title: Exercise for bone health: rationale and prescription.
abstract: OBJECTIVE
  Patients frequently inquire about exercise as a means to improve bone strength and reduce osteoporotic fracture. Understanding the biologic mechanisms and the available clinical evidence supporting the role of exercise in bone health is the key to an educated discussion.
  
  
  RESULTS
  Exercise downregulates sclerostin expression by the osteocyte favoring osteoblastogenesis. These changes are enhanced by dynamic cyclical load with rest periods and may be promoted by low-amplitude high-frequency stimuli. In the prepubertal years, exercise results in periosteal gains, whereas exercise later in life maintains bone mass, reduces falls and probably associated fractures, and improves quality-of-life measures.
  
  
  CONCLUSIONS
  Future studies should examine the effect of exercise on bone strength and determine the minimum quantity and frequency and the exercise type most effective to reduce osteoporotic fractures.
authors.affiliation: Portland Veterans Affairs Medical Center, Oregon Health and Science University, Portland, Oregon, USA. schwabp@ohsu.edu
authors.forename: Pascale
authors.initials: P
authors.lastname: Schwab
authors.forename: Kenneth
authors.initials: K
authors.lastname: Scalapino
mesh_terms: D000058:Accidental Falls; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D011788:Quality of Life; D016474:Weight-Bearing / Q000502:physiology