As physiotherapists that work in the community (we operate across Lichfield, Sutton Coldfield, Walsall, Cannock, Rugeley and Tamworth) we see a large number of elderly female patients who have osteoporosis and as such I am always trying to find out more about what is best to do to help them and what works best in terms of exercise and physiotherapy. So, a recent study looking at the effects of high intensity resistance and impact training on bone density, fitness and functional performance caught my eye. Traditionally it has been thought that post menopausal women with osteoporosis should avoid high impact exercise due to the risk of bone fractures (specifically the risk of hip fractures and spinal fractures) and so there has been a difficuty about what type of exercise can they do that will increase their bone density. After all bone density responds to load, so if you are not doing any load bearing activity such as walking, jumping, jogging, lifting weights etc then your bone density is unlikely to change. You may very well get very aerobically fit e.g. by swimming but because of the low load put through your skeleton your bone density is unlikley to change. So, the quandary when treating elderly patients with low bone density has always been: "how do I best help this patient get stronger and increase their bone density without putting them at too large a risk of fractures?"

A recent study of over 100 women in their mid 60s with low bone density helps give some answers to the problem above. They assigned the women to two groups for approximately 8 months and asked one group to follow a low intensity home based exercise programme and the other to follow a twice a week supervised high intensity and high impact exercise programme. The study showed that high intensity and high impact was more effective at improving strength, fitness and bone density. The full study can be found here https://onlinelibrary.wiley.com/doi/abs/10.1002/jbmr.3284

This is a really useful and helpful piece of research for physiotherapists such as our practice who operate in the community and regularly see elderly and frail patients with reduced bone density. It means that we can confidently give patients and supervise them doing high intensity and high impact exercises as long as we build things up slowly and sensibly.

I hope that you have found this article helpful. If you or anyone you know has had osteoporosis then please feel free to get in touch. We are a home visit physiotherapy service serving Lichfield, Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.