Common Questions
Does the initiation of exercise in sedentary, postmenopausal women with osteopenia reduce their future risk of osteoporosis and fracture?
Patients of all ages can benefit from an exercise program; for the sedentary elderly, that program should begin at low intensity and be performed under the supervision of a physical therapist.
- Several small prospective randomized (1) and non-randomized (2, 3) trials of women with osteoporosis and osteopenia showed that a structured exercise program increased or preserved BMD. Another small study, plagued by a high drop-out rate, showed no benefit from exercise (4).
- Results of the few studies of exercise in postmenopausal women without osteopenia or osteoporosis have been mixed (5, 6).
Conclusion: Very few studies have addressed this question. The sedentary elderly, especially those with impairments (such as to balance, vision, or gait), should be encouraged to start an exercise program, which may, in addition to other benefits, increase or stabilize BMD. The program should be performed under the supervision of a physical therapist and should start at low intensity to prevent falls and injury (7).
- NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA 2001; 285(6): 785-95.
- Sinaki M, Wahner HW, Bergstralh EJ, Hodgson SF, Offord KP, Squires RW, Swee RG, Kao PC. Three-year controlled, randomized trial of the effect of dose-specified loading and strengthening exercises on bone mineral density of spine and femur in nonathletic, physically active women. Bone 1996; 19(3): 233-44.
- Lohman T, Going S, Pamenter R, Hall M, Boyden T, Houtkooper L, Ritenbaugh C, Bare L, Hill A, Aickin M. Effects of resistance training on regional and total bone mineral density in premenopausal women: A randomized prospective study. J Bone Miner Res 1995; 10(7): 1015-24.
- Heinonen A, Kannus P, Sievanen H, Oja P, Pasanen M, Rinne M, Uusi-Rasi K, Vuori I. Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 1996; 348(9038): 1343-7.
- Friedlander AL, Genant HK, Sadowsky S, Byl NN, Gluer CC. A two-year program of aerobics and weight training enhances bone mineral density of young women. J Bone Miner Res 1995; 10(4): 574-85.
- Salamone LM, et al. Effect of a lifestyle intervention on bone mineral density in premenopausal women: A randomized trial.. AJCN 1999; 70(1): 97-103.