Abstract
Antiosteoporotic medications are often used to reduce fracture risk and treat osteoporosis. Similarly, regular physical activity also plays an important role in both maintaining and improving bone density. Recently, it has been shown that exercise combined with osteoporosis medications may produce greater benefits on bone associated with osteoporosis than either intervention alone. This commentary evaluates the current literature mostly produced in our laboratory from animal models to determine the optimal combination of physical exercise and medications on osteoporosis induced by ovariectomy and exogenous glucocorticoids. The data suggest that both approaches enhance bone healing, however the combined effects of these two therapies do not appear to produce any remarkable synergetic or additive effects. Clinical studies are needed to fully understand the effects of exercise and selective medications on bone remodelling in order to optimise treatment of fragility fractures in patients with underlying osteoporosis.
Highlights
Several approaches have been used to treat osteoporosis in order to reduce fracture risk, including therapies and increasing physical activity
The mechanical stresses generated by physical exercise are primarily detected by the osteocytes which transduce these mechanical strains into biological signals [8,12,13,14]
This anabolic pathway due to mechanical loading has been reported to be mainly related to the modulation of sclerostine levels [15]
Summary
Several approaches have been used to treat osteoporosis in order to reduce fracture risk, including therapies and increasing physical activity. Physical activity increases mechanical stresses within bone which in turn signals osteoblastic activation and decreased osteoclast resorption [8,11]. Besides these essential signalling pathways, exercise produces changes in circulating levels of hormones including growth hormone (GH) and insulin-like growth factor (IGF)-1, which together have an anabolic effect on both bone and skeletal muscle [12,13,17].
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