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.