Exercise that targets a weak region of the hipbone may
help prevent fractures, but simple walking will not, new
research indicates.
As people age, the outer "cortical" layer of bone in a
particular region the hipbone or upper femur become thinner,
making the hip more prone to fracture, according to the
report in The Lancet medical journal.
The findings are based on a CT scan analysis of 77 femurs
from people between 20 and 95 years of age who died suddenly
of causes not related to bone disease or fractures.
Substantially thinning of the cortical layer in the neck
of bone that connects the hip "ball" to the rest of the
thighbone was observed with aging, Dr. Jonathan Reeve, from
Addenbrooke's Hospital in Cambridge, UK, and colleagues
found.
After 60 years of age, bone thickness in this zone fell
by 6.4 percent per decade, the report indicates.
Regardless of whether the bone-thinning disease osteoporosis
was present or not, thinning in the cortical layer impaired
the femur's ability to absorb energy, making it more likely
to break, the researchers note.
"Because walking does not sufficiently (condition the upper
femur), the fragile zones in healthy bones may need strengthening,
for example with more well targeted exercise," the authors
conclude.
They point out that while walking does not put a significant
load the fragile area, other exercises that basically flex
the hip joint do "involve extension of the upper femur under
load." These include cycling, sculling, gymnastics and weights.
In a related editorial, Dr. Charles H. Turner, from Indiana
University in Indianapolis, notes that the present report
provides "a compelling argument for more diligent assessment
of the regional patterns of bone loss in the (upper femur)
and point to the need for targeted interventions that strengthen
bone" in this area.
SOURCE: The Lancet, July 9, 2005.