Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 5, May, p. 633–642

doi: 10.17219/acem/68381

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Effect of physical activity on the sequelae of osteoporosis in female residents of residential care facilities

Agnieszka J. Nawrat-Szołtysik1,2,A,B,C,D,F, Anna Polak3,B,C, Andrzej Małecki4,C,E, Laura Piejko5,B, Dominika Grzybowska-Ganszczyk5,B, Michał Kręcichwost6,B,C, Józef Opara4,A,E,F

1 Department of Health Promotion and Methodology of Research, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland

2 St. Elizabeth Center, Ruda Śląska, Poland

3 Department of Basic Physical Therapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland

4 Department of Nervous System and Musculoskeletal System, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland

5 The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland

6 Department of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland


Background. Osteoporosis is one of the most common diseases that develop with age and cause high morbidity and mortality among elderly people.
Objectives. This study was set out to evaluate the influence of a program of modified Sinaki exercises, Nordic walking (NW) and a combination of these physical activities on people with osteoporosis.
Material and Methods. A sample consisting of 91 women aged 65–98 years living in residential care facilities was randomized into 4 groups. The control group (group 1) received only pharmacological treatment. In the other 3 groups, the same drug therapy was enhanced by a program of modified Sinaki exercises (group 2), Nordic walking (group 3), and Sinaki exercises and Nordic walking applied together (group 4). At baseline and after 12 months of intervention, the participants were assessed for bone density, rib cage mobility, motor abilities, risk of falling (Timed Up and Go Test – TUG, Functional Reach Test – FRT), and locomotor activity (based on pedometer readings). The intervention was completed by 83 participants.
Results. Bone density (T-score) was higher in all intervention groups and in the control group (p < 0.003). The improvement in rib cage mobility was statistically significant in groups 2 (p < 0.001) and 4 (p < 0.002). Locomotor activity significantly improved in groups 3 (p < 0.000) and 4 (p < 0.000). The post-intervention results of the TUG and FRT tests showed a significantly lower risk of falling in group 4. In groups 1 and 2, the risk was higher, but not statistically significantly, and in group 3, it did not change.
Conclusion. Modified Sinaki exercises and Nordic walking significantly improved the mobility of the rib cage, locomotor activity and motor abilities in the women comprising groups 2 and 3, but the best results of the intervention were noted in the group treated with both forms of physical activity.

Key words

physical activity, osteoporosis, Nordic walking, elderly people

References (39)

  1. Badurski J, Czerwiński E, Marcinowska-Suchowierska E. Osteoporoza – ocena ryzyka złamania. Status Quo Arte Anno 2007/2008: Przegląd stanowisk Światowej Organizacji Zdrowia (WHO), Europejskiej Agencji Medycznej (EMEA), Europejskiego Towarzystwa Klinicznych i Ekonomicznych Aspektów Osteoporozy (ESEAO), Międzynarodowej Fundacji Osteoporozy (IOF), Polskiej Fundacji Osteoporozy (PFO) i Polskiego Towarzystwa Osteoartrologii (PTOA). Post Nauk Med. 2008;21(6):335–359.
  2. Sran MM, Karim M, Khan KM. Physiotherapy and osteoporosis: Practice behaviors and clinicians’ perceptions – A survey. Manual Therapy.
  3. Yamazaki S, Ichimura S, Iwamoto J, et al. Effect of walking exercise on bone metabolizm in postmenopausal women with osteopenia/osteoporosis. J Bone Miner Metab. 2004;22:500–508.
  4. Hansen L. Nordic walking does not reduce the loading of knee joint. Skan J Med Sci Sports. 2008;18:436–441.
  5. Suija K. Physical activity of depressed patients and their motivation to exercise: Nordic walking in family practice. Int J Rehabil Res. 2009;32(2):132–138.
  6. Morgulec-Adamowicz N, Rutkowska I, Rekowski W, et al. Aktywność fizyczna osób starszych w Uniwersytecie Trzeciego Wieku w Polsce. Post Rehab. 2010;24(2):73–80.
  7. Bello M, Cirilo Cousa M, Neto G, et al. The effect of a long-term, community-based exercise program on bone mineral density in postmenopausal women with pre-diabetes and type 2 diabetes. J Human Kinetics. 2014;43:43–48.
  8. Sinaki M. Exercise and osteoporosis. Arch Phys Med Rehab. 1989,70(3): 220–229.
  9. Sinaki M, Khosia S, Limburg PJ. Muscle strength in osteoporotic versus normal women. Osteoporosis Int. 1993;3:8–12.
  10. Izquierdo M, Gonzalez-Badillo JJ, Häkkinen K, et al. Effect of loading on unintentional lifting velocity declines during singles sets of repetitions to failure during upper and lower extremity muscle actions. Int J Sports Med. 2006;27:718–724.
  11. Simkin E, Ayalon J. Osteoporoza, zapobieganie i zwalczanie ruchem. Warszawa: SIC; 1996.
  12. 1. Nawrat-Szołtysik A, Opara J, Kucio C. Własna modyfikacja ćwiczeń według Mehrsheed Sinaki w osteoporozie u osób starszych. Rehabil Prakt. 2011;5:27–32.
  13. Siggeirsdóttir K, Jónsson BY, Jónsson H Jr, Iwarsson S.The timed 'Up & Go' is dependent on chair type. Clin Rehabil. 2002;16(6):609–616.
  14. Żak M. Physical rehabilitation of geriatric patients with gait and functional disorders. Adv Rehabil. 2005;1:37–40.
  15. Tudor-Locke C. Taking steps toward increased physical activity: Using pedometers to measure and motivate. Res Digest. 2002;3(7):1–8.
  16. Wolff I, Croonenborg I, Temper HCG, et al. The effect of exercise training programs on bone mass: A meta-analysis of published controlled trials in pre-and postmenopausal women. Osteoporosis Int. 1999;9:1–2.
  17. Tan AM, Lamontage AD, Sarmugan R, et al. A cluster-randomised, controlled trial to assess the impact of a workplace osteoporosis prevention intervention on the dietary and physical activity behaviours of working women: Study protocol. BMC Public Health. 2013;29(1): 405–416.
  18. Bravo G, Gauthier P, Roy P, et al. Impact of 12-month exercise program on the physical and psychological health of osteoporosis women. J Am Geriatr Soc. 1996;44(7):756–762.
  19. Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ Jr. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med. 1998;108:824–828.
  20. Ishimi Y. Osteoporosis and lifestyle. J Nutr Sci Vitaminol (Tokyo). 2015; 61(S):139–141.
  21. Opara J. Nordic walking w zapobieganiu upadkom. In: Czerwiński E, ed. Osteoporoza. Problem interdyscyplinarny. Warszawa: PZWL; 2015:229–235.
  22. Weber-Rajek M, Mieszkowski J, Niespodziński B, Ciechanowska K. Whole-body vibration exercise in postmenopausal osteoporosis. Prz Menopauz. 2015;14:41–47.
  23. Hakestad KA, Torstveit MK, Nordsletten L, Risberg MA. Effect of exercises with weight vests and a patient education programme for women with osteopenia and a healed wrist fracture: A randomized, controlled trial of the OsteoACTIVE programme. BMC Musculoskelet Disord. 2015;16(1):352–360.
  24. Dawson-Hughes B, Jacques P, Shipp C. Bone density of the radius, spine and hip inrelation to percent ideal body weight in postmenopausal women. Calcif Tissue Int. 1987;40:310–314.
  25. Shangold MM. Exercise and menopause. Phys Sports Med. 1998;26(12): 45–59.
  26. Pindel B, Pluskiewicz W. Rola wysiłku fizycznego w zapobieganiu i leczeniu osteoporozy. Pol Tyg Lek. 1993;48(37/49):780–781.
  27. Bonaiuti D, Shea B, Lovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Sys Rev. 2002;3:333–339.
  28. Smidt GL. The effects of high-intensity trunk exercise on bone mineral density of postmenopausal women. Spine. 1992;17(3):
  29. Cukras Z, Jegier A. Aktywność fizyczna a gęstość mineralna kości – aktualny stan wiedzy. Pol Arch Med Wew. 2005;113(2):164–171.
  30. Kemmler W. Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: The randomized controlled senior fitness and prevention (SEFIP) study. Arch Int Med. 2010;70(2):179–185.
  31. Roczniak W, Babińska-Roczniak M, Roczniak A, et al. Zalecenia rehabilitacyjne dla pacjentów z osteoporozą. Probl Med Rodz. 2011;13(3): 35–42.
  32. Żak M, Melcher U. Rehabilitacja jako element programu zapobiegania upadkom osób starszych. Przegl Lek. 2002;59:4–5.
  33. Kozak-Szkopek E, Galus K. Wpływ rehabilitacji ruchowej na sprawność psychofizyczną osób w podeszłym wieku. Gerontol Pol. 2009; 17(2):79–94.
  34. Ballad JE, McFarland C, Wallace LS, Holiday DB, Roberson G. The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65–89 years. J Am Med Womens Assoc. 2004;59:255–261.
  35. Mętel S, Milert A, Szczygieł A, et al. Wpływ 6-miesięcznego treningu sensomotorycznego na sprawność funkcjonalną osób starszych z przewlekłym bólem krzyża. Post Rehab. 2010;24(3):51–65.
  36. Żak M, Skalska A, Szczerbańska K. Programy nauki samodzielnego podnoszenia się po upadku dla osób starszych – badanie randomizowane. Ortop Traumatol Rehabil. 2008;10(5):491–502.
  37. Wnuk B, Walusiak M, Durmała J, et al. Wpływ fizjoterapii rozszerzonej o różne formy treningu chodu na bieżni ruchomej na sprawność funkcjonalną osób starszych zagrożonych upadkiem. Fizjoterapia. 2010;18(2):3–9.
  38. Maciaszek J, Osiński W, Szeklicki R. Effect of Tai Chi on body balance: Randomized controlled trial in men with osteopenia or osteoporosis. Am J Chin Med. 2007;35(1):1–9.
  39. Fitzpatrick SE, Reddy S, Lommel TS, et al. Physical activity and physical function improved following a community-based intervention in older adults in Georgia senior centers. J Nutr Elder. 2008;27:1–2.