Longitudinal evaluation of supervised versus unsupervised exercise programs for the treatment of osteoporosis

The efficacy of an exercise program was investigated in a study of 89 post- menopausal women with osteoporosis over a 5-year follow-up period. The stud y attempted to examine and compare potential differences in bone mineral de nsity (BMD), incidence of fracture, and loss of height, between a group of patients (n = 42) who attended the supervised exercise program in the hospi tal, and a group (n = 47) who exercised at home. Habitual physical activity , as estimated using the Harvard Alumni Questionnaire, and a Physical Activ ity Index were combined to obtain an estimate of overall weekly caloric exp enditure over the 5-year period. The exercise program involved weight-beari ng aerobic activities of moderate intensity, and muscle strengthening exerc ise using free weights. The mean percentage change for the lumbar BMD was 4.4% in the hospital group and +3.4% in the home group while for the femora l neck BMD was +1.1% in the hospital group and -0.9% in the home group. The re was a significant reduction in the number of fractures and no significan t loss of height over the 5-year follow-up period for both groups. As the c orrelation between BMD and weekly caloric expenditure of the subjects was n ot significant, no conclusion can be drawn as to the minimum level of calor ic expenditure necessary in order to retard bone loss. It was concluded tha t for the post-menopausal women with osteoporosis who participated in the p rogram it was possible to stabilize their height and the BMD of the lumbar site, and to reduce fractures over the 5-year study period regardless if th ey exercised in a supervised or in an unsupervised setting.