What is the effect of Osteoporosis in Australia?
The increase in health care costs and rising pressure on the healthcare system associated with an aging population is of great concern , with chronic diseases being responsible for the greatest healthcare costs in the older population. Osteoporosis currently affects 1.2 million Australians , while a further 6.3 million Australians have osteopenia . In fact, approximately one in four women aged over 50 and one in two women aged over 80 are osteoporotic .
A recent Burden of Disease analysis concluded that the total costs of osteoporotic fractures over the next 10 years in Australia alone will be $33.6 billion . In fact, in 2013, there were nearly 400 osteoporotic fractures per day in Australia; a figure that is projected to increase to 500 per day by 2022 .
Osteoporosis – It’s got to be the right type of Exercise!
Physical activity participation is important for maintaining a healthy musculoskeletal system and is associated with benefits to physical performance [4-6], body composition , and psychosocial factors [8, 9]. With increasing age, a decrease in physical activity participation is associated with poorer health . However, the skeletal response to exercise is highly dependent on the nature of the activity. Animal research has established that the most osteogenic loads are those that are dynamic and not static , induce high magnitude bone strains , at high loading rates .
New research gives new direction
Exercise and Sports Science Australia (ESSA) released a position statement on exercise prescription for the prevention and management of osteoporosis in 2016. This position statement concluded that
“For the high-risk individual with established osteoporosis and increased risk of fracture, falls prevention programs with a focus on balance and mobility training and high intensity progressive resistance training are essential” .
Furthermore, the position statement suggested that
“High load progressive resistance training and moderate impact loading may not only improve bone mass and reduce kyphosis, but be safe and well-tolerated in older adults with low bone mass” .
“Ongoing supervision is required for individuals at high risk of low trauma fracture and those unaccustomed to high intensity exercise” .
This is imperative. The “Onero” bone building classes we offer at Burleigh Heads Physiotherapy Centre were developed by Lisa Weiss and Belinda Beck (Directors of The Bone Clinic) and researched at Griffith University (15). We are the only premises licenced to deliver this program on the central and southern Gold Coast.
At Burleigh Physio, we assess everyone first as to their suitability for the classes. We do a Musculo-skeletal pre-screening with the physiotherapist, an assessment with our dietician to discuss their contributing dietary factors and then we do a baseline physical assessment (height, balance tests etc) with our exercise physiologist. Once the assessment is completed, taking approximately 2 hours in total, we take the client through the actual exercises and their education in the correct technique will begin. They may need a few sessions of this so that they lift safely.
We may refer for an EOS scan and/or send them to their GP for a DXA scan referral.
The classes are small limited to 4 participants to ensure close supervision and technique correction, as necessary, from our team of exercise scientists, exercise physiologists and physiotherapists to reduce the risk of injury. Participants are continually assessed to progress their load as appropriate.
A minimum of two 30-minute sessions per week are necessary over at least a twelve-month period to demonstrate bone gains on DXA (15).
At the 12 month anniversary of commencement of Onero program, the client will have a complimentary review of their baseline tests with the Exercise Physiologist to measure their progress. Ideally, they would have another DXA scan at this time also.
Are you interested in our ONERO program or do you know someone who could benefit? Contact us or call 5535 5218 for further information.
- Australian Bureau of Statistics, Population projections, Australia, 2004–2101. 2006, Australian Bureau of Statistics: Commonwealth of Australia: Canberra.
- Henry, M.J., et al., Prevalence of osteoporosis in Australian men and women: Geelong Osteoporosis Study. Med J Aust, 2011. 195(6): p. 321-2.
- Watts, J.J., J. Abimanyi-Ochom, and K.M. Sanders, Osteoporosis costing all Australians A new burden of disease analysis – 2012 to 2022. 2013, Osteoporosis Australia: Sydney.
- Vaapio, S., et al., Increased muscle strength improves managing in activities of daily living in fall-prone community-dwelling older women. Aging Clin Exp Res, 2011. 23(1): p. 42-48.
- Taguchi, N., et al., Effects of a 12-month multicomponent exercise program on physical performance, daily physical activity, and quality of life in very elderly people with minor disabilities: an intervention study. J Epidemiol, 2010. 20(1): p. 21-9.
- Lord, S.R., et al., 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): p. 1198-206.
- Brach, J.S., et al., The association between physical function and lifestyle activity and exercise in the health, aging and body composition study. J Am Geriatr Soc, 2004. 52(4): p. 502-9.
- Netz, Y., et al., Physical activity and psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging, 2005. 20(2): p. 272-84.
- Middleton, L.E., et al., Physical activity over the life course and its association with cognitive performance and impairment in old age. J Am Geriatr Soc, 2010. 58(7): p. 1322-6.
- Nied, R.J. and B. Franklin, Promoting and prescribing exercise for the elderly. Am Fam Physician, 2002. 65(3): p. 419-26.
- Lanyon LE, Rubin CT. Static vs dynamic loads as an influence on bone remodelling. J Biomech 1984; 17(12):897–905.
- O’Connor JA, Lanyon LE, MacFie H. The influence of strain rate on adaptive bone remodelling. J Biomech 1982; 15(10):767–781.
- Rubin CT, Lanyon LE. Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 1985; 37(4):411–417
- Beck BR, Daly RM, Singh MR, Taaffe DR. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport 2016; Oct 31. doi: 10.1016/j.jsams.2016.10.001
- Watson SL, Weeks BK, Weis LJ, Horan SA, Beck BR. Heavy resistance training is safe and improves bone, function and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporos Int (2015)26:2889-2894. Doi:10.1007/s00198-015-3263-2
Gold Coast Physiotherapy and Allied Health at Burleigh Heads and Broadbeach