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Cited by 1,043Bone health and osteoporosis researchPhysical Activity and HealthLower Extremity Biomechanics and Pathologies

Physical Activity and Bone Health

Kohrt, Wendy M., Bloomfield, Susan A., Little, Kathleen D., Nelson, Miriam E., Yingling, Vanessa R.·2004·Medicine & Science in Sports & Exercise
DOI 10.1249/01.mss.0000142662.21767.58
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Abstract

SUMMARY Weight-bearing physical activity has beneficial effects on bone health across the age spectrum. Physical activities that generate relatively high-intensity loading forces, such as plyometrics, gymnastics, and high-intensity resistance training, augment bone mineral accrual in children and adolescents. Further, there is some evidence that exercise-induced gains in bone mass in children are maintained into adulthood, suggesting that physical activity habits during childhood may have long-lasting benefits on bone health. It is not yet possible to describe in detail an exercise program for children and adolescents that will optimize peak bone mass, because quantitative dose-response studies are lacking. However, evidence from multiple small randomized, controlled trials suggests that the following exercise prescription will augment bone mineral accrual in children and adolescents: Mode: impact activities, such as gymnastics, plyometrics, and jumping, and moderate intensity resistance training; participation in sports that involve running and jumping (soccer, basketball) is likely to be of benefit, but scientific evidence is lacking Intensity: high, in terms of bone-loading forces; for safety reasons, resistance training should be <60% of 1-repetition maximum (1RM) Frequency: at least 3 d·wk−1 Duration: 10–20 min (2 times per day or more may be more effective) During adulthood, the primary goal of physical activity should be to maintain bone mass. Whether adults can increase bone mineral density (BMD) through exercise training remains equivocal. When increases have been reported, it has been in response to relatively high intensity weight-bearing endurance or resistance exercise; gains in BMD do not appear to be preserved when the exercise is discontinued. Observational studies suggest that the age-related decline in BMD is attenuated, and the relative risk for fracture is reduced, in people who are physically active, even when the activity is not particularly vigorous. However, there have been no large randomized, controlled trials to confirm these observations, nor have there been adequate dose-response studies to determine the volume of physical activity required for such benefits. It is important to note that, although physical activity may counteract to some extent the aging-related decline in bone mass, there is currently no strong evidence that even vigorous physical activity attenuates the menopause-related loss of bone mineral in women. Thus, pharmacologic therapy for the prevention of osteoporosis may be indicated even for those postmenopausal women who are habitually physically active. Given the current state of knowledge from multiple small randomized, controlled trials and large observational studies, the following exercise prescription is recommended to help preserve bone health during adulthood: Mode: weight-bearing endurance activities (tennis; stair climbing; jogging, at least intermittently during walking), activities that involve jumping (volleyball, basketball), and resistance exercise (weight lifting) Intensity: moderate to high, in terms of bone-loading forces Frequency: weight-bearing endurance activities 3–5 times per week; resistance exercise 2–3 times per week Duration: 30–60 min·d−1 of a combination of weight-bearing endurance activities, activities that involve jumping, and resistance exercise that targets all major muscle groups It is not currently possible to easily quantify exercise intensity in terms of bone-loading forces, particularly for weight-bearing endurance activities. However, in general, the magnitude of bone-loading forces increases in parallel with increasing exercise intensity quantified by conventional methods (e.g., percent of maximal heart rate or percent of 1RM). The general recommendation that adults maintain a relatively high level of weight-bearing physical activity for bone health does not have an upper age limit, but as age increases so, too, does the need for ensuring that physical activities can be performed safely. In light of the rapid and profound effects of immobilization and bed rest on bone loss, and the poor prognosis for recovery of mineral after remobilization, even the frailest elderly should remain as physically active as their health permits to preserve skeletal integrity. Exercise programs for elderly women and men should include not only weight-bearing endurance and resistance activities aimed at preserving bone mass, but also activities designed to improve balance and prevent falls. Maintaining a vigorous level of physical activity across the lifespan should be viewed as an essential component of the prescription for achieving and maintaining good bone health. INTRODUCTION In Caucasian, postmenopausal women, osteoporosis is defined as a bone mineral density (BMD) value more than 2.5 standard deviations below the young value with or Whether the should to women, women of or men remains to be In the and the of osteoporosis is increasing

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  • Across all trials, evidence for exercise to improve bone health in cancer survivors is inconsistent.

    “Two recent systematic reviews in cancer survivors concluded that across all trials the evidence for exercise to improve bone health is inconsistent(45, 46), though RCTs that were designed with bone health as the primary outcome were largely consistent with the exercise recommendations in the ACSM Position Stand for exercise and bone health(47).”

    From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [45]

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Authors
Kohrt, W. M., Bloomfield, S. A., Little, K. D., Nelson, M. E., & Yingling, V. R.
Affiliations
American College of Sports Medicine (US)
ORCID
Venue
Medicine & Science in Sports & Exercise
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-11
Volume
36
Issue
11
Pages
1985-1996
ISSN
0195-9131 (ISSN-L)
DOI
10.1249/01.mss.0000142662.21767.58
OpenAlex
W1973828494
Cited by
1,043
References
128
Citations by year
2026: 40 · 2025: 49 · 2024: 40 · 2023: 38 · 2022: 53 · 2021: 56 · 2020: 65 · 2019: 52 · 2018: 45 · 2017: 51 · 2016: 56 · 2015: 45 · 2014: 67 · 2013: 67 · 2012: 60
FWCI
21.46
Type
journal article
Language
en
Open access
closed
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords
weight-bearing exercise, bone mineral density, bone mineral accrual, peak bone mass, children and adolescents, resistance training, plyometric training, gymnastics, exercise prescription, fracture risk, menopause, osteoporosis prevention, physical activity guidelines, dose-response relationship, exercise adherence, exercise safety
MeSH terms
Adolescent, Adult, Aged, Animals, Bone and Bones, Child, Humans, Life Style, Middle Aged, Motor Activity, Osteoporosis, Physical Endurance, Sports, Sports Medicine, Health Behavior, Exercise, Bone Density, Weight-Bearing, Models, Animal, Fractures, Bone

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