Does adding exercise or physical activity to pharmacological osteoporosis therapy in patients with increased fracture risk improve bone mineral density and lower fracture risk? A systematic review and meta-analysis

Review written by Dr Mariana Wingood info

Key Points

  1. Clinical practice guidelines recommend that individuals with osteopenia and osteoporosis participate in exercise or physical activity.
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BACKGROUND & OBJECTIVE

Osteoporosis is a progressive systematic skeletal disease characterized by decreased bone mass and micro-architectural deterioration of bone tissue or the presence of a fragility fracture. It is diagnosed via a DEXA scan, with those with T-scores between 1.0 to 2.5 below the young adult reference values having low bone mass (i.e. osteopenia) and those with a T-score less than or equal to 2.5 below the young adult reference values being identified as having osteoporosis (1).

Based on the US-adapted FRAX model, individuals with osteopenia at the femoral neck or total hip have a 10-year hip fracture risk ≥ 3% while those with osteoporosis have a fracture risk ≥ 20% (1). As hip fractures are associated with high rates of disability, institutionalization, and death (1), it is essential that we try to prevent osteoporosis and fragility fractures.

The aim of this study was to investigate whether exercise and pharmacology therapy has an additive effect over pharmacology alone on bone mineral density (BMD), bone turnover marker (BTM), fracture healing, and fractures in patients with increased fracture risk due to osteopenia or osteoporosis.

As hip fractures are associated with high rates of disability, institutionalization, and death, it is essential that we try to prevent osteoporosis and fragility fractures.
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Participating in exercise is still a recommended intervention for individuals with osteopenia or osteoporosis as exercise has benefits that go beyond changes in bone mineral density.

METHODS

Design: Systematic review and meta-analysis utilizing four separate databases

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