The word osteoporosis comes from two Latin words, “osteo” and “porosis”, with “osteo” defined as bone, and “porosis” defined as porous. The disease of osteoporosis is in effect, porous bone, leading to brittle fragile bones. Of most concern is the progression of the disease leading to the loss of lifestyle functional abilities, or ADL, activities of daily living. Although osteoporosis may come from different causes and affect different ages and sexes, the benefits of exercise as prevention and a treatment option cannot be overstated. Consistent physical activity made up of weight bearing exercise several days per week over time leads to the prevention, reversal or slowing of the progression of osteoporosis.
The prevention of osteoporosis starts at the growth stage before puberty in children. At this age, the greatest amount of bone density is accumulated through the participation in regular, weight bearing exercise (Hind & Burrows, 2007). The participation in regular exercise needs to be continued throughout puberty for maximum accumulation of bone mass. Bone mass built during this time in a person’s life is critical for the prevention of osteoporosis later in life. Activities such as sports participation or weight bearing exercises participated in regularly each week at all growth stages of youth until adulthood are essential for prevention of the disease (Hind & Burrows, 2007). Exercise was shown to inhibit bone reabsorption and promote bone formation and hence bone density in adults as well. High impact activity was shown to be especially beneficial in the prevention of the disease in adults (Cech 2012). Low impact, high intensity exercise, weight bearing exercise, impact exercise, and jumping exercise was all shown to have benefits with bone density increasing after six months of training (Yuan, et al., 2016).
For those who have already been diagnosed with osteoporosis or osteopenia, the precursor to osteoporosis, exercise has been shown to slow the progression or reverse the disease. While most studies looked at results of subjects after six months of exercise, one study examined results from three months of daily weight bearing exercise for thirty, sixty and ninety minutes (Han, Li, Zhai, Guo, & Chen, 2017). The study found no improvement for thirty minutes, yet improvement was demonstrated at sixty minutes, with the greatest improvement at ninety minutes of daily resistance, or weight bearing exercise. In conclusion, reversal of osteoporosis was found after sixty to ninety minutes of daily weight bearing exercise in just three months (Han, et al., 2017). It is also significant to note that the patients used for this study suffered from hemiplegia (Han, et al., 2017).
In multiple studies (Hind & Burrows, 2007; Shanb & Youssef, 2014; Yuan, et al., 2016; Kemmler, Stengel, & Kohl, 2016), weight-bearing exercise performed on a minimum of two days per week for six months demonstrated favorable results for prevention, slowing progression, and the reversal of osteoporosis. In one study (Han, et al., 2017), weight-bearing exercise in the form of resistance training performed daily for sixty to ninety minutes showed great improvement in just three months. It has been clearly demonstrated that exercise is essential for the prevention and treatment of osteoporosis. However, in spite of this overwhelming evidence, the greatest obstacle to this non-invasive, cost effective treatment is adherence (Kemmler, et al., 2016). Commitment to regular exercise for a minimum of two days per week for sixty minutes of weight bearing, high impact exercise is critical to the retention of bone mass density and the reversal of osteoporosis (Kemmler, et al., 2016). Since the evidence of the benefits of exercise is solid, the next step to reducing the prevalence of osteoporosis will be motivating an increasingly sedentary population to see the benefit worthwhile enough to participate (Kemmler, et al., 2016).
References
Cech, D. (2012). Prevention of osteoporosis: From infancy through older adulthood. Hong Kong Physiotherapy Journal,30(1), 6-12. doi:10.1016/j.hkpj.2012.01.002
Han, L., Li, S., Zhai, H., Guo, P., & Chen, W. (2017). Effects of weight training time on bone mineral density of patients with secondary osteoporosis after hemiplegia. Experimental and Therapeutic Medicine,13(3), 961-965. doi:10.3892/etm.2017.4078
Hind, K., & Burrows, M. (2007). Weight-bearing exercise and bone mineral accrual in children and adolescents: A review of controlled trials. Bone,40(1), 14-27. doi:10.1016/j.bone.2006.07.006
Kemmler, W., Stengel, S. V., & Kohl, M. (2016). Exercise frequency and bone mineral density development in exercising postmenopausal osteopenic women. Is there a critical dose of exercise for affecting bone? Results of the Erlangen Fitness and Osteoporosis Prevention Study. Bone,89, 1-6. doi:10.1016/j.bone.2016.04.019
Shanb, A., & Youssef, E. (2014). The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis. Journal of Family and Community Medicine,21(3), 176. doi:10.4103/2230-8229.142972
Yuan, Y., Chen, X., Zhang, L., Wu, J., Guo, J., Zou, D., . . . Zou, J. (2016). The roles of exercise in bone remodeling and in prevention and treatment of osteoporosis. Progress in Biophysics and Molecular Biology,122(2), 122-130. doi:10.1016/j.pbiomolbio.2015.11.005
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