Exercise and fracture prevention. Recommendations on types of exercise for bone strengthening

Willert S, von Stengel S, Kohl M, Jakob F, Kerschan-Schindl K, Lange U, Peters S, Thomasius F, Kemmler W (2023)

Publication Type: Journal article

Publication year: 2023


DOI: 10.1055/a-2080-2362


In basic exercise science, training contents characterize the types of exercise needed to address the training aim. The usual classification of exercise contents into endurance, resistance or coordination exercise is hardly applicable for bone, however. As an example, endurance exercise includes various types of exercise that considerably vary in their mechanical demands (e. g. running vs. swimming). Following a more bone-specific approach, a classification of training contents into three site-specific, mechanical bone factors and one systemic endocrine factor is more appropriate. Applying bone factors, i. e. axial loading, muscular tension, load distribution and endocrine effect of exercise, enables the relevance of different sports for bone strength to be judged by analyzing their inherent exercise characteristic. Many cross-sectional studies focus on highly trained athletes because of the high training compliance and the long exercise exposure in this cohort. As confirmed by longitudinal exercise trials with older adults, the study results indicate that types of exercise with high demands on axial loading, muscular tension and load distribution, which in turn generate a favorable hormonal milieu, are particularly effective in increasing bone-strength parameters. Dynamic resistance exercise (DRT) or exercises with high impact (e. g. exercises with jumping or sprinting components) largely offer such favorable exercise characteristics. However, the physical status and safety aspects related to the predominately older cohorts prone to osteoporosis frequently conflict with the application of high-impact exercise. On the other hand, current evidence suggests that even high intensity DRT can be applied safely and pain-free in older cohorts with osteoarthritis. For particularly vulnerable cohorts, aquatic gymnastics can be recommended for increasing bone mineral density at the lumbar spine and proximal femur. As a sustainable vehicle for implementing exercise, consistently supervised "Rehabilitationssport" or "Funktionstraining" can be recommended as a feasible and widespread training option for fracture prevention.

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Willert, S., von Stengel, S., Kohl, M., Jakob, F., Kerschan-Schindl, K., Lange, U.,... Kemmler, W. (2023). Exercise and fracture prevention. Recommendations on types of exercise for bone strengthening. Osteologie. https://doi.org/10.1055/a-2080-2362


Willert, Sebastian, et al. "Exercise and fracture prevention. Recommendations on types of exercise for bone strengthening." Osteologie (2023).

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