Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)
Summary This trial is the first exercise study that focuses on fracture incidence as a primary study endpoint. Although we marginally failed to determine significant effects on “overall” fracture risk ( p = .074) or rate ratio ( p = .095), our findings further increased the evidence that exercise...
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| Veröffentlicht in: | Osteoporosis international 2012-04, Vol.23 (4), p.1267-1276 |
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| creator | Kemmler, W. von Stengel, S. Bebenek, M. Engelke, K. Hentschke, C. Kalender, W. A. |
| description | Summary
This trial is the first exercise study that focuses on fracture incidence as a primary study endpoint. Although we marginally failed to determine significant effects on “overall” fracture risk (
p
= .074) or rate ratio (
p
= .095), our findings further increased the evidence that exercise relevantly prevents fractures in the elderly.
Introduction
The purpose of this study is to determine the effect of strictly supervised long-term exercise training on “overall” fracture incidence and bone mineral density (BMD) in postmenopausal osteopenic women.
Methods
Eighty-five early postmenopausal (1–8 years), osteopenic women living in the area of Erlangen–Nuremberg, Germany without any medication or diseases affecting bone metabolism were assessed after 12 years of supervised exercise (EG) or unvarying lifestyle (control, CG).
Exercisers were encouraged to perform two group sessions/week and two home training sessions/week. Calcium and vitamin D supplementation was provided for both groups. “Overall” fractures were determined by questionnaires and structured interviews. The BMD was assessed at lumbar spine and proximal femur by dual-energy X-ray absorptiometry.
Results
“Overall” fracture risk ratio in the EG was 0.32 (95% confidence interval (CI), 0.08 to 1.05;
p
= .074), and the rate ratio for “overall” fractures was 0.38 (95% CI, 0.11 to 1.15;
p
= .095). BMD changes at lumbar spine (EG, −0.8%; 95% CI, 0.8% to −2.7% vs. CG, −4.0%; 95% CI, −2.4% to −5.7%;
p
= .011) and femoral neck (EG, −3.7%; 95% CI, −2.4% to −5.0% vs. CG, −6.7%; 95% CI, −5.3% to −8.2%;
p
= .003) significantly differed between both groups.
Conclusion
Although we marginally failed to determine significant effects on overall fracture risk or rate ratio, our study increased the body of evidence for the fracture prevention efficiency of exercise programs, with special regard on bone strength (as assessed by bone mineral density measurement). Future studies should focus on subjects more prone to fractures to generate enough statistical power to clearly determine this issue. |
| doi_str_mv | 10.1007/s00198-011-1663-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_968184431</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2609877631</sourcerecordid><originalsourceid>FETCH-LOGICAL-c402t-a61028b85c900a5b3ec0a87a9795e3f57d73e78ccf4e60bb91c78e94768f293c3</originalsourceid><addsrcrecordid>eNqFkUGL1DAYhoO4uOPoD_AiwYt6qOZL2ibxJsuMu7AwC6vgraSZr9ql09R8qTpH_7kZZ1dBEE8h5HnfJN_D2BMQr0AI_ZqEAGsKAVBAXauiuscWUCpVSFtX99lCWKULW8LHU_aQ6EbkjLX6ATuVUMvKGFiwH6vvGH1PyN245V10Ps0RifcjnwKlHY5hcjO5gX8LefOGgyz26CLP0Dwk4qHj6TPyVRzc-AlHvu7TiES_6jaUMEwhBuqJX0X8imPqw8iv07zd8xer9ebq-uUjdtK5gfDx7bpkH9ar92fnxeXm3cXZ28vCl0KmwtUgpGlN5a0QrmoVeuGMdlbbClVX6a1WqI33XYm1aFsLXhu0pa5NJ63yasmeH3unGL7MSKnZ9eRxyO_GMFNjawOmLBX8n5TGApSgM_nsL_ImzHHM3zhAArTMCpYMjpDPg6CIXTPFfufivgHRHDw2R49N9tgcPDZVzjy9LZ7bHW5_J-7EZUAeAcpHefDxz83_bv0JJ-SoQQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>928017209</pqid></control><display><type>article</type><title>Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kemmler, W. ; von Stengel, S. ; Bebenek, M. ; Engelke, K. ; Hentschke, C. ; Kalender, W. A.</creator><creatorcontrib>Kemmler, W. ; von Stengel, S. ; Bebenek, M. ; Engelke, K. ; Hentschke, C. ; Kalender, W. A.</creatorcontrib><description>Summary
This trial is the first exercise study that focuses on fracture incidence as a primary study endpoint. Although we marginally failed to determine significant effects on “overall” fracture risk (
p
= .074) or rate ratio (
p
= .095), our findings further increased the evidence that exercise relevantly prevents fractures in the elderly.
Introduction
The purpose of this study is to determine the effect of strictly supervised long-term exercise training on “overall” fracture incidence and bone mineral density (BMD) in postmenopausal osteopenic women.
Methods
Eighty-five early postmenopausal (1–8 years), osteopenic women living in the area of Erlangen–Nuremberg, Germany without any medication or diseases affecting bone metabolism were assessed after 12 years of supervised exercise (EG) or unvarying lifestyle (control, CG).
Exercisers were encouraged to perform two group sessions/week and two home training sessions/week. Calcium and vitamin D supplementation was provided for both groups. “Overall” fractures were determined by questionnaires and structured interviews. The BMD was assessed at lumbar spine and proximal femur by dual-energy X-ray absorptiometry.
Results
“Overall” fracture risk ratio in the EG was 0.32 (95% confidence interval (CI), 0.08 to 1.05;
p
= .074), and the rate ratio for “overall” fractures was 0.38 (95% CI, 0.11 to 1.15;
p
= .095). BMD changes at lumbar spine (EG, −0.8%; 95% CI, 0.8% to −2.7% vs. CG, −4.0%; 95% CI, −2.4% to −5.7%;
p
= .011) and femoral neck (EG, −3.7%; 95% CI, −2.4% to −5.0% vs. CG, −6.7%; 95% CI, −5.3% to −8.2%;
p
= .003) significantly differed between both groups.
Conclusion
Although we marginally failed to determine significant effects on overall fracture risk or rate ratio, our study increased the body of evidence for the fracture prevention efficiency of exercise programs, with special regard on bone strength (as assessed by bone mineral density measurement). Future studies should focus on subjects more prone to fractures to generate enough statistical power to clearly determine this issue.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-011-1663-5</identifier><identifier>PMID: 21625881</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Absorptiometry, Photon - methods ; Bone density ; Bone Density - physiology ; Bone Diseases, Metabolic - physiopathology ; Bone Diseases, Metabolic - rehabilitation ; Endocrinology ; Exercise ; Exercise Therapy - methods ; Female ; Femur Neck - physiopathology ; Follow-Up Studies ; Fractures ; Humans ; Lumbar Vertebrae - physiopathology ; Medicine ; Medicine & Public Health ; Menopause ; Middle Aged ; Original Article ; Orthopedics ; Osteoporosis, Postmenopausal - physiopathology ; Osteoporosis, Postmenopausal - prevention & control ; Osteoporotic Fractures - physiopathology ; Osteoporotic Fractures - prevention & control ; Physical Fitness - physiology ; Preventive medicine ; Rheumatology</subject><ispartof>Osteoporosis international, 2012-04, Vol.23 (4), p.1267-1276</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2011</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-a61028b85c900a5b3ec0a87a9795e3f57d73e78ccf4e60bb91c78e94768f293c3</citedby><cites>FETCH-LOGICAL-c402t-a61028b85c900a5b3ec0a87a9795e3f57d73e78ccf4e60bb91c78e94768f293c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-011-1663-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-011-1663-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21625881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kemmler, W.</creatorcontrib><creatorcontrib>von Stengel, S.</creatorcontrib><creatorcontrib>Bebenek, M.</creatorcontrib><creatorcontrib>Engelke, K.</creatorcontrib><creatorcontrib>Hentschke, C.</creatorcontrib><creatorcontrib>Kalender, W. A.</creatorcontrib><title>Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
This trial is the first exercise study that focuses on fracture incidence as a primary study endpoint. Although we marginally failed to determine significant effects on “overall” fracture risk (
p
= .074) or rate ratio (
p
= .095), our findings further increased the evidence that exercise relevantly prevents fractures in the elderly.
Introduction
The purpose of this study is to determine the effect of strictly supervised long-term exercise training on “overall” fracture incidence and bone mineral density (BMD) in postmenopausal osteopenic women.
Methods
Eighty-five early postmenopausal (1–8 years), osteopenic women living in the area of Erlangen–Nuremberg, Germany without any medication or diseases affecting bone metabolism were assessed after 12 years of supervised exercise (EG) or unvarying lifestyle (control, CG).
Exercisers were encouraged to perform two group sessions/week and two home training sessions/week. Calcium and vitamin D supplementation was provided for both groups. “Overall” fractures were determined by questionnaires and structured interviews. The BMD was assessed at lumbar spine and proximal femur by dual-energy X-ray absorptiometry.
Results
“Overall” fracture risk ratio in the EG was 0.32 (95% confidence interval (CI), 0.08 to 1.05;
p
= .074), and the rate ratio for “overall” fractures was 0.38 (95% CI, 0.11 to 1.15;
p
= .095). BMD changes at lumbar spine (EG, −0.8%; 95% CI, 0.8% to −2.7% vs. CG, −4.0%; 95% CI, −2.4% to −5.7%;
p
= .011) and femoral neck (EG, −3.7%; 95% CI, −2.4% to −5.0% vs. CG, −6.7%; 95% CI, −5.3% to −8.2%;
p
= .003) significantly differed between both groups.
Conclusion
Although we marginally failed to determine significant effects on overall fracture risk or rate ratio, our study increased the body of evidence for the fracture prevention efficiency of exercise programs, with special regard on bone strength (as assessed by bone mineral density measurement). Future studies should focus on subjects more prone to fractures to generate enough statistical power to clearly determine this issue.</description><subject>Absorptiometry, Photon - methods</subject><subject>Bone density</subject><subject>Bone Density - physiology</subject><subject>Bone Diseases, Metabolic - physiopathology</subject><subject>Bone Diseases, Metabolic - rehabilitation</subject><subject>Endocrinology</subject><subject>Exercise</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Femur Neck - physiopathology</subject><subject>Follow-Up Studies</subject><subject>Fractures</subject><subject>Humans</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Menopause</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis, Postmenopausal - physiopathology</subject><subject>Osteoporosis, Postmenopausal - prevention & control</subject><subject>Osteoporotic Fractures - physiopathology</subject><subject>Osteoporotic Fractures - prevention & control</subject><subject>Physical Fitness - physiology</subject><subject>Preventive medicine</subject><subject>Rheumatology</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUGL1DAYhoO4uOPoD_AiwYt6qOZL2ibxJsuMu7AwC6vgraSZr9ql09R8qTpH_7kZZ1dBEE8h5HnfJN_D2BMQr0AI_ZqEAGsKAVBAXauiuscWUCpVSFtX99lCWKULW8LHU_aQ6EbkjLX6ATuVUMvKGFiwH6vvGH1PyN245V10Ps0RifcjnwKlHY5hcjO5gX8LefOGgyz26CLP0Dwk4qHj6TPyVRzc-AlHvu7TiES_6jaUMEwhBuqJX0X8imPqw8iv07zd8xer9ebq-uUjdtK5gfDx7bpkH9ar92fnxeXm3cXZ28vCl0KmwtUgpGlN5a0QrmoVeuGMdlbbClVX6a1WqI33XYm1aFsLXhu0pa5NJ63yasmeH3unGL7MSKnZ9eRxyO_GMFNjawOmLBX8n5TGApSgM_nsL_ImzHHM3zhAArTMCpYMjpDPg6CIXTPFfufivgHRHDw2R49N9tgcPDZVzjy9LZ7bHW5_J-7EZUAeAcpHefDxz83_bv0JJ-SoQQ</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Kemmler, W.</creator><creator>von Stengel, S.</creator><creator>Bebenek, M.</creator><creator>Engelke, K.</creator><creator>Hentschke, C.</creator><creator>Kalender, W. A.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120401</creationdate><title>Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)</title><author>Kemmler, W. ; von Stengel, S. ; Bebenek, M. ; Engelke, K. ; Hentschke, C. ; Kalender, W. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-a61028b85c900a5b3ec0a87a9795e3f57d73e78ccf4e60bb91c78e94768f293c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Absorptiometry, Photon - methods</topic><topic>Bone density</topic><topic>Bone Density - physiology</topic><topic>Bone Diseases, Metabolic - physiopathology</topic><topic>Bone Diseases, Metabolic - rehabilitation</topic><topic>Endocrinology</topic><topic>Exercise</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Femur Neck - physiopathology</topic><topic>Follow-Up Studies</topic><topic>Fractures</topic><topic>Humans</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis, Postmenopausal - physiopathology</topic><topic>Osteoporosis, Postmenopausal - prevention & control</topic><topic>Osteoporotic Fractures - physiopathology</topic><topic>Osteoporotic Fractures - prevention & control</topic><topic>Physical Fitness - physiology</topic><topic>Preventive medicine</topic><topic>Rheumatology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kemmler, W.</creatorcontrib><creatorcontrib>von Stengel, S.</creatorcontrib><creatorcontrib>Bebenek, M.</creatorcontrib><creatorcontrib>Engelke, K.</creatorcontrib><creatorcontrib>Hentschke, C.</creatorcontrib><creatorcontrib>Kalender, W. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kemmler, W.</au><au>von Stengel, S.</au><au>Bebenek, M.</au><au>Engelke, K.</au><au>Hentschke, C.</au><au>Kalender, W. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS)</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>23</volume><issue>4</issue><spage>1267</spage><epage>1276</epage><pages>1267-1276</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
This trial is the first exercise study that focuses on fracture incidence as a primary study endpoint. Although we marginally failed to determine significant effects on “overall” fracture risk (
p
= .074) or rate ratio (
p
= .095), our findings further increased the evidence that exercise relevantly prevents fractures in the elderly.
Introduction
The purpose of this study is to determine the effect of strictly supervised long-term exercise training on “overall” fracture incidence and bone mineral density (BMD) in postmenopausal osteopenic women.
Methods
Eighty-five early postmenopausal (1–8 years), osteopenic women living in the area of Erlangen–Nuremberg, Germany without any medication or diseases affecting bone metabolism were assessed after 12 years of supervised exercise (EG) or unvarying lifestyle (control, CG).
Exercisers were encouraged to perform two group sessions/week and two home training sessions/week. Calcium and vitamin D supplementation was provided for both groups. “Overall” fractures were determined by questionnaires and structured interviews. The BMD was assessed at lumbar spine and proximal femur by dual-energy X-ray absorptiometry.
Results
“Overall” fracture risk ratio in the EG was 0.32 (95% confidence interval (CI), 0.08 to 1.05;
p
= .074), and the rate ratio for “overall” fractures was 0.38 (95% CI, 0.11 to 1.15;
p
= .095). BMD changes at lumbar spine (EG, −0.8%; 95% CI, 0.8% to −2.7% vs. CG, −4.0%; 95% CI, −2.4% to −5.7%;
p
= .011) and femoral neck (EG, −3.7%; 95% CI, −2.4% to −5.0% vs. CG, −6.7%; 95% CI, −5.3% to −8.2%;
p
= .003) significantly differed between both groups.
Conclusion
Although we marginally failed to determine significant effects on overall fracture risk or rate ratio, our study increased the body of evidence for the fracture prevention efficiency of exercise programs, with special regard on bone strength (as assessed by bone mineral density measurement). Future studies should focus on subjects more prone to fractures to generate enough statistical power to clearly determine this issue.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>21625881</pmid><doi>10.1007/s00198-011-1663-5</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0937-941X |
| ispartof | Osteoporosis international, 2012-04, Vol.23 (4), p.1267-1276 |
| issn | 0937-941X 1433-2965 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_968184431 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Absorptiometry, Photon - methods Bone density Bone Density - physiology Bone Diseases, Metabolic - physiopathology Bone Diseases, Metabolic - rehabilitation Endocrinology Exercise Exercise Therapy - methods Female Femur Neck - physiopathology Follow-Up Studies Fractures Humans Lumbar Vertebrae - physiopathology Medicine Medicine & Public Health Menopause Middle Aged Original Article Orthopedics Osteoporosis, Postmenopausal - physiopathology Osteoporosis, Postmenopausal - prevention & control Osteoporotic Fractures - physiopathology Osteoporotic Fractures - prevention & control Physical Fitness - physiology Preventive medicine Rheumatology |
| title | Exercise and fractures in postmenopausal women: 12-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS) |
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