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Strong, Steady and Straight: UK consensus statement on physical activity and exercise for osteoporosis

Paskins

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Abstract

Exercise and physical activity can improve bone strength and the risk of falls, which may offer benefits in the prevention and management of osteoporosis. However, uncertainty about the types of exercise that are safe and effective instigates lack of confidence in people with osteoporosis and health professionals. Existing guidelines leave some questions unresolved. This consensus statement aimed to determine the physical activity and exercise needed to optimise bone strength, reduce fall and fracture risk, improve posture and manage vertebral fracture symptoms, while minimising potential risks in people with osteoporosis. The scope of this statement was developed following stakeholder consultation. Meta-analyses were reviewed and where evidence was lacking, individual studies or expert opinion were used to develop recommendations. A multidisciplinary expert group reviewed evidence to make recommendations, by consensus when evidence was not available. Key recommendations are that people with osteoporosis should undertake (1) resistance and impact exercise to maximise bone strength; (2) activities to improve strength and balance to reduce falls; (3) spinal extension exercise to improve posture and potentially reduce risk of falls and vertebral fractures. For safety, we recommend avoiding postures involving a high degree of spinal flexion during exercise or daily life. People with vertebral fracture or multiple low trauma fractures should usually exercise only up to an impact equivalent to brisk walking. Those at risk of falls should start with targeted strength and balance training. Vertebral fracture symptoms may benefit from exercise to reduce pain, improve mobility and quality of life, ideally with specialist advice to encourage return to normal activities. Everyone with osteoporosis may benefit from guidance on adapting postures and movements. There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.

Journal Article Type Article
Acceptance Date Mar 29, 2022
Online Publication Date Jul 15, 2022
Publication Date May 16, 2022
Publicly Available Date Mar 28, 2024
Journal British Journal of Sports Medicine
Print ISSN 0306-3674
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 56
Issue 15
DOI https://doi.org/10.1136/bjsports-2021-104634
Keywords Osteoporosis; Exercise; Hip; Spine; Bone density
Publisher URL https://bjsm.bmj.com/content/early/2022/04/24/bjsports-2021-104634

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