PHYSICAL-ACTIVITY AS THERAPY FOR OSTEOPOROSIS

Objective: To examine exercise as a therapy for people with osteoporos is. Options: Immobilization, standing low-load and high-load physical activities. Outcomes: Risk of injury, quality of life, risk of falls a nd fractures, strength and posture and pain management. Evidence: Rele vant epidemiologic studies, clinical trials and reviews were examined, including the large-scale FICSIT trial in the United States, a prospe ctive 4-year study of women enrolled in an exercise program in Toronto and the large-scale Study of Osteoporotic Fractures. Values: Minimizi ng risk of injury and increasing quality of life were given a high val ue. Benefits, harms and costs: Moderate physical activity in people wi th osteoporosis can reduce the risk of falls and fractures, decrease p ain and improve fitness and overall quality of life. IT may also stimu late bone gain and decrease bone loss. Its positive effects are an adj unct to other interventions, such as hormonal therapy. It may give pat ients the confidence to resume regular activity and can provide social interaction and support. During exercise programs, proper nutrition i s necessary to prevent excessive weight loss and impaired immune funct ion resulting from inadequate protein, vitamin and mineral intake. Rec ommendations: Immobilization should be avoided if possible in anyone w ith osteoporosis or at increased risk for osteoporosis. Regular, moder ate physical activity is recommended for those with osteoporosis. Elde rly people should be assessed for risk of falling to identify those in greatest need of an exercise program. Community group exercise progra ms are beneficial. Younger people with osteoporosis also need exercise that will preserve or improve bone mass, muscular strength, endurance and cardiovascular fitness. Weight loss as a result of physical activ ity should be avoided and adequate intake of protein, vitamins and min erals assured. Because the benefits of physical activity are independe nt of the effects of other therapies, physical activity is an essentia l adjunct to appropriate nutrition and other therapies. Validation: Th ese recommendations were developed by the Scientific Advisory Board of the Osteoporosis Society of Canada at its 1995 Consensus Conference. They are in agreement with the position taken on osteoporosis and exer cise by the United States Centers for Disease control and Prevention a nd the American College of Sports Medicine. Sponsors: Sponsors of the 1995 conference included the Dairy Farmers of Canada, Eli Lilly Canada , Inc., Hoffmann-La Roche Canada Ltd., Merck Frosst Canada Inc. and Pr octor & Gamble Pharmaceuticals Canada Inc.