Osteoporosis International

, Volume 18, Issue 10, pp 1379–1387

Simple, novel physical activity maintains proximal femur bone mineral density, and improves muscle strength and balance in sedentary, postmenopausal Caucasian women

Original Article



A simple, appealing, physical activity program can be prescribed to reduce the risk of falls in sedentary, postmenopausal, independent-living, Caucasian women. Foot stamping, progressively loaded squats, and in-line dancing positively influence proximal femoral bone mineral density, lower extremity strength, and static and dynamic balance.


Foot stamping, squats exercises, and in-line dancing together create a suitable activity program for sedentary, independent-living older women.


Forty-five postmenopausal women not taking medications for bone health were randomly assigned to one of three groups. All groups attended one line dance class per week. Two groups additionally performed progressively loaded squats five times per week. One group also performed four foot stamps, twice daily, five times per week. Broadband ultrasound attenuation (BUA), proximal femur (PF) and lumbar spine (LS) bone mineral density (BMD), squats number, and balance variables were measured.


There were no differences within or between groups in baseline and follow-up BUA, PF or LS BMD; however, a strong stamp compliance effect was apparent for BUA (r = 0.73) and PF BMD (r = 0.79). Number of squats (p < 0.01) and single leg stance time (p < 0.01) increased, while timed up and go time decreased (p < 0.01) for all participants.


Line dancing, particularly in concert with regular squats and foot stamping, is a simple and appealing strategy that may be employed to reduce lower extremity bone loss, and improve lower limb muscle strength and balance, in independent living, otherwise healthy, postmenopausal Caucasian women.


Foot stamps Hip fracture risk Linedance Osteoporosis Squats 


  1. 1.
    Wainwright SA, Marshall LM, Ensrud KE et al (2005) Hip fracture in women without osteoporosis. J Clin Endocrinol Metab 90:2787–2793PubMedCrossRefGoogle Scholar
  2. 2.
    North American Menopause Society (2002) Management of postmenopausal osteoporosis: position statement of the North American Menopause Society. Menopause 9:84–101Google Scholar
  3. 3.
    Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg 66:397–402PubMedGoogle Scholar
  4. 4.
    Cavanaugh DJ, Cann CE (1988) Brisk walking does not stop bone loss in postmenopausal women. Bone 9:201–204PubMedCrossRefGoogle Scholar
  5. 5.
    Turner CH, Owan I, Takano Y (1995) Mechanotransduction in bone-Role of strain rate. Am J Physiol-Endocrin M 32:E438–E442Google Scholar
  6. 6.
    Lanyon LE (1996) Using functional loading to influence bone mass and architecture: objectives, mechanisms, and relationship with estrogen of the mechanically adaptive process in bone. Bone 18:37S–43SPubMedCrossRefGoogle Scholar
  7. 7.
    Hans D, Genton L, Drezner MK et al (2002) Monitored impact loading of the hip: initial testing of a home-use device. Calcified Tissue Int 71:112–120CrossRefGoogle Scholar
  8. 8.
    Bassey EJ, Ramsdale SJ (1995) Weight-bearing exercise and ground reaction forces: a 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. Bone 16:469–476PubMedGoogle Scholar
  9. 9.
    Kerr D, Morton A, Dick I et al (1996) Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res 11:218–225PubMedCrossRefGoogle Scholar
  10. 10.
    Hurley BF, Roth SM (2000) Strength training in the elderly: effects on risk factors for age-related diseases. Sports Med 30:249–268PubMedCrossRefGoogle Scholar
  11. 11.
    Cussler EC, Lohman TG, Going SB et al (2003) Weight lifted in strength training predicts bone change in postmenopausal women. Med Sci Sports Exerc 35:10–17PubMedCrossRefGoogle Scholar
  12. 12.
    Judge JO, Lindsey C, Underwood M et al (1993) Balance improvements in older women: effects of exercise training. Phys Ther 73:254–262PubMedGoogle Scholar
  13. 13.
    Shaw JM, Snow CM (1998) Weighted vest exercise improves indices of fall risk in older women. J Gerontol A Biol Sci Med Sci 53:53–58Google Scholar
  14. 14.
    Shigematsu R, Chang M, Yabushita N et al (2002) Dance-based aerobic exercise may improve indices of falling risk in older women. Age Ageing 31:261–266PubMedCrossRefGoogle Scholar
  15. 15.
    Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry: scientific review. JAMA 288:1889–1897PubMedCrossRefGoogle Scholar
  16. 16.
    Liebenson C (2003) Safe squatting procedures. Journal of Bodywork and Movement Therapies 7:228–229CrossRefGoogle Scholar
  17. 17.
    Nowson CA, Green G, Guest CS et al (1995) Limitations of dietary calcium assessment in female twins of different ages Ares-Seronon Symposia PublicationsGoogle Scholar
  18. 18.
    Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Am Geriatr Soc 39:142–148Google Scholar
  19. 19.
    Jamsa T, Vainionpaa A, Korpelainen R et al (2006) Effect of daily physical activity on proximal femur. Clinical Biomechanics 21:1–7PubMedCrossRefGoogle Scholar
  20. 20.
    Korpelainen R, Keinanen-Kiukaanniemi S, Heikkinen J et al (2005) Effect of impact exercise on bone mineral density in elderly women with low BMD: a population-based randomized controlled 30-month intervention. Osteoporosis IntGoogle Scholar
  21. 21.
    Winters-Stone KM, Snow CM (2003) Musculoskeletal response to exercise is greatest in women with low initial values. Med Sci Sports Exerc 35:1691–1696PubMedCrossRefGoogle Scholar
  22. 22.
    Bassey EJ, Littlewood JJ, Taylor SJ (1997) Relations between compressive axial forces in an instrumented massive femoral implant, ground reaction forces, and integrated electromyographs from vastus lateralis during various ‘osteogenic’ exercises. J Biomech 30:213–223PubMedCrossRefGoogle Scholar
  23. 23.
    Nikander R, Sievanen H, Heinonen A et al (2005) Femoral neck structure in adult female athletes subjected to different loading modalities. J Bone Min Res 20:520–528CrossRefGoogle Scholar
  24. 24.
    Seeman E, Delmas PD (2006) Bone quality-the material and structural basis of bone strength and fragility. N Engl J Med 354:2250–2261PubMedCrossRefGoogle Scholar
  25. 25.
    Forwood MR (2001) Mechanical effects on the skeleton: are there clinical implications? Osteoporos Int 12:77–83PubMedCrossRefGoogle Scholar
  26. 26.
    van den Bogert AJ, Pavol MJ, Grabiner MD (2002) Response time is more important than walking speed for the ability of older adults to avoid a fall after a trip. J Biomech 35:199–205PubMedCrossRefGoogle Scholar
  27. 27.
    Gillespie LD, Gillespie WJ, Robertson MC et al (2001) Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 3:CD000340Google Scholar
  28. 28.
    Rogers MW, Johnson ME, Martinez KM et al (2003) Step training improves the speed of voluntary step initiation in aging. J Gerontol A Biol Sci Med Sci 58:46–51PubMedGoogle Scholar
  29. 29.
    Turner CH, Robling AG (2003) Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev 31:45–50PubMedCrossRefGoogle Scholar
  30. 30.
    Mayoux-Benhamou MA, Roux C, Perraud A et al (2005) Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study. Osteoporos Int 16:325–331PubMedCrossRefGoogle Scholar
  31. 31.
    van der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med 22:120–133PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  1. 1.School of Physiotherapy and Exercise ScienceGriffith UniversityQueenslandAustralia

Personalised recommendations