Common Questions
What are the standards of exercise recommended for osteoporosis prevention and overall health and fitness?
A diverse exercise program that includes aerobic activity, strength training, and flexibility training has many beneficial effects and should be recommended for all patients regardless of their risk for osteoporosis. In addition to positive effects on BMD, exercise improves cardiorespiratory fitness, strength, endurance, quality of life, and psychological health and helps reduce falls. Specific recommendations for all adults include (1-5):
- Moderate-intensity aerobic activity*: Twenty to 60 minutes of continuous or intermittent aerobic activity, 3 to 5 days per week at 65 percent to 90 percent of maximal heart rate (MHR**). Sedentary patients and frail elderly should start with light-intensity exercise (35 percent to 54 percent of MHR) and gradually increase intensity. The patient should choose an activity that uses large muscle groups and can be maintained continuously, such as brisk walking, hiking, running, bicycling, cross-country skiing, dancing, jumping rope, swimming, skating, or stair climbing.
- Strength training: One set (eight to 12 repetitions) of eight to ten different exercises that condition the major muscle groups (arms, shoulders, chest, abdomen, back, hips, and legs) 2 to 3 days per week. Examples of these exercises include weight machines, free weights, and resistance bands. The patient should chose a weight that results in maximum muscle fatigue after eight to ten repetitions. Load-bearing exercises have been most effective for building and maintaining bone strength.
- Flexibility training: Stretch major muscle groups 2 to 3 days per week. Static stretches should be held for 10 to 30 seconds and repeated at least four times per stretch.
Recommendations should be individualized to promote a permanent lifestyle change and a lifetime of physical activity.
*Contraindications include unstable angina, recent myocardial infarction, uncontrolled arrhythmia, acute congestive heart failure, and symptomatic valvular heart disease (2).
** Maximal heart rate = 220 minus age
- American College of Sports Medicine. The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults.. Medicine & Science in Sports & Exercise. Position Stand. 1998; 30(6): 1-27.
- American College of Sports Medicine. Exercise and Physical Activity for Older Adults.. Medicine & Science in Sports & Exercise. Position Stand 1998; 30(6): 1-22.
- American College of Sports Medicine. Osteoporosis and Exercise.. Medicine & Science in Sports & Exercise. Position Stand 1995; 27(4): 1-7.
- Fletcher GF, Balady G, Blair SN, Blumenthal J, Caspersen C, Chaitman B, Epstein S, Sivarajan Froelicher ES, Froelicher VF, Pina IL, Pollock ML. Statement on exercise: Benefits and recommendations for physical activity programs for all Americans.. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation 1996; 94(4): 857-62.
- Osteoporosis: Cost-effectiveness analysis and review of the evidence for prevention, diagnosis and treatment. Osteoporos Int 8 1998; 10: S001-S002.