OsteoEd

Exercise in Osteoporosis Prevention

Deborah Greenberg, MD Literature reviewed April 17, 2006. Updated October 17, 2008

A 43-year-old woman comes to clinic with concerns about osteoporosis because her mother was recently diagnosed with osteoporosis after a hip fracture. Your patient has been sedentary most of her life. She weighs 178 pounds, does not take any medications, and does not smoke cigarettes. She has questions about exercise and how she can avoid a hip fracture in the future.

Click an answer under each question.

1. What is the quality of evidence linking exercise to osteoporosis prevention and treatment?

   • Option A Multiple randomized controlled trials show that exercise reduces risk for initial and subsequent osteoporotic fractures
   • Option B A few small randomized and non-randomized controlled trials suggest that exercise increases bone mineral density (BMD)
   • Option C A few, small randomized trials show that load-bearing exercise in women with osteoporosis reduces the risk for subsequent fracture

2. How many risk factors does this patient have for osteoporosis?

   • Option A One
   • Option B Two
   • Option C Three

3. Will the initiation of an exercise program now help this patient prevent a hip fracture later in life?

   • Option A Most likely
   • Option B Yes
   • Option C No

4. What type of exercise program should you recommend for this patient?

   • Option A Load-bearing aerobic exercise, 20 to 60 minutes, 3 to 5 days per week
   • Option B Weight lifting, 2 to 3 days per week
   • Option C Stretching, 2 to 3 days per week
   • Option D All of the above

5. The patient has 9-year-old and 15-year-old daughters. Like their mother, they are sedentary. Would the initiation of a lifelong exercise program help them prevent osteoporosis?

   • Option A Physical activity will increase BMD in both daughters.
   • Option B Physical activity in young girls can be harmful and is not recommended.
   • Option C Physical activity should improve BMD in both daughters. The 9-year-old may have more benefit.

6. The patient's 85-year-old grandmother comes to see you regarding osteoporosis. She has no history of fracture. She does have some balance problems due to diabetic neuropathy. Her DXA shows a T-score of -1.2 at the femoral neck. She is sedentary. Should you recommend an exercise program?

   • Option A Yes. You should recommend a program of resistance training, light-intensity high-impact aerobics, and flexibility training under the supervision of a physical therapist.
   • Option B No. Exercise has no benefit in the very old and may lead to injuries.
   • Option C Yes. You should recommend weight lifting 2 to 3 days per week.

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