The Effect of Exercise in Postmenopausal Women with Low Bone Density

Inclusion Criteria: * Be aged greater than 50 years * Be at least 5 years post menopause (defined as the last normal menstrual bleed) * Have osteopenia of the hip defined as a DXA T-score between -1 and -2.5 in one or more regions of the proximal femur (total hip, neck or trochanter regions). * Have primary osteopenia * Be community dwelling (not in residential care) * Be able to attend an exercise program 3 times per week over the 12-month period * Be able to read and write English Exclusion Criteria: * Secondary causes of bone loss such as osteomalacia, glucocorticoid medication * Co-morbidities that would interfere with participation in exercise such as severe heart or pulmonary disease, inflammatory joint disease, severe osteoarthritis, psychiatric condition * Physical or orthopaedic disabilities that would place the subject at risk or limit their ability to perform exercise * Spinal osteoporosis defined as DXA T-score \<-2.5 * A past vertebral fracture * Body mass index \> 35 or \< 18. * Currently on hormone replacement therapy (HRT) * Current smoker * Past use of HRT within the past 3 years and for more than 6 months duration * Taking medication known to affect bone including oestrogen or steroid hormones * Known clinically significant liver or renal disease * Cancer within the past 5 years * Doing regular strength training and/or weight-bearing exercise at least once per week in past 6 months * Unlikely to comply with the intervention protocol