Effects of COVID-19 Lockdown on Adherence to Individual 2 Home or Gym Based Exercise Training among Women with 3 Post-Menopausal Osteoporosis

Adherence is important for an exercise program efficacy. This study aims at investigating 23 whether the COVID-19 lockdown had different consequences on the adherence to an exercise pro-24 gram specifically designed for women with post-menopausal osteoporosis when administered as 25 individual home training (IHT) or gym group training (GGT). At the start of the lockdown, which 26 imposed the temporary closure of any gym activities, GGT participants, were invited to continue to 27 exercise at home. IHT participants continued to exercise at home as usual. Adherence was recorded 28 via logs and measured as a percentage of exercise sessions actually performed out of the total num-29 ber of scheduled sessions in three 1-month periods: one before (PRE) and two after (M1 and M2) the 30 beginning of lockdown. Before lockdown IHT (66.8%±26.6) and GGT (76.3%±26.6) adherence were 31 similar. During lockdown IHT participation increased (M1: 81.5%±31.0; M2: 88.0%±28.3) while that 32 of GGT showed no statistical differences (M1: 79.4%±34.2; M2: 80.6%±36.4). Exercise protocols based 33 on supervised gym practice, must consider the possibility of disruptive events which could cause a 34 sudden interruption of gym activity and include educational initiatives to instruct participants to 35 exercise effectively and safely without trainer’s direct supervision.