Brooke-Wavell, Katherine, Skelton, Dawn A., Barker, Karen L., Clark, Emma M., De Biase, Sarah, Arnold, Susanne, Paskins, Zoe, Robinson, Katie R., Lewis, Rachel, Tobias, Jonathan H., Ward, Kate A., Whitney, Julie and Leyland, Sarah (2022) Strong, steady and straight : UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine, 56 (15). pp. 929-944. doi:10.1136/bjsports-2021-104634

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Abstract

Exercise and physical activity can improve bone strength and the risk of falls, which may offer benefits in the prevention and management of osteoporosis. However, uncertainty about the types of exercise that are safe and effective instigates lack of confidence in people with osteoporosis and health professionals. Existing guidelines leave some questions unresolved. This consensus statement aimed to determine the physical activity and exercise needed to optimise bone strength, reduce fall and fracture risk, improve posture and manage vertebral fracture symptoms, while minimising potential risks in people with osteoporosis. The scope of this statement was developed following stakeholder consultation. Meta-analyses were reviewed and where evidence was lacking, individual studies or expert opinion were used to develop recommendations. A multidisciplinary expert group reviewed evidence to make recommendations, by consensus when evidence was not available. Key recommendations are that people with osteoporosis should undertake (1) resistance and impact exercise to maximise bone strength; (2) activities to improve strength and balance to reduce falls; (3) spinal extension exercise to improve posture and potentially reduce risk of falls and vertebral fractures. For safety, we recommend avoiding postures involving a high degree of spinal flexion during exercise or daily life. People with vertebral fracture or multiple low trauma fractures should usually exercise only up to an impact equivalent to brisk walking. Those at risk of falls should start with targeted strength and balance training. Vertebral fracture symptoms may benefit from exercise to reduce pain, improve mobility and quality of life, ideally with specialist advice to encourage return to normal activities. Everyone with osteoporosis may benefit from guidance on adapting postures and movements. There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.

Item Type:	Journal Item
Alternative Title:
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	British Journal of Sports Medicine
Publisher:	B M J Group
ISSN:	0306-3674
Official Date:	2022
Dates:	Date Event 2022 Published 16 May 2022 Available 28 March 2022 Accepted
Volume:	56
Number:	15
Number of Pages:	35
Page Range:	pp. 929-944
DOI:	10.1136/bjsports-2021-104634
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	5 April 2022
Date of first compliant Open Access:	17 May 2022
Related URLs:	Publisher

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