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Adverse events and safety issues associated with physical activity and exercise for adults with osteoporosis and osteopaenia: A systematic review of observational studies and an updated review of interventional studies

Research output: Contribution to journalArticle (Academic Journal)

Original languageEnglish
Pages (from-to)155-178
Number of pages24
JournalJournal of Frailty, Sarcopenia and Falls
Issue number4
Early online date3 Dec 2018
DateAccepted/In press - 16 Nov 2018
DateE-pub ahead of print - 3 Dec 2018
DatePublished (current) - Dec 2018


Objectives: We conducted a systematic review to identify adverse effects of physical activity and/or exercise for adults with osteoporosis/osteopenia. We synthesised evidence from observational studies, and updated three previously published systematic reviews. Methods: We searched MEDLINE, EMBASE, CINAHL, Web of Science, grey literature and reference lists of relevant studies. Selection criteria were: (1) observational studies in patients with osteoporosis/osteopenia; and (2) in accordance with the criteria used in the previous reviews. A narrative synthesis was conducted for the observational data. Random effects meta-analysis was undertaken for the review updates. Results: For the observational synthesis 14 studies were included. The majority of studies reported no adverse events, reduced incidence/improvement, or no significant change after physical activity or exercise. Activities that involved spinal flexion (certain yoga moves and sit-ups) were associated with a greater risk of vertebral fractures but these events were rare. For the update of reviews, 57 additional studies were identified. Exercise was generally associated with a greater number of minor adverse events including mild muscle/joint pain. Serious adverse events were rare and could not be attributed to the intervention. Conclusion: Patients with osteoporosis/osteopenia can safely participate in structured exercise programmes, whether at home or in supervised facilities. Systematic review registration for observational studies: PROSPERO 2017: CRD42017070551

    Research areas

  • Osteoporosis, Physical activit, Exercise, Adverse events, Systematic review

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