Melissa Lemery
NTR 404
Bone research article
Osteoporosis amongst older adults is a common condition in which bones become
porous, thereby leaving bones fragile and subject to fractures and falls. Although bone mineral
can’t be improved at later stages in life, exercise has been shown to slow the loss of bone mineral
density in older adults.
A study was conducted to measure the effect of a multicomponent dual-modality exercise
program targeting oststeoporsis of postmenopausal woman. The exercises used in the
multicomponent study included strength, aerobic capacity, balance, and joint mobility on land
and in water. The study used participants that were identified by family doctors as potential
participants with osteoporosis/ osteopenia, and underwent a bone mass assessment by DEXA
(Dual energy x-ray absorptiometry). Selection was also based on bone mineral density scores
and the femoral and neck T-score. Out of the initial 500 possible participants, 239 of those
participants had further evaluations to assess their clinical conditions and physical functioning
capacity, and to detect any contradiction against the use of exercise as treatment. (Tolomio,
Ermolao, Lalli&Zaccaria)
The study used different tests to evaluate for physical functioning including: arm curl,
chair stand, two min step, chair sit and reach, back scratch, handgrip, and modified clinical test
of sensory interaction in balance. (Schumway-Cook & Horak, 1986) Of the 161 participants
chosen from the sample, 79 showed clinical impairment and thus, were used as the control group
who received no exercise treatment. The other 81participants were given the exercise treatment.
The exercise prescription was given over an 11 month time period of specific
multicomponent dual-modality exercise program that aimed to improve strength, aerobic
capacity, balance, and joint mobility that were performed on land and in water. The exercises
were for 60 minutes three days a week during the first 11 weeks on land only, and two land
workouts with one water workout after that time period. Materials used during classes included
dumbbells, ball, steps, and thera-bands. (Tolomio, Ermolao, Lalli, & Zaccaria)
At the end of the 1 month period participants were given another bone assessment using
DEXA and osteosonography and a physical functioning test. Prior to the exercise training
program there were no difference noted between the two groups. Results of the study showed no
change in the exercise groups neck and total femur BMD, as well as the total T score. However,
the neck t-score significantly improved, decreasing from -1.40 +/- 0.80 to -1.30+/- 0.84. There
was no significance in decrease in the control group.
The osteosonography results from the study showed no change in the exercise group, but
notes significant changes in the control group, with decreased AD-Sos (Amplitude-dependent
Speed of sound), UBPI (Ultrasound Bone Profile Index), and T – score. The importance of the
results reveals that during the 11 month exercise program the exercise group maintained bone
density levels, while the control groups bone mineral density worsened.
The research suggests that the exercise program performed was helpful in slowing down
bone loss associated with osteoporosis. Of interesting importance, the study concluded that
water-based exercise program weren’t as beneficial as land exercises on bone. According to
Krause, swimming and walking have minor effects in adults bone health, while weight-bearing
exercises and intensive walking has a positive effect on bone mineral density. (Mahan, EscottStump, & Raymond, 2012, p. 543)
The second article evaluated optimum frequency of exercise for bone health in healthy
premenopausal women between the ages of 18 and 45. The study evaluated the effectiveness of
exercise on femoral neck bone density. The exercise performed consisted of 50 hops, on one leg
(the exercise leg), which controlled for confounding variables. 61 women were chosen for the
study and those women were equally divided into four groups: control: performed no hopping,
group 2 performed hopping on two days a week, group four hopping was performed four days a
week, and group 7 performed hopping seven days per week.
The only significance was seen in the femoral neck bone and the upper neck bone density
with the group that exercised 7 days a week seeing the greatest increase in bone density. The
groups that exercised less frequently had no significant effects over 6 months
The Academy of Sports Medicine recommends weight bearing activity 3 to 5 times per week and
resistance exercise two to three times per week with moderate to high bone-loading force for a
combination of 30-60 minutes per week. (Mahan, Escott-Stump, &Raymond, 2012, p. 543)
Krause’s recommendations for exercise in slowing down bone loss corroborate the results
of the study. Exercise is known as a great way to slow bone loss. Maintaining bone density
through exercise can be beneficial in the prevention of fractures and falls in older adults, since
weight bearing exercise leads to higher gravitational forces on the skeleton and local strain on
the bone. (Marcus, 2001) According to Krause, stresses from muscle contraction and maintaining
the body in an upright position against the pull of gravity stimulated osteoblast function, while
bones not subjected to normal use rapidly lose mass. (Mahan, Escott-Stump, &Raymond, 2012,
p. 542) an interesting point mentioned by Krause states that astronauts living in condition of zero
gravity for only a few days experience bone loss, especially in their lower extremities. (Mahan,
Escott-Stump, &Raymond, 2012, p.542)
The importance of exercise in slowing down bone loss as an adult can be used in clinical
practice by encouraging older adults to follow the guidelines established by the Academy of
Sports Medicine to maintain and slow down the loss of bone in older adults. However, exercising
at an early age is also critical in improving and maintaining bone mineral density. Exercise is a
healthy activity in helping to maintain bone density and may be more tolerable for many older
adults compared with hormone replacement therapy that may have side effects for the
postmenopausal woman. Exercise should be used in practice as a healthy alternative to slow and
maintain bone loss in older adults. The best take away message to de given to clients of all ages
is that exercise is imperative in building and maintain healthy bones.
References
1. Mahan, K., Escott-Stump, S., Raymond, J.(2012) Krause’s Food and the Nutrition Care
Process(13th edition).St.Louis, Missouri:Elsevier Saunders
2. Tolomio, S., Ermolao, A., Lalli, A., Zaccaria, M. (2010). The Effect of a MultiComponent dual-modality exercise program targeting osteoporosis on bone health status
and physical function capacity of postmenopausal women. Journal of Women & Aging
20, 241-253.
3. Shumway-Cook, A., & Horack, F.B. (1986). Assessing the influence of sensory
interaction of balance: Suggestion from the field. Physical Therapy, 66(10), 1548-1550.
4. Marcus, R. (2001). Role of exercise in preventing and treating osteoporosis. Rheumatic
Disease Clinics of North America, 27(1), 131-141.
5. Bailey, C., Brooke-Wavell, K. (2010). Optimum frequency of exercise on bone health:
randomized controlled trial of a high-impact unilateral intervention. School of Sport,
Exercise, and Health Sciences, Bone 46. 1023 -1049.