Effect of resistance exercises on function in older adults with osteoporosis or osteopenia: a systematic review. Exercise therapy for osteoporosis: results of a randomised controlled trial. The impact of osteoporosis on quality-of-life: the OFELY cohort. Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial A randomized controlled trial of mailed osteoporosis education to older adults Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial. Evaluation of an osteoporosis and fall risk intervention program for community-dwelling elderly. A quasi-experimental study of behavioral modifications Osteoporosis action: design of the healthy bones project trial. Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures Effects of exercise and nutrition on postural balance and risk of falling in elderly people with decreased bone mineral density: randomized controlled trial pilot study Interpreting studies of exercise and osteoporosis: a call for rigor. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures Long-term effects of a progressive and specific balance-training programme with multi-task exercises for older adults with osteoporosis: a randomized controlled study Improving adherence to and persistence with oral therapy of osteoporosis Impact of the fit and strong intervention on older adults with osteoarthritis. Effects of Educational Materials concerning Osteoporosis on Women's Knowledge, Beliefs, and Behavior Effects of exercise on bone density and falls risk factors in post-menopausal women with osteopenia: a randomised controlled trial.
PURPOSE To examine the effect of resistance exercises on self-reported physical function and activities of daily living ( ADL ) in older adults with osteoporosis or osteopenia . METHODS A search of available literature was conducted using PubMed , CINAHL , SPORTD iscus , PEDro , ProQuest Nursing and Allied Health Source , and Cochrane Controlled Trials Register . Studies were included if they involved ( 1 ) r and omized controlled trials ; ( 2 ) participants with osteoporosis or osteopenia ; ( 3 ) resistance exercise as an intervention ;  and ( 4 ) self-report of physical function or ADL . Articles were independently review ed for quality by two authors using the Physiotherapy Evidence Data base ( PEDro ) scale . Cohen 's d effect size was calculated by dividing st and ardized mean differences by the st and ard deviation to determine treatment effect in terms of physical function or ADL . RESULTS Five full-text articles were selected for inclusion . PEDro scores ranged from 5 to 7 ( out of 10 ) . Effect size mean differences as a result of resistance intervention ranged from 0.08 to 1.74 , suggesting " trivial " to " large " effects on self-reported physical function and ADL . CONCLUSION RESULTS suggest that interventions using resistance training have a beneficial impact on the domains of physical function and ADL in participants with osteoporosis or osteopenia . More high- quality studies are needed to lend further validity to this supposition OBJECTIVE : To define the effects of therapeutic exercise on bone density and back complaints . METHODS : A r and omised controlled trial with parallel groups was conducted in an outpatient clinic , Medical School , University of Vienna . Ninety two sedentary post-menopausal women with back problems were r and omly allocated to either exercise ( groups 1 and 2 ) or control ( group 3 , no exercise , n = 31 ) ; the exercise group was retrospectively subdivided into compliant ( group 1 , n = 27 ) and not fully compliant patients ( group 2 , n = 34 ) . Regular , initially supervised therapeutic exercise aim ed at restoring biomechanical function was performed for four years . Bone density in the forearm was measured by single photon absorptiometry at entry and after four years ; subjective back complaints were documented . RESULTS : A significant decrease in bone density was observed in groups 2 and 3 ; no change was noted in group 1 ; back complaints decreased in group 1 only . CONCLUSIONS : Sedentary postmenopausal women may benefit from regular long term therapeutic exercise in terms of subjective back complaints and slowed loss of bone mass Although the long-term outcomes of osteoporosis ( Op ) such as fracture , kyphosis , and pain are well known , the physical , psychological , and social consequences , beyond fracture and pain , are less clear . The Osteoporosis-targeted Quality -of-life ( OPTQoL ) question naire aim ed at assessing the physical difficulty , fears , and adaptations to one 's daily life was developed as a cross-sectional instrument to characterize the burden of Op within a community . The purpose of this study was to assess the impact of Op and related factors on community women participating in the OFELY study in France .  Femoral neck bone mineral density ( BMD ) and  OPTQoL question  naire data were collected from women r and omly selected from a large insurance company . Data were obtained for 756 women ( mean age 59 years , range 36 - 92 ) , most of whom were white . Women were classified into five groups based on the extent of physical manifestations and family history of Op . Women who had prior fractures , height loss , and /or kyphosis or both reported greater physical difficulty , more adaptations to their lives , and greater fears than women reporting no such changes . Scores on the Physical Difficulty domain , however , did not differ significantly based on BMD alone ( BMD T score < or=2.5 ) , after controlling for age and self-reported arthritis . The negative impact of Op on quality -of-life ( QoL ) seems to be more related to the physical manifestations of Op than to bone density levels . Recognition of the impact of Op-related factors on QoL may help health-care providers more fully appreciate the importance of prevention and treatment Summary The aim of this r and omized controlled trial was to evaluate the effect of a 3-month course of exercises on mobility , balance , disease-specific , and generic health-related quality of life ( HRQOL ) for women with osteoporosis and a history of vertebral fractures . Our results showed that exercises improved their mobility , balance , and HRQOL . Introduction The aim was to evaluate the effect of a 3-month course of circuit exercises plus a 3-h lesson on how to cope with osteoporosis on mobility , balance , and the HRQOL for postmenopausal women ( 60–84 years ) with osteoporosis and a history of vertebral fracture . Our hypothesis was that a 3-month course would have a significantly positive effect on the women 's mobility and balance as well as on their HRQOL . Methods The participants ( 89 ) were r and omized to an intervention group ( IT ) or a control group ( CT )  and assessed at baseline at 3 months and at 12 months with measurement of maximum walking speed ( MWS ) , Timed Up and GO ( TUG ) , Functional Reach ( FR ) , the Quality of Life Question naire issued by the European Foundation for Osteoporosis ( ‘ QUALEFFO-41 ’ ) and the General Health Question naire ( GHQ-20 ) . The sample size was calculated with reference to walking speed ( primary outcome ) , and the statistical approaches used were Student 's t test or the chi-square test . Results At 3 months , better results were registered on the primary outcome , MWS as well as TUG , FR , sum score of GHQ-20 , and “ QUALEFFO-41 : mental function ” in the IT compared with the CT . At 12 months , those in the IT had a better result on the primary outcome , MWS as well as TUG , “ QUALEFFO-41 : total score ” “ QUALEFFO-41 : mental function ” , “ QUALEFFO-41 : physical function ” , and “ QULEFFO-41 : pain ” compared with CT . Conclusion Circuit exercises will improve mobility and health-related quality of life of elderly women with osteoporosis and a history of vertebral fractures Introduction Osteoporosis represents a growing public health concern ; however , current rates of management are sub-optimal . The aim of our study was to assess , in a r and omized controlled trial , the effect of a mailed educational intervention on older adults ’ knowledge , attitudes , and preventive behaviors regarding osteoporosis . The setting was a large publicly funded state pharmacy benefits program . The patients were 31,715 Medicare beneficiaries from Pennsylvania who participated in a drug benefits program for low-to-moderate income elderly people . Methods All women aged over 65 years , and all men and women with a history of fracture or long-term oral use of glucocorticoid , were included . Approximately half of the participants ( intervention group ) were r and omly selected to receive three mailings aim ed at improving knowledge of osteoporosis and enhancing preventive activities , such as using calcium and vitamin D , reducing fall risks in the home , obtaining a bone mineral density ( BMD ) test , and taking medications when necessary . The other participants did not receive the intervention mailings and served as controls . We surveyed a sample of intervention and control subjects to determine the effects of the intervention on knowledge , attitudes , self-efficacy ( confidence in one ’s ability to perform specific activities ) , and behavior regarding osteoporosis prevention and treatment . Six hundred r and omly selected participants in the intervention group and an equal number in the control group were invited to participate . Results Twenty-six had died and 636 of the remaining 1,185 ( 54 % ) completed the survey . Respondents and non-respondents did not differ significantly with respect to measured sociodemographic factors . All scales had good reliability ( all Cronbach ’s alphas > 0.65 ) . Knowledge of osteoporosis was generally very good and did not differ between intervention ( mean = 65 % correct responses ) and control subjects ( mean = 67 % correct ; P=0.4 ) . Perceived susceptibility to osteoporosis was relatively high and similar across groups ( P=0.4 ) . Self-efficacy for participating in osteoporosis prevention and treatment was very strong in both the intervention ( mean = 4.3 on a 0–5 scale ) and control ( mean = 4.2 , P=0.03 ) groups . On average , subjects in the intervention group reported participating in 3.5 of 6 preventive osteoporosis activities compared with 3.4 in the control group ( P=0.5 ) . Conclusions Compared with the controls , a mailed educational intervention for osteoporosis was not associated with better knowledge , higher perceived susceptibility , or performance of preventive measures among the at-risk older adults that we studied . The intervention group demonstrated a small increase in self-efficacy . More intensive patient interventions or intervention aim ed at other aspects of the care process may be required to bring about changes that lead to a reduction in fractures OBJECTIVE To evaluate the efficacy of the Nijmegen Falls Prevention Program ( NFPP ) for persons with osteoporosis and a fall history in a r and omized controlled trial . Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength . A decrease in the number of falls therefore is expected to be particularly beneficial for these persons . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Persons with osteoporosis and a fall history ( N=96 ; mean ± SD age , 71.0±4.7y ; 90 women ) . INTERVENTION After baseline assessment , participants were r and omly assigned to the exercise ( n=50 ; participated in the NFPP for persons with osteoporosis [ 5.5wk ] ) or control group ( n=46 ; usual care ) . MAIN OUTCOME MEASURES Primary outcome measure was fall rate , measured by using monthly fall calendars for 1 year . Secondary outcomes were balance confidence ( Activity-specific Balance Confidence Scale ) , quality of life ( QOL ; Quality of Life Question naire of the European Foundation for Osteoporosis ) , and activity level ( LASA Physical Activity Question naire , pedometer ) , assessed posttreatment subsequent to the program and after 1 year of follow-up . RESULTS The fall rate in the exercise group was 39 % lower than for the control group ( .72 vs 1.18 falls/person-year ; risk ratio , .61 ; 95 % confidence interval , .40-.94 ) . Balance confidence in the exercise group increased by 13.9 % ( P=.001 ) . No group differences were observed in QOL and activity levels . CONCLUSION The NFPP for persons with osteoporosis was effective in decreasing the number of falls and improving balance confidence . Therefore , it is a valuable new tool to improve mobility and independence of persons with osteoporosis Background and aims : Osteoporosis and fall fractures are increasing problems amongst the elderly . The aim of this study was to explore whether combined population -based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population . Methods : A quasi-experimental design was used for the study . Persons aged ≥65 years were r and omly selected in the intervention and control community . An intervention program was managed from the primary health care center and delivered to the community . Health education was design ed to increase awareness of risk factors for the development of osteoporosis and falling . Question naires about lifestyle , health , previous fractures , safety behavior and physical activity level were distributed at baseline in 1989 and at the follow-ups in 1992 and 1994 in both communities . Results : There was a difference of 17.7 % between the dual intervention ( receiving both population -based and individual interventions ) and the control sample s regarding the self-reported use of shoe/cane spikes , and a difference of 20.5 % regarding the reported “ moderate level ” of physical activity in 1994 . There was an increase in the number of participants in the dual intervention sample who , at baseline , had not reported equipping their homes with non-slip mats and removing loose rugs but who did report these changes in 1994 . The increase in the reported use of shoe/cane spikes in the dual intervention sample was observed mainly for the period 1992–1994 . Conclusions : A public health intervention model , including both population -based and individual inter- ventions , can contribute to behavioral changes in the prevention of falls and changed physical activity patterns amongst elderly people Although osteoporosis is common in older adults , it is often under-diagnosed and under-treated . We developed community-based patient- and physician-directed interventions for fracture prevention and compared them in a 2 x 2 factorial r and omized controlled trial . The study population included older adults who were enrolled in a state-run pharmacy benefits program ( The Pharmaceutical Assistance Contract for the Elderly in Pennsylvania ) for Medicare beneficiaries . We r and omly assigned 826 primary care physicians and their 31,715 patients to one of four trial arms -- no patient and no physician intervention , patient but no physician intervention , physician but no patient intervention , both patient and physician interventions . The patient intervention consisted of targeted communication about fall and fracture prevention and osteoporosis diagnosis and treatment . It was delivered through several mailings . The physician intervention entailed one-on-one academic detailing encounters covering the same topics . The composite primary endpoint consisted of use of osteoporosis medication or a bone mineral density test . Other endpoints included patient 's knowledge and attitudes towards fractures and osteoporosis , use of lower extremity strengthening to prevent falls , and the occurrence of fractures . All outcomes will be analyzed using r and om effects models accounting for clustering of subjects within physicians ' practice BACKGROUND Osteoporotic fractures among the elderly are common , and without preventive measures the burden of these fractures on health-care systems will increase further . The purpose of this r and omised controlled study was to evaluate , in premenopausal women , the effects of high-impact loading on several determinants osteoporotic fractures . METHODS 98 healthy , sedentary female volunteers aged 35 - 45 years were r and omly assigned to either a training ( n = 49 ) or a control group ( n = 49 ) . Progressive high-impact exercises were done three times per week for 18 months . We measured bone mineral density ( BMD ) in specific axial and lower-limb sites , by dual-energy X-ray absorptiometry , at baseline and after 12 and 18 months . Maximum isometric strength , muscular and cardiovascular performance , and dynamic balance were also assessed . FINDINGS BMD at the femoral neck , a weightbearing site , increased significantly more in the training group ( mean 1.6 % [ 95 % CI 0.8 - 2.4 ] ) than in the control group ( 0.6 % [ -0.2 to 1.4 ] , p = 0.006 ) . By contrast , at non-weightbearing sites , such as the distal radius , there was no significant difference between the training and control groups ( -1.5 % [ -2.7 to -0.3 ] vs -0.7 % [ -1.9 to -0.5 ] , p = 0.60 ) . In the training group there was a significant improvement in vertical jump and predicted oxygen consumption per min at maximum exercise compared with controls . INTERPRETATION High-impact exercises that load bones with a rapidly rising force profile in versatile movements improve skeletal integrity , muscular performance , and dynamic balance in premenopausal women . If done on a regular basis , this type of exercise may help decrease the risk of osteoporotic fractures in later life . Long-term studies are required to show whether these 18-month results can be translated into long-term benefit Objective : To compare the effect of calcium/vitamin D supplements with a combination of calcium/vitamin D supplements and exercise/protein on risk of falling and postural balance . Design : R and omized clinical trial . Setting : University hospital physiotherapy department . Subjects : Twenty-four independently living elderly females aged 65 years and older with osteopenia or osteoporosis and mean total hip T-score ( SD ) of —1.8 ( 0.8 ) . Interventions : A three-month programme consisting of exercise/protein including training of muscular strength , co-ordination , balance and endurance . Calcium/ vitamin D was supplemented in all participants for a 12-month period . Outcome measures : Assessment took place prior to and following the months 3 , 6 , 9 and at the end of the study ; primary dependent variables assessed were risk of falling ( Berg Balance Test ) and postural balance ( forceplate ) . Secondary measures included body composition , strength , activity level , number of falls , bone mineral content , biochemical indices , nutritional status and general health . Results : Significant reductions of risk of falling ( repeated measures ANOVA F = 8.90 , P = 0.008 ) , an increase in muscular strength ( ANOVA F = 3.0 , P = 0.03 ) , and an increase in activity level ( ANOVA F = 3.38 , P = 0.02 ) were found in the experimental group as compared to the control group . Further on , there was 89 % reduction of falls reported in the experimental group ( experimental pre/post 8/1 falls ; control group pre/post 5/6 falls ) . Conclusion : This study provides support for our intervention programme aim ed at reducing the risk of falling in elderly participants diagnosed with osteopenia or osteoporosis . The data obtained from the pilot study allow the calculation of the actual sample size needed for a larger r and omized trial In 1987 I contributed a commentary that seriously evaluated the method ologic quality of studies promulgating the assumption that exercise has a role in the prevention of osteoporosis [ l ] . Along with a more comprehensive review published separately in 1989 121 , that commentary recommended r and omized controlled trials to confirm the well-recognized association between above average levels of physical activity and higher bone mineral density ( BMD ) [ l-4 ] . A recent literature search revealed eight reports published since 1989 that utilized a r and omized study design to determine the potential effects of various types of exercise interventions on BMD 15 - 121 . These studies had equivocal results ; some showed mild positive effects but others showed virtually no effect of exercise on BMD ( Table 1 ) . What is most disturbing about these studies is the generalIy high level of subject attrition reported . Indeed , subject dropout rates ranged from 4 % to 50 % . Five of the studies had attrition rates above 20 % ( Table 1 ) . Such high levels of attrition have serious implication s for analyzing and interpreting the results of these trials . In fact , not a single study presented a valid intention-to-treat ( ITT ) analysis to adjust statistically for significant subject attrition . Interestingly , a recent position statement on exercise and osteoporosis made no mention of this problem , its potential impact on the results of r and omized trials , or its statistical implication s 1131 . As articulated by a working group of the American Statistical Association , ITT analysis includes all r and omized subjects in the groups to which they were r and omly assigned , regardless of their compliance to the intervention and regardless of subsequent withdrawal from treatment or deviation from the protocol 1141 . ITT requires that all subjects initially r and omized into the study be included in the primary test statistics . Because this type of analysis may require imputation of data , its consequences can be profound in studies with attrition rates as high as many of these exercise studies . Some study reports stated that withdrawal rates were similar between groups ill ] , that reasons for withdrawal were not study related [ 9,11 ] , or that dropouts were not dissimilar to subjects who remained in the study on selected baseline variables 1121 . While these findings may This r and omized controlled trial was design ed to investigate the effect of a 6-month home-based exercise program versus control ( usual activities ) on quality of life for postmenopausal women with osteoporosis who had at least one vertebral fracture . Twelve-month assessment s of outcomes were completed to determine if women would continue exercising with minimal supervision and if benefit could be sustained . The home exercise program followed a " lifestyle exercise " approach where participants completed exercises 60 min per day , 3 days a week and could complete exercises in small periods of time throughout the day . Exercise activities included stretching , strength training and aerobics ( i.e. walking ) . Participants were assessed at baseline , 6 months , and 12 months using the Osteoporosis Quality of Life Question naire ( OQLQ ) , the Sickness Impact Profile ( SIP ) , a balance test , and the Timed Up And Go test . Bone mineral density was assessed at baseline and 12 months for both the lumbar spine and femoral neck . Quality of life ( OQLQ ) improved over 6 months in the exercise group compared to the control group in the domains of symptoms ( P=0.003 ) , emotion ( P=0.01 ) and leisure ( P=0.03 ) . Results from the balance test indicated a greater effect in the exercise group over 12 months ( P<0.05 ) . There were no significant differences between groups in measures of Timed Up and Go , SIP at 6 and 12 months , and femoral neck and lumbar spine bone mineral density at 12 months . Home-based exercise with minimal supervision improves quality of life in elderly women with vertebral fractures . Future research is needed to determine if home exercise programs reduce falls and fall-related injuries in the elderly Objective : To evaluate long-term effects of balance-training on concerns about falling , gait , balance performance , and physical function in older adults with osteoporosis and increased risk of falling . Design : R and omized controlled trial , including three groups ( training , training+physical activity , and control group ) , with follow-ups at three , nine , and 15 months . Short-term , three-month follow-up , benefits for those who fulfilled the first follow-up ( n = 69 ) have previously been reported . Setting : Stockholm , Sweden . Participants : A total of 96 elderly , age 66–87 , with verified osteoporosis . Interventions : Balance-training programme including dual- and multitasks , with or without supplementary physical activity , three times/week over 12 weeks . Measurements : Concerns about falling Falls Efficacy Scale -International ( FES-I ) , walking at preferred speed with and without a cognitive dual-task and at fast speed , balance tests ( one-leg stance and modified figure-of-eight ) , and physical function Late-Life Function and Disability Instrument ( LLFDI ) . Results : Participants in the training group maintained positive effects throughout the study period for concerns about falling ( baseline vs. 15 months , median 27.5 vs. 23 points , p < 0.001 ) and walking performance ( baseline vs. 15 months , p ⩽ 0.05 with an improvement of 0.9–1.4 m/s ) . The Training+physical activity group declined to baseline values at the nine-month follow-up , and were even lower at the 15-month follow-up for concerns about falling ( median 26 vs. 26 points ) , walking performance ( changes of −0.02 to 0.04 m/s ) , and physical function ( mean 44.0 vs. 42.9 points ) . The control group remained unchanged throughout the study period . Conclusions : This balance-training programme reduced concerns about falling , and also improved gait in older adults with osteoporosis and increased risk of falling in a long-term perspective – important issues for fall prevention Summary Osteoporosis treatment has low adherence and persistence . This study evaluated if greater patient involvement could improve them . At 12 months , only 114 out of 344 participants were “ fully adherent and persistent ” ( all drug doses taken throughout the study ) . Only frequency of drug administration had a significant influence on adherence . Introduction Osteoporosis affects millions of individuals worldwide . There are now several effective drugs , but adherence to and persistence with treatment are low . This 12-month multicenter , prospect i ve , r and omized study evaluated the efficacy of two different methods aim ed at improving adherence and persistence through greater patient involvement , compared with st and ard clinical practice . Methods Three hundred thirty-four post-menopausal women , receiving an oral prescription for osteoporosis for the first time , were recruited and r and omized into three groups : group 1 ( controls , managed according to st and ard clinical practice ) and groups 2 and 3 ( managed with greater patient and caregiver involvement and special reinforcements : group 2 , instructed to use several different “ reminders ” ; group 3 , same “ reminders ” as group 2 , plus regular phone calls from and meetings at the referring Center ) . All enrolled women had two visits ( baseline and 12 months ) . Results Of 334 enrolled women , 247 ( 74 % ) started the prescribed therapy . Of those who started , 219 ( 88.7 % ) persisted in therapy for at least 10 months . At final evaluation , only 114 women were considered as “ fully adherent and persistent ” ( all doses taken throughout the 12 months ) . There were no significant differences regarding “ full adherence ” among the three r and omized groups . The frequency of drug administration had a significant influence : weekly administration had a > 5-fold higher adherence and monthly administration an 8-fold higher adherence ( p < 0.0001 ) than daily administration . Conclusions The special effort of devising and providing additional reminders did not prove effective . Additional interventions during the follow-up , including costly interventions such as phone calls and educational meetings , did not provide significant advantages PURPOSE This study assessed the impact of a low cost , multicomponent physical activity intervention for older adults with lower extremity osteoarthritis . DESIGN AND METHODS A r and omized controlled trial compared the effects of a facility-based multiple-component training program followed by home-based adherence  ( n = 80 ) to a  wait list control group ( n = 70 ) . Assessment s were conducted at baseline and at 2 and 6 months following r and omization . The training program consisted of range of motion , resistance training , aerobic walking , and education-group problem solving regarding self-efficacy for exercise and exercise adherence . All training group participants developed individualized plans for posttraining adherence . RESULTS Relative to the persons in the control group , individuals who participated in the exercise program experienced a statistically significant improvement in exercise efficacy , a 48.5 % increase in exercise adherence , and a 13.3 % increase in 6-min distance walk that were accompanied by significant decreases in lower extremity stiffness at 2 and 6 months . Program participants also experienced a significant decrease in lower extremity pain and a borderline significant improvement in efficacy to adhere to exercise over time at 6 months ( p = .052 ) . In contrast , persons in the control group deteriorated over time on the efficacy and adherence measures and showed no change on the other measures . No adverse health effects were encountered . IMPLICATION S These benefits indicate that this low-cost intervention may hold great promise as one of a growing number of public health intervention strategies for older adults in the United States with osteoarthritis Purpose . This study examined the effects of brief written educational material s on osteoporosis-related knowledge , beliefs , and behaviors . The study also examined whether observed effects varied as a function of one 's stage in the pre caution adoption process . Design . The study used an experimental research design . Setting . Participants were identified from North Carolina driver 's license records . Subjects . Of the 1476 women in the initial sample , 536 ( 36.3 % ) enrolled in the study and 307 completed all follow-up assessment s. Intervention . Participants were r and omly assigned to one of four groups . One group received an information packet containing general information about osteoporosis . One group received an action plan packet containing instructions on how to increase one 's level of exercise and calcium intake .  One group received both packets . The final group received neither packet . Measures . Primary study variables were beliefs related to osteoporosis , calcium , and exercise ; osteoporosis knowledge ; calcium and exercise stage ; calcium intake ; and exercise level . Results . Overall , receipt of the information packet was associated with changes in knowledge and beliefs ( F[18,283 ] = 2.11 , p < .01 ) irrespective of participants ' stage of change . No effects on behavior were observed . Conclusions . These findings suggest that brief written educational material s can facilitate knowledge and belief change but that they do not promote behavior change . The generalizability of these findings is limited by the low study response rate OBJECTIVES This study aim ed to determine the efficacy of an exercise program for post-menopausal women with osteopenia undertaken in community exercise facilities . DESIGN R and omised , single-blind controlled trial . METHODS Thirty-nine community volunteers with hip osteopenia and not taking bone-enhancing medication were r and omly allocated to an  exercise (  EX ) or control ( CON ) group . EX participants attended an exercise facility in Melbourne , Australia , three times/week for 52 weeks ( with a 2 week break ) for partially supervised exercises targeting hip bone strength , muscle strength and balance . They also performed daily jumping exercises at home . CON participants continued with their usual care . All participants were given calcium supplementation . Assessment at baseline and 52 weeks measured bone mineral density ( BMD ) at the proximal femur and lumbar spine . Health-related quality of life ( QOL ) and objective measures of strength and balance were also collected . RESULTS ANCOVA adjusting for baseline values revealed a small benefit of exercise in mean total hip BMD ( the primary outcome ) with a significant mean difference in change between groups of -0.012 g/cm(2 ) ( 95 % CI -0.022 to -0.002 g/cm(2 ) ) . EX participants improved 0.5 % compared with a 0.9 % loss for CON participants . The only other between-group differences were in QOL and a test of trunk and upper limb endurance , which both favoured the EX group . CONCLUSIONS This exercise program appears to have modest benefits for post-menopausal women with osteopenia who are not taking bone-enhancing medication . This mode of exercise delivery has adherence and progression limitations but may be appropriate to recommend for some people
Conclusions A multicomponent exercise program of high-speed training combined with simulated functional tasks is promising to enhance functional outcomes .
Due to substantial clinical heterogeneity of the target groups and specific dem and s of exercise modes , it is unclear which exercise program is optimal
Summary Osteoporosis affects many aspects of daily life .
The aim of this systematic review was to assess the effects of exercise interventions on functional outcomes in persons with osteoporosis , in comparison with controls .