Leisure-time physical activity levels and changes in relation to risk of hip fracture in men and women.

The Copenhagen Center for Prospective Population Studies, Danish Epidemiology Science Center at the Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
American Journal of Epidemiology (Impact Factor: 5.23). 08/2001; 154(1):60-8.
Source: PubMed


The authors prospectively studied the effect of leisure-time physical activity level on hip fracture risk along with the influence of within-subject changes in activity levels, while taking possible confounding by other health behaviors and poor health into account. Analyses were based on pooled data from three population studies conducted in Copenhagen, Denmark. Among 13,183 women and 17,045 men, 1,121 first hip fractures were identified during follow-up. In comparison with being sedentary, the relative risk (RR) of hip fracture associated with being moderately physically active 2-4 hours per week was 0.72 (95% confidence interval (CI): 0.59, 0.89) in women and 0.75 (95% CI: 0.55, 1.03) in men after adjustment for confounders. Being in the most active leisure activity category did not decrease the risk of hip fracture further. Adjustment for poor health affected the risk estimates only modestly. Subjects who, during follow-up, reduced their physical activity level from the highest or the intermediate activity level to a sedentary level had a higher risk of hip fracture than did those who remained moderately physically active at the intermediate level (multivariate adjusted RR = 2.19, 95% CI: 1.00, 4.84 and RR = 1.89, 95% CI: 1.21, 2.95, for reduction from the highest and intermediate levels, respectively). There was no evidence of a fracture-protective effect from increasing physical activity. In conclusion, moderate levels of physical activity appear to provide protection against later hip fracture. Decline in the physical activity level over time is an important risk factor for hip fracture.

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    • "In recent years a number of studies have demonstrated the benefits of promoting an increase in PA to reduce pain and improve quality of life in the adult population with MSDs, [19-21] to reduce musculoskeletal impairment in the elderly, [20] and reduce pain for those with low back pain (LBP) [22], neck pain, and shoulder pain [23]. Physical activity has also been shown to play a role in protecting against later hip fracture in an adult population [24] and reducing the incidence of osteoporotic vertebral fractures in an elderly population [25]. Results from a systematic review also support the effectiveness of PA to treat and prevent a number of chronic disorders [26]. "
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    ABSTRACT: Background Physical activity (PA) plays an important role in the prevention and management of a number of chronic conditions. Aim: to investigate the evidence for effectiveness of pedometer-driven walking programs to promote physical activity among patients with musculoskeletal disorders (MSDs). Method A comprehensive systematic review was performed using 11 electronic databases up to 20 February 2014. Keywords and MeSH terms included “musculoskeletal disorders”, “walking”, and “pedometer”. Randomized controlled trials, published in English, that examined the effects of a pedometer-based walking intervention to increase physical activity levels and improve physical function and pain in patients with musculoskeletal disorders were included. Result Of the 1996 articles retrieved, seven studies ranging in date of publication from 1998 to 2013 met the inclusion criteria, allowing data extraction on 484 participants with an age range of 40 to 82 years. Interventions lasted from 4 weeks to 12 months and the results across studies showed significant increases in step count (p < 0.05) following the intervention. Across these studies, there was a mean increase in PA of 1950 steps per day relative to baseline. Four studies reported improved scores for pain and/or physical function at the intervention completion point relative to controls. Conclusion This study provides strong evidence for the effectiveness of pedometer walking interventions in increasing PA levels for patients with MSDs. Our findings suggest that a combination of interventions is likely to be the most effective strategy to maximize health benefits in the short term. Further research should include larger sample sizes, and longer intervention durations are required to support the role of pedometer walking interventions as a long term intervention for management of musculoskeletal disorders.
    Full-text · Article · Jul 2014 · BMC Musculoskeletal Disorders
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    • "During the last few decades, physical inactivity has been shown to be associated with a greater hip fracture risk among older people [7]. In large, prospective studies, moderate or high leisure time physical activity has been associated with a 28-42% reduction in hip fracture risk [6,8-10]. Physical activity has several advantages, including increased bone strength [11] and decreased risk of falling [12]. "
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    ABSTRACT: Background Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. Methods The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures. Results During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3). Conclusions Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.
    Full-text · Article · Sep 2012 · BMC Musculoskeletal Disorders
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    • "There is about 30-40% lower hip fracture incidence amongst physically active elderly compared to physically inactive. The decrease in fracture incidence in the elderly by being physically active is probably caused by the improvement of muscle strength, bone mass and balance performance (American College of Sports Medicine 2004, Englund et al. 2005, Gregg et al. 2000, Høidrup et al. 2001, Järvinen et al. 2008, Jessup et al. 2003, Joakimsen et al. 1997, Korpelainen et al. 2006, Pfeifer et al. 2004). Thus, the prevention of fractures should focus both on the prevention of osteoporosis and on the prevention of falls (Järvinen et al. 2008). "
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    ABSTRACT: The use of physical activity is widely accepted in preventive medicine practice. Therapeutic exercises are especially beneficial in supporting the treatment of some chronic diseases. The choice of appropriate and effective exercises in the treatment and prevention of osteoporosis is crucial. The duration, intensity, frequency, and the involved muscle mass are to be taken into account in the prescription of exercises, which are basically a combination of movement patterns. The musculo-skeletal system is in continuous interaction with the environment. It is a very dynamic system with a high adaptive capacity. The response to stimuli depends on the biological age, health, and sports activity experience of the individual. Weight bearing activities with different movement patterns like ball games are accepted to be more effective in the prevention of osteoporosis, especially when performed till the end of puberty. This type of activity seems to be also effective in the middle-aged. Porprioceptive and strength exercises are important in supporting postmenopausal women. In elderly people, though progressive resistance exercises are very effective, even walking and simple gymnastics can be beneficial in more sedentary cases. Less intensive exercise of shorter duration have to be performed by people with advanced stage osteoporosis with or without previous fracture complication. Strength exercises can be fulfilled isometrically in critical cases.
    Preview · Article · Jan 1988 · AAOHN Journal
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