AVALIAÇÃO E PRESCRIÇÃO DE EXERCÍCIOS FÍSICOS PARA GRUPOS ESPECIAIS (OSTEOPOROSE)

Abstract

Osteoporosis increases the risk of fractures and disability in older adults, making exercise a central component of care. We conducted an integrative and narrative qualitative literature review using the PubMed, SciELO, ScienceDirect, BMC Geriatrics, Cochrane Library, and gray literature (Google Scholar) databases, covering the period from 2010 to 2024. We used Portuguese and English descriptors related to osteoporosis, exercise, and fall prevention; clinical trials, original studies, reviews/meta-analyses, and expert consensuses were included. After PRISMA-guided screening, 20 studies were fully analyzed. The results indicate modest yet significant gains in bone mineral density, particularly in the lumbar spine and hip, when moderate to high-intensity resistance training with controlled impact is employed. Additionally, consistent reductions in falls were observed in programs that challenge balance; supervised high-intensity protocols showed functional improvement with a favorable safety profile, and guidelines converge toward a multicomponent approach. In the discussion, effectiveness depends on dose, rate of load application, and novelty of the stimulus, with fall reduction being the main mediator of lower fracture risk. Adherence and supervision enhance outcomes, although protocol heterogeneity and gaps remain, particularly for men and adults aged ≥80 years. We conclude that multicomponent, individualized exercise prescription, integrated with pharmacotherapy when indicated, is safe and effective for individuals with osteoporosis.