While low-impact activities such as walking are beneficial to general health, they do not improve bone density. To improve or maintain bone health, exercises need to create a ‘loading’ effect on the bone. However, relatively few loading cycles (repetitions) are needed – short bouts separated by periods of rest are more effective than the same number of loads performed all at once.
Risk factors that limit the benefits of exercise include smoking, excessive alcohol consumption, vitamin D deficiency and insufficient dietary calcium or protein.
The benefits of exercise on bone density are lost over time if exercise is not maintained, so adherence strategies are important.
High-impact exercise may be a problem for women with continence issues, and so pelvic floor exercise training is important.