Abstract
Studies on the association between physical activity and hip fractures are reviewed. All the studies, which comprise four follow-up studies, one nested case-control study and 17 case-control studies, suggest a protective effect of physical activity with regard to hip fractures. The association is strong and consistent with physical activity in leisure, weaker with respect to physical activity at work. The association is present for physical activity from childhood to adult age, and it is consistent in study populations from the USA, Australia, Asia and Northern and Southern Europe, in spite of very different hip fractures incidences in these populations. The magnitude of the association is difficult to assess because of varying criteria for exposure, but to be among the physically active seems to reduce the risk of later hip fracture by up to 50%. It seems that even daily chores, such as climbing stairs and walking, protect against hip fracture.
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Maggi S, Kelsey JL, Litvak J, Heyse SP. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1991;1:232–41.
Rowe SM, Yoon TR, Ryang DH. An epidemiological study of hip fracture in Honam, Korea. Int Orthop 1993;17:139–43.
Lee CM, Sidhu JS, Pan KL. Hip fracture incidence in Malaysia 1981–1989. Acta Orthop Scand 1993;64:178–80.
Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285–9.
Kanis JA. The incidence of hip fracture in Europe. Osteoporos Int 1993;3(Suppl 1):10–5.
Lau EM. Admission rates for hip fracture in Australia in the last decade: the New South Wales scene in a world perspective. Med J Aust 1993;158:604–6.
Melton LJ, O’Fallon WM, Riggs BL. Secular trends in the incidence of hip fractures. Calcif Tissue Int 1987;41:57–64.
Obrant KJ, Bengner U, Johnell O, Nilsson BE, Sernbo I. Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 1989;44:157–67.
Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ. Population-based study of survival after osteoporotic fractures. Am J Epidemiol 1993;137:1001–5.
Melton LJ, Chrischilles EA, Cooper C, Lane AW, Riggs BL. Perspective. How many women have osteoporosis? J Bone Miner Res 1992;7:1005–10.
Johnston CC, Melton LJ, Lindsay R. Clinical indications for bone mass measurements. J Bone Miner Res 1989;4(Suppl 2):1.
Barrett-Connor E. The economic and human costs of osteoporotic fracture. Am J Med 1995;98(Suppl 2A):S3–8.
Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States: numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop 1990;252:163–6.
Kanis JA, Pitt FA. Epidemiology of osteoporosis. Bone 1992;13(Suppl 1):S7–15.
Jensen JS, Tondevold E. Mortality after hip fractures. Acta Orthop Scand 1979;50:161–7.
Petitti DB, Sidney S. Hip fracture in women: incidence, in-hospital mortality, and five-year survival probabilities in members of a prepaid health plan. Clin Orthop 1989;246:150–5.
Jacobson SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA. Hip fracture incidence among the old and very old: a population-based study of 745435 cases. Am J Public Health 1990;80:871–3.
Lewinnek GE, Kelsey J, White AA, Kreiger NJ. The significance and a comparative analysis of the epidemiology of hip fractures. Clin Orthop 1980;152:35–43.
Campbell AJ. Femoral neck fractures in elderly women: a prospective study. Age Ageing 1976;5:102–9.
Boyce WJ, Vessey MP. Habitual physical inertia and other factors in relation to risk of fracture of the proximal femur. Age Ageing 1988;17:319–27.
Anderson JJ, Metz JA. Contributions of dietary calcium and physical activity to primary prevention of osteoporosis in females. J Am Coll Nutr 1993;12:378–83.
Abramson AS, Delagi EF. Influence of weight-bearing and muscle contraction on disuse osteoporosis. Arch Phys Med Rehabil 1961;42:147–51.
Parkkari J, Kannus P, Niemi S, et al. Increasing age-adjusted incidence of hip fractures in Finland: the number and incidence of fractures in 1970–1991 and prediction for the future. Calcif Tissue Int 1994;55:342–5.
Naessen T, Parker R, Persson I, Zack M, Adami HO. Time trends in incidence rates of first hip fracture in the Uppsala Health Care Region, Sweden, 1965–1983. Am J Epidemiol 1989;130:289–99.
Chalmers J, Ho KC. Geographical variations in senile osteoporosis. The association with physical activity. J Bone Joint Surg Br 1970;52:667–75.
Law MR, Wald NJ, Meade TW. Strategies for prevention of osteoporosis and hip fracture. BMJ 1991;303:453–9.
Scott JC. Osteoporosis and hip fractures. Rheum Dis Clin North Am 1990;16:717–40.
Rothman KJ. Modern epidemiology. Boston: Little, Brown, 1995.
Astrom J, Ahnqvist S, Beertema J, Jonsson B. Physical activity in women sustaining fracture of the neck of the femur. J Bone Joint Surg Br 1987;69:381–3.
Yamamoto K, Nakamura T, Kishimoto H, Hagino H, Nose T. Risk factors for hip fracture in elderly Japanese women in Tottori Prefecture, Japan. Osteoporos Int 1993;3(Suppl 1):48–50.
Perez Cano R, Galan Galan F, Dilsen G. Risk factors for hip fracture in Spanish and Turkish women. Bone 1993;14(Suppl 1):S69–72.
Johnell O, Gullberg B, Kanis JA, et al. Risk factors for hip fracture in European women: The MEDOS study. J Bone Miner Res 1995;10:1802–15.
Meyer HE, Tverdal A, Falch JA. Risk factors for hip fracture in middle-aged Norwegian women and men. Am J Epidemiol 1993;137:1203–11.
Wickham CA, Walsh K, Cooper C, et al. Dietary calcium, physical activity, and risk of hip fracture: a prospective study. BMJ 1989;299:889–92.
Coupland C, Wood D, Cooper C. Physical inactivity is an indepentent risk factor for hip fracture in the elderly. J Epidemiol Community Health 1993;47:441–3.
Paganini Hill A, Chao A, Ross RK, Henderson BE. Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology 1991;2:16–25.
Jaglal SB, Kreiger N, Darlington G. Past and recent physical activity and risk of hip fracture. Am J Epidemiol 1993;138:107–18.
Cumming RG, Klineberg RJ. Case-control study of risk factors for hip fractures in the elderly. Am J Epidemiol 1994;139:493–503.
Farmer ME, Harris T, Madans JH, Wallace RB, Cornoni Huntley J, White LR. Anthropometric indicators and hip factures: the NHANES I epidemiologic follow-up study. J Am Geriatr Soc 1989;37:9–16.
Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. N Engl J Med 1995;332;767–73.
Nieves JW, Grisso JA, Kelsey JL. A case-control study of hip fracture: evaluation of selected dietary variables and teenage physical activity. Osteoporos Int 1992;2:122–7.
Lau E, Donnan S, Barker DJ, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. BMJ 1988;297:1441–3.
Cooper C, Wickham C, Coggon D. Sedentary work in middle life and fracture of the proximal femur. Br J Ind Med 1990;47:69–70.
Cooper C, Barker DJ, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. BMJ 1988;297:1443–6.
Paganini Hill A, Ross RK, Gerkins VR, Henderson BE, Arthur M, Mack TM. Menopausal estrogen therapy and hip fractures. Ann Intern Med 1981;95:28–31.
Lau EMC, Donnan SPB. Falls and hip fracture in Hong Kong Chinese. Public Health 1990;104:117–21.
Meyer HE, Henriksen C, Falch JA, Pederson JI, Tverdal A. Risk factors for hip fractures in a high incidence area: a case-control study from Oslo, Norway. Osteoporos Int 1995;5:239–46.
Michaelsson K, Holmberg L, Mallmin H, et al. Diet and hip fracture risk:a case-control study. Int J Epidemiol 1995;24:771–82.
Jaglal SB, Kreiger N, Darlington GA. Lifetime occupational physical activity and risk of hip fracture in women. Ann Epidemiol 1995;5:321–4.
Blair SN, Dowda M, Pate RR, et al. Reliability of long-term recall of participation in physical activity by middle-aged men and women. Am J Epidemiol 1991;133:266–75.
Jacobs DR, Jr, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993;25:81–91.
Ainsworth BE, Jacobs DR, Jr, Leon AS. Validity and reliability of self-reported physical activity status: the Lipid Research Clinics questionnaire. Med Sci Sports Exerc 1993;25:92–8.
Hopkins WG, Wilson NC, Russell DG. Validation of the physical activity instrument for the Life in New Zealand national survey. Am J Epidemiol 1991;133:73–82.
Myers AH, Young Y, Langlois JA. Prevention of falls in the elderly. Bone 1996;18(Suppl 1):S87–101.
Grisso JA, Kelsey JL, Strom BL, et al. Risk factors for falls as a cause of hip fracture in women: the Northeast Hip Fracture Study Group. N Engl J Med 1991;324:1326–31.
Dunn JE, Rudberg MA, Furner SE, Cassel CK. Mortality, disability, and falls in older persons: the role of underlying disease and disability. Am J Public Health 1992;82:395–400.
Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 1989;44:M112–7.
Blake AJ, Morgan K, Bendall MJ, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing 1988;17:365–72.
Svensson ML, Rundgren A, Landahl S. Falls in 84- to 85-year-old people living at home. Accid Anal Prev 1992;24:527–37.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–7.
Robbins AS, Rubenstein LZ, Josephson KR, Schulman BL, Osterweil D, Fine G. Predictors of falls among elderly people: results of two population-based studies. Arch Intern Med 1989;149:1628–33.
Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990;263:3029–34.
Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996;44:489–97.
Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA 1995;273:1341–7.
Reinsch S, MacRae P, Lachenbruch PA, Tobis JS. Attempts to prevent falls and injury: a prospective community study. Gerontologist 1992;32:450–6.
MacRae P, Feltner ME, Reinsch S. A 1 year exercise program for older women: effects on falls, injuries, and physical performance. J Aging Phys Activity 1994;2:127–42.
Malmivaara A, Heliovaara M, Knekt P, Reunanen A, Aromaa A. Risk factors for injurious falls leading to hospitalization of death in a cohort of 19500 adult. Am J Epidemiol 1993;138:384–94.
Porter RW, Miller CG, Grainger D, Palmer SB. Prediction of hip fracture in elderly women: a prospective study. BMJ 1990;301:638–41
Kelsey JL, Browner WS, Seeley DG, Nevitt MC, Cummings SR. Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group [published erratum appears in Am J Epidemiol 1992;135:1183]. Am J Epidemiol 1992;135:477–89.
O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993;137:342–54.
Myers AH, Baker SP, Van Natta ML, Abbey H, Robinson EG. Risk factors associated with falls and injuries among elderly institutionalized persons. Am J Epidemiol 1991;133:1179–90.
Magnus JH, Joakimsen RM, Bernsten GK, Tollan A, Sogaard AJ. What do Norwegian women and men know about osteoporosis? Osteoporos Int 1996;6:31–6.
Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures [letter]. J Am Geriatr Soc 1994;42:909.
Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 1993;52:192–8.
Whedon GD. Disuse osteoporosis: physiological aspects. Calcif Tissue Int 1984;36(Suppl 1):S146–50.
Mazess RB, Whedon GD. Immobilization and bone. Calcif Tissue Int 1983;35:265–7.
Leblanc AD, Schneider VS, Evans HJ, Engelbretson DA, Krebs JM. Bone mineral loss and recovery after 17 weeks of bed rest. J Bone Miner Res 1990;5:843–50.
Suominen H. Bone mineral density and long term exercise: an overview of cross-sectional athlete studies. Sports Med 1993;16:316–30.
Chilibeck PD, Sale DG, Webber CE. Exercise and bone mineral density. Sports Med 1995;19:103–22.
Bouxsein ML, Marcus R. Overview of exercise and bone mass. Rheum Dis Clin North Am 1994;20:787–802.
Forwood MR, Burr DB. Physical activity and bone mass: exercises in futility? Bone Miner 1993;21:89–112.
Vuori I. Peak bone mass and physical activity: a short review. Nutr Rev 1996;54:S11–4.
Specker BL. Evidence for an interaction between intake and physical activity on changes in bone mineral density. J Bone Miner Res 1996;11:1539–44.
Kannus P, Haapasalo H, Sankelo M, et al. Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 1995;123:27–31.
Karlsson MK, Johnell O, Obrant KJ. Bone mineral density in weight lifters. Calcif Tissue Int 1993;52:212–5.
Karlsson MK, Johnell O, Obrant KJ. Is bone mineral density advantage maintained long-term in previous weight lifters? Calcif Tissue Int 1995;57:325–8.
Michel BA, Lane NE, Bloch DA, Jones HH, Fries JF. Effect of changes in weight-bearing exercise on lumbar bone mass after age fifty. Ann Med 1991;23:397–401.
Kannus P, Haapasalo H, Sievanen H, Ojas P, Vuori I. The site-specific effects of long-term unilateral activity on bone mineral density and content. Bone 1994;15:279–84.
Haapasalo H, Kannus P, Sievanen H, Heinonen A, Oja P, Vuori I. Long-term uniliateral loading and bone mineral density in female squash players. Calcif Tissue Int 1994;54:249–55.
Nordstrom P, Thorsen K, Nordstrom G, Bergstrom E, Lorentzon R. Bone mass, muscle strength, and different body constitutional parameters in adolescent boys with a low or moderate exercise level. Bone 1995;17:351–6.
Colletti LA, Edwards J, Gordon L, Shary J, Bell NH. The effects of muscle-building exercise on bone mineral density of the radius, spine, and hip in young men. Calcif Tissue Int 1989;45:12–4.
Grimston SK, Willows ND, Hanley DA. Mechanical loading regime and its relationship to bone mineral density in children. Med Sci Sports Exerc 1993;25:1203–10.
Heinrich CH, Going SB, Pamenter RW, Perry CD, Boyden TW, Lohman TG. Bone mineral content of cyclically menstruating female resistance and endurance trained athletes. Med Sci Sports Exerc 1990;22:558–63.
Heinonen A, Oja P, Kannus P, Sievanen H, Manttari A, Vuori I. Bone mineral density of female athletes in different sports. Bone Miner 1993;23:1–14.
Taaffe DR, Snow Harter C, Connolly DA, Robinson TL, Brown MD, Marcus R. Differential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletes. J Bone Miner Res 1995;10:586–93.
Robinson TL, Snow Harter C, Taaffe DR, Gillis D, Shaw J, Marcus R. Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea. J Bone Miner Res 1995;10:26–35.
Orwoll ES, Ferar J, Oviatt SK, McClung MR, Huntington K. The relationship of swimming exercise to bone mass in men and women. Arch Intern Med 1989;149:2197–200.
Risser WL, Lee EJ, LeBlanc A, Poindexter HB, Risser JM, Schneider V. Bone density in eumenorrheic female college athletes. Med Sci Sports Exerc 1990;22:570–4.
Goodpaster BH, Costill DL, Trappe SW, Hughes GM. The relationship of sustained exercise training and bone mineral density in aging male runners. Scand J Med Sci Sports 1996;6:216–21.
Michel BA, Lane NE, Bjorkengren A, Bloch DA, Fries JF. Impact of running on lumbar bone density: a 5-year longitudinal study. J Rheumatol 1992;19:1759–63.
Bilanin JE, Blanchard MS, Russek Cohen E. Lower vertebral bone density in male long distance runners. Med Sci Sports Exerc 1989;21:66–70.
Wolman RL, Faulmann L, Clark P, Hesp R, Harries MG. Different training patterns and bone mineral density of the femoral shaft in elite, female athletes. Ann Rheum Dis 1991;50:487–9.
Kirk S, Sharp CF, Elbaum N, et al. Effect of long-distance running on bone mass in women. J Bone Miner Res 1989;4:515–22.
Williams JA, Wagner J, Wasnich R, Heilbrun L. The effect of long-distance running upon appendicular bone mineral content. Med Sci Sports Exerc 1984;16:223–7.
Taaffe DR, Pruitt L, Lewis B, Marcus R. Dynamic muscle strength as a predictor of bone mineral density in elderly women. J Sports Med Phys Fitness 1995;35:136–42.
Michel BA, Bloch DA, Fries JF. Weight-bearing exercise, overexercise, and lumbar bone density over age 50 years. Arch Intern Med 1989;149:2325–9.
Margulies JY, Simkin A, Leichter I, et al. Effect of intense physical activity on the bone-mineral content in the lower limbs of young adults. J Bone Joint Surg Am 1986;68:1090–3.
Leichter I, Simkin A, Margulies JY, et al. Gain in mass density of bone following strenuous physical activity. J Orthop Res 1989;7:86–90.
Sinaki M, Wahner HW, Bergstralh EJ, et al. Three-year controlled, randomized trial of the effect of dose-specified loading and strengthening exercises on bone mineral density of spine and femur in nonathletic, physically active women. Bone 1996;19:233–44.
Bassey EJ, Ramsdale SJ. Weight-bearing exercise and ground reaction forces: a 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. Bone 1995;16:469–76.
Gleeson PB, Protas EJ, Leblanc AD, Schneider VS, Evans HJ. Effects of weight lifting on bone mineral density in premenopausal women. J Bone Miner Res 1990;5:153–8.
Rikli RE, McManis BG. Effects of exercise on bone mineral content in postmenopausal women. Res Q Exerc Sport 1990;61:243–9.
Krolner B, Toft B, Pors Nielsen S, Tondevold E. Physical exercise as prophylaxis against involutional vertebral bone loss: a controlled trial. Clin Sci 1983;64;541–6.
Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures: a randomized controlled trial. JAMA 1994;272:1909–14.
Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJJ. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med 1988;108:824–8.
Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J Clin Res Ed 1987;295:1441–4.
Bassey EJ, Ramsdale SJ. Increase in femoral bone density in young women following high-impact exercise. Osteoporos Int 1994;4:72–5.
Lohman T, Going S, Pamenter R, et al. Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study. J Bone Miner Res 1995;10:1015–24.
Snow Harter C, Bouxsein ML, Lewis BT, Carter DR, Marcus R. Effects of resistance and endurance exercise on bone mineral status of young women: a randomized exercise intervention trial. J Bone Miner Res 1992;7:761–9.
Notelovitz M, Martin D, Tesar R, et al. Estrogen therapy and variable-resistance weight training increase bone mineral in surgically menopausal women. J Bone Miner Res 1991;6:583–90.
Heinonen A, Kannus P, Sievanen H, et al. Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 1996;348:1343–7.
Kerr D, Morton A, Dick I, Prince R. Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res 1996;11:218–25.
Pruitt LA, Taaffe DR, Marcus R. Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women. J Bone Miner Res 1995;10:1788–95.
Martin D, Notelovitz M. Effects of aerobic training on bone mineral density of postmenopausal women. J Bone Miner Res 1993;8:931–6.
Rockwell JC, Sorensen AM, Baker S, et al. Weight training decreases vertebral bone density in premenopausal women: a prospective study. J Clin Endocrinol Metab 1990;71:988–93.
Smith EL, Gilligan C, McAdam M, Ensign CP, Smith PE. Deterring bone loss by exercise intervention in premenopausal and postmenopausal women. Calcif Tissue Int 1989;44:312–21.
Smidt GL, Lin SY, O’Dwyer KD, Blanpied PR. The effect of high-intensity trunk exercise on bone mineral density of postmenopausal women. Spine 1992;17:280–5.
Klesges RC, Ward KD, Shelton ML, et al. Changes in bone mineral content in male athletes: mechanisms of action and intervention effects. JAMA 1996;276:226–30.
Dalsky GP. Effect of exercise on bone: permissive influence of estrogen and calcium. Med Sci Sports Exerc 1990;22:281–5.
Anderson JJB, Rondano P, Holmes A. Nutrition, life style and quality of life; roles of diet and physical activity in the prevention of osteoporosis. Scand J Rheumatol 1996;25(Suppl 103):65–74.
Prior JC, Vigna YM, Schechter MT, Burgess AE. Spinal bone loss and ovulatory disturbances [published erratum appears in N Engl J Med 1993;328:1724]. N. Engl J Med 1990;323:1221–7.
Prince RL, Smith M, Dick IM, et al. Prevention of postmenopausal osteoporosis: a comparative study of exercise, calcium supplementation, and hormone-replacement therapy. N Engl J Med 1991;325:1189–95.
Wyshak G, Frisch RE, Albright TE, Albright NL, Schiff I. Bone fractures among former college athletes compared with nonathletes in the menopausal and postmenopausal years. Obstet Gynecol 1987;69:121–6.
Michel BA, Bloch DA, Fries JF. Physical activity and fractures over the age of fifty years. Int Orthop 1992;16:87–91.
Sorock GS, Bush TL, Golden AL, Fried LP, Breuer B, Hale WE. Physical activity and fracture risk in a free-living elderly cohort. J Gerontol 1988;43:M134–9.
Greendale GA, Barrett-Connor E, Edelstein S, Ingles S, Haile R. Lifetime leisure exercise and osteoporosis: the Rancho Bernardo study. Am J Epidemiol 1995;141:951–9.
Elward K, Larson EB. Benefits of exercise for older adults: a review of existing evidence and current recommendations for the general population. Clin Geriatr Med 1992;8:35–80.
Blair SN, Kohl HW, Gordon NF, Paffenbarger RSJ. How much physical activity is good for health? Annu Rev Public Health 1992;13:99–126.
Cauley JA, Seeley DG, Ensrud K, Ettinger B, Black D, Cummings SR. Estrogen replacement therapy and fractures in older women. Ann Intern Med 1995;122:9–16.
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Joakimsen, R.M., Magnus, J.H. & Fønnebø, V. Physical activity and predisposition for hip fractures: A review. Osteoporosis Int 7, 503–513 (1997). https://doi.org/10.1007/BF02652555
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DOI: https://doi.org/10.1007/BF02652555