews the age-associated changes in muscle strength, skeletal muscle mass, and bone density and the effect of resistance training in attenuating or reversing such detrimental changes in postmenopausal women. In addition, the hormonal mechanisms contributing to the decline musculoskeletal health and the hormonal response to resistance training in postmenopausal women will also be discussed. A common finding among studies is that skeletal muscle in late postmenopausal women retains a high level of residual plasticity and demonstrates significant increases in both size and strength when exposed to a chronic resistance training stimulus. In contrast, evidence to support a large effect of resistance training on bone density in late postmenopausal women is lacking. However, resistance training does appear to substantially attenuate bone loss postmenopause, which may assist to preserve skeletal integrity in ageing women. Although available research supports the use of resistance training to enhance and/or maintain musculoskeletal health, and prevents disability in late postmenopausal women, dpertaining to the effect of resistance training muscle strength, skeletal muscle mass, and bone density in early postmenopausal women is limited. This is surprising given the rapid rate decline in musculoskeletal integrity during the early postmenopausal period. Future research should attempt to assess the extent to which resistance training is capability of attenuating the hormonal cascade that occurs during the menopausal transition and effect of such changes on indices of musculoskeletal health in middle-aged women.