Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription

Abstract

Background: Osteoporosis and related fragility fractures are a global public health problem in which pharmaceutical agents targeting bone mineral density (BMD) are the first line of treatment. However, pharmaceuticals have no effect on improving other key fracture risk factors, including low muscle strength, power and functional capacity, all of which are associated with an increased risk for falls and fracture, independent of BMD. Targeted exercise training is the only strategy that can simultaneously improve multiple skeletal and fall-related risk factors, but it must be appropriately prescribed and tailored to the desired outcome(s) and the specified target group. Objectives: In this review, we provide an overview of the general principles of training and specific loading characteristics underlying current exercise guidelines for the prevention of osteoporosis, and an update on the latest scientific evidence with regard to the type and dose of exercise shown to positively influence bone mass, structure and strength and reduce fracture risk in postmenopausal women.

Vitamin D and Indices of Bone and Carbohydrate Metabolism in Postmenopausal Women Subjected to a 12-Week Aerobic Training Program—The Pilot Study

“…Perez-Soriano et al [27] suggested that NW could be considered an intermediate mode between normal walking and running because of bigger walking stability and higher maximum speeds. Exercises that are characterized by high load dynamics are of particular importance for maintaining high bone mass values and appear to be the most effective in reducing postmenopausal bone loss at the hip and spine [28]. However, in our study, the mechanical stress that was imposed during training was not sufficient for inhibiting the bone resorption rate.…”

Impact of Rheumatoid Arthritis and Its Management on Falls, Fracture and Bone Mineral Density in UK Biobank

“…Indeed, smoking status constitutes part of the FRAX algorithm for assessing osteoporotic fracture risk (24) and this is consistent with our cohort where the number of cigarettes currently smoked daily was associated with eBMD in both sexes (men: β −0.017, 95% CI −0.018, −0.016 p < 0.001; women: OR −0.008, 95% CI −0.009, −0.007 p < 0.001). Several studies have shown that exercise is associated with improved BMD (25)(26)(27) but in our population the association between hours of moderate or vigorous activity in a typical week and eBMD was small (men: β −0.001, 95% CI −0.001, 0.000 p = 0.103; women: OR −0.002, 95% CI −0.003, −0.002 p < 0.001). Nevertheless, adjustment for these confounders did not attenuate the association we observed between RA and lower eBMD in both men and women.…”

Long-Term Recreational Football Training and Health in Aging

“…Moreover, Hagman reported a higher BMD in femural trochanter and in the legs of lifelong older football players compared to untrained young subjects, regardless of age [63]. The osteogenic effect of football also has an instrumental influence in the prevention/management of osteoporosis in pre/post-menopausal women [86]. Increased BMD in lumbar spine and in upper femur was reported in long-term exercised premenopausal women [87]; moreover, 15 weeks of football training allowed a significant increase in plasma levels of bone turnover markers and in leg bone mass and BMD in middle-aged sedentary hypertensive women and in untrained premenopausal women [88,89].…”