Exercise to Prevent and Manage Frailty and Fragility Fractures

Curr Osteoporos Rep. 2023 Apr;21(2):205-215. doi: 10.1007/s11914-023-00777-8. Epub 2023 Mar 28.

Abstract

Purpose of review: This review identifies exercise-based recommendations to prevent and manage frailty and fragility fractures from current clinical practice guidelines. We also critically assess recently published literature in relation to exercise interventions to mitigate frailty and fragility fractures.

Recent findings: Most guidelines presented similar recommendations that included the prescription of individually tailored, multicomponent exercise programs, discouragement of prolonged sitting and inactivity, and combining exercise with optimal nutrition. To target frailty, guidelines recommend supervised progressive resistance training (PRT). For osteoporosis and fragility fractures, exercise should include weight-bearing impact activities and PRT to target bone mineral density (BMD) at the hip and spine, and also incorporate balance and mobility training, posture exercises, and functional exercise relevant to activities of daily living to reduce falls risk. Walking as a singular intervention has limited benefits for frailty and fragility fracture prevention and management. Current evidence-based clinical practice guidelines for frailty, osteoporosis, and fracture prevention recommend a multifaceted and targeted approach to optimise muscle mass, strength, power, and functional mobility as well as BMD.

Keywords: Exercise training; Fracture prevention; Osteoporosis, Frailty.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control
  • Activities of Daily Living
  • Bone Density / physiology
  • Exercise Therapy
  • Fractures, Bone* / prevention & control
  • Frailty* / prevention & control
  • Humans
  • Osteoporosis* / prevention & control