Too Fit To Fracture: a consensus on future research priorities in osteoporosis and exercise

Abstract

Summary-An international consensus process identified the following research priorities in osteoporosis and exercise: study of exercise in high-risk cohorts, evaluation of multimodal interventions, research examining translation into practice and a goal to examine fracture outcomes.Introduction-To identify future research priorities related to exercise for people with osteoporosis with and without osteoporotic spine fracture via international consensus.

Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures

“…Resistance exercise for individuals with osteoporosis-Progressive resistance training for major muscle groups (with the exception of spinal extensors, rotators, and flexors, see next paragraph) should be designed to increase muscle strength, i.e., [8][9][10][11][12] repetitions at an intensity rating of 5-8 on a 0-10 scale (e.g., Borg Rating of Perceived Exertion, see also ""How much weight can I lift during exercise?" (Key points in Box 3)" section), consistent with the ACSM Position Stand on Exercise and Physical Activity for Older Adults [20].…”

“…Indeed, studies evaluating strength training for spinal extensors in women with osteoporosis, with target ranges of [8][9][10][11][12] repetitions maximum, have demonstrated improvements in muscle strength in spinal extensors, while improvements in trunk and arm endurance have been observed after training using isometric holds [33]. The absence of conclusive evidence supporting strength over endurance training for spinal extensors (or vice versa) to improve posture or reduce fracture risk in individuals with osteoporosis precludes any definitive statement about which is better.…”

“…The Too Fit To Fracture initiative has also developed priorities for future research to advance the field [8]. Hip hinge for sitting or bending Shoulder press: an example of an exercise for training spinal extensor endurance Walking patterns that could be used to provide a dynamic balance challenge.…”

“…Hip hinge for sitting or bending Shoulder press: an example of an exercise for training spinal extensor endurance Walking patterns that could be used to provide a dynamic balance challenge. Individuals with osteoporosis should start with static balance challenges (e.g., semi-tandem stance, oneleg stance) using a support object, and progress to harder challenges, or less reliance on support object, before progressing to dynamic balance challenges An illustration of a step to turn followed by a hip hinge Questions were asked related to research priorities, and nutrition and exercise and are not included here as they do not address the objectives of the current project but can be found here [8] Osteoporos Int. Author manuscript; available in PMC 2016 November 08.…”

Establishing cross-discipline consensus on contraception, pregnancy and breast feeding-related educational messages and clinical practices to support women with rheumatoid arthritis: an Australian Delphi study

“…Panellists were sampled via a range of strategies, including self-nomination, purposive sampling via personal invitation from the researchers and snowballing; consistent with standard practice and recent Delphi studies and protocols in rheumatology research 1320 26–31 The specific sampling strategies used for each discipline are summarised below: Rheumatologists : a study flyer was provided to all attendees of the 2015 Australian Rheumatology Association Annual Scientific Meeting, inviting rheumatologists who met the inclusion criteria to contact one of the investigators (SVD) to express their interest in participating. The same investigator also sent email invitations to rheumatologists in each Australian state and territory who were known to the research team to practice clinically and/or who had an interest in pregnancy-related care.…”