Exercise for fracture prevention - evidence and consensus-based practice guideline of the osteology umbrella association (DVO)
Abstract
Exercise is considered a cornerstone of fracture prevention in people at increased risk of fractures. However the most effective exercise strategy for preventing fractures has yet to be determined. The primary aim of the present evidence- and consensus-based guideline was thus to derive practice recommendations for effective, feasible and safe training programs to prevent fractures in various cohorts. A novelty of our approach was the assignment of dedicated cohorts at risk for fractures to training objectives that prioritized bone strength or/and fall risk or/and fall impact reduction. In summary, bone strength exercise protocols should include periods of high loading magnitude and rate provided by impact loading and dynamic strength/power training. Fall risk should be addressed by an individualized mix of balance, perturbation, functional, stepping and interactive cognitive-motor exercises. Simple and low-risk strategies for safe landing can be advised unreservedly, however more sophisticated strategies derived from martial arts require close and experienced supervision and high safety standards. If the latter strategies are chosen in interventions, they should be reserved for dedicated training periods. Training frequency should be set at least 2 (bone strength) or 3 (fall risk) sessions/week, possibly with a (block) periodized approach with intense periods intermitted by low/regenerative phases, with varying training aims focusing on progression.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.