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

Strong, Steady and Straight: UK consensus statement on physical activity and exercise for osteoporosis
Strong, Steady and Straight: UK consensus statement on physical activity and exercise for osteoporosis
Exercise and physical activity can improve bone strength and fall risk, 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, whilst 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 (i) resistance and impact exercise to maximise bone strength; (ii) activities to improve strength and balance to reduce falls; (iii) 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 only exercise 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.
Bone density, Exercise, Hip, Osteoporosis, Spine
0306-3674
837-846
Brooke-Wavell, Katherine
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Skelton, Dawn A
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Barker, Karen L.
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Clark, Emma M.
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De Biase, Sarah
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Arnold, Susanne
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Paskins, Zoe
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Robinson, Katie
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Lewis, Rachel M.
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Tobias, Jonathan H.
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Ward, Kate
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Whitney, Julie
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Leyland, Sarah
e6dd6698-569c-481f-af9d-e3ffcde68ee3
Brooke-Wavell, Katherine
d16645bd-8033-4636-b278-06b2d33e5c26
Skelton, Dawn A
531ca71e-d164-4257-94d1-38c57d4887a4
Barker, Karen L.
34b7d5f3-60f9-4481-bfba-95235b46aa70
Clark, Emma M.
524dafd7-6620-480e-a5dc-fb3a7c629e69
De Biase, Sarah
ea7aa97f-8b9b-45bb-a950-81201356d579
Arnold, Susanne
e0dc1c61-489d-4f0c-a201-cdfb26888869
Paskins, Zoe
a11d2204-963b-4def-b36f-3e617caed75a
Robinson, Katie
32d0fec7-3571-451a-99a8-0ea6fe9ccad4
Lewis, Rachel M.
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Tobias, Jonathan H.
514342d7-3491-4a7b-bbeb-b00dcf244daa
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Whitney, Julie
662622d9-6af9-491a-b7dc-4e4eaf314f05
Leyland, Sarah
e6dd6698-569c-481f-af9d-e3ffcde68ee3

Brooke-Wavell, Katherine, Skelton, Dawn A, Barker, Karen L., Clark, Emma M., De Biase, Sarah, Arnold, Susanne, Paskins, Zoe, Robinson, Katie, Lewis, Rachel M., Tobias, Jonathan H., Ward, Kate, Whitney, Julie and Leyland, Sarah (2022) Strong, Steady and Straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine, 56 (15), 837-846. (doi:10.1136/bjsports-2021-104634).

Record type: Article

Abstract

Exercise and physical activity can improve bone strength and fall risk, 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, whilst 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 (i) resistance and impact exercise to maximise bone strength; (ii) activities to improve strength and balance to reduce falls; (iii) 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 only exercise 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.

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BJSM exercise osteoporosis consensus statement- accepted version - Accepted Manuscript
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Accepted/In Press date: 28 March 2022
e-pub ahead of print date: 16 May 2022
Published date: 15 July 2022
Keywords: Bone density, Exercise, Hip, Osteoporosis, Spine

Identifiers

Local EPrints ID: 456586
URI: http://eprints.soton.ac.uk/id/eprint/456586
ISSN: 0306-3674
PURE UUID: 4768aab9-f678-4b4c-8fcf-09135b2e4a1e
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 05 May 2022 16:42
Last modified: 30 Nov 2022 05:02

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Contributors

Author: Katherine Brooke-Wavell
Author: Dawn A Skelton
Author: Karen L. Barker
Author: Emma M. Clark
Author: Sarah De Biase
Author: Susanne Arnold
Author: Zoe Paskins
Author: Katie Robinson
Author: Rachel M. Lewis
Author: Jonathan H. Tobias
Author: Kate Ward ORCID iD
Author: Julie Whitney
Author: Sarah Leyland

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