Clinical Research Directory

Exercise and Fall Prevention for Fracture Reduction

Sponsor: Wolfgang Kemmler, PhD

Summary

According to the current guideline of the German Osteology Association (DVO), pharmacological treatment is a cornerstone of osteoporosis-related fracture prevention, effectively increasing bone mineral density and reducing fracture risk. However, particularly in older adults, falls represent a major independent fracture risk factor. Pharmacological treatment has limited effects on fall-related factors such as muscle strength, balance, mobility, and fall incidence. Physical exercise, either alone or combined with pharmacological treatment, can address these risk factors and improve fracture prevention. However, specialized osteoporosis exercise programs are not widely available, often face high demand, and require qualified instructors and suitable facilities. Older adults, particularly those with mobility limitations, face additional barriers to participation. Many prefer flexible home-based exercise, whereas fixed schedules and organizational requirements of group programs may compromise adherence and effectiveness. Currently available home-based osteoporosis exercise programs do not consistently follow the guideline "Physical Exercise for Fracture Prevention", which targets specific fracture risk determinants according to individual risk profiles. Moreover, these programs lack scientific evaluation. To address these limitations, our research group developed a home-based exercise program based on our S3 guideline "Physical Exercise for Fracture Prevention". The program differentiates between fracture risk profiles and enables accessible, flexible, and location-independent exercise. The present study will evaluate the effectiveness of this program in women with reduced bone strength and increased fall risk, a particularly relevant combination of osteoporotic fracture risk factors. Outcomes include surrogate measures of bone strength, fall risk, and mobility under real-world conditions. Research Question Is a guideline-based, fracture risk-adapted home exercise program effective in improving fracture risk determinants in women with reduced bone strength and increased fall risk when performed independently at home under real-world conditions?

Official title: Evaluation of a Guideline-based Home Exercise Programme for the Prevention of Falls and Fractures

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