Contributors: Dr. Adrian Lau, Dr. Lora Giangregorio, Dr. Claudia Gagnon, Dr. Laëtitia Michou, Dr. Alan Low, Dr. Emma Billington, Dr. Zahra Bardai, Dr. Vithika Sivabalasundaram, Dr. Rowena Ridout, Dr. Sandra Kim.

Recommendations from Osteoporosis Canada Rapid Response Team.

In February 2025, a new article was published in the Journal of Clinical Endocrinology and Metabolism (JCEM) regarding Osteostrong.

Osteostrong is described as “a bone-strengthening system implementing 4 devices and incorporating brief (10-minute), weekly, low-impact, and high-intensity osteogenic loading exercises”.  This study claims that participation in Osteostrong for 10 minutes, once a week for 12 months resulted in improved bone mineral density (BMD) at the lumbar spine for women, whether they were on anti-resorptive therapies or not.  The study also claims that “Osteostrong enhanced the effect of antiresorptive therapy on BMD and TBS (trabecular bone score*) of the spine, hip and femoral neck”.

However, it was brought to Osteoporosis Canada’s attention that there may be concerns about the validity and reliability of this study.  These include flaws in the study design, non-adherence to reporting guidelines, and inappropriate analysis and reporting of results.

Some concerns about the Osteostrong study include:

• No clear objectives or hypotheses
• No information about ethical approval
• No clear statistical analysis plan
• No description of how the authors collected and analyzed all the data
• No evidence that the trial’s clinical protocol was registered online, for transparency
• Lack of efforts to reduce the risk of bias, such as randomization of participants and blinding of assessors
• Lack of considerations of confounding variables, such as the use of osteoporosis medications, and the duration and adherence of their use
• Lack of reporting standard outcomes, such as between group differences in bone mineral density at the hip or spine

Prior studies of Osteostrong are limited to observational studies with small sample sizes that are also at high risk of bias and are industry funded. There is one randomized controlled trial that compared devices like those used in Osteostrong facilities to a high intensity strength and impact exercise program. The devices did not increase bone mineral density compared to high intensity strength and impact exercise. Five people in the group that used the devices had spine fractures, compared to none in the exercise group.

The existing evidence regarding the benefits and harms of Osteostrong is of very low certainty and thus, Osteoporosis Canada cannot support recommendations regarding its use for fracture prevention based on existing research. There is a cost to participating.

Osteoporosis Canada also encourages health care professionals to analyze and assess these studies for themselves.

Those living with osteoporosis who are considering Osteostrong are encouraged to seek guidance from their health care professionals.

* Trabecular bone score (TBS) is an index of bone architecture, which is an indicator of bone quality.