Abstract
One hundred and seventy-nine women aged 60–85 years (mean age 71.6 years, SD 5.3 years) were randomly recruited from the community to participate in a 12-month randomized controlled trial to determine whether a program of twice-weekly structured exercise has beneficial effects on three factors associated with osteoporotic fractures: quadriceps strength, postural sway and bone density. At initial testing, there were no significant differences in the strength, sway and bone density measures (assessed at the hip and lumbar spine) between the exerciser and control groups. The exercise classes included strengthening, coordination and balance exercises, and approximately 35 min of each class comprised weight-bearing exercise. The mean number of classes attended for the 68 exercisers who completed the program was 59.8 of the 82 classes (72.9%). At the completion of the trial, the intervention group showed significant improvements in quadriceps strength and sway but not bone mineral density when compared with the control group. Indices of fracture risk, indicated by (i) the sum of standard score results and (ii) the sum of quartile grades of the femoral neck bone density, sway and strength measures, decreased significantly in the exercisers at the end of the trial compared with the controls. In conclusion, the program of general aerobic exercise may have reduced overall fracture risk, even though it did not significantly increase bone density. Further long-term studies are required that include acceptable weight-loaded exercises to determine optimal programs for reducing fracture risk factors by improving bone density as well as strength and balance.
Similar content being viewed by others
References
Cummings SR. Are patients with hip fracture more osteoporotic? Review of the evidence. Am J Med 1985;78:487–94.
Felson DT, Anderson JJ, Hannan MT, Milton RC, Wilson PW, Kiel DP. Impaired vision and hip fracture: the Framingham study. J Am Geriatr Soc 1989;37:495–500.
Nevitt M, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc 1993;41:1226–34.
Cummings SR, Nevitt M. A hypothesis: the cause of hip fractures. J Gerontol (Med Sci) 1987;44:M107–11.
Lips P, Obrant KJ. The pathogenesis and treatment of hip fracture. Osteoporosis Int 1991;1:218–31.
Nguyen T,Sambrook P, Kelly P, Jones G, Lord S, Freund J, et al. Prediction of osteoporotic fractures by postural instability and bone density. BMJ 1993;307:1111–15.
Gutin B, Kasper MJ. Can vigorous exercise play a role in osteoporosis prevention? Osteoporosis Int 1992;2:55–69.
Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990;263:3029–34.
Charlette SL, McEvoy L, Pyka G, Snow-Harter C, Guido D, Wiswell RA, et al. Muscle hypertrophy response to resistance training in older women. J Appl Physiol 1991;70:1912–6.
Nichols JF, Omizo DK, Peterson KK, Nelson KP. Efficacy of heavy-resistance training for active women over sixty: muscular strength, body composition and program adherence. J Am Ger-iatr Soc 1993;41:205–10.
Era P. Posture control in the elderly. Int J Technol Aging 1988;1:166–79.
Johansson G, Jarlno G. Balance training in 70 year old women. Physiotherapy Theory and Practice 1991;7:121–5.
Lichtenstein MJ, Shields SL, Shiavi RG, Burger C. Exercise and balance in aged women: a pilot controlled clinical trial. Arch Phys Med Rehabil 1989;70:138–43.
Crilly RG, Willems DA, Trenholm K, Hayes KC, Delaquerriere-Richardson FLO. Effects of exercise on postural sway in the elderly. Gerontology 1989;35:137–43.
Lord SR, Castell S. The effect of a physical activity program on balance, strength, neuromuscular control and reaction time in older persons. Arch Phys Med Rehabil 1994;75:648–52.
Lord SR, Ward JA, Williams P, Strudwick M. The effect of a 12-month exercise program on balance, strength and falls in older women: a randomised controlled trial. J Am Geriatr Soc 1995;43:1198–206.
Lord SR, Ward JA, Williams P. The effect of exercise on dynamic stability in older women: a randomised controlled trial. Arch Phys Med Rehabil 1996;77:232–6.
Lord SR, Ward JA, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994;42:1110–7.
American College of Sports Medicine. Guidelines for graded exercise testing and exercise prescription, 2nd ed. Philadelphia: Lea and Febiger, 1980.
Benson H. The relaxation response. New York: William Morrow, 1975.
SPSS Inc. SPSS reference guide. Chicago: SPSS Inc., 1990.
Ring C, Nayak USL, Isaacs B. The effect of visual deprivation and proprioceptive change on postural sway in healthy adults. J Am Geriatr Soc 1989;37:745–9.
Lord SR, Ward JA, Williams P, Anstey KJ. Age-related changes in sensori-motor function and balance in community-dwelling women. Age Ageing 1994;23:452–60.
Steinberg FU. Exercise in prevention and therapy of osteoporosis. In: Avioli LV, editor. The osteoporotic syndrome: detection, prevention and treatment, 2nd ed. Orlando: Grune and Stratton, 1987;109–20.
Lord SR, Lloyd DG, Nirui M, Raymond J, Williams P, Stewart RA. The effect of exercise on gait patterns in older women: a randomised controlled trial. J Gerontol (Med Sc) 1996;51A:M64-M70.
Smith EL, Tommerup L. Exercise: a prevention and treatment for osteoporosis and injurious falls in the older adult. J Aging Phys Activity 1995;3:178–92.
Dishman RK (ed). Exercise adherence: its impact on public health. Illinois: Human Kinetics Books, 1988.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lord, S.R., Ward, J.A., P., W. et al. The effects of a community exercise program on fracture risk factors in older women. Osteoporosis Int 6, 361–367 (1996). https://doi.org/10.1007/BF01623009
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623009