No announcement yet.

Osteoporosis references - sorry, a bit late

This topic is closed.
  • Filter
  • Time
  • Show
Clear All
new posts

  • Osteoporosis references - sorry, a bit late

    Mark, and others interested in the osteoporosis/exercise discussion,

    My apologies for taking a while to respond to your comments.

    You say:

    To my knowledge, there are in fact no
    >well-designed (randomised controlled, longitudinal) studies published for
    >exercise intervention in a sample of individuals classified as having

    I agree that the majority of exercise intervention trials have tended to
    exclude osteoporotic individuals and that this is problematic for the
    wholesale application of results. A few papers, however, such as Ayalon et
    al., Arch Phys Med Rehab 68(5): 280-83, 1987; Dilsen et al., Clin Rheumatol
    8 (Suppl 2): 70-5, 1989; and Simkin et al., Calcif Tiss Int 40:59-63, 1987,
    have reported findings specifically from osteoporotic cohorts. Although
    these trials were relatively short term (5-6 months), each reported a
    beneficial effect of exercise on BMD. One problem in this area is that it
    is often difficult to tell whether some or all of the subjects in a study
    were osteoporotic because it was not specifically stated. For example, the
    subjects in a study by Krolner et al. (Clinical Science, 64: 541-546, 1983)
    may have been at least osteopenic as they were recruited from women treated
    for previous Colle's fractures, but they were not described as such.

    A paper which addresses the question of the safety of exercising
    osteoporotic patients (Chow et al., Int J Rehabil Res 12[1]:49-56, 1989)
    describes a Toronto program aimed to prevent bone loss in osteoporotic
    patients. They reported improvements in bone mass (and other indices of
    well-being and health) after one year of exercise with no incidence of
    fracture. Unfortunately, I have only been able to get the abstract of this
    paper so I have not been able to critique it in full. Along the same lines
    of exercise and fracture risk, the Tromso study (Joakimsen et al., 1998,
    13[7]:1149-1157) concluded that physically active people, 45 yrs or older,
    suffered fewer low-energy fractures in the weight bearing skeleton than
    sedentary people.

    Just to clarify a point from my last post, I would not recommend HIGH
    impact activities for osteoporotic individuals. I should probably have
    used the term "weight bearing" rather than "impact" to avoid the
    implication that sudden, large magnitude loads are non-injurious to an
    osteoporotic skeleton, which, of course, they can be. Further, Joakimsen
    et al. (1998) found that it was not necessary to perform vigorous, high
    intensity activity to invoke the protective effect of exercise against
    fracture risk.

    I want to also include a disclaimer that, as do the vast majority of
    reports in this area, the above cited studies contain a number of design
    and methodological flaws. Pristine design and methodology of human
    exercise intervention trials is an important goal, but has clearly been
    very difficult to achieve.

    All the best,

    Belinda Beck, Ph. D.
    Stanford University
    Musculoskeletal Research Lab
    Veterans Affairs Medical Center, Menlo Park
    795 Willow Road, Bldg. 301
    Menlo Park, CA 94025
    U. S. A.
    Phone: (650) 493 5000 x22336
    Fax: (650) 617 2606

    To unsubscribe send UNSUBSCRIBE BIOMCH-L to
    For information and archives: