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Too Fit To Fracture: a consensus on future research priorities in osteoporosis and exercise

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Abstract

Summary

An international consensus process identified the following research priorities in osteoporosis and exercise: study of exercise in high-risk cohorts, evaluation of multimodal interventions, research examining translation into practice and a goal to examine fracture outcomes.

Introduction

To identify future research priorities related to exercise for people with osteoporosis with and without osteoporotic spine fracture via international consensus.

Methods

An international expert panel and representatives from Osteoporosis Canada led the process and identified opinion leaders or stakeholders to contribute. A focus group of four patient advocates identified quality of life, mobility, activities of daily living, falls, bone mineral density, and harms as outcomes important for decision-making. Seventy-five individuals were invited to participate in an online survey asking respondents to define future research priorities in the area of osteoporosis and exercise; the response rate was 57 %. Fifty-five individuals from seven countries were invited to a half-day consensus meeting; 60 % of invitees attended. The results of the online survey, knowledge synthesis activities, and results of the focus group were presented. Nominal group technique was used to come to consensus on research priorities.

Results

Research priorities included the study of exercise in high-risk cohorts (e.g., ≥ 65 years, low BMD, moderate/high risk of fracture, history of osteoporotic vertebral fractures, hyperkyphotic posture, functional impairments, or sedentary), the evaluation of multimodal interventions, research examining translation into practice, and a goal to examine fracture outcomes. The standardization of outcomes or protocols that could be evolved into large multicentre trials was discussed.

Conclusions

The research priorities identified as part of the Too Fit To Fracture initiative can be used to inform the development of multicentre collaborations to evaluate and implement strategies for engaging individuals with osteoporosis in a safe and effective exercise.

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Acknowledgments

We would like to thank Cheryl Kieswetter, Christin Tabije, Marq Nelson, Kate Harvey, Francine Stephens, Patricia Versteegh, and Michael McLeod for their assistance with meeting organization and data collection. We gratefully acknowledge financial support from the Schlegel-UW Research Institute for Aging, the University of Waterloo, and Osteoporosis Canada. We would also like to thank Osteoporosis Canada and representatives from the Canadian Osteoporosis Patient Network for contributing their input during the design and conduct of the project, consistent with an integrated knowledge translation approach. Dr. Giangregorio is the recipient of a Canadian Institutes of Health Research New Investigator Award, and an Early Researcher Award from the Ontario Ministry of Research and Innovation.

Funding sources

University of Waterloo, Schlegel-UW Research Institute for Aging and Osteoporosis Canada

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada

    L. M. Giangregorio, S. McGill & H. Keller

  2. Toronto Rehabilitation Institute—University Health Network, Toronto, ON, Canada

    L. M. Giangregorio

  3. School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada

    N. J. MacIntyre

  4. Department of Health Sciences, University of Jyväskylä, Jyvaskyla, Finland

    A. Heinonen

  5. Department of Medicine, University of Toronto, Toronto, ON, Canada

    A. M. Cheung

  6. Royal Melbourne Hospital Department of Medicine, University of Melbourne, Melbourne, Australia

    J. D. Wark

  7. Department of Community and Family Medicine, Duke University, Durham, NC, USA

    K. Shipp

  8. Department of Family Practice, University of British Columbia, and the Centre for Hip Health and Mobility, Vancouver, BC, Canada

    M. C. Ashe

  9. Ontario Osteoporosis Strategy & Osteoporosis Canada, Toronto, ON, Canada

    J. Laprade

  10. Division of Anatomy, University of Toronto, Toronto, ON, Canada

    J. Laprade & R. Jain

  11. Department of Medicine, McMaster University, Hamilton, ON, Canada

    A. Papaioannou

Authors
  1. L. M. Giangregorio
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  2. N. J. MacIntyre
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  3. A. Heinonen
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  4. A. M. Cheung
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  5. J. D. Wark
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  6. K. Shipp
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  7. S. McGill
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  8. M. C. Ashe
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  9. J. Laprade
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  10. R. Jain
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  11. H. Keller
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  12. A. Papaioannou
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Corresponding author

Correspondence to L. M. Giangregorio.

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Giangregorio, L.M., MacIntyre, N.J., Heinonen, A. et al. Too Fit To Fracture: a consensus on future research priorities in osteoporosis and exercise. Osteoporos Int 25, 1465–1472 (2014). https://doi.org/10.1007/s00198-014-2652-2

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  • DOI: https://doi.org/10.1007/s00198-014-2652-2

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