The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients

Abstract

Physical exercise is considered an effective means to stimulate bone osteogenesis in osteoporotic patients. The authors reviewed the current literature to define the most appropriate features of exercise for increasing bone density in osteoporotic patients. Two types emerged: (1) weight-bearing aerobic exercises, i.e., walking, stair climbing, jogging, and Tai Chi. Walking alone did not appear to improve bone mass; however it is able to limit its progressive loss. In fact, in order for the weight-bearing exercises to be effective, they must reach the mechanical intensity useful to determine an important ground reaction force. (2) Strength and resistance exercises: these are carried out with loading (lifting weights) or without (swimming, cycling). For this type of exercise to be effective a joint reaction force superior to common daily activity with sensitive muscle strengthening must be determined. These exercises appear extremely site-specific, able to increase muscle mass and BMD only in the stimulated body regions. Other suggested protocols are multicomponent exercises and whole body vibration. Multicomponent exercises consist of a combination of different methods (aerobics, strengthening, progressive resistance, balancing, and dancing) aimed at increasing or preserving bone mass. These exercises seem particularly indicated in deteriorating elderly patients, often not able to perform exercises of pure reinforcement. However, for these protocols to be effective they must always contain a proportion of strengthening and resistance exercises. Given the variability of the protocols and outcome measures, the results of these methods are difficult to quantify. Training with whole body vibration (WBV): these exercises are performed with dedicated devices, and while it seems they have effect on enhancing muscle strength, controversial findings on improvement of BMD were reported. WBV seems to provide good results, especially in improving balance and reducing the risk of falling; in this, WBV appears more efficient than simply walking. Nevertheless, contraindications typical of senility should be taken into account.

The clinical outcomes of cementless unicompartmental knee replacement in patients with reduced bone mineral density

“…The likely explanation is that patients with medial arthritis have varus in the knee and often preexisting tibia vara. As a result, they will have increased loading through the medial compartment of the knee, which will preserve bone quality medially allowing cementless fixation, even if there is a central decrease in BMD [25][26][27]. Furthermore, with the mobile bearing, the loads on the bone-implant interface are predominantly compressive which is ideal for cementless fixation [28].…”

The Application of Heavy Strength Training in Relative Energy Deficiency in Sport

“…As osteoporosis is a significant public health concern, it has been much more studied in older, frail populations than athletic populations. In these older populations, many randomized controlled trials as well as systematic reviews and meta-analyses (for a comprehensive list see [5]) have been conducted investigating various forms of exercise, such as aerobic activity and strength training in the prevention of osteoporosis. In summary of this vast area of research, it is suggested that aerobic training is able to limit the reduction of BMD, particularly if it is of high intensity and speed [5].…”

“…In these older populations, many randomized controlled trials as well as systematic reviews and meta-analyses (for a comprehensive list see [5]) have been conducted investigating various forms of exercise, such as aerobic activity and strength training in the prevention of osteoporosis. In summary of this vast area of research, it is suggested that aerobic training is able to limit the reduction of BMD, particularly if it is of high intensity and speed [5]. However, in comparison to strength training, it is suggested that progressive resistance training for the lower limbs is superior to aerobic activity for developing BMD [5].…”

“…In summary of this vast area of research, it is suggested that aerobic training is able to limit the reduction of BMD, particularly if it is of high intensity and speed [5]. However, in comparison to strength training, it is suggested that progressive resistance training for the lower limbs is superior to aerobic activity for developing BMD [5].…”

The Beneficial Effects of Square Dance on Musculoskeletal System in Early Postmenopausal Chinese Women: A Cross-sectional Study.

“…Different exercises focus on different effects and some exercises are span multiple categories like Yoga, Pilates and Tai Chi Chun (TCC) (9,10). Square dance, also known as Dama square dance, is a unique phenomenon in China and is gaining popularity with middle-aged or older women due to increased awareness of health and exercise (11,12).…”