Building better bones with exercise

Lora Giangregorio in foreground with female teaching another female exercises in backgroundLora Giangregorio is trying to apprehend a “silent thief.”

The culprit is osteoporosis: a disease characterized by reduced bone strength where bone tissue is stolen over time, often without symptoms.

According to Osteoporosis Canada, at least one in three women and one in five men will suffer from an osteoporotic fracture during their lifetime. Twenty-eight per cent of women and 37% of men who suffer a hip fracture will die within the following year.

Exercise is often advised for individuals with osteoporosis, says Giangregorio, an associate professor of kinesiology. Research suggests that exercise can prevent falls, and may prevent bone loss. However, there is very little research about safe and effective exercise for high-risk individuals, such as those with osteoporotic spine fractures.

“When someone has a heart attack they receive exercise rehabilitation funded by the health care system. Perhaps an individual who has an osteoporotic spine fracture should also receive instruction on safe and effective exercise,” suggests Giangregorio. “Currently, the only treatments funded by our health care system are medications for patients’ bones, or pain medication that may actually increase their risk for falls and more fractures.”   

More research is needed to develop guidelines for safe and effective exercise prescription among individuals with hip or vertebral fractures. Experts believe the first step is a large-scale trial demonstrating that exercise can actually prevent fractures.

Giangregorio has joined forces with researchers at University Health Network, McMaster University, the University of Western Ontario, the University of British Columbia and the University of Melbourne Australia to conduct a multi-centre study evaluating the feasibility of such a trial.

The research, funded by the Canadian Institutes of Health Research, will also evaluate the effect of exercise on quality of life, mobility, and many other outcomes important to individuals with vertebral fractures.

Findings may be used to inform initiatives such as Bone FitTM, a training program offered by Osteoporosis Canada, designed for physical therapists and kinesiologists on screening and safe exercise prescription for individuals with osteoporosis. The team will also collect data about this population’s use of health services to help evaluate the benefits of exercise relative to the cost of implementing exercise prescription.

“Acute care, outpatient care, and prescription drugs to treat osteoporosis represent significant costs for the health care system. Osteoporosis can also have huge costs for quality of life,” suggests Giangregorio. ““We believe that advocating for safe and effective exercise-related resources for individuals at high risk of fractures may improve health outcomes.”