Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials

Kam, Digna de; Smulders, Ellen; Weerdesteyn, Vivian; Smits-Engelsman, B.C.M.

doi:10.1007/s00198-009-0938-6

Cited by 157 publications

(134 citation statements)

References 67 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…29 Removal of an individual's first cataract reduced the frequency of falls, 29 but interventions to reduce falls did not reduce fractures. 30 Hip protectors have been cost-effective in reducing hip fractures among residents of Canadian long-term care facilities but not for those residing in the community, probably because of poor compliance. 31 …”

Section: What Are the Therapeutic Options?mentioning

confidence: 99%

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Παπαϊωάννου

Morin²,

Cheung³

et al. 2010

Canadian Medical Association Journal

1,175

958

View full text Add to dashboard Cite

Since the publication of the Osteoporosis Canada guidelines in 2002, there has been a paradigm shift in the prevention and treatment of osteoporosis and fractures.1,2 The focus now is on preventing fragility fractures and their negative consequences, rather than on treating low bone mineral density, which is viewed as only one of several risk factors for fracture. Given that certain clinical factors increase the risk of fracture independent of bone mineral density, it is important to take an integrated approach and to base treatment decisions on the absolute risk of fracture. Current data suggest that many patients with fractures do not undergo appropriate assessment or treatment.3 To address this care gap for high-risk patients, the 2010 guidelines concentrate on the assessment and management of women and men over age 50 who are at high risk of fragility fractures and the integration of new tools for assessing the 10-year risk of fracture into overall management. Burden and care gapsFragility fractures, the consequence of osteoporosis, are responsible for excess mortality, morbidity, chronic pain, admission to institutions and economic costs. [4][5][6] They represent 80% of all fractures in menopausal women over age 50.3 Those with hip or vertebral fractures have substantially increased risk of death after the fracture.5 Postfracture mortality and institutionalization rates are higher for men than for women. 7Despite the high prevalence of fragility fractures in the Canadian population and the knowledge that fractures predict future fractures, 8 fewer than 20% of women 3,9 and 10% of men 10 receive therapies to prevent further fractures. These statistics contrast sharply with the situation for cardiovascular disease, where 75% of patients who have had myocardial infarction receive β-blockers to prevent another event. 11 Scope of the guidelinesThe target population for these guidelines is women and men over age 50, because of the overall burden of illness in that age group. As a consequence, we focused our systematic literature reviews on this population. The application of these guidelines to children and young adults, as well as high-risk groups such as transplant recipients, was considered, but indepth reviews of conditions that increase risk were largely beyond the scope of these guidelines. Development of the guidelinesThe development of these guidelines followed the Appraisal of Guidelines, Research and Evaluation (AGREE) framework. 12 We surveyed primary care physicians, patients, osteoporosis specialists from various disciplines, radiologists, allied health professionals and health policy-makers to identify priorities for these guidelines. We then conducted system-

show abstract

Section: What Are the Therapeutic Options?mentioning

confidence: 99%

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Παπαϊωάννου

Morin²,

Cheung³

et al. 2010

Canadian Medical Association Journal

1,175

958

View full text Add to dashboard Cite

show abstract

“…A number of interventions have been developed to address this condition. The benefits of regular physical exercise include alleviation of pain, prevention of falls, and improvement of mobility and quality of life [4,7,11,20,29,30]. Fitness factors such as strength, stamina, and easy motion are encouraged.…”

Section: Introductionmentioning

confidence: 99%

Trunk stabilization with sling training in osteoporosis patients—a randomized clinical trial

Schröder

Knauerhase

Kundt

et al. 2013

Eur Rev Aging Phys Act

View full text Add to dashboard Cite

Fractures due to osteoporosis are one of the principal causes of functional limitations, chronic pain, and greater morbidity in advanced age. In addition to bone risk factors for osteoporotic fractures include extraosseous causes such as falls or reduced neuromuscular capacity. Muscle and coordination exercises enhance the patients' abilities in daily life and prevent falls. In view of recent conclusions drawn from competitive sports, which stress the significance of the muscles of the trunk in respect of reducing back pain and optimizing posture, we used sling exercises to determine whether osteoporosis patients benefit from it and whether it is more advantageous than traditional physiotherapy. Fifty patients were randomized into two groups. Group A received traditional physiotherapy, while group B was given sling exercises, in each case twice a week for a period of 3 months. The results of treatment (prepost) were analyzed in terms of pain levels, mobility, trunk strength, and the shape of the back. After a further 3 months with no specific exercise treatment, we retested all patients in order to draw conclusions about the long-term effects of the two types of exercise. Forty-four patients (88 %) completed the study. Patients were assigned to small groups (a maximum of five patients in each group) and, thus, received individual attention and motivation. Positive training effects were achieved in both groups. Significantly better results as regards improvement of mobility and reduction of falls were registered in the sling exercise group.

show abstract

“…Whether or not exercise provides clinically important differences to bone health in clinical populations requires further study but some trials suggest that falls and fall-related fractures may be reduced in patients with age-related osteoporosis [54]. The most clinically relevant trials related to bone health, will likely be long-term, adequately-powered RCTs that examine the role of exercise and the incidence of falls and fractures.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with primary osteopenia or osteoporosis, a systematic review of 28 randomized controlled trials (RCTs), observed a reduction in falls and fall-related fractures in exercising patients in interventions that ranged from 10 weeks to 30 months (median duration = 26 weeks) [54]. Improvements in BMD ranged from 0.5% to 10.2% (mean improvement of approximately 2.5%), however, the most consistent, and arguably most important, finding throughout the trials is that exercise preserves BMD in low-BMD patients relative to non-exercising participants and improves muscular strength, endurance, and balance.…”

Section: Secondary Osteoporosismentioning

confidence: 99%

Physical Exercise for Secondary Osteoporosis

Mina

Alibhai²,

Matthew³

et al. 2012

TOBONEJ

View full text Add to dashboard Cite

Bone loss caused by an underlying medical illness or associated treatment is often termed secondary osteoporosis and is a growing concern for a variety of patients. Exercise has demonstrated efficacy in maintaining bone health for individuals with age-related osteoporosis and its application to other clinical populations with specific interest in preserving bones is being increasingly explored. While there are many causes of secondary osteoporosis, only a few clinical populations have been studied for the role of exercise as a non-pharmacologic approach to bone preservation. This article briefly reviews secondary osteoporosis and the effect of exercise on bone health, while highlighting the current exercise intervention literature on bone outcomes for several clinical populations.

show abstract

Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials

Abstract: Exercise can reduce falls, fall-related fractures, and several risk factors for falls in individuals with low BMD. Exercise interventions for patients with osteoporosis should include weight-bearing activities, balance exercise, and strengthening exercises to reduce fall and fracture risk.

Cited by 157 publications

References 67 publications

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Trunk stabilization with sling training in osteoporosis patients—a randomized clinical trial

Physical Exercise for Secondary Osteoporosis

Contact Info

Product

Resources

About