Table 6.

Exercise prescription details for older adults with osteoporosis or osteoporotic vertebral fracture

Type	How often per week?	How hard should it be?	Examples	Comments
Resistance training	2 days a week minimuma	One exercise for each major muscle group, 2 sets per exercise, 8–12 repetitions maximuma: If >12 reps can be performed → too easy: If <8 reps → too hard	Exercises that result in work being performed against resistance (e.g., body weight relative to gravity, or external resistance)	Individuals who are previously sedentary, with comorbid conditions that affect activity participation, at high fracture risk or unfamiliar with resistance training may need to train at a lower intensity, at least initially.
Balance training	15–20 min per day, accumulating 2 h per week.	Start with static balance exercises and progress to dynamic	Table 5	Can be performed in short bouts throughout the day, or embedded in daily activities. Consultation with a health care provider on exercise selection and progression is recommended
Aerobic exercisea,b (for general health benefits)	3–5 days per week for 30–60 min per day	Moderate to vigorous intensity	Weight-bearing e.g., dancing, walking	Shorter, more frequent bouts (e.g., 10 min at a time) are acceptable and may be preferable for individuals with vertebral fractures, with comorbid conditions that limit activity participation, or who were previously sedentary.
Total exercise time = minimum of 150 min of moderate- or vigorous-intensity exercise per weeka,c

Bold text is used to highlight the exercise domains that are emphasized in the recommendations

^aIn accordance with physical activity guidelines for older adults put forward by the Canadian Society for Exercise Physiology (http://www.csep.ca/english/view.asp?x=587), the Centers for Disease Control (http://www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html) or the American College of Sports Medicine (http://journals.lww.com/acsm-msse/Fulltext/2009/07000/Exercise_and_Physical_Activity_for_Older_Adults.20.aspx

^bIncluded to reinforce recommendations in CSEP, CDC, and ASCM physical activity guidelines for achieving general health benefits

^cPhysical activity guidelines from CSEP, CDC, and ACSM recommend 150 min of moderate- to vigorous-intensity aerobic physical activity per week for general health benefits. Sherrington et al. reported that at least 2 h per week of exercise (that included challenging balance exercises) was most effective for fall prevention. Therefore, a minimum of 150 min per week of exercise is proposed. In the event that time is limited, aerobic exercise should not supplant resistance and balance training