Exercise and Osteoporosis-Related Fractures: Perspectives and Recommendations of the Sports and Exercise Scientist

References

• . Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a worldwide projection. Osteoporos Int. 1992;2(6):285–289
   PubMed Web of Science ®Google Scholar
• . Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22(3):465–475
   PubMed Web of Science ®Google Scholar
• . Ray NF, Chan JK, Thamer M, Melton LJ 3rd. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997;12(1):24–35
   PubMed Web of Science ®Google Scholar
• . Gregg EW, Pereira MA, Caspersen CJ. Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence. J Am Geriatr Soc. 2000;48(8):883–893
   PubMed Web of Science ®Google Scholar
• . Karlsson MK, Nordqvist A, Karlsson C. Physical activity, muscle function, falls and fractures. Food Nutr Res. 2008;52
   Google Scholar
• . Moayyeri A. The association between physical activity and osteoporotic fractures: a review of the evidence and implications for future research. Ann Epidemiol. 2008;18(11):827–835
   Google Scholar
• . Gregg EW, Cauley JA, Seeley DG, Ensrud KE, Bauer DC. Physical activity and osteoporotic fracture risk in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med. 1998;129(2):81–88
   PubMed Web of Science ®Google Scholar
• . Silman AJ, O'Neill TW, Cooper C, Kanis J, Felsenberg D. Influence of physical activity on vertebral deformity in men and women: results from the European Vertebral Osteoporosis Study. J Bone Miner Res. 1997;12(5):813–819
   Google Scholar
• . Gillespie LD, Robertson MC, Gillespie WJ, . Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;(2):CD007146
   Google Scholar
• . Ashburn A, Fazakarley L, Ballinger C, Pickering R, McLellan LD, Fitton C. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2007;78(7):678–684
   PubMed Web of Science ®Google Scholar
• . Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. Age Ageing. 1999;28(6):513–518
   PubMed Web of Science ®Google Scholar
• . Korpelainen R, Keinänen-Kiukaanniemi S, Heikkinen J, Väänänen K, Korpelainen J. Effects of impact exercise on bone mineral density in elderly women with low BMD: a population based randomized controlled 30-month intervention. Osteoporos Int. 2006;17(1):109–118
   PubMed Web of Science ®Google Scholar
• . McMurdo ME, Mole PA, Paterson CR. Controlled trial of weight bearing exercise in older women in relation to bone density and falls. BMJ. 1997;314(7080):569
   PubMedGoogle Scholar
• . Robertson MC, Devlin N, Gardner MM, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: randomised controlled trial. BMJ. 2001;322(7288):697–701
   PubMedGoogle Scholar
• . Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315(7115):1065–1069
   PubMed Web of Science ®Google Scholar
• . Kemmler W, von Stengel S, Engelke K, Haberle L, Kalender WA. Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) study. Arch Intern Med. 2010;170(2):179–185
   Google Scholar
• . Robertson MC, Gardner MM, Devlin N, McGee R, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 2: controlled trial in multiple centres. BMJ. 2001;322(7288):701–704
   PubMed Web of Science ®Google Scholar
• . Karinkanta S, Piirtola M, Sievanen H, Uusi-Rasi K, Kannus P. Physical therapy approaches to reduce fall and fracture risk among older adults. Nat Rev Endocrinol. 2010;6(7):396–407
   PubMed Web of Science ®Google Scholar
• . Korpelainen R, Keinänen-Kiukaanniemi S, Heikkinen J, Väänänen K, Korpelainen J. Effect of exercise on extraskeletal risk factors for hip fractures in elderly women with low BMD: a population-based randomized controlled trial. J Bone Miner Res. 2006;21(5):772–779
   Google Scholar
• . Sinaki M, Itoi E, Wahner HW, . Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone. 2002;30(6):836–841
   PubMed Web of Science ®Google Scholar
• . Järvinen TL, Sievanen H, Khan KM, Heinonen A, Kannus P. Shifting the focus in fracture prevention from osteoporosis to falls. BMJ. 2008;336(7636):124–126
   PubMedGoogle Scholar
• . Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19(4):385–397
   PubMed Web of Science ®Google Scholar
• . Kannus P, Sievänen H, Palvanen M, Järvinen T, Parkkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366(9500):1885–1893
   PubMed Web of Science ®Google Scholar
• . Sinaki M. Muskuloskeletal challenges of osteoporosis. Aging (Milano). 1998;10(3):249–262
   Google Scholar
• . Bunout D, Barrera G, Avendao M, . Results of a community-based weight-bearing resistance training programme for healthy Chilean elderly subjects. Age Ageing. 2005;34(1):80–83
   Google Scholar
• . Carter ND, Khan KM, McKay HA, . Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ. 2002;167(9):997–1004
   PubMed Web of Science ®Google Scholar
• . Lord SR, Ward JA, Williams P, Strudwick M. The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial. J Am Geriatr Soc. 1995;43(11):1198–1206
   Google Scholar
• . McMurdo ME, Johnstone R. A randomized controlled trial of a home exercise programme for elderly people with poor mobility. Age Aging. 1995;24(5):425–428
   PubMed Web of Science ®Google Scholar
• . Reinsch S, MacRae P, Lachenbruch PA, Tobis JS. Attempts to prevent falls and injury: a prospective community study. Gerontologist. 1992;32(4):450–456
   Google Scholar
• . Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age Ageing. 2007;36(6):656–662
   PubMed Web of Science ®Google Scholar
• . Chang JT, Morton SC, Rubenstein LZ, . Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomized controlled trials. BMJ. 2004;328(7441):680–687
   PubMed Web of Science ®Google Scholar
• . de Kam D, Smulders E, Weerdesteyn V, Smits-Engelsman BC. Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int. 2009;20(12):2111–2125
   Google Scholar
• . Moreland J, Richardson J, Chan DH, . Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49(2):93–116
   Google Scholar
• . Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing. 2006;35(1):5–10
   PubMed Web of Science ®Google Scholar
• . Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, . Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339:b3692
   PubMed Web of Science ®Google Scholar
• . Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc. 1999;47(7):850–853
   Google Scholar
• . Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. Does a home-based strength and balance programme in people aged > or = 80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med. 2010;44(2):80–89
   PubMed Web of Science ®Google Scholar
• . Frick KD, Kung JY, Parrish JM, Narrett MJ. Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. J Am Geriatr Soc. 2010;58(1):136–141
   PubMed Web of Science ®Google Scholar
• . Province MA, Hadley EC, Hornbrook MC, . The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA. 1995;273(17):1341–1347
   PubMed Web of Science ®Google Scholar
• . Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc. 1996;44(5):489–497
   PubMed Web of Science ®Google Scholar
• . Fiatarone MA, O'Neill EF, Doyle N, . The Boston FICSIT study: the effects of resistance training and nutritional supplementation on physical frailty in the oldest old. J Am Geriatr Soc. 1993;41(3):333–337
   Google Scholar
• . Wolfson L, Whipple R, Judge J, Amerman P, Derby C, King M. Training balance and strength in the elderly to improve function. J Am Geriatr Soc. 1993;41(3):341–343
   Google Scholar
• . Li F, Harmer P, Fisher KJ, . Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005;60(2):187–194
   PubMed Web of Science ®Google Scholar
• . Voukelatos A, Cumming RG, Lord SR, Rissel C. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc. 2007;55(8):1185–1191
   PubMed Web of Science ®Google Scholar
• . Close JC. Prevention of falls—a time to translate evidence into practice. Age Ageing. 2005;34(2):98–100
   Google Scholar
• . Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall related injuries in older people: a review of randomized controlled trials. Br J Sports Med. 2000;34(1):7–17
   PubMed Web of Science ®Google Scholar
• . Day L, Fildes B, Gordon I, Fitzharris M, Flamer H, Lord SR. Randomized factorial trial of falls prevention among older people living in their own homes. BMJ. 2002;325(7356):128–131
   PubMed Web of Science ®Google Scholar
• . Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing. 2003;32(4):407–414
   PubMed Web of Science ®Google Scholar
• . Means KM, Rodell DE, O'Sullivan PS. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil. 2005;84(4):238–250
   Google Scholar
• . Skelton D, Dinan S, Campbell MK, Rutherford O. Tailored group exercise (Falls management - FaME) reduces falls in community-dwelling older frequent fallers (an RCT). Age Ageing. 2005;34(6):636–639
   PubMed Web of Science ®Google Scholar
• . Wolf SL, Barnhart HX, Ellison GL, Coogler CE. The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies on Intervention Techniques. Phys Ther. 1997;77(4):371–381
   PubMed Web of Science ®Google Scholar
• . Buchner DM, Cress ME, Wagner EH, de Lateur BJ, Price R, Abrass IB. The Seattle FICSIT/MoveIt study: the effect of exercise on gait and balance in older adults. J Am Geriatr Soc. 1993;41(3):321–325
   Google Scholar
• . Ploutz-Snyder LL, Manini T, Ploutz-Snyder RJ, Wolf DA. Functionally relevant thresholds of quadriceps femoris strength. J Gerontol A Biol Sci Med Sci. 2002;57(4):B144–B152
   PubMed Web of Science ®Google Scholar
• . Buchner DM, Cress ME, de Lateur BJ, . The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol A Biol Sci Med Sci. 1997;52(4):M218–M224
   PubMed Web of Science ®Google Scholar
• . Campbell AJ, Robertson MC, La Grow SJ, . Randomised controlled trial of prevention of falls in people aged > or = 75 with severe visual impairment: the VIP trial. BMJ. 2005;331(7520):817
   PubMed Web of Science ®Google Scholar
• . Lord SR, Tiedemann A, Chapman K, . The effect of an individual fall prevention program on fall risk and falls in older people: a randomized controlled trial. J Am Geriatr Soc. 2005;53(8):1296–1304
   PubMed Web of Science ®Google Scholar
• . Teixeira LE, Silva KN, Imoto AM, . Progressive load training for the quadriceps muscle associated with proprioception exercises for the prevention of falls in postmenopausal women with osteoporosis: a randomized controlled trial. Osteoporos Int. 2010;21(4):589–596
   Google Scholar
• . Gardner MM, Phty M, Robertson MC, McGee R, Campbell AJ. Application of a falls prevention program for older people to primary health care practice. Prev Med. 2002;34(5):546–553
   PubMed Web of Science ®Google Scholar
• . Rose DJ. Preventing falls among older adults: no “one size suits all” intervention strategy. J Rehabil Res Dev. 2008;45(8):1153–1166
   Web of Science ®Google Scholar
• . Weerdesteyn V, Rijken H, Geurts AC, Smits-Engelsman CM, Mulder T, Duysens J. A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontology. 2006;52(3):131–141
   PubMed Web of Science ®Google Scholar
• . Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–2243
   PubMed Web of Science ®Google Scholar
• . DeGoede KM, Ashton-Miller JA, Schultz AB. Fall-related upper body injuries in the older adult: a review of the biomechanical issues. J Biomech. 2003;36(7):1043–1053
   Google Scholar
• . Groen BE, Weerdesteyn V, Duysens J. Martial arts fall techniques decrease the impact forces at the hip during sideways falling. J Biomech. 2007;40(2):458–462
   Google Scholar
• . Groen BE, Smulders E, de Kam D, Duysens J, Weerdesteyn V. Martial arts fall training to prevent hip fractures in the elderly. Osteoporos Int. 2010;21(2):215–221
   Google Scholar
• . Lo J, Ashton-Miller JA. Effect of pre-impact movement strategies on the impact forces resulting from a lateral fall. J Biomech. 2008;41(9):1969–1977
   Google Scholar
• . Sabick MB, Hay JG, Goel VK, Banks SA. Active responses decrease impact forces at the hip and shoulder in falls to the side. J Biomech. 1999;32(9):993–998
   PubMed Web of Science ®Google Scholar
• . Weerdesteyn V, Groen BE, van Swigchem R, Duysens J. Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training. J Electromyogr Kinesiol. 2008;18(2):235–242
   Google Scholar
• . Black DM, Cummings SR, Karpf DB, . Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996;348(9041):1535–1541
   PubMed Web of Science ®Google Scholar
• . Bonnick S, Saag KG, Kiel DP, . Comparison of weekly treatment of postmenopausal osteoporosis with alendronate versus risedronate over two years. J Clin Endocrinol Metab. 2006;91(7):2631–2637
   PubMed Web of Science ®Google Scholar
• . Orwoll E, Ettinger M, Weiss S, . Alendronate for the treatment of osteoporosis in men. N Engl J Med. 2000;343(9):604–610
   PubMed Web of Science ®Google Scholar
• . Pluijm SM, Smit JH, Tromp EA, . A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int. 2006;17(3):417–425
   PubMed Web of Science ®Google Scholar
• . Gruber R, Pietschmann P, Peterlik M. Introduction to bone development, remodelling and repair. In: Baerth AL, Knauth M, Sartor K, eds. Radiology of Osteoporosis. Heidelberg, Germany: Springer-Verlag; 2008:1–23
   Google Scholar
• . Griffith JF, Engelke K, Genant HK. Looking beyond bone mineral density: imaging assessment of bone quality. Ann N Y Acad Sci. 2010;1192(1):45–56
   Google Scholar
• . Adams JE. Dual Energy Absorptiometry. In: Baert AL, Knauth M, Sartor K, eds. Radiology of Osteoporosis. Heidelberg, Germany: Springer-Verlag; 2008:105–124
   Google Scholar
• . van Rijn RP, van Kuijk C. Spinal quantitative computed tomography. In: Baert AL, Knauth M, Sartor K, eds. Radiology of Osteoporosis. Heidelberg: Springer-Verlag; 2008:137–142
   Google Scholar
• . Prevhal S, Engelke K, Genant HK. pQCT: Peripheral computed tomography. In: Baert AL, Knauth M, Sartor K, eds. Radiology of Osteoporosis. Heidelberg: Springer-Verlag; 2008:143–162
   Google Scholar
• . Genant HK, Engelke K, Fuerst T, . Noninvasive assessment of bone mineral and structure: state of the art. J Bone Miner Res. 1996;11(6):707–730
   PubMed Web of Science ®Google Scholar
• . Guglielmi G, Floriani I, Torri V, . Effect of spinal degenerative changes on volumetric bone mineral density of the central skeleton as measured by quantitative computed tomography. Acta Radiol. 2005;46(3):269–275
   Web of Science ®Google Scholar
• . Faulkner KG, Wacker WK, Barden HS, . Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporos Int. 2006;17(4):593–599
   PubMed Web of Science ®Google Scholar
• . Ferretti JL. Perspectives of pQCT technology associated to biomechanical studies in skeletal research employing rat models. Bone. 1995;17( 4 suppl):353S–364S
   Google Scholar
• . Almstedt HC, Canepa JA, Ramirez DA, Shoepe TC. Changes in bone mineral density in response to 24 weeks of resistance training in college-age men and women [published online ahead of print July 17, 2010]. J Strength Cond Res
   Google Scholar
• . Bonaiuti D, Shea B, Iovine R, . Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002;(3):CD000333
   Google Scholar
• . Guadalupe-Grau A, Fuentes T, Guerra B, Calbet JA. Exercise and bone mass in adults. Sports Med. 2009;39(6):439–468
   PubMed Web of Science ®Google Scholar
• . Kelley GA, Kelley KS, Tran ZV. Exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis of individual patient data. J Gerontol. 2002;57A(9):M599–M604
   Google Scholar
• . Kelley GA, Kelley KS. Efficacy of resistance exercise on lumbar spine and femoral neck bone mineral density in premenopausal women: a meta-analysis of individual patient data. J Womens Health (Larchmt). 2004;13(3):293–300
   Google Scholar
• . Martyn-St. James M, Caroll S. High intensity exercise training and postmenopausal bone loss: a meta-analysis. Osteoporos Int. 2006;17(8):1225–1240
   Google Scholar
• . Miller LE, Nickols-Richardson SM, Ramp WK, Gwazdauskas FC, Cross LH, Herbert WG. Bone mineral density in postmenopausal woman: does exercise training make a difference? Phys SportsMed. 2004;32(2):18–24
   PubMed Web of Science ®Google Scholar
• . Vuori IM. Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc. 2001;33( 6 suppl):S551–S586
   PubMed Web of Science ®Google Scholar
• . Wallace BA, Cumming RG. Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Calcif Tissue Int. 2000;67(1):10–18
   PubMed Web of Science ®Google Scholar
• . Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR; American College of Sports Medicine. American College of Sports Medicine Position Stand: physical activity and bone health. Med Sci Sports Exerc. 2004;366(11):1985–1996
   Google Scholar
• . Rogers RS, Hinton PS. Bone loading during young adulthood predicts bone mineral density in physically active, middle-aged men. Phys SportsMed. 2010;38(2):146–155
   PubMed Web of Science ®Google Scholar
• . Suominen H. Muscle training for bone strength. Aging Clin Exp Res. 2006;18(2):85–93
   PubMed Web of Science ®Google Scholar
• . Bassey EJ, Rothwell MC, Littlewood JJ, Pye DW. Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res. 1998;13(12):1805–1813
   PubMed Web of Science ®Google Scholar
• . Hamilton CJ, Swan VJ, Jamal SA. The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies. Osteoporos Int. 2010;21(1):11–23
   Google Scholar
• . Kelley GA. Exercise and regional bone mineral density in postmenopausal women: a meta-analytic review of randomized trials. Am J Phys Med Rehabil. 1998;77(1):76–87
   Google Scholar
• . Kelley GA, Kelley KS, Tran ZV. Exercise and bone mineral density in men: a meta-analysis. J Appl Physiol. 2000;88(5):1730–1736
   Google Scholar
• . Engelke K, Kemmler W, Lauber D, Beeskow C, Pintag R, Kalender WA. Exercise maintains bone density at spine and hip EFOPS: a 3-year longitudinal study in early postmenopausal women. Osteoporos Int. 2006;17(1):133–142
   Google Scholar
• . Kemmler W, von Stengel S, Weineck J, Lauber D, Kalender W, Engelke K. Exercise effects on risk factors in early postmenopausal women: 3-yr Erlangen fitness osteoporosis prevention study results. Med Sci Sports Exerc. 2005;37(2):194–203
   Google Scholar
• . von Stengel S, Kemmler W, Kalender WA, Engelke K, Lauber D. Differential effects of strength versus power training on bone mineral density in postmenopausal women: a 2-year longitudinal study. Br J Sports Med. 2007;41(10):649–655
   PubMed Web of Science ®Google Scholar
• . von Stengel S, Kemmler W, Lauber D, Weineck J, Kalender WA, Engelke K. Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. J Appl Physiol. 2005;99(1):181–188
   Google Scholar
• . Senn E. Grundlagen der positiv-trophischen Wirksamkeit physikalischer Belastung auf normales, osteopenisches und osteoporotisches Knochengewebe. Phys Med. 1994;4:133–134
   Google Scholar
• . Häkkinen K, Pakarinen A, Kraemer WJ, Häkkinen A, Valkeinen H, Alen M. Selective muscle hypertrophy, changes in EMG and force, and serum hormones during strength training in older women. J Appl Physiol. 2001;91(2):569–580
   PubMed Web of Science ®Google Scholar
• . Kemmler W, Wildt L, Engelke K, . Acute hormonal responses of a high impact physical exercise session in early postmenopausal women. Eur J Appl Physiol. 2003;90(1–2):199–209
   Google Scholar
• . Maïmoun L, Sultan C. Effect of physical activity on calcium homeostasis and calciotropic hormones: a review. Calcif Tissue Int. 2009;85(4):277–286
   Google Scholar
• . Kemmler W, von Stengel S, Engelke K, Diziol P, Kalender W. Exercise effects on bone anabolic hormones in elderly females: preliminary results of the senior fitness and prevention study (SEFIP). Endocrine Abstracts. 2008(16):P103
   Google Scholar
• . Frost HM. The role of changes in mechanical usage set points in the pathogenesis of osteoporosis. J Bone Miner Res. 1992;7(3):253–261
   PubMedGoogle Scholar
• . Turner CH. Homeostatic control of bone structure: an application of feedback theory. Bone. 1991;12(3):203–217
   Google Scholar
• . Cheng MZ, Zaman G, Rawlinson SC, Pitsillides AA, Suswillo RF, Lanyon LE. Enhancement by sex hormones of the osteoregulatory effects of mechanical loading and prostaglandins in explants of rat ulnae. J Bone Miner Res. 1997;12(9):1424–1430
   Google Scholar
• . Li CY, Jee WS, Chen JL, . Estrogen and “exercise” have a synergistic effect in preventing bone loss in the lumbar vertebra and femoral neck of the ovariectomized rat. Calcif Tissue Int. 2003;72(1):42–49
   Google Scholar
• . Milliken LA, Going SB, Houtkooper LB, . Effects of exercise training on bone remodeling, insulin-like growth factors, and bone mineral density in postmenopausal women with and without hormone replacement therapy. Calcif Tissue Int. 2003;72(4):478–484
   Google Scholar
• . Villareal DT, Binder EF, Yarasheki KE, . Effects of exercise training added to ongoing hormone replacement therapy on bone mineral density in frail elderly women. J Am Ger Soc. 2003;51(7):985–990
   PubMed Web of Science ®Google Scholar
• . Constantini NW, Warren MP. Menstrual dysfunction in swimmers: a distinct entity. J Clin Endocrinol Metab. 1995;80(9):2740–2744
   PubMed Web of Science ®Google Scholar
• . Chae AE, Platen P, Antz R, . Knochendichte bei Leistungssportler/innen aus verschiedenen Sportarten im Vergleich zu Sportstudent/innen und untrainierten Kontrollpersonen. In: Liesen H, Weiß M, Baum M, eds. Regulations- und Repaimechanismen. Paderborn, Germany; 1994
   Google Scholar
• . Fehling PC, Alekel L, Clasey J, Rector A, Stillman RJ. A comparison of bone mineral densities among female athletes in impact loading and active loading sports. Bone. 1995;17(3):205–210
   Google Scholar
• . Heinonen A, Oja P, Kannus P, . Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton. Bone. 1995;17(3):197–203
   PubMed Web of Science ®Google Scholar
• . Kemmler W, Engelke K, Baumann H, . Bone status in elite male runners. Eur J Appl Physiol. 2006;96(1):78–85
   Google Scholar
• . Morel J, Combe B, Francisco J, Bernard J. Bone mineral density of 704 amateur sportsmen involved in different physical activities. Osteoporos Int. 2001;12:152–157
   PubMed Web of Science ®Google Scholar
• . Nevill AM, Holder RL, Stewart AD. Modeling elite male athletes' peripheral bone mass, assessed using regional dual x-ray absorptiometry. Bone. 2003;32(1):62–68
   Google Scholar
• . Nikander R, Sievanen H, Heinonen A, Kannus P. Femoral neck structure in adult female athletes subjected to different loading modalities. J Bone Miner Res. 2005;20(3):520–528
   PubMed Web of Science ®Google Scholar
• . Steward AD. Comparison of bone mineral density in athletes of impact and non impact sports. Calcif Tiss Int. 1999;9:377
   Google Scholar
• . Alfredson H, Nordström P, Pietilä T, Lorentzon R. Long-term loading and regional bone mass of the arm in female volleyball players. Calcif Tissue Int. 1998;62(4):303–308
   Google Scholar
• . Haapasalo H, Kannus P, Sievänen H, . Effect of long-term unilateral activity on bone mineral density of female junior tennis players. J Bone Miner Res. 1998;13(2):310–319
   PubMed Web of Science ®Google Scholar
• . Haapasalo H, Kontulainen S, Sievänen H, Kannus P, Järvinen M, Vuori I. Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone. 2000;27(3):351–357
   PubMed Web of Science ®Google Scholar
• . Kannus P, Haapasalo H, Sankelo M, . Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med. 1995;123(1):27–31
   PubMed Web of Science ®Google Scholar
• . Kontulainen S, Sievänen H, Kannus P, Pasanen M, Vuori I. Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res. 2002;17(12):2281–2289
   Web of Science ®Google Scholar
• . Wolff J. Über die innere Architektur der Knochen und ihre Bedeutung für die Frage vom Knochenwachstum. Virchow Arch Path Anat Physio. 1870;50(3):389–453
   Google Scholar
• . Buhl KM, Jacobs CR, Turner RT, Evans GL, Farrell PA, Donahue HJ. Aged bone displays an increased responsiveness to low-intensity resistance exercise. J Appl Physiol. 2001;90(4):1359–1364
   Google Scholar
• . Heinonen A, Sievanen H, Kannus P, Oja P, Vuori I. Site-specific skeletal response to long-term weight training seems to be attributable to principal loading modality: a pQCT study of female weightlifters. Calcif Tissue Int. 2002;70(6):469–474
   PubMed Web of Science ®Google Scholar
• . Nilsson BE, Westlin NE. Bone density in athletes. Clin Orthop. 1971;77:179–182
   PubMed Web of Science ®Google Scholar
• . Kerr D, Morton A, Dick I, Prince R. Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res. 1996;11(2):218–225
   PubMed Web of Science ®Google Scholar
• . Frost HM. Bone mass and the mechanostat. A proposal. Anat Rec. 1987;219(1):1–19
   PubMedGoogle Scholar
• . Rubin CT, Lanyon LE. Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int. 1985;37(4):411–417
   PubMed Web of Science ®Google Scholar
• . Hsieh YF, Turner CH. Effects of loading frequency on mechanically induced bone formation. J Bone Miner Res. 2001;16(5):918–924
   PubMed Web of Science ®Google Scholar
• . Biewener AA. Safety factors in bone strength. Calcif Tissue Int. 1993;53( suppl 1):S68–S74
   Google Scholar
• . Hsieh YF, Robling AG, Ambrosius WT, Burr DB, Turner CH. Mechanical loading of diaphyseal bone in vivo: the strain threshold for an osteogenic response varies with location. J Bone Miner Res. 2001;16(12):2291–2297
   Google Scholar
• . Mosley JR, March BM, Lynch J, Lanyon LE. Strain magnitude related changes in whole bone architecture in growing rats. Bone. 1997;20(3):191–198
   Google Scholar
• . Turner CH. Three rules for bone adaptation to mechanical stimuli. Bone. 1998;23(5):399–407
   PubMed Web of Science ®Google Scholar
• . McDonald F, Yettram AL, MacLeod K. The response of bone to external loading regimes. Med Eng Phys. 1994;16(5):384–397
   Google Scholar
• . Skerry TM, Peet NM. “Unloading” exercise increases bone formation in rats. J Bone Miner Res. 1997;12(9):1520
   Google Scholar
• . Turner CH, Owan I, Takano Y. Mechanotransduction in bone: role of strain rate. Am J Physiol Endocrinol Metab. 1995;269(3 pt 1):E438–E442
   Google Scholar
• . Mosley JR, Lanyon LE. Strain rate as a controlling influence on adaptive modeling in response to dynamic loading of the ulna in growing male rats. Bone. 1998;23(4):313–318
   PubMed Web of Science ®Google Scholar
• . Judex S, Zernicke RF. High-impact exercise and growing bone: relation between high strain rates and enhanced bone formation. J Appl Physiol. 2000;88(6):2183–2191
   Google Scholar
• . Judex S, Zernicke RF. Does the mechanical milieu associated with highspeed running lead to adaptive changes in diaphyseal growing bone? Bone. 2000;26(2):153–159
   Google Scholar
• . Bassey EJ, Ramsdale SJ. Increase in femoral bone density in young women following high-impact exercise. Osteoporos Int. 1994;4(2):72–75
   PubMed Web of Science ®Google Scholar
• . Grove KA, Londeree BR. Bone density in postmenopausal women: high impact vs low impact exercise. Med Sci Sports Exerc. 1992;24(11):1190–1194
   PubMed Web of Science ®Google Scholar
• . Rubin CT, Lanyon LE. Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am. 1984;66(3):397–402
   PubMed Web of Science ®Google Scholar
• . Umemura Y, Ishiko T, Tsujimoto H, Miura H, Mokushi N, Suzuki H. Effects of jump training on bone hypertrophy in young and old rats. Int J Sports Med. 1995;16(6):364–367
   Google Scholar
• . Kato T, Terashima T, Yamashita T, Hatanaka Y, Honda A, Umemura Y. Effect of low-repetition jump training on bone mineral density in young women. J Appl Physiol. 2006;100(1):839–843
   Google Scholar
• . Whalen RT, Carter DR, Steele CR. Influence of physical activity on the regulation of bone density. J Biomech. 1988;21(10):825–837
   Web of Science ®Google Scholar
• . Cullen DM, Smith RT, Akhter MP. Bone-loading response varies with strain magnitude and cycle number. J Appl Physiol. 2001;91(5):1971–1976
   PubMed Web of Science ®Google Scholar
• . Rubin CT, McLeod KJ. Promotion of bony ingrowth by frequency specific, low-amplitude mechanical strain. Clin Orthop. 1994;298:165–174
   PubMed Web of Science ®Google Scholar
• . McDonald F, Yettram AL, MacLeod K. The response of bone to external loading regimens. Med Eng Phys. 1994;16(5):384–397
   Google Scholar
• . Judex S, Lei X, Han D, Rubin C. Low-magnitude mechanical signals that stimulate bone formation in the ovariectomized rat are dependent on the applied frequency but not on the strain magnitude. J Biomech. 2007;40(6):1333–1339
   PubMed Web of Science ®Google Scholar
• . Turner CH, Forwood MR, Otter MW. Mechanotransduction in bone: do bone cells act as sensors of fluid flow? FASEB J. 1994;8(11):875–878
   Google Scholar
• . Rubin C, Xu G, Judex S. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli. FASEB J. 2001;15(12):2225–2229
   PubMed Web of Science ®Google Scholar
• . Rubin C, Turner AS, Mallinckrodt C, Jerome C, McLeod K, Bain S. Mechanical strain, induced noninvasively in the high-frequency domain, is anabolic to cancellous bone, but not cortical bone. Bone. 2002;30(3):445–452
   PubMed Web of Science ®Google Scholar
• . Sehmisch S, Galal R, Kolios L, . Effects of low-magnitude, high-frequency mechanical stimulation in the rat osteopenia model. Osteoporos Int. 2009;20(12):1999–2008
   PubMed Web of Science ®Google Scholar
• . Xie L, Jacobson JM, Choi ES, . Low-level mechanical vibrations can influence bone resorption and bone formation in the growing skeleton. Bone. 2006;39(5):1059–1066
   PubMedGoogle Scholar
• . Xie L, Rubin C, Judex S. Enhancement of the adolescent murine musculoskeletal system using low-level mechanical vibrations. J Appl Physiol. 2008;104(4):1056–1062
   PubMed Web of Science ®Google Scholar
• . Yang P, Jia B, Ding C, Wang Z, Qian A, Shang P. Whole-body vibration effects on bone before and after hind-limb unloading in rats. Aviat Space Environ Med. 2009;80(2):88–93
   Google Scholar
• . Welch JM, Weaver CM, Turner CH. Adaptation of free-fall impact are different in the shafts and bone ends in rat forelimbs. J Appl Physiol. 2004;97:1859–1865
   Google Scholar
• . Gilsanz V, Wren TA, Sanchez M, Dorey F, Judex S, Rubin C. Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res. 2006;21(9):1464–1474
   PubMed Web of Science ®Google Scholar
• . Gusi N, Raimundo A, Leal A. Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial. BMC Musculoskelet Disord. 2006;7:92
   PubMed Web of Science ®Google Scholar
• . Ruan XY, Jin FY, Liu YL, Peng ZL, Sun YG. Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis. Chin Med J (Engl). 2008;121(13):1155–1158
   PubMed Web of Science ®Google Scholar
• . Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S. Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study. J Bone Miner Res. 2004;19(3):352–359
   PubMed Web of Science ®Google Scholar
• . Ward K, Alsop C, Caulton J, Rubin CT, Adams J, Mulghal Z. Low magnitude mechanical loading is osteogenic in children with disabling conditions. J Bone Min Res. 2004;19(3):360–369
   PubMed Web of Science ®Google Scholar
• . Humphries B, Fenning A, Dugan E, Guinane J, MacRae K. Whole-body vibration effects on bone mineral density in women with or without resistance training. Aviat Space Environ Med. 2009;80(12):1025–1031
   Google Scholar
• . von Stengel S, Kemmler W, Engelke K, Kalender WA. Effects of whole body vibration on bone mineral density and falls: results of the randomized controlled ELVIS study with postmenopausal women [published online ahead of print March 20, 2010]. Osteoporos Int
   Google Scholar
• . Russo CR, Lauretani F, Bandinelli S, . High-frequency vibration training increases muscle power in postmenopausal women. Arch Phys Med Rehabil. 2003;84(12):1854–1857
   PubMed Web of Science ®Google Scholar
• . Verschueren SM, Bogaerts A, Delecluse C, . The effects of whole body vibration training and vitamin D supplementation on muscle strength, muscle mass and bone density in institutionalised elderly women—a 6-month randomised controlled trial [published online ahead of print July 20, 2010]. J Bone Miner Res
   Google Scholar
• . Rubin C, Recker R, Cullen D, Ryaby J, McCabe J, McLeod K. Prevention of postmenopausal bone loss by a low-magnitude, high frequency mechanical stimuli: a clinical trial assessing compliance efficacy, and safety. J Bone Miner Res. 2004;19(3):343–351
   PubMed Web of Science ®Google Scholar
• . Burr DB, Robling AG, Turner CH. Effects of biomechanical stress on bones in animals. Bone. 2002;30(5):781–786
   PubMed Web of Science ®Google Scholar
• . Hassler CG, Rybicki EF, Cummings KD, Clark LC. Quantification of bone stresses during remodeling. J Biomechanics. 1980;13(2):185–190
   PubMedGoogle Scholar
• . Meade JB, Cowins SC, Klawitter JJ, Van Buskirk WC, Skinner HB. Bone remodeling due to continuously applied loads. Calcif Tissue Int. 1984;36( suppl):S25–S30
   Web of Science ®Google Scholar
• . Robling AG, Duijvelaar KM, Geevers JV, Ohashi N, Turner CH. Modulation of appositional and longitudinal bone growth in the rat ulna by applied static and dynamic force. Bone. 2001;29(2):105–113
   Google Scholar
• . Umemura Y, Ishiko T, Yamauchi T, Kurono M, Mashiko S. Five jumps per day increase bone mass and breaking force in rats. J Bone Miner Res. 1997;12(9):1480–1485
   PubMed Web of Science ®Google Scholar
• . Turner CH, Robling AG. Exercise as an anabolic stimulus for bone. Curr Pharm Des. 2004;10(21):2629–2641
   Google Scholar
• . LaMothe JM, Zernicke RF. Rest insertion combined with high-frequency loading enhances osteogenesis. J Appl Physiol. 2004;96(5):1788–1793
   PubMed Web of Science ®Google Scholar
• . Robling AG, Burr DB, Turner CH. Recovery periods restore mechanosensitivity to dynamically loaded bone. J Exp Biol. 2001;204:3389–3399
   PubMed Web of Science ®Google Scholar
• . Srinivasan S, Gross TS. Intermittend rest enhances osteoblastic activation induced by mechanical loading. Trans Orthop Res Soc. 2000;25(4):628
   Google Scholar
• . Srinivasan S, Weimer DA, Agans SC, Bain SD, Gross TS. Low-magnitude mechanical loading becomes osteogenic when rest is inserted between each load cycle. J Bone Miner Res. 2002;17(9):1613–1620
   PubMed Web of Science ®Google Scholar
• . Umemura Y, Sogo N, Honda A. Effects of intervals between jumps or bouts on osteogenic response to loading. J Appl Physiol. 2002;93(4):1345–1348
   Google Scholar
• . Robling AG, Burr DB, Turner CH. Partitioning a daily mechanical stimulus into discrete loading bouts improves the osteogenic response to loading. J Bone Miner Res. 2000;15(8):1596–1602
   PubMed Web of Science ®Google Scholar
• . Robling AG, Hinant FM, Burr DB, Turner CH. Shorter, more frequent mechanical loading sessions enhance bone mass. Med Sci Sports Exerc. 2002;34(2):196–202
   PubMed Web of Science ®Google Scholar
• . Nelson DA, Bouxsein ML. Exercise maintains bone mass, but do people maintain exercise? J Bone Miner Res. 2001;16(2):202–205
   Google Scholar
• . Saxon LK, Robling AG, Alam IM, Turner CH. Mechanosensitivity of the rat skeleton decreases after a long period of loading, but is improved with time off. Bone. 2005;36(3):454–464
   Google Scholar
• . Bailey CA, Brooke-Wavell K. Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention. Bone. 2010;46(4):1043–1049
   PubMed Web of Science ®Google Scholar
• . Hagihara Y, Fukuda S, Goto S, Iida H, Yamazaki M, Moriya H. How many days per week should rats undergo running exercise to increase BMD? Osteoporos Int. 2005;23(4):289–294
   Google Scholar
• . Raab-Cullen DM, Akhter MP, Kimmel DB, Recker RR. Bone response to alternate-day mechanical loading of the rat tibia. J Bone Miner Res. 1994;9(2):203–211
   Google Scholar
• . Kemmler W, Riedel H. Körperliche Belastung und Osteoporose - Einfluß einer 10 monatigen Interventionsmaßnahme auf ossäre und extraossäre Risikofaktoren einer Osteoporose. Dtsch Z SportMed. 1998;49(9):270–277
   Google Scholar
• . Cussler EC, Going SB, Houtkooper LB, . Exercise frequency and calcium intake predict 4-year bone changes in postmenopausal women. Osteoporos Int. 2005;16:2129–2141
   PubMed Web of Science ®Google Scholar
• . Kemmler W, Engelke K, Lauber D, Weineck J, Hensen J, Kalender WA. Exercise effects on fitness and BMD in early postmenopausal women: 1 year EFOPS results. Med Sci Sports Exerc. 2002;34(12):2115–2123
   PubMedGoogle Scholar
• . Bebenek M, Kemmler W, von Stengel S, Engelke K, Kalender WA. Effect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) study. Menopause. 2010;17(4):791–800
   PubMed Web of Science ®Google Scholar
• . Tesch-Römer C. Zukunftsfähige Altersvorsorge—deutsche und internationale Perspektiven. Presented at Lebenslagen älterer Menschen in Deutschland: Berlin, Germany; 2004
   Google Scholar
• . McLeod KJ, Rubin CT. Sensitivity of the bone remodeling response to the frequency of applied strain. Trans Orthop Res Soc. 1992;17:533
   Google Scholar
• . Qin YX, Rubin CT, McLeod KJ. Nonlinear dependance of loading intensity and cycle number in the maintenance of bone mass and morphology. J Orthop Res. 1998;16(4):482–489
   PubMed Web of Science ®Google Scholar