gms | German Medical Science

Objective: Patients with osteoporosis have a high risk of falling and thus osteoporotic fractures due to deficits in muscle strength, endurance, coordination and balance. Therefore, we aimed to evaluate the effects of specific osteoporosis exercises on these parameters.

Material/Methods: 42 patients with osteoporosis (mean age 68 ys.) receiving adequate calcium and vitamin D supplementation and bisphosphonate therapy were included. Of these, 17 patients served as control group without exercise and 25 patients underwent specific training once a week (exercise group). Outcome parameters at baseline and after 1 and 2 years included bone mineral density (BMD) of the lumbar spine and right femur, markers of bone metabolism (osteocalcin, crosslaps), as well as assessment of coordination, balance (standing on a balancing board and cone, “tandem standing”), muscle strength and endurance (chair rising test, standing on one leg), and pain (visual analogue scale 0-100 mm).

Results: After 2 years, the exercise group showed a significant increase in BMD of the right femur (p<0.02), whereas the control group had a decrease of BMD. The exercise group showed a significant increase of osteocalcin levels after 1 and 2 years (p<0.01) and a significant decrease of the crosslaps after 2 years. Both groups presented a tendency towards increased lumbar BMD as well as improved chair rising test results. Standing on one leg was significantly better after 1 year in both groups, but after 2 years only in the exercise group (p<0.01). Both groups showed a tendency towards improvement in the balancing board test. However after 2 years, significantly improved results were found in the exercise group only (p<0.01). The so-called cone test improved significantly after 1 (p<0.03) and 2 years (p<0.01) in the exercise group. Regarding “tandem standing”, no amelioration could be observed in both groups during the follow-up period. A significant reduction of pain was detected only in the exercise group after 1 and 2 years (p<0.01).

Conclusion: A standardised osteoporosis exercise programme once weekly causes significant positive effects on bone mineral density, bone metabolism and the risk of falling in patients with osteoporosis and osteoprotective medication. These results support the necessity for specific osteoporosis exercise. Of note, even once-weekly exercise appears to be sufficient to sustain these positive effects. Thus, osteoporosis exercise training is highly efficient, simple and cost-effective in daily practice.