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Exercise for Prevention of Bone Loss: The Role of Sports Medicine

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Non-Pharmacological Management of Osteoporosis

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Abstract

Physical activity and especially physical exercise are considered as cornerstones of musculoskeletal health. Indeed, dedicated exercise protocols can affect all fracture parameters, i.e. fall risk, fall impact, and bone strength, and should thus be considered as optimum candidates for non-pharmacological fracture prevention. Some evidence for the general anti-fracture efficacy of exercise was provided by dedicated exercise trials and a corresponding meta-analysis, but the optimum strategy (if there is any) on how to prevent fractures in elderly subjects is still under discussion. Although some researchers postulate to focus more on falls than on osteoporosis to prevent fractures, the most promising and feasible exercise strategy is to select types of exercise that address both factors, falls, and osteoporosis. This approach, however, ought to consider the requirements and determining factors of each individual. That is, the need for fall prevention is higher for elderly subjects with several fall risk factors, while for early postmenopausal women with distinct bone loss, this topic is of lesser relevance. But even with careful adaptation of the exercise program to subjects’ changing bone, health, and fitness status, effectivity may still decrease over the time. This could specifically be the case where the limitations of higher age collide with the specification of the exercise program. In the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS), the overall aim was to evaluate the effect of a multipurpose exercise program on clinical low-trauma fractures in postmenopausal women starting to exercise in their early postmenopausal years. In detail, we intended to answer the following research questions:

  1. 1.

    Can exercise reduce the risk of osteoporotic fractures in postmenopausal women?

  2. 2.

    Is there an optimal exercise program to increase or maintain bone mineral density?

  3. 3.

    Are there temporary limitations on the effectivity of exercise on bone?

  4. 4.

    Can exercise program that focuses on fracture reduction relevantly affect other risk factors with advancing age?

  5. 5.

    Are high-intensity anti-fracture exercise programs attractive and feasible?

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Authors and Affiliations

  1. Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nuremberg, Henkestrasse 91, Erlangen, 91052, Germany

    Wolfgang Kemmler PhD & Simon von Stengel PhD

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  1. Wolfgang Kemmler PhD
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  2. Simon von Stengel PhD
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Correspondence to Wolfgang Kemmler PhD .

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Editors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA

    Mehrsheed Sinaki

  2. Institute of Clinical Osteology and Clinic “DER FÜRSTENHOF”, German Osteology Foundation, Bad Pyrmont, Niedersachsen, Germany

    Michael Pfeifer

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Kemmler, W., von Stengel, S. (2017). Exercise for Prevention of Bone Loss: The Role of Sports Medicine. In: Sinaki, M., Pfeifer, M. (eds) Non-Pharmacological Management of Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54016-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-54016-0_6

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