Exercise to prevent minimal-trauma fracture

Exercise has a positive effect on two of the major risk factors for minimal-trauma fracture—falls and low BMD. Exercise maintains muscle strength, muscle mass, flexibility, mobility and balance, which can reduce the frequency and severity of falls. Exercise can also prevent the loss of, or even increase, BMD, although evidence that exercise reduces the incidence of fractures is lacking.

The benefits of exercise vary according to the type of exercise:

• A combination of weight-bearing and high-impact exercise has the most significant benefit on BMD, and also improves muscle strength. The intensity of exercise should be progressively increased as the patient gains fitness.
• Balance training and muscle strengthening exercises can reduce the risk of falls, and can also be beneficial for BMD.
• Tai Chi, and group and home-based exercise programs have been shown to reduce falls in older people.
• Non–weight-bearing exercise (eg swimming, cycling) does not increase bone density, but has other health benefits, and can improve or maintain muscle strength.

Advise and assist all patients to exercise, with individualised exercise plans that consider the patient’s abilities and fracture risk. Consider referral to an exercise physiologist or physiotherapist for an individualised plan, particularly for a patient with existing osteoporosis or prior minimal-trauma fracture.

For more detail about exercises to prevent osteoporosis and fractures, including patient information, see the Healthy Bones Australia website. Videos for patients are available from the Osteoporosis Canada website.