Background: Individuals diagnosed with osteoporosis have a high risk of skeletal injury. Regular physical activity may contribute to preventing osteoporosis, but the efficacy of exercise intervention once the disease is established has not been rigorously investigated.
Objective: To provide recommendations focusing specifically on exercise goals for osteoporosis, taking into account evidence for maximisation and maintenance of bone strength and minimisation of trauma, and to identify the levels of evidence that support this.
Discussion: The primary benefit of exercise for adult bones is conservation, not acquisition. In elderly individuals, improved fitness and muscle strength contribute to the prevention of falls and a lower risk of fracture. Physical activity may also reduce the rate of bone loss. Exercise goals for osteoporosis should include pain reduction, increased mobility and improvements in muscle endurance, balance and stability. These are worthwhile end points because not only may they prevent falls but they may improve the quality of life. In conjunction with advice to increase dietary calcium, exercise plays a significant part in a lifestyle prescription for reducing fractures in later life. In postmenopausal women, although less effective than oestrogen for maintaining bone mineral density, exercise should be regarded as part of an overall treatment strategy.