Effects of Exercise and Physical Interventions on Bone: Clinical Studies - Skeletal Aging and Osteoporosis: Biomechanics and Mechanobiology - page 248

intervention reduces the incidence of fracture, but larger RCTs will be necessary to
confirm the anti-fracture efficacy of exercise.
Recommendations for the type of exercise likely to preserve bone health [ 48 ]
have evolved from preclinical investigations of the key factors that influence the
bone formation response to mechanical loading. Further optimization of the
exercise prescription for bone health will likely require mechanistically-driven
clinical studies that are guided by preclinical research. The translation of pre-
clinical findings to clinical investigation can be accelerated if preclinical studies
are focused not only on mechanistic underpinnings, but also on the potential
clinical implications of the findings.
In general, the public health message that exercise is beneficial for both the
prevention and treatment of osteoporosis has a firm foundation of supporting
evidence. However, it must also be recognized that, under certain conditions,
exercise may have unfavorable effects on bone metabolism. Therefore, it is
important that future clinical research efforts be focused not only on identifying
factors that optimize the skeletal adaptations to exercise, but also on factors that
may compromise the adaptive response.

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