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Exercise Frequency and Fracture Risk in Older Adults—How Often Is Enough?

  • Nutrition, Exercise and Lifestyle in Osteoporosis (S Shapses and J Lappe, Section Editors)
  • Published:
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Abstract

Purpose of Review

Due to older people’s low sports participation rates, exercise frequency may be the most critical component for designing exercise protocols that address fracture risk. The aims of the present article were to review and summarize the independent effect of exercise frequency (ExFreq) on the main determinants of fracture prevention, i.e., bone strength, fall frequency, and fall impact in older adults.

Recent Findings

Evidence collected last year suggests that there is a critical dose of ExFreq that just affects bone (i.e., BMD). Corresponding data for fall-related fracture risk are still sparse and inconsistent, however.

Summary

The minimum effective dose (MED) of ExFreq that just favorably affects BMD at the lumbar spine and femoral neck has been found to vary between 2.1 and 2.5 sessions/week. Although this MED cannot necessarily be generalized to other cohorts, we speculate that this “critical exercise frequency” might not significantly vary among adult cohorts.

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Notes

  1. We use the 90% quantile of the control group as the boundary value to distinguish between normal bone change and exercise effect.

  2. The authors calculated that 700 subjects are needed to detect a 25% reduction (from 50 to 37%) in the percentage of people that had at least one fall during the interventional period (β-1 80%; α 5%). Applying slightly more positive expectations (33%) in subjects with higher fall risk will still result in a necessary sample size of 230 people per group. However, considering the results of the bone-strengthening studies listed above, a mean difference between the groups in the range of 2 ± 2.5% (for 12 months) corresponds to a necessary sample size (β-1 80%; α 5%) of 25 participants per group.

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Acknowledgements

We are thankful for the support of the “Behinderten und Rehabilitations-Sportverband Bayern” (Munich, Germany), “Netzwerk Knochengesundheit” (Erlangen, Germany), and the Institute of Sports and Sport Sciences, Friedrich-Alexander University of Erlangen-Nürnberg, Germany.

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Authors and Affiliations

  1. Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany

    Wolfgang Kemmler & Simon von Stengel

  2. Department of Medical and Life Sciences, University of Furtwangen, Jakob-Kienzle-Straße 17, Furtwangen im Schwarzwald, Germany

    Matthias Kohl

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  1. Wolfgang Kemmler
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  2. Simon von Stengel
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  3. Matthias Kohl
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Correspondence to Wolfgang Kemmler.

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Wolfgang Kemmler, Matthias Kohl, and Simon von Stengel declare no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Nutrition, Exercise and Lifestyle in Osteoporosis

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Kemmler, W., von Stengel, S. & Kohl, M. Exercise Frequency and Fracture Risk in Older Adults—How Often Is Enough?. Curr Osteoporos Rep 15, 564–570 (2017). https://doi.org/10.1007/s11914-017-0407-7

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