For physicians

Supervised, osteoporosis-specific strength training for your patients

A small-group program in Courtenay led by a Certified Athletic Therapist and licensed ONERO® instructor.

What the program involves

Each participant completes a pre-evaluation and a one-to-one baseline assessment before joining classes.

Small-group classes, Monday to Thursday, 3:45 to 4:45 pm and 5 to 6 pm, supervised throughout
Training twice weekly built around balance, functional and progressive resistance work and impact training
Individual exercise selection and progression, adjusted for fracture history and bone density
Re-assessment of strength and function over time
A 4-class decision window before committing to ongoing membership

Where this fits in Canadian guidelines

The 2023 Osteoporosis Canada clinical practice guideline (CMAJ 2023;195(39):E1333) applies to postmenopausal females and males aged 50 and older. It recommends balance and functional training at least twice weekly to reduce falls (Rec. 1.1, strong recommendation) and suggests progressive resistance training at least twice weekly, including exercises for the abdominal and back extensor muscles (Rec. 1.2, conditional recommendation). It also advises seeking exercise professionals with osteoporosis-specific training for exercise selection, intensity and progression, especially after a recent fracture or when fracture risk is high (good practice statement 1.5). The guideline notes that the safety and efficacy of impact exercise is uncertain in people at high fracture risk, and that loaded spinal twisting or flexion may need modification. For higher-risk participants, exercise selection and progression in this program are modified accordingly. Strong Bones Blueprint runs twice weekly, fully supervised, led by a licensed ONERO® instructor. This is consistent with the guideline's frequency and its advice on professional involvement; the guideline does not name or endorse any specific program.

Read the guideline

What the evidence shows

The guideline's exercise recommendations draw on these findings:

Functional and balance training in adults over 50 reduces the rate of falls (rate ratio 0.76; high-certainty evidence from a Cochrane review cited in the guideline).
Progressive resistance training may improve quality of life, physical functioning and bone mineral density. Combined with balance and functional training, it can reduce falls.
The certainty of evidence for resistance training is lower than for balance training, which is why the guideline's resistance recommendation is conditional.
Impact exercise may improve bone density and physical functioning, but its benefit in isolation is uncertain, and its safety is uncertain in people at high fracture risk.

Research results

In the original clinical research behind this method, 86% of participants increased bone density in their spine, and 69% increased it in their hip. This is the same program, delivered under license, right here in the Comox Valley.

86%

increased bone density in the spine

In the original clinical research behind the ONERO® class.

69%

increased bone density in the hip

Same original research, same supervised, bone-specific protocol.

And here's what's been recorded since, as the program moved out of the trials and into real clinical practice at The Bone Clinic:

82%

increased lumbar spine bone mineral density

Among 415 ONERO® participants, 82% increased their lumbar spine bone mineral density; 78% increased femoral neck (hip) density.

+20.2%

back extensor strength

The muscle group that holds you upright. Kyphosis (rounding of the upper back) fell 7.1% on average.

-18.8%

time on balance testing

Alongside faster Timed Up and Go (-10.3%) and sit-to-stand (-11.7%) — the measures that track fall risk.

91%

fewer new fractures

Reported in a three-year longitudinal report from The Bone Clinic (2022), in a supervised clinical setting.

Findings come from the LIFTMOR and LIFTMOR-M randomised controlled trials and The Bone Clinic's ongoing outcome data, published by Dr. Belinda Beck, PhD and colleagues.

These are program results, not a guarantee of individual outcomes.

Read the LIFTMOR study

Watson et al. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research, 2018;33(2):211–220. DOI: 10.1002/jbmr.3284.

Download study PDF Open study PDF Original study source

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Who it suits and how participants are screened

Suitable for

Adults with osteoporosis or low bone density, including those with past vertebral fractures or other health concerns such as osteoarthritis (OA) or chronic pain. Suitability is assessed individually. People with an unstable fracture cannot participate.

If the program is not a good fit for someone, they will be told why.

How screening works

Pre-evaluation: contact details, current activity and goals, with screening answers used only to review suitability and contact the applicant. Detailed health history, diagnoses, test results and medication names are covered at the baseline assessment, not in the form's text boxes.
One-to-one baseline assessment, including health history, strength and function testing.
Participants with past vertebral fractures or very low spine bone density follow a modified, more conservative progression. People with an unstable fracture cannot participate.

How patients get started

Patients submit a pre-evaluation form on this website, then book a one-to-one baseline assessment. If the program is appropriate, they register to begin classes.

Patient pre-evaluation

Membership is $250 CAD per month, paid privately by the patient. Some patients are able to use an employer wellness spending account, and extended health coverage for athletic therapy varies by plan. Itemized receipts are provided on request.

Scope and credentials

This program is exercise training, not medical treatment. It does not diagnose osteoporosis, replace medical care or change medication, and does not advise patients on medication.

Questions about the program? Email info@bonehealthcomox.com.