Promoting adherence to bone-loading exercises in postmenopausal women with low bone mass

Nancy Waltman, Melissa A. Cole, Kevin A. Kupzyk, Joan M. Lappe, Lynn R. Mack, Laura D. Bilek

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: We recently completed a parent study (Bone Loading Exercises versus Risedronate on Bone Health in Post-menopausal Women [NIH# R01NR015029]) examining bone-loading exercises to prevent bone loss in postmenopausal women with low bone mass. Forty-three million US women have low bone mass and increased risk for fractures. Bone-loading exercises (weight-bearing and resistance training) can preserve bone mass and decrease risk of fractures. However, multiple barriers prevent women from exercising and adherence rates are low. Purpose: This secondary analysis of the parent study (a) examined barriers specific to women participating in boneloading exercises; (b) described effectiveness of self-efficacy strategies used in the parent study for increasing confidence in knowledge and reducing barriers; and (c) applied study findings and principles of self-efficacy and selfregulation in development of guidelines for promoting adherence to exercises. Methods: Seventy-two women were randomized to the exercise group and completed 12 months of exercises. Instruments for self-efficacy were completed at 2 weeks and barriers interference at 6 months. Percent adherence was measured as the number of exercise sessions attended divided by the number prescribed. Results: In the 12-month study, average adherence to exercises was 58.9%. Lower adherers reported lack of selfregulation skills such as "lack of time" as the most frequent barriers to exercise. Implications for practice: Guidelines developed included promotion of skills for self-regulation (such as regulation of time) as well as self-efficacy to improve adherence rates. Nurse practitioners may be the most motivated of all providers to use guidelines promoting exercise for women in their clinical practice.

Original languageEnglish (US)
Pages (from-to)50-61
Number of pages12
JournalJournal of the American Association of Nurse Practitioners
Issue number1
StatePublished - Jan 4 2022


  • Adherence
  • Barriers
  • Bone-loading exercises
  • Evidence-based guidelines
  • Low bone mass
  • Postmenopausal women
  • Self-efficacy
  • Self-regulation

ASJC Scopus subject areas

  • Nursing(all)


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