Exercise for optimising peak bone mass in women

Physical activity is one of the major non-pharmacological methods for increasing and maintaining bone mineral density (BMD) and geometry. As such, it has an important role in maintaining peak bone mass and strength, thus reducing the risk of future osteoporotic fracture. However, not all exercise is effective, so a prescription in terms of optimal type, intensity, frequency and duration is required. Studies using animal models suggest that loading that is high in magnitude, rapidly applied and novel is most effective, whilst duration is less important beyond a threshold number of cycles. In human subjects cross-sectional studies comparing different athletic populations suggest that those who participate in high- or odd-impact sports have higher BMD; whilst impact exercise, strength training and brief high-impact-jump training interventions increase BMD in premenopausal women. In order to further elucidate exercise recommendations to optimise bone health in this population, the usefulness of brief high-impact unilateral exercises has been evaluated. Brief hopping exercises were shown to be feasible for sedentary premenopausal women, producing ground-reaction forces as high as those from jumping. Regularly performing these hopping exercises over 6 months was found to increase femoral-neck BMD of the trained leg relative to the control leg. Unilateral high-impact exercise may therefore improve bone strength of the trained limb and provide a useful model for comparing exercise prescriptions to help define the most efficient and effective exercise recommendations for the bone health of premenopausal women.