Effectiveness of Exercise for Managing Osteoporosis in Women Postmenopause

<LEAP> highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medications, surgery, education, nutrition, exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature.1 Each article in this PTJ series summarizes a Cochrane review or other scientific evidence resource on a single topic and will present clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on exercise for the management of osteoporosis in women postmenopause. Which, if any, approaches to exercise reduce loss of bone mineral density or reduce the chance of fractures in women who are healthy postmenopause? A 2003 report from the Surgeon General of the United States estimated that 10 million individuals had osteoporosis and almost 34 million had low bone mass, placing them at increased risk for osteoporosis.2 Analysis of data from people with 6 to 7 years of Medicare coverage in the United States in 2005 estimated the prevalence of osteoporosis to be approximately 30%.3 The major outcome of concern in osteoporosis is minimal trauma fracture. This is a type of fracture resulting from injury that would be insufficient to fracture normal bone and are referred to as low-impact fracture, fragility fracture, and osteoporotic fracture.4 One study estimated that by 2025, osteoporotic fractures will grow to more than 3 million, incurring $25.3 billion in costs.5