Longitudinal evaluation of supervised versus unsupervised exercise programs for the treatment of osteoporosis

The efficacy of an exercise program was investigated in a study of 89 post-menopausal women with osteoporosis over a 5-year follow-up period. The study attempted to examine and compare potential differences in bone mineral density (BMD), incidence of fracture, and loss of height, between a group of patients (n = 42) who attended the supervised exercise program in the hospital, and a group (n = 47) who exercised at home. Habitual physical activity, as estimated using the Harvard Alumni Questionnaire, and a Physical Activity Index were combined to obtain an estimate of overall weekly caloric expenditure over the 5-year period. The exercise program involved weight-bearing aerobic activities of moderate intensity, and muscle strengthening exercise using free weights. The mean percentage change for the lumbar BMD was + 4.4% in the hospital group and +3.4% in the home group while for the femoral neck BMD was + 1.1% in the hospital group and -0.9% in the home group. There was a significant reduction in the number of fractures and no significant loss of height over the 5-year follow-up period for both groups. As the correlation between BMD and weekly caloric expenditure of the subjects was not significant, no conclusion can be drawn as to the minimum level of caloric expenditure necessary in order to retard bone loss. It was concluded that for the post-menopausal women with osteoporosis who participated in the program it was possible to stabilize their height and the BMD of the lumbar site, and to reduce fractures over the 5-year study period regardless if they exercised in a supervised or in an unsupervised setting.