Background: Scandinavia has one of the highest incidences of osteoporosis and osteoporotic fractures worldwide [1]. In Norway, around 300,000 individuals have osteoporosis, the prevalence is higher among woman, with prevalence increasing with age [2]. Osteoporotic fractures represent a health burden for the individual and a significant economic cost on the health care system [3]. Proper osteoporosis management includes both pharmacological and nonpharmacological interventions targeting lifestyle, nutrition and exercise [4]. Physical activity and exercise are key in self-management of osteoporosis, and evidence indicates that resistance and weight-bearing impact exercise can maintain bone health, enhance muscle strength and balance, and reduce fall and fracture risk ^[5]. However, fear of movement and uncertainty regarding which type of exercise is safe constitutes a significant concern among individuals with osteoporosis [6], underscoring the need for accessible, evidence-based guidance on safe and effective physical activity. Existing guidelines provide evidence-based recommendations tailored to an individual`s functional capacity and fracture risk [7]. However, these guidelines are typically written for health professionals and may be too complex for users. Individuals with osteoporosis require information that is clear, accessible, and actionable. Therefore, there is a need for detailed, Norwegian-language exercise programs that are freely available to the public.

Objectives: To support self-management of osteoporosis by increasing accessibility to, and dissemination of, tailored evidence-based exercise programs and educational materials for individuals diagnosed with osteoporosis in Norway.

Methods: This development project is a collaboration between the Norwegian Rheumatism Association (NRF) and its Osteoporosis Diagnosis Group, Oslo Metropolitan University (OsloMet) and the Danish institution Learn Osteoporosis. Learn Osteoporosis has developed detailed, evidence-based digital exercise materials for individuals with osteoporosis. The material was translated into Norwegian by two physiotherapist researchers with expertise in osteoporosis and exercise from OsloMet in close collaboration with Learn Osteoporosis. NRF and the Diagnosis Group worked with the researchers to adapt and implement the program for members and non-members living with osteoporosis. The program is grounded in established professional recommendations from leading exercise and osteoporosis research communities in the United Kingdom.

Results: Tailored, diagnosis-specific exercise programs and a self-assessment tool, translated and culturally adapted from Danish to Norwegian, were made publicly and freely available through NRF`s website February 2025. Users are encouraged to fill out the self-assessment tool first, to support appropriate exercise-level. The self-assessment tool considers bone mineral density, numbers and sites of fracture, and levels of physical function. There are five different exercise programs, each corresponding to a distinct level of function and exercise capacity. The programs also include instructional training videos on the recommended exercises, with Norwegian subtitles provided for video content. Today, the main page with information about the exercise programs has just under 15,000 page views.

Conclusions: Physical activity and weight-bearing impact exercise, tailored to each individual’s level of function and fracture risk, are central to osteoporosis prevention and management. Accessible evidence-based guidance can reduce barriers to physical activity among individuals with osteoporosis and contribute to improved physical and psychological health outcomes. It also provides a resource for healthcare personnel to recommend to patients. NRF’s involvement ensures that the program reaches individuals directly, leverages the organization’s expertise in patient education, benefits from established networks, and strengthens collaboration between voluntary and professional health sectors.

REFERENCES: [1] Kanis JA, Cooper C, Rizzoli R, Reginster JY: European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2019, 30(1):3-44

[2] Meyer, E. H. & Holvik, K. (2025). Beinskjørhet og brudd (osteoporose og osteoporotiske brudd). Folkehelseinstituttet.

[3] Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA: Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Archives of osteoporosis 2013, 8:136.

[4] Kanis JA, Cooper C, Rizzoli R, Reginster JY: European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2019, 30(1):3-44

[5] Wong, R.M.Y., Chong, K.C., Law, S.W., Ho, W.T., Li, J., Chui, C.S., Chow, S.K.H., Cheung, W.H. (2020). The effectiveness of exercises on fall and fracture prevention amongst community elderlies: A systematic review and meta-analysis.

[6] Halvarsson A, Ståhle A, Halén C, Roaldsen KS: “Better safe than sorry”: a qualitative content analysis of participant’s perspectives of fall-related concerns and balance in older women with osteoporosis after balance training. Disability and Rehabilitation 2016, 38(8):796-802

[7] Daly RM, Dalla Via J, Duckham RL, Fraser SF, Helge EW: Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther 2019, 23(2):170-180

Acknowledgments: NIL.

Disclosure of Interests: None declared.