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Effects of exercise on physical functioning, bone strength and fall risk among older women

The study investigated the effects of exercise on the physical performance and functioning, bone strength, quality of life and risk of falling among older women. The project included an exercise section and follow-up of the participants one year and five years after the study. Multicomponent exercise was found to be the most effective to prevent functional decline and bone fragility. In addition, a long-term risk for having an injurious fall more than halved among the multicomponent exercisers.


Good functional ability is important to older people because a reduced level of functional ability predisposes them to falling and fall-related injuries. It also limits their social circles, makes it difficult for them to live at home independently, and may lead to institutional care.

Exercise is essential in maintaining and improving one’s functional ability. Exercise is also essential in the prevention of falls and fall-related injuries such as fractures. Exercise can affect several risk factors at the same time, for example by improving balance and muscle strength, strengthening bones and reducing the fear of falling.

Therefore it is necessary to conduct versatile studies to investigate how different exercise programs can be implemented and how useful they are in the short and long term.


The study investigated the effects of resistance and balance and jumping training on muscle performance, balance, bone mass, bone geometry, quality of life and fear of falling among women over the age of 70.

In addition, the study investigated the permanence of the effects one year after the end of training. Moreover, a five-year follow-up study was conducted to assess the long-term effects of the exercise intervention on the women’s functional ability, quality of life, falls and fall-induced injuries.


The study was a randomized, controlled study. A total of 149 home-dwelling women aged between 70 and 78 were randomly assigned to four groups:

  1. resistance training group
  2. balance and jumping training group
  3. combined training group including resistance and balance-jumping training
  4. control group.

The training groups took part in supervised, progressively advancing training three times a week for 12 months. The control group members were asked to maintain their pre-study level of physical activity.

Balance and agility, reaction time, muscle performance, bone mass and geometry, health-related quality of life, fear of falling, falls and fall-induced injuries were assessed at baseline, after the 12-month intervention and one-year after the end of intervention.
A five-year follow-up study was started in order to assess the long-term effects of exercise among elderly women and it was carried out in two parts.

The first part assessed the participants’ health, functional ability, health-related quality of life and fear of falling by a questionnaire and interview. 83% of the women who took part in the intervention participated in the follow-up interview. The second part of the study investigated the fall-induced injuries that required a health care contact with the help of a register-based study for a period of five years following the end of the intervention (n=145, 97%).


The results of the study have been analyzed and reported. Please find the main research articles below.
In summary, all training modes were feasible and safe for home-dwelling older women. Combined resistance and balance-jumping training was found to be the most effective exercise method to prevent functional decline and bone fragility. In addition, a long-term risk for having an injurious fall more than halved among these multicomponent exercisers.


Harri Sievänen  
Researcher Director  

Main publications 

Karinkanta S. To keep fit and function: effects of three exercise programs on multiple risk factors for falls and related fractures in home-dwelling older women. Tampere: University of Tampere, 2011. Acta Universitatis Tamperensis 1643. Academic dissertation (PhD). 

Karinkanta S, Kannus P, Uusi-Rasi K, Heinonen A, Sievänen H. Combined resistance and balance-jumping exercise reduces older women´s injurious falls and fractrues: 5-year follow-up study. Age Ageing 2015;44(5):784-789. Doi: 10.1093/ageing/afv064. 

Karinkanta S, Nupponen R, Heinonen A, Pasanen M, Sievänen H, Uusi-Rasi K, Kannus P. Effects of exercise on health-related quality of life and fear of falling in home-dwelling older women. Journal of Aging and Physical Activity 2012;20:198-214. 

Karinkanta S, Heinonen A, Sievänen H, Uusi-Rasi K, Fogelholm M, Kannus P. Maintenance of exercise-induced benefits in physical functioning and bone among elderly women. Osteopor Int 2009;20:665-674. 

Karinkanta S et al. A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial. Osteoporos Int 2007;18:453-62. 

Last updated: 21.9.2023

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