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IRD IA – Keep bones strong

Many people with inflammatory rheumatic disease are at increased risk of having a lower bone mineral density and developing osteporosis [1,2].  There is evidence from the general population of an inverse association between physical activity and risk of hip fracture and vertebral fracture. The magnitude of the effect of physical activity on bone mineral density is 1% to 2%. Increases in exercise and training can increase spine and hip bone marrow density and can also minimise age related reduction in spine and hip bone mineral density [3].

Quality of evidence:

Low Quality

Strength of recommendation

Weak Recommendation


Those with inflammatory rheumatic disease are at risk of osteoporosis. Evidence from the general population suggests keeping active is positive for bone health.


  1. Hauser B, Riches PL, Wilson JF, Horne AE, Ralston SH. Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis. Rheumatology (Oxford). 2014;53(10):1759-1766
  2. Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis register. Arthritis Rheum. 2000;43(3):522-530
  3. Department of Health. Start Active, Stay Active. In: Strategy; 2011