Exercise Interventions for Osteoporosis Prevention and Management

Osteoporosis is characterised by diminished bone strength and an elevated risk of fragility fractures, arising primarily from age-related loss of bone mass and microarchitectural deterioration. Exercise interventions harness the adaptive capacity of bone tissue to mechanical stimuli and muscle forces. Weight-bearing activities such as brisk walking, stair climbing and impact exercises induce ground reaction forces that stimulate osteogenesis, while resistance training applies targeted loads to augment muscle mass and enhance skeletal load bearing. Multicomponent programmes that combine aerobic, resistance and balance training have demonstrated particular efficacy in preserving bone mineral density and reducing fall risk among older adults. Emerging approaches include whole-body vibration to improve neuromuscular function and virtual reality–guided exercise to enhance adherence and quality of life. Across the lifespan, early interventions during growth maximise peak bone mass, and continued physical activity through midlife and beyond mitigates age-related bone loss. Tailored prescriptions consider individual health status, fracture risk and functional capacity to optimise safety and efficacy. The global significance of exercise as a low-cost, widely accessible strategy is underscored by its capacity to complement pharmacological treatments, reduce healthcare burden and improve musculoskeletal health in diverse populations.

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Exercise Interventions for Osteoporosis Prevention and Management publication trend

The graph below shows the total number of articles in exercise interventions for osteoporosis prevention and management across all publications each year (not limited to Nature Index journals).

Technical terms

Bone Mineral Density (BMD): Quantitative measure of mineral content in bone, reflecting strength and fracture risk.

Weight-bearing exercise: Physical activity in which the skeleton supports body weight, generating mechanical forces that stimulate bone formation.

Resistance training: Exercise involving external loads (e.g. free weights, machines) to induce muscle contraction and increase bone strain.

Mechanical loading: Application of force to bone tissue, promoting adaptive remodelling through osteoblast and osteoclast activity.

References

1. Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity (2020).
2. Effects of Different Types of Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis. Calcified Tissue International (2020).
3. Gamified Exercise with Kinect: Can Kinect-Based Virtual Reality Training Improve Physical Performance and Quality of Life in Postmenopausal Women with Osteopenia? A Randomized Controlled Trial. Sensors (2024).
4. Exercise and bone health across the lifespan. Biogerontology (2017).