Is there a synergy between physical exercise and drug therapies for osteoporosis?

Combining physical exercise with drug therapies for osteoporosis has been attempted with the aim to maximize osteogenic stimulus. Potential synergetic effects may prevent post-menopausal bone loss, or maximise gains during peak bone mass acquisition. However, research studies yielded mixed results, impeding the emergence of a consensus on the effects of exercise and drug therapies for osteoporosis on bone tissue. Independent, additive or synergetic effects of exercise and drug therapies have been reported, but while animal studies offer promising results, human studies are less clear. The aim of this work was to critically review existing data on the subject in an attempt to clarify existing knowledge and to encourage further investigations with a 2 x 2 factorial design, as elucidation of these questions will benefit osteoporosis prevention.