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Answering Questions about How Exercise Affects Bone Density

Much research shows that exercise helps women build bone mineral density (BMD), before and after menopause. But the studies have been mostly short term and have tested a wide range of exercises on women of a wide range of ages. So what type of exercise is best, and does it really help over the long term? This three-year study in Germany is designed to help answer those questions.

This article reports on the first 14 months of the study. The authors are following two groups of women, all of whom are within eight years of menopause. The authors chose this age range because women lose much of their BMD in the years right after menopause. All the women in the study were diagnosed with osteopenia. Osteopenia is low BMD but not as low as in osteoporosis.

All the women in the study are taking calcium and vitamin D. However, only one group of women is doing a prescribed exercise routine. The exercise group does two one-hour group exercise sessions each week and two shorter sessions at home. The sessions built up gradually over the months to help avoid injuries. The exercise sessions include endurance, jumping, and stretching, with a special focus on strength training.

After 14 months, the authors compared the two groups' endurance, strength, and BMD. BMD was checked in the lower spine, the pelvis, and the neck of the femur (the part of the thighbone that is right by the ball of the hip joint). These are common fracture sites in women with osteoporosis. Results showed that BMD increased in the spine and hip of the women who exercised. The researchers expect to see some improvement in the femur over the following two years of the study. The exercise group also had significantly better endurance and strength levels, which also play a role in preventing fractures.

The authors note that this study will not fully answer the questions of what type and how much exercise is best. But they feel confident that the exercise routine they designed is easy to adapt to "real life," and that most women tend to stick with the program over time.

References: Wolfgang Kemmler, PhD, et al. The Erlangen Fitness Osteoporosis Prevention Study: A Controlled Exercise Trial in Early Postmenopausal Women with Low Bone Density--First-Year Results. In Archives of Physical Medicine and Rehabilitation. May 2003. Vol. 84. No. 5. Pp. 673-682.

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