ABSTRACT
Background@#The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations. @*Methods@#A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations. @*Results@#The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended. @*Conclusions@#A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.
ABSTRACT
BACKGROUND: An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research.METHODS: Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified.RESULTS: An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep·set⁻¹ 1-2 set·region⁻¹ and 3 days·week⁻¹ using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps·min⁻¹, 10 min·day⁻¹ and 2 days·week⁻¹.CONCLUSIONS: Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.