Exercise, bone strength and osteoporosis is a subject that commonly raises questions and, indeed, uncertainties for some physiotherapists
Back in 2018 the Royal Osteoporosis Society (ROS) worked with experts and practitioners in the field to tackle key questions about effectiveness and safety. Strong, Steady, Straight: A Consensus Statement on physical activity and exercise for osteoporosis set out exercise recommendations to promote bone strength, improve steadiness to reduce falls and how adapting moving and lifting might reduce the risk of vertebral fractures. Recommendations on exercises to help with pain and posture problems after vertebral fracture were also included.
The Statement explored the potential of exercise to strengthen bone and set out optimal exercise levels. Most importantly it aimed to build confidence, explaining exercise could continue despite an ‘osteoporosis’ diagnosis, ideally moderate impact weight-bearing exercise plus some progressive muscle training for those who are fit and well enough.
Many fears about exercise causing fractures in the spine have not been confirmed by the evidence so explaining this in more detail was central.
The Statement was followed by a suite of films and fact sheets for the public to use and also for practitioners to signpost patients to. These have been highly evaluated by users but some gaps remained.
Now the ROS has worked with experts again to provide further information under the STRONG theme, providing more detailed exercise plans to encourage those who are less confident or experienced, but who are young and well enough, to build up exercise intensity. It has launched an exercise plan in three stages for both impact and muscle resistance so that people are able to build up levels of appropriate exercise with confidence. Patients with osteoporosis without fractures rarely need to see a physiotherapist for specific exercise advice but they do need good information. Understanding the principles and signposting them to expert information is a key role for physios and the new ROS resources aim to meet this need.
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