The role of exercise in the prevention and rehabilitation of osteoporosis -: A current review

The objectives of physical activity in osteoporosis therapy are both preventive and rehabilitative. Prevention involves the development of a high Peak Bone Mass and the reduction of the bone loss rate. In childhood and during adolescence effective prevention is achieved with an optimal diet in combination with an extensive amount of general exercise. Sports activity facilitates a sufficient Peak Bone Mass and thus sets positive preconditions for later life and a better health. It is unclear, however, whether the increase in intensity, frequency or duration of physical training exerts the most intensive osteoanabolic effect in humans. It is typically the case in the development of osteoporosis that after the achievement of Peak Bone Mass, the ongoing bone remodelling results in a continuous, slightly negative balance. Conversely, physical activity has a decelerating effect on the bone loss rate in postmenopausal women, independent of hormone replacement therapy. In this context, it is of interest that exercise-induced disturbances of the menstrual cycle with lower sexual steroid hormone levels together with eating disorders represent a well-known condition among female athletes in competitive sports. The consequence is a decrease in bone mass with a corresponding increase in the prevalence of stress fractures despite the very intensive physical activity and the osteoblastic stimuli. On the other hand, an important therapeutic aspect for older people consists in reducing the risk of falling and thus, indirectly, of fractures. The objectives of physical exercise include the development and preservation of bone mass, pain relief, and the prevention of falls. This article provides a review of the significance of exercise for the prevention and therapy of osteoporosis.