Endocrine Abstracts

Osteoporosis is a condition characterised by bone loss, architectural deterioration and increased susceptibility to fractures, which cause substantial pain and limitations in function. One in two women, and one in five men, aged over 50 will experience a fracture in their remaining lifetime. Exercise may reduce risk of osteoporotic fracture by increasing bone strength and reducing risk of falls, which precipitate many osteoporotic fractures. The types of exercise effective on bone differ from those recommended for prevention of other chronic conditions. The most effective exercise modes for increasing bone strength are those that exert high forces on bone, for instance resistance exercise or moderate to high impact exercise. The intensity of loading seems more important than the volume. As effects are local, exercise needs to load the skeletal sites at risk of fracture, such as proximal femur, spine and forearm. The most effective exercise for reducing fall risk includes individualised and challenging lower limb strengthening and balance training. Exercise may also have benefits in maintaining spinal alignment and reducing pain and physical function in those with vertebral fractures. There is substantial evidence for the benefits of exercise on bone health, but many people diagnosed with osteoporosis may limit exercise for fear of breaking a bone, hence further increasing bone loss. It is important that prompt guidance is available about the movements where modification may be appropriate as well as the exercise that may benefit bone strength.