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Anti-rejection therapy using drugs like prednisone causes
osteoporosis in the upper body skeleton of heart transplant
recipients. There is no standard remedy for this bone loss.
We studied whether alendronate along with weight lifting
reduced post-transplant bone loss.
	25 heart recipients were randomly assigned to
alendronate (10 mg/day) for 6 months (8 patients), alendronate
(10 mg/day) plus controlled resistance exercises for 6 months
(8) or to a control group (9). Alendronate was started 2
months after transplant.
	Bone mineral density of the total body, thigh, neck,
and lower spine was measured before transplant and at 2, 5
and 8 months after transplant. Resistance training included
MedX (a high-tech version of hyperextensions) done once a week
and 8 other resistance exercises done twice each week.
	Pre-transplant bone density was the same in all 3
groups. Density for the total body, thigh, neck, and lower
back was much reduced 2 months after transplant. The control
group had further serious bone density losses at 3 and 6
months. The alendronate-only group stayed the same once the
drug was started.
	Alendronate plus weight training restored all bone
density measures to almost pre-transplant levels - to within
this close of "normal"

Whole body: 0.9%
Thigh: 2.1%
Neck and lower spine: 3.4%

Resistance exercise plus alendronate was more effective than
alendronate alone in restoring bone density in heart
recipients. Anti-osteoporosis therapy in heart recipients
should include both an anti-resorptive agent and resistance
training.

Source:  J Heart Lung Transplant. 2003 Oct;22(10):1082-90.
Title:   Resistance exercise training and alendronate
         reverse glucocorticoid-induced osteoporosis in
         heart transplant recipients.
Authors: Braith RW, Magyari PM, Fulton MN, Aranda J, Walker
         T, Hill JA.
PMID:    14550817.