Background: The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations.Methods: A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations.Results: The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended.Conclusions: A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.

PURPOSE: The purpose of this study was to investigate the effects of 8 weeks of mat Pilates exercise on back pain, muscle mass, isokinetic muscle function, and core stability in healthy college female.METHODS: Twenty healthy college females (aged 21.7±2.5 years) were recruited for the study. The participants were divided into two groups: mat Pilates exercise group (MP, n=10) and non-Pilates control group (CON, n=10). The MP group participated in the mat Pilates exercise program for 60 minutes a day, 3 days per week for 8 weeks. Back pain and basal physical fitness were assessed before and after the experimental period. Left and right core stabilities at 0°, 45°, 90°, 135°, and 180° were measured using Centaur (BFMC, Germany). Isokinetic muscle function (60°/s) of both the knee and trunk was also measured using the isokinetic dynamometer Cybex.RESULTS: After mat Pilates exercise for 8 weeks, there was a significant interaction between the MP and CON groups in back pain during daily activity and lower back stiffness (<i>p</i><.05), respectively. There was also a significant interaction between the two groups in the left and right core stability at 45°, 90°, 135°, and 180° (<i>p</i><.05, <i>p</i><.01, <i>p</i><.001), respectively. Additionally, there was a significant interaction between the two groups in the right knee and left knee isokinetic extensor muscle strength (<i>p</i><.05, <i>p</i><.001, respectively). However, there was no significant interaction between the two groups in trunk isokinetic extensor and flexor muscle strength (NS). There were no significant interactions between two groups in the muscle mass of total body, trunk, and legs (NS), respectively. Regarding basic physical fitness, there were significant interaction effects between the two groups in cardiovascular fitness, sagittal reach, and sit-ups (<i>p</i><.05).CONCLUSIONS: These results suggest that continued mat Pilates exercise can improve back pain and core stability with enhancement of leg isokinetic muscle strength independent of the muscle mass of the total body, trunk, and legs.