How do muscle and bone strengthening and balance activities (MBSBA) vary across the life course, and are there particular ages where MBSBA are most important?

This narrative review focuses on the role of strength and balance activities throughout the lifecycle to improve physical capacity and reduce all-cause mortality. The evidence suggests strong associations in middle and older age, with poor balance, poor strength or poor physical function having strong associations with mortality. Currently in the UK, the proportions of adults (69% of men and 76% of women) not meeting the strength and balance guidelines (of 2 or more sessions/week) is concerning. This report identifies specific time points in the lifecycle where specific promotion of and engagement with strength and balance activities would be most beneficial for health: 18-24y to maximize bone and muscle mass gains, 40-50y to maintain strength and reduce that downward cycle, and over 65s to preserve balance and strength and maintain independence). This review also suggests specific transition points/events in life where there may be an increase in sedentary behaviour or loss of muscle function (pregnancy, menopause, onset of on diagnosis of disease, retirement, on becoming a carer and following hospitalization), where it would be useful to initiate additional strength and balance exercises to improve future health outcomes

Which strength and balance activities are safe and efficacious for individuals with specific challenges (osteoporosis, vertebral fractures, frailty, dementia)?: A Narrative review

Physical activity guidelines advocate the inclusion of strength and balance activities, twice a week, for adults and older adults, but with caveat that in some individuals there will be certain movements and activities that could lead to adverse events. This scoping review summarizes the evidence about how safe and efficacious these activities are in older adults with specific challenges that might make them more prone to injury (e.g. having recently fractured or at risk of fracture (osteoporosis) or those who are frail or who have cognitive impairment). The review identified that for prevention of falls in people with a falls history and/or frailer older adults, structured exercise programmes that incorporate progressive resistance training (PRT) with increasing balance challenges over time are safe and effective if performed regularly, with supervision and support, over at least 6 months. Some minor adverse effects mainly transient musculoskeletal pain) have been reported. For those with a higher risk of falls and fractures (very poor balance, vertebral fractures), supervised structured exercise programmes are most appropriate. People with diagnosed osteoporosis should be as active as possible and only avoid activities with a high risk of falls if they are naive to those activities. For those in transition to frailty who have poor strength and balance, exercises that are known to help maintain strength and balance (such as Tai Chi) are effective in preventing a decline in falls risk. For the very frail older adult, supervised structured exercise that has PRT, balance training and some endurance work, supervised and progressed by a trained person are advocated

Beyond “#endpjparalysis”, tackling sedentary behaviour in health care

Reducing sedentary behaviour after hospitalization starts with reducing sedentary behaviour whilst in hospital. Although we have eradicated immobilisation as a therapeutic tool due to its potent detrimental effects, it is still in systemic use within health care systems and hospitals. Evidence shows that when in hospital, patients spend most of their time sedentary. In this editorial, we explore the determinants of, and a system-based approach to, reducing sedentary behaviour in health care

Exploring osteoporosis sufferers knowledge on sedentary behaviour in the management of their disease

Objectives: 1) To develop an understanding of the thoughts and opinions of older women diagnosed with osteoporosis regarding sedentary behaviour and 2) Investigate strategies used to reduce sedentary behaviour for future intervention development. Methods: Eleven older women with osteoporosis (mean age=68.2y±6.6(SD)) participated in semi-structured interviews (March-May 2020). They were recruited from the Royal Osteoporosis Society (Scottish) support group networks and the Strathclyde Age-Friendly-Academy. Telephone interviews were recorded, transcribed verbatim and thematically analysed using Braun & Clarke (2006). Results: Three main themes emerged: ‘Older Women’s Knowledge’, ‘Motivators to reduce Sedentary Behaviour’ and ‘Older Adult’s and Technology’. Participants reported an increase/maintenance of physical activity levels after osteoporosis diagnosis, had a good understanding and awareness of sedentary behaviour and how it affects health holistically. Participants identified motivators to interrupt sedentary behaviour (e.g. family/friends) and facilitators of sedentary behaviour (e.g. Television). Technology appeared to be used widely among participants to track movement patterns (e.g. Fitbit) but access and usability were identified as potential barriers when using technology to reduce sedentary behaviour among older adults. Conclusion: Knowledge does not appear to be a factor that needs addressing in relation to sedentary behavior in older women diagnosed with osteoporosis. Identified motivators and barriers could increase awareness of sedentary behaviour among older adults

Seasonal Variation in 25(OH)D at Aberdeen (57°N) and Bone Health Indicators- Could Holidays in the Sun and Cod Liver Oil Supplements Alleviate Deficiency?

Vitamin D has been linked with many health outcomes. The aim of this longitudinal study, was to assess predictors of seasonal variation of 25-hydroxy-vitamin D (25(OH)D) (including use of supplements and holidays in sunny destinations) at a northerly latitude in the UK (57°N) in relation to bone health indicators. 365 healthy postmenopausal women (mean age 62.0 y (SD 1.4)) had 25(OH)D measurements by immunoassay, serum C-telopeptide (CTX), estimates of sunlight exposure (badges of polysulphone film), information regarding holidays in sunny destinations, and diet (from food diaries, including use of supplements such as cod liver oil (CLO)) at fixed 3-monthly intervals over 15 months (subject retention 88%) with an additional 25(OH)D assessment in spring 2008. Bone mineral density (BMD) at the lumbar spine (LS) and dual hip was measured in autumn 2006 and spring 2007 (Lunar I-DXA). Deficiency prevalence (25(OH)

Correction to : Prevalence and novel risk factors for vitamin D insufficiency in elite athletes: systematic review and meta-analysis

The original version of this article unfortunately contained a mistake. Author name Alexandra Mavroeidi was incorrectly written as Alexandra Mavroedi. ORCID id for author Alexandra Mavroeidi should be 0000-0001-5213-1596

An explorative study of current strategies to reduce sedentary behaviour in hospital wards

Prolonged sitting (or sedentary behaviour—SB) has profound detrimental effects on health and is associated with increased risk of chronic disease, hospitalisation and premature death. However, while in hospital, a person will spend the vast majority of the day sitting or lying down. A number of strategies have started to be implemented to counteract this phenomenon and get patients up and moving. This is the first explorative study that used device-based measurements of the postural physical activity of older hospitalised adults taking part in such initiatives. A total of 43 patients, mean age 83.8y (SD 8.3), wore a waterproofed activity monitor (activPAL3) for 4 days (including overnight); physical activity was analysed for waking hours. Interventions designed to get patients up and moving were introduced sequentially. Participants were grouped based on the highest level of intervention they received. There were 4 groups: “control” (n = 12), “education” (advice on SB reduction via infographics on the ward noticeboards, n = 12), “#endpjparalysis” (up and dressed by the nurses before 11: 30 am, n = 9), “personalised activity passports” (agreed by Occupational Therapists and other members of the multidisciplinary team with patients, on SB reduction, n = 10). ANOVA revealed the absence of any differences between the 4 groups for total sitting time (p = 0.989), time spent upright (standing and walking) (p = 0.700), number of sitting events (i.e. sit to stand transitions) (p = 0.418) and longest upright period (p = 0.915). This small explorative study of sequential initiatives within a ward setting to reduce SB found they were not successful. The cross-sectional service-improvement nature of the study limited the ability to assess change in individuals as interventions were introduced. Further work is warranted to untangle the determinants of SB in hospital settings and implement interventions of sustainable SB change in this setting