Bone and Muscle Research Group

About Bone and Muscle Health Research

The Bone and Muscle Research Group (BMRG), nested within the Monash University Department of Medicine, is working to achieve:

Falls and fracture prevention
An advanced understanding of interactions between cardiovascular, metabolic and endocrine systems
Healthy ageing in our local and global communities
Better bone health for vulnerable patient populations
Better treatment for osteoporosis patients
Better detection of osteoporotic fractures
Better understanding of genetic causes of atypical femur fracture and early detection and intervention/prevention
Efficient and tailored exercise regimens for building and maintaining healthy bone

We offer a comprehensive platform for assessing bone and muscle health, physical performance and cardiovascular risk factors.

Join our research studies: Recruitment Registry

Group Head

Associate Professor Ayse Zengin

Bone Banter - our podcast

Bone Banter
iTunes or SoundCloud

Contact us

Ph: 03 8572 2919
Email: med-bmrg@monash.edu

Donate to Osteoporosis Research
in the link, please select "Osteoporosis Research" for "Area of giving"

Research groups

Cardio-Skeletal Medicine Unit View

2026 Cardio-Skeletal Medicine Unit L-R: Dr Alexander Rodriguez (Group Lead); Harrison Hood (MBBS Hons); Dr Ruth Liu (Research Associate); Dr Dueanchonnee “Pam” Sribenjalak (Visiting Fellow in Endocrinology); Dr Hyeonmok Kim (Visiting Fellow in Endocrinology); Dr Arpit Sharma (Research Associate)

The Cardio-Skeletal Medicine Unit is a part of the Bone & Muscle Health Research Group based at the School of Clinical Sciences at Monash Health. Our programme of research is dedicated to medication safety and in identifying a group of patients (cardiac) who have under-recognised skeletal risk. Cardiovascular disease and osteoporosis frequently coexist, yet therapeutic decisions are often made in isolation between specialties. Ultimately, we want our work to lead to better treatment decision making to design the right treatment regimens for the right patients; and to build clinical pathways to improve the skeletal health in the cardiac population.

We undertake clinical studies using real-world hospital data to study the skeletal health of cardiac patients; a group that has an underappreciated burden of poor bone health. Additionally, through clinical and epidemiological studies, we examine the effects of osteoporosis medications on cardiovascular risk. We are also focused on understanding how atherosclerotic vascular disease influences responses to osteoporosis treatments, and how derangements in mineral metabolism influence the cardiovascular and autonomic systems. We have research collaborators across Monash University and Monash Health as well as nationally (ECU in Perth) and internationally in Denmark, USA, South Korea and UK. We undertake many systematic review and meta-analysis projects; with undergraduate biomed and final year medical students often leading these projects. We are clinicians, scientists, epidemiologists and data wranglers all wrapped in one.

Selected references (arising from student/associate projects)

Liu, H., R. Hii, N. Nerlekar, P. Ebeling, and A. Rodriguez. "Coronary Artery Calcification Scores are Positively Correlated With Fracture Risk." Heart, Lung and Circulation 34 (2025): S638. DOI: 10.1016/j.hlc.2025.06.862
Lo HZ, Leow K, Hii R, Nerlekar N, Ebeling PR, Rodríguez AJ. “Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis”. Osteoporos Int. 2025 Apr 7; doi:10.1007/s00198-025-07468-3
Rodriguez A, Hii R, Ebeling P, Nerlekar N, Caesar. Coronary artery calcification is associated with smaller increases in femoral neck bone mineral density with anti-resorptive therapy. European Heart Journal. 2023;44(Supplement_2):ehad655.1345doi.10.1093/eurheartj/ehad655.1345
Shoung A, Shoung N, Hii R, Nerlekar N, Ebeling PR, Rodríguez AJ. Electrocardiogram Changes Following Intravenous Bisphosphonate Infusion: A Systematic Review and Meta-Analysis. J Bone Miner Res. 2023 Sep 8. doi: 10.1002/jbmr.4911
Rodríguez AJ, Nerlekar N, Ebeling PR. Cardiac adverse events in bisphosphonate and teriparatide users: An international pharmacovigilance study. Bone. 2022 Dec 18;168:116647. doi: 10.1016/j.bone.2022.116647
Seeto AH, Tadrous M, Gebre AK, Lewis JR, Fink HA, Ebeling PR, Rodríguez AJ. Evidence for the cardiovascular effects of osteoporosis treatments in randomized trials of post-menopausal women: A systematic review and Bayesian network meta-analysis. Bone. 2022 Nov 11;167:116610. doi: 10.1016/j.bone.2022.116610.
Rodríguez AJ, Ernst MT, Nybo M, et al. “Oral bisphosphonate use reduces cardiovascular events in a cohort of Danish patients referred for bone mineral density”. J Clin Endocrinol Metab (2020); published online July 27. DOI:10.1210/clinem/dgaa481.
Seeto AH, Abrahamsen B, Ebeling PR, Rodríguez AJ. “Cardiovascular safety of denosumab across multiple indications: a systematic review and meta‐analysis of randomized trials” J Bone Miner Res (2020) DOI:10.1002/JBMR.4157

Sarcopenia, Obesity and Lifestyle Laboratory View

Research Overview

The Sarcopenia, Obesity and Lifestyle laboratory is led by Dr David Scott, a NHMRC Career Development Fellow within the Bone and Muscle Research Group at the School of Clinical Sciences at Monash Health. Our research explores the contributions of age-related changes in body composition to functional decline and loss of independence in older adults. We collaborate on a several national and international cohort studies to investigate associations of sarcopenia (the age-related decline in skeletal muscle mass and function) and obesity with development of poor bone health, disability and falls and fractures. We also utilise these datasets to identify lifestyle behaviours that prevent muscle and bone quality declines during ageing. We are currently conducting trials exploring how to best deliver lifestyle modification to community-dwelling older adults at high risk for functional decline. These trials include physical activity and nutrition interventions such as osteogenic exercise, resistance training, weight loss and vitamin D supplementation.

- NHMRC R.D. Wright Biomedical Career Development Fellowship: Reducing Risk Factors for Falls and Fracture in Obese Older Australians. PI: David Scott
- Rebecca L. Cooper Foundation Project Grant: Exercise for Musculoskeletal and Metabolic Health During Weight Loss in Sarcopenic Obese Older Adults. PI: David Scott
- American Society for Bone and Mineral Research Rising Star Award: The Exercise for the Prevention of Falls in Older Adults with Sarcopenic Obesity Pilot Study (ESPRESSO-P). PI: David Scott
- MIME-SPARK Scheme: Wearable sensors to optimise exercise for bone health. PIs: David Scott, Peter Ebeling
- Tasmanian Older Adult Cohort Study (TASOAC) – Prof. Graeme Jones and Dr. Dawn Aitken (Menzies Institute for Medical Research, Tasmania)
- Perth Longitudinal Study of Ageing Women (LSAW) – Dr. Joshua Lewis and Dr. Marc Sim (Edith Cowan University, Western Australia)
- Concord Health and Ageing in Men Project (CHAMP) – Dr. Vasant Hirani and Prof. Robert Cumming (University of Sydney, New South Wales)
- VITAL-D Study – Prof. Kerrie Sanders (University of Melbourne, Victoria)
- The Healthy Ageing Initiative – Prof. Anna Nordstrom and Prof. Peter Nordstrom (Umea University, Sweden)
- Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth C, Zhu K, Woodman RJ, Hodgson JM, Lewis JR (2018). Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women. Osteoporosis International (In press).
- Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth C, Zhu K, Woodman RJ, Hodgson JM, Lewis JR (2018). Sarcopenia definitions and their associations with mortality in older Australian women. Journal of the American Medical Directors Association (In press).
- Zanker J, Scott D, Reijnierse EM, Brennan-Olsen SL, Daly RM, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth CA, Iuliano S, Keogh J, Lewis J, Maier AB, Pasco JA, Phu S, Sanders KM, Sim M, Visvanathan R, Waters DL, Yu SCY, Duque G on behalf of the Australian and New Zealand Society for Sarcopenia and Frailty Research Task Force on Diagnostic Criteria for Sarcopenia (2018). Establishing an Operational Definition of Sarcopenia in Australia and New Zealand: Delphi Method Based Consensus Statement. Journal of Nutrition, Health and Aging (In press).
- Scott D, Cumming RG, Blyth F, Naganathan V, Le Couteur DG, Waite LM, Handelsman DJ, Seibel MJ, Hirani V (2018). Does combined osteopenia/osteoporosis and sarcopenia confer greater risk of fracture than either condition alone in older men? The Concord Health and Ageing in Men Project. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences (In press).
- McMillan LB, Aitken D, Ebeling P, Jones G, Scott D (2018). The relationship between objectively-assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass. Osteoporosis International (In press).
- Scott D, Shore-Lorenti C, McMillan L, Mesinovic J, Clark RA, Hayes A, Sanders KM, Duque G, Ebeling PR (2018). Associations of components of sarcopenic obesity with bone health and balance in older adults. Archives of Gerontology and Geriatrics 75:125-31.
- Scott D, Shore-Lorenti C, McMillan L, Mesinovic J, Clark RA, Hayes A, Sanders KM, Duque G, Ebeling PR (2018). Calf muscle density is independently associated with physical function in overweight and obese older adults. Journal of Musculoskeletal and Neuronal Interactions (In press)
- McMillan L, Zengin A, Ebeling PR, Scott D (2017). Prescribing physical activity for the prevention and treatment of osteoporosis in older adults. Healthcare 5(4):85.
- Sanders K, Lim K, Stuart A, Macleod A, Scott D, Nicholson G, Busija, L (2017). Diversity in fall characteristics hampers effective prevention: The precipitants, the environment, the fall and the injury. Osteoporosis International 28(10):3005-15.
- Rodriguez A, Scott D, Khan B, Khan N, Hodge A, English DR, Giles GG, Ebeling PR (2017). Associations between hip bone mineral density, aortic calcification and cardiac workload in community-dwelling older Australians. Osteoporosis International 28:2239-45.
- Scott D, Seibel MJ, Cumming RG, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Hirani V (2017). Sarcopenic obesity and its temporal associations with changes in bone mineral density, incident falls and fractures in older men: The Concord Health and Ageing in Men Project. Journal of Bone and Mineral Research 32(3):575-83.
- Scott D, De Courten BD, Ebeling PR (2016). Sarcopenia: A potential cause and consequence of type 2 diabetes mellitus in Australia’s ageing population? Medical Journal of Australia 205(7):329-33. IF = 3.369
- Scott D, Chandrasekara SD, Laslett LL, Cicuttini F, Ebeling PR, Jones G (2016). Associations of sarcopenic obesity and dynapenic obesity with bone mineral density and incident fractures over five to 10 years in community-dwelling older adults. Calcified Tissue International 99(1):30-42.

More about BMRG

Research studies View

Our current research studies

TRAFFIC Study View

TRAFFIC Sub-Study View

THOR Study View

SIMBA Study View

TEPIN Trial View

Osteogenesis Imperfecta Trial View

OAS Load Instability Project View

HPP Registry View

Hickory Trial View

STOP Trial View

REFERENCE study View

Clinical imaging service View

Our Clinical Imaging Service includes four devices, used to assess bone, muscle, cardiovascular and joint health. To our knowledge, we are the only group in the world with this complete suite of bone imaging machines. The Service is available to research groups and for clinical cases at the discretion of the Bone and Muscle Research Group (BMRG).

Dual Energy X-Ray Absorptiometry (DXA) View

DXA (dual-energy X-ray absorptiometry) densitometer, used primarily to evaluate bone mineral density and body composition

DXA has long been the gold-standard for bone mineral density (BMD) measurements at the hip, spine and forearm. BMD results are used to screen, detect, diagnose and manage osteoporosis and osteopenia.

DXA uses have now expanded to include identification of atypical femur fractures, structural analyses of the hip and silent vertebral fractures. In addition, DXA is used to assess cardiovascular risk factors: abdominal aortic calcification and body composition – including lean mass and visceral fat.
$Femur fracture$ Complete Atypical Femur Fracture – Xray Imaging	Extended Femur scans Early detection of atypical femur fractures can help prevent complete fractures, as shown to the left. Instant vertabral assessment Vertebral fractures often go undetected, and can be a sign of undiagnosed osteoporosis. This scan allows analysis of the size, height and shape of the vertebral bodies (the bones in your spine), to detect these fractures.
Abdominal aortic calcification Screening for abdominal aortic calcification using instant vertebral assessment may identify people at a higher risk of cardiovascular disease.
Body composition Skeletal muscle mass and adipose tissue can be quantified easily with a whole body DXA scan.	Hip structural analysis Geometry of the bone can be analysed to estimate measurements such as bone mass, cross-sectional area and cortical thickness.

With our specialised add-on program, our DXA machine can also analyse the deterioration of the micro-architecture of the lumbar spine by reporting a trabecular bone score (TBS).
When combined, BMD and TBS create a powerful prediction of fracture risk (roughly 20% better than using BMD alone, with or without other risk factors such as substance abuse, diabetes, rheumatoid arthritis etc).
DXA uses a low dose of x-ray radiation and is otherwise non-invasive. You can view the product brochure here.

High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) View

Leonardo Mechanograph® Ground Reaction Force Platform (GRFP) Lite (LT) View

Peripheral Quantitative Computed Tomography (pQCT) View

Quantitative Heel Ultrasound View

Staff, students and collaborators View

Researchers

Research Assistants

Ms Vanessa Gan

Research Coordinators

Mrs Chen Wang
Ms Sarah Bullen

PhD Students

Ms Lucy Collins
Dr Simon Zhang

Honours student

Mystica Jude

Alumni

Ms Carol Alonso
Ms Mavil Cervo
Ms Anoohya Gandham
Dr Amar Lakhani
Dr Lachlan McMillan
Mr Jakub Mesinovic
Ms Carrie-Anne Ng
Dr Eleanor Thong
Mr Theo Di Pauli von Treuheim

Visiting Scientists

Carol Daniela Alonso Gonzalez (2019): National University of Colombia
Juan Diego Pena Rodriguez (2019): National University of Colombia
Luisa Fernanda Rubio Pachon (2022): National University of Colombia
Camila Andrea Rodriguez Gaitan (2022): National University of Colombia
Cristian Andres Pena Rodriguez (2022): National University of Colombia
Prof Dominik Schulte (2023) - University of Kiel, Germany

Monash Health Collaborators

Professor Peter Fuller, AM NHMRC Senior Principal Research Fellow
Associate Professor Amanda Vincent Adjunct Research Fellow
Associate Professor Francis Milat, Hudson Institute/Monash Health
Dr Phillip Wong NHMRC Early Career Research Fellow
Dr Anne Trinh Monash Health Endocrinologist
Dr Wei-Ling Chiu PhD student

National Collaborators

Professor Richard Sinnott, University of Melbourne
Professor Louise Maple-Brown, Menzies Institute of Medical Research, Darwin
Associate Professor Cherie Chiang, The University of Melbourne/Austin Health/Melbourne Health
Associate Professor Vivian Grill, Western Health
Associate Professor Rory Clifton-Bligh, University of Sydney
Associate Professor Christopher Yates, University of Melbourne
Dr Shoshana Sztal-Mazer, Alfred Health
Dr Christian Girgis, University of Sydney

International Collaborators

Professor M Carola Zillikens, Erasmus University
Professor Rajesh Thakker, May Professor of Medicine, University of Oxford
Professor Bo Abrahamsen, University of Southern Denmark
Professor Aasis Unnanuntana, Mahidol University, Thailand
Associate Professor Kate Ward, University of Southampton

Student opportunities View

Student Opportunities

If you are thinking of a career in musculoskeletal, endocrine, cardiovascular or metabolic research the BMRG is a great place to start. We are located at Monash Medical Centre (MMC) Clayton within easy walking distance of both Monash University Clayton Campus and the Clayton Shopping District. If you have any questions about a project, feel free to get in touch with the relevant researcher.
Available Projects

Honours/PhD

The effects of lifestyle differences on musculoskeletal health in ethnic populations
Genome wide association studies have shown that several genetic variants are associated with certain diseases, including osteoporosis and osteoarthritis. However, these genetic variants explain less than 10% of those diseases' variance – suggesting that the variability in disease susceptibility is mainly due to environmental lifestyle factors. Lifestyle factors include, but are not limited to: stress, physical activity, nutrition and socioeconomic status. This research project will look at the differences in lifestyle factors between ethnic populations from The Gambia, India and Vietnam, and how these are associated with bone and muscle health.
Supervisors: Dr Ayse Zengin, Dr David Scott, Professor Peter Ebeling
Contact: 03 8572 2918 or Ayse.Zengin@monash.edu

PhD

Musculoskeletal health of Indigenous Australians
Research on non-communicable diseases (NCD) in Indigenous Australians has mostly focused on diabetes mellitus, chronic kidney and cardiovascular disease. Musculoskeletal diseases, such as osteoporosis, share common comorbidities with these NCDs – with a combination further increasing bone fragility and fracture risk. There are no data on bone or muscle health in ageing Indigenous Australians. This research project will be the first to characterise the musculoskeletal health of Indigenous Australians using the latest bone imaging (DXA, pQCT, HRpQCT) and muscle function devices (jumping mechanography, grip strength).
Supervisors: Dr Ayse Zengin, Dr David Scott, Professor Peter Ebeling
Contact: 03 8572 2918 or Ayse.Zengin@monash.edu

Ethnic differences in bone health in The Gambia, India and Vietnam
There are differences in fracture risk between ethnic groups in both men and in women across the globe. Bone structure, geometry and strength, in addition to body composition affect mobility, fall and fracture risk. This epidemiological research project will utilise data from large studies from The Gambia, India and Vietnam to examine the ethnic differences in bone geometry and body composition in order to determine how these affect bone fragility and fracture risk.
Supervisors: Dr Ayse Zengin, Dr David Scott, Professor Peter Ebeling
Contact: 03 8572 2918 or Ayse.Zengin@monash.edu

The HR-pQCT is a 3D imaging platform. While the DXA is the gold-standard for measuring BMD, the deterioration of the micro-architecture of bone is a key component of osteoporosis and is best assessed using HR-pQCT.
The device scans the forearm and/or lower leg to assess volumetric bone density and 3D-structure of the tibia and radius (cortical and trabecular density and thickness, trabecular separation, cortical porosity and more).
Radius scan	Finite Element Analysis (FEA) FEA can be used to calculate bone stiffness, failure load and more.
Cortical density/thickness	Trabecular density/thickness
Taking bone micro-architecture into account in combination with bone density improves fracture risk prediction and may aid in the management of patients with osteoporosis. This imaging modality uses a low dose of x-ray radiation and is otherwise non-invasive. You can read more about our device here.

Like the HR-pQCT, the pQCT is a 3D imaging platform used to assess bone density and micro-architecture of the bones in the forearm and lower leg. Typical scans performed during a pQCT examination include the 4%, 30% and 66% site of the tibia. The trabecular bone density is assessed near the ankle at the 4% site, while cortical bone parameters can be assessed at the 30% and 66% sites. Muscle and adipose tissues are quantified at the 66% site.
Tibia Scan: 4% siteTrabecular bone density at 4% of the tibia	Tibia Scan: 66% siteCortical bone density, muscle density, muscle area and fat area at 66% of the tibia. Muscle density has been related to important patient outcomes, for example physical performance, hospitalisation events and falls.
This imaging modality uses a low dose of x-ray radiation and is otherwise non-invasive. You can read more about our device here.