Exercise Guidance for Osteoporosis and Spinal Fracture

Osteoporosis patients with spinal fracture recommended to include multiple types of exercise

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Osteoporosis is a chronic condition in which bones become very fragile and at risk for fracture. Patients with osteoporosis and spinal fractures need to be especially careful when they exercise.

A recent recommendation suggested that people with osteoporosis who've had a spinal fracture should use an exercise program that includes a combination of resistance, balance and aerobic training, and not focus only on aerobic training.

The authors believe that this recommendation can help healthcare providers provide a safe and enjoyable exercise program for osteoporosis patients with spinal fractures.

"Discuss a safe exercise program with your doctor."

The lead author of this recommendation was Lora M. Giangregorio, PhD, from the Department of Kinesiology at the University of Waterloo in Waterloo, Canada.

A panel of health care professionals from different disciplines looked at the effects of exercise on 1) falls, fractures, bone mineral density and adverse events for people with osteoporosis and spinal fractures; and 2) pain, quality of life, and physical function after a spinal fracture.

The authors considered three types of osteoporosis patients that had varying risk:

  • those who have osteoporosis based on bone density
  • those who have osteoporosis and one spinal fracture
  • those who have osteoporosis and multiple spinal fractures, chronic pain and a curved spine creating a "hump back" effect (called hyperkyphosis)

The current national physical activity guidelines may apply to people with osteoporosis who have not had a spine fracture.

The recommendation also said that people who have experienced a spinal fracture should only engage in a moderate level of aerobic activity, and the authors suggested that spinal fracture patients should consult a physical therapist before starting an exercise program.

All people with osteoporosis are recommended to do balance and endurance training daily to strengthen their back muscles.

The recommendation also states that healthcare providers should consider a patient's specific history and exercise preferences, rather than issuing general restrictions, when determining which exercises are safe and which aren't.

"Looking at the patient's individual condition that is specific only to him or her is essential in prescribing a safe, effective and enjoyable workout, especially people in special populations," said Rusty Gregory, a personal trainer and wellness coach in Austin, Texas and a dailyRx Contributing Expert.

"Generally speaking, multimodal exercise programs that include cardiovascular, flexibility and strength training are more comprehensive. This will address many areas of their fitness. Without question, always have your physical therapist approve your workout to make sure it is safe and falls under the guidelines and recommendations for appropriate exercises for patients with osteoporosis," Gregory told dailyRx News.

"People with osteoporosis and spinal fractures should be encouraged to participate in resistance training and balance training, as the strongest evidence we have supports multimodal exercise programs," Dr. Giangregorio said in a press statement.

"We have developed evidence-based recommendations, as well as a report that addresses the 'frequently asked questions' of patients and health care providers around physical activity. We hope that the recommendations are helpful to health professionals worldwide as they guide their osteoporosis patients in safe, effective — and enjoyable — exercise regimens," Dr. Giangregorio said.

This study was presented on April 4 at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.

Review Date: 
April 5, 2014
Last Updated:
April 29, 2014