Kelly Ann McLeod

People living with osteoporosis can experience worse mental health and quality of life (QoL), including pain and psychological distress than those without. Psychological stress and poor mental health are associated with an increased risk of osteoporosis (OP). We conducted a systematic review and meta-analysis of randomised controlled trials investigating the effect of exercise on mental health, QoL and pain in people living with OP. A systematic review and meta-analysis was conducted following PRISMA guidelines (PROSPERO: CRD42023440020). Inclusion criteria were randomised controlled trials investigating exercise in people diagnosed with OP, including QoL, mental health, and/or pain outcomes. Exclusion criteria were non-human studies or studies not translatable into English. An electronic search of the literature was performed from inception to December 2025 in PubMed, EMBASE, PsycINFO, CINAHL, Scopus, and Web of Science. Bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The Consensus on Exercise Reporting Template was used to assess reporting quality. Three authors independently extracted data into Microsoft Excel. Data were analysed using Cochrane Review Manager Web (version 9.4.1), including mean differences (MD) and standardised mean differences (SMD) using a random-effects inverse variance model. Moderator analyses assessed modality, intensity, duration, frequency, setting, participant age, the presence of fracture (%), the nature of fracture and the osteoporosis diagnosis (postmenopausal or other). Certainty and quality of evidence were assessed using the GRADE approach. Twenty-three trials (n = 2120, mean age 67.1 ± 5.98yrs, 95.1% female) were included: five resistance training, six balance training, six combined resistance and balance training, three multi-modality, two Clinical Pilates, one aquatic, one combined aerobic, strength and Yi Jin Jing. A total of 1135 participants underwent exercise (low-high intensity, 2-7 times weekly) for 19 ± 12 weeks targeting upper, lower and full body, with seventeen studies reporting progression. Exercise improved mental health (SMD 0.53 [0.25, 0.81], p = 0.0002, moderate certainty evidence), QoL (SMD 0.62 [0.29, 0.95], p = 0.0003, moderate certainty evidence) pain (SMD 0.36 [0.17, 0.55], p = 0.0002, low certainty evidence), and pain at rest MD - 1.69 [- 2.38, - 0.99], p < 0.00001, moderate certainty evidence). Clinical Pilates was most effective for mental health (p = 0.006), QoL (p < 0.00001) and pain (p = 0.01). For mental health, the largest effect was seen with interventions performed three times per week for 4-11 weeks. Reporting quality varied (CERT, mean 11.1 ± 3.4, range 5-18), as did bias, with concerns regarding evidence certainty, internal validity and statistical conclusion validity bias. Exercise improves mental health, QoL, and pain. Pilates appeared most effective for all outcomes; however, resistance training was also effective for both QoL and pain. Further high-quality research following standardised reporting guidelines is needed for people living with osteoporosis. KEY POINTS: • Exercise improves mental health, quality of life and pain for people living with osteoporosis. Pilates was most effective, while resistance training also showed an effect for quality of life and pain outcomes. Further high-quality research is needed for people living with osteoporosis and poor mental health.

Background: Globally, approximately 55 million people are living with dementia. Osteoarthritis occurs in half of all older adults and is associated with pain, depression, and increased dementia risk. Currently, no program exists for people with osteoarthritis and cognitive decline that addresses modifiable risk factors, such as physical inactivity and lifestyle behaviors. Objective: This study aims to examine the feasibility, acceptability, and health outcomes following the 12-week Healthy Body and Mind Program, designed for people with osteoarthritis who are experiencing cognitive decline. The findings will inform the designs of larger trials. Methods: In total, 20 consenting participants aged 45 years or older with osteoarthritis and cognitive decline will be randomly allocated to the 12-week program or a waitlist control group. Feasibility and acceptability will be assessed based on retention and adherence rates to the program, the number of people who provide consent to take part in the study, and evaluation questions following completion of the program. Health outcomes will include quality of life, cognition (global, attention, learning, and memory), pain, psychological health (stress, anxiety, and depression), and physical health. Results: This study has been reviewed and approved by the University of New South Wales Human Research Ethics Committee (HC230506). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). As of October 2025, we have enrolled 18 participants and completed their data collection. Results are expected to be published in peer-reviewed journals during the first quarter of 2026. Participant confidentiality will be maintained in line with ethical considerations. Conclusions: This protocol reports methods to determine feasibility, acceptability, and preliminary health outcome data of the Healthy Body and Mind Program informed by individuals with lived experience of dementia and osteoarthritis. Trial Registration: ClinicalTrials.gov NCT06070818; clinicaltrials.gov/study/NCT06070818 International Registered Report Identifier (IRRID): DERR1-10.2196/75816

BACKGROUND Globally, approximately 55 million people are living with dementia. Osteoarthritis occurs in half of all older adults and is associated with pain, depression, and increased dementia risk. Currently, no program exists for people with osteoarthritis and cognitive decline that addresses modifiable risk factors, such as physical inactivity and lifestyle behaviors. OBJECTIVE This study aims to examine the feasibility, acceptability, and health outcomes following the 12-week Healthy Body and Mind Program, designed for people with osteoarthritis who are experiencing cognitive decline. The findings will inform the designs of larger trials. METHODS In total, 20 consenting participants aged 45 years or older with osteoarthritis and cognitive decline will be randomly allocated to the 12-week program or a waitlist control group. Feasibility and acceptability will be assessed based on retention and adherence rates to the program, the number of people who provide consent to take part in the study, and evaluation questions following completion of the program. Health outcomes will include quality of life, cognition (global, attention, learning, and memory), pain, psychological health (stress, anxiety, and depression), and physical health. RESULTS This study has been reviewed and approved by the University of New South Wales Human Research Ethics Committee (HC230506). This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). As of October 2025, we have enrolled 18 participants and completed their data collection. Results are expected to be published in peer-reviewed journals during the first quarter of 2026. Participant confidentiality will be maintained in line with ethical considerations. CONCLUSIONS This protocol reports methods to determine feasibility, acceptability, and preliminary health outcome data of the Healthy Body and Mind Program informed by individuals with lived experience of dementia and osteoarthritis. CLINICALTRIAL ClinicalTrials.gov NCT06070818; clinicaltrials.gov/study/NCT06070818 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/75816

Kelly A. McLeod , Matthew D. Jones , Jeanette M. Thom , Belinda J. Parmenter Resistance Training and HIIT Improve Cardiometabolic Health in High Risk Older Adults: A Systematic Review and Meta-Anaylsis Int J Sports Med 2021; eFirst DOI: 10.1055/a-1560-6183 Published online: 15.07.2021. Correction in Table 1, the control group data has been repositioned to an additional row below each studies intervention data. Publication Date: 22 November 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

High blood pressure (BP) is a global health challenge. Isometric resistance training (IRT) has demonstrated antihypertensive effects, but safety data are not available, thereby limiting its recommendation for clinical use. We conducted a systematic review of randomized controlled trials comparing IRT to controls in adults with elevated BP (systolic ≥130 mmHg/diastolic ≥85 mmHg). This review provides an update to office BP estimations and is the first to investigate 24-h ambulatory BP, central BP, and safety. Data were analyzed using a random-effects meta-analysis. We assessed the risk of bias with the Cochrane risk of bias tool and the quality of evidence with GRADE. Twenty-four trials were included (n = 1143; age = 56 ± 9 years, 56% female). IRT resulted in clinically meaningful reductions in office systolic (–6.97 mmHg, 95% CI –8.77 to –5.18, p < 0.0001) and office diastolic BP (–3.86 mmHg, 95% CI –5.31 to –2.41, p < 0.0001). Novel findings included reductions in central systolic (–7.48 mmHg, 95% CI –14.89 to –0.07, p = 0.035), central diastolic (–3.75 mmHg, 95% CI –6.38 to –1.12, p = 0.005), and 24-h diastolic (–2.39 mmHg, 95% CI –4.28 to –0.40, p = 0.02) but not 24-h systolic BP (–2.77 mmHg, 95% CI –6.80 to 1.25, p = 0.18). These results are very low/low certainty with high heterogeneity. There was no significant increase in the risk of IRT, risk ratio (1.12, 95% CI 0.47 to 2.68, p = 0.8), or the risk difference (1.02, 95% CI 1.00 to 1.03, p = 0.13). This means that there is one adverse event per 38,444 bouts of IRT. IRT appears safe and may cause clinically relevant reductions in BP (office, central BP, and 24-h diastolic). High-quality trials are required to improve confidence in these findings. PROSPERO (CRD42020201888); OSF (https://doi.org/10.17605/OSF.IO/H58BZ).

Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5.3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) −0.33 [−0.47, −0.20], p≤0.0001), body fat% (standardised mean difference (SMD) −0.71 [−1.34, −0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD −0.27 [−0.52, −0.01], p=0.04), and blood glucose (SMD −0.31 [−0.58, −0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health. (PROSPERO: CRD42019128527).