***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Summary This study showed that combination of strength , balance , agility and jumping training prevented functional decline and bone fragility in home-dwelling elderly women . The finding supports the idea that it is possible to maintain good physical functioning by multi-component exercise program and thus postpone the age-related functional problems . Introduction This 1-year r and omized , controlled exercise intervention trial assessed the effects of two different training programs and their combination on physical functioning and bone in home-dwelling elderly women . Methods One hundred and forty-nine healthy women aged 70–78 years were r and omly assigned into : group 1—resistance training ( RES ) , group 2—balance-jumping training ( BAL ) , group 3—combination of resistance and balance-jumping training ( COMB ) , and group 4—controls ( CON ) . Self-rated physical functioning , leg extensor force , dynamic balance , and bone mass and structure were measured . Results Self-rated physical functioning improved in the COMB group , but was reduced in the CON group ; the mean inter-group difference was 10 % ( 95 % CI : 0–22 % ) . Mean increase in the leg extensor force was higher in the RES ( 14 % ; 4–25 % ) and COMB ( 13 % ; 3–25 % ) compared with the CON groups . Dynamic balance improved in the BAL ( 6 % ; 1–11 % ) and in the COMB ( 8 % ; 3–12 % ) groups . There were no inter-group differences in BMC at the proximal femur . In those COMB women who trained at least twice a week , the tibial shaft structure weakened 2 % ( 0–4 % ) less than those in the CON group . Conclusions Strength , balance , agility , and jumping training ( especially in combination ) prevented functional decline in home-dwelling elderly women . In addition , positive effects seen in the structure of the loaded tibia indicated that exercise may also play a role in preventing bone fragility Summary This study showed that about a half of the exercise-induced  gain in dynamic balance and bone strength was maintained one year after cessation of the supervised high-intensity training  of home-dwelling elderly women . However , to maintain exercise-induced gains in lower limb muscle force and physical functioning , continued training seems necessary . Introduction Maintenance of exercise-induced benefits in physical functioning and bone structure was assessed one year after cessation of 12-month r and omized controlled exercise intervention . Methods Originally 149 healthy women 70–78 years of age participated in the 12-month exercise RCT and 120 ( 81 % ) of them completed the follow-up study .  Self-rated physical functioning , dynamic balance , leg extensor force , and bone structure were assessed . Results During the intervention , exercise  increased dynamic balance by 7 % in the combination resistance and balance-jumping training group ( COMB ) . At the follow-up , a 4 % ( 95 % CI : 1–8 % ) gain compared with the controls was still seen , while the exercise-induced isometric leg extension force and self-rated physical functioning benefits had disappeared . During the intervention , at least twice a week trained COMB subjects obtained a significant 2 % benefit in tibial shaft bone strength index compared to the controls . A half of this benefit seemed to be maintained at the follow-up . Conclusions Exercise-induced  benefits in dynamic balance and rigidity in the tibial shaft may partly be maintained one year after cessation of a supervised 12-month multi-component training in initially healthy elderly women . However , to maintain the achieved gains in muscle force and physical functioning , continued training seems necessary UNLABELLED We prospect ively examined vBMD and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up . Periosteal apposition occurred both in men and women . Endocortical resorption causes  bone loss  in older women despite periosteal apposition . INTRODUCTION To address the hypothesis that age-related changes in BMD and bone geometry may be different in men and women , we prospect ively examined volumetric BMD ( vBMD ) and structural bone parameters assessed by QCT among participants of the InCHIANTI study over a 6-yr follow-up . MATERIAL S AND METHODS Three hundred forty-five men and 464 women 21 - 102 yr of age from the InCHIANTI study , a population -based study in Tuscany , Italy , were included .  Tibial QCT bone parameters were measured at enrollment ( 1998 - 2000 ) and at 3- ( 2001 - 2003 ) and 6-yr ( 2004 - 2006 ) follow-ups . RESULTS Periosteal apposition occurred both in men and women . The annual rate of bone periosteal apposition was higher in younger than in older men , whereas in women , the rate of apposition was homogenous across age groups . The age-related medullary expansion , expression of endocortical resorption , was significantly higher in women compared with men . In women , but not in men , accelerated endocortical resorption not sufficiently balanced by periosteal apposition caused accelerated loss in cortical bone mass . The cross-sectional moment of inertia decreased progressively over the life span in both sexes . CONCLUSIONS Endocortical resorption causes bone loss in older women despite periosteal apposition . Obtaining a balance between endocortical resorption and periosteal apposition should be the target for interventions aim ed to decrease bone loss and prevent osteoporosis in older women UNLABELLED The increase in bone fragility after menopause results from reduced periosteal bone formation and increased endocortical resorption . Women with highest remodeling had greatest loss of bone mass and estimated bone strength , whereas those with low remodeling lost less bone and maintained estimated bone strength . INTRODUCTION Bone loss from the inner ( endocortical ) surface contributes to bone fragility , whereas deposition of bone on the outer ( periosteal ) surface is believed to be an adaptive response to maintain resistance to bending . MATERIAL S AND METHODS To test this hypothesis , changes in bone mass and estimated indices of bone geometry and strength of the one-third distal radius , bone turnover markers , and fracture incidence were measured annually in 821 women 30 - 89 years of age for 7.1 + /- 2.5 years . The analyses were made in 151 premenopausal women , 33 perimenopausal women , 279 postmenopausal women , and 72 postmenopausal women receiving hormone replacement therapy ( HRT ) .  RESULTS In premenopausal women , periosteal apposition increased the radius width , partly off setting endocortical resorption ; therefore , the estimated cortical thickness decreased . Outward displacement of the thinner cortex maintained bone mass and cortical area and increased estimated bending strength . Estimated endocortical resorption accelerated during perimenopause , whereas periosteal apposition decreased . Further cortical thinning occurred , but estimated bending strength was maintained by modest outward cortical displacement . Endocortical resorption accelerated further during the postmenopausal years , whereas periosteal apposition declined further ; cortices thinned , but because outward displacement was minimal , estimated cortical area and bending strength now decreased . Women with highest remodeling had the greatest loss of bone mass and strength . Women with low remodeling lost less bone and maintained estimated bone strength . In  HRT-treated women , loss of bone strength was partly prevented . These structural indices predicted incident fractures ; a 1 SD lower section modulus doubled fracture risk . CONCLUSIONS Periosteal apposition does not increase after menopause to compensate for bone loss ; it decreases . Bone fragility of osteoporosis is a consequence of reduced periosteal bone formation and increased endocortical resorption . Underst and ing the mechanisms of the age-related decline in periosteal apposition will identify new therapeutic targets . On the basis of our results , it may be speculated that the stimulation of periosteal apposition will increase bone width and improve skeletal strength CONTEXT Despite decades of accumulated observational evidence , the balance of risks and benefits for hormone use in healthy postmenopausal women remains uncertain . OBJECTIVE To assess the major health benefits and risks of the most commonly used combined hormone preparation in the United States . DESIGN Estrogen plus progestin component of the Women 's Health Initiative , a r and omized controlled primary prevention trial ( planned duration , 8.5 years ) in which 16608 postmenopausal women aged 50 - 79 years with an intact uterus at baseline were recruited by 40 US clinical centers in 1993 - 1998 . INTERVENTIONS Participants received conjugated equine estrogens , 0.625 mg/d , plus medroxyprogesterone acetate , 2.5 mg/d , in 1 tablet ( n = 8506 ) or placebo ( n = 8102 ) . MAIN OUTCOMES MEASURES The primary outcome was coronary heart disease ( CHD ) ( nonfatal myocardial infa rct ion and CHD death ) , with invasive breast cancer as the primary adverse outcome . A global index summarizing the balance of risks and benefits included the 2 primary outcomes plus stroke , pulmonary embolism ( PE ) , endometrial cancer , colorectal cancer , hip fracture , and death due to other causes . RESULTS On May 31 , 2002 , after a mean of 5.2 years of follow-up , the data and safety monitoring board recommended stopping the trial of estrogen plus progestin vs placebo because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits . This report includes data on the major clinical outcomes through April 30 , 2002 . Estimated hazard ratios ( HRs ) ( nominal 95 % confidence intervals [ CIs ] ) were as follows : CHD , 1.29 ( 1.02 - 1.63 ) with 286 cases ; breast cancer , 1.26 ( 1.00 - 1.59 ) with 290 cases ; stroke , 1.41 ( 1.07 - 1.85 ) with 212 cases ; PE , 2.13 ( 1.39 - 3.25 ) with 101 cases ; colorectal cancer , 0.63 ( 0.43 - 0.92 ) with 112 cases ; endometrial cancer , 0.83 ( 0.47 - 1.47 ) with 47 cases ; hip fracture , 0.66 ( 0.45 - 0.98 ) with 106 cases ; and death due to other causes , 0.92 ( 0.74 - 1.14 ) with 331 cases . Corresponding HRs ( nominal 95 % CIs ) for composite outcomes were 1.22 ( 1.09 - 1.36 ) for total cardiovascular disease ( arterial and venous disease ) , 1.03 ( 0.90 - 1.17 ) for total cancer , 0.76 ( 0.69 - 0.85 ) for combined fractures , 0.98 ( 0.82 - 1.18 ) for total mortality , and 1.15 ( 1.03 - 1.28 ) for the global index . Absolute excess risks per 10 000 person-years attributable to estrogen plus progestin were 7 more CHD events , 8 more strokes , 8 more PEs , and 8 more invasive breast cancers , while absolute risk reductions per 10 000 person-years were 6 fewer colorectal cancers and 5 fewer hip fractures . The absolute excess risk of events included in the global index was 19 per 10 000 person-years . CONCLUSIONS Overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2-year follow-up among healthy postmenopausal US women .  All-cause mortality was not affected during the trial . The risk-benefit profile found in this trial is not consistent with the requirements for a viable intervention for primary prevention of chronic diseases , and the results indicate that this regimen should not be initiated or continued for primary prevention of CHD Introduction Bone fragility and decreased functional performance are risk factors for osteoporotic fractures . The influence of long-term recreational gymnastics on the maintenance of bone rigidity and physical performance was evaluated . Methods One hundred and seven gymnasts and 110 referents ( 93 % of the original sample ) participated in this 6-year prospect i ve study .  Analysis of covariance ( ANCOVA ) was used to estimate the between-group differences and changes by time , and regression analyses to find predictors for changes . Results In both groups agility and leg extensor power decreased by over 3 % and 10 % , respectively , but the original between-group differences , favoring the gymnasts , persisted . Proximal femur bone mineral content ( BMC ) decreased approximately 0.5 % per year in both groups , and femoral neck section modulus decreased . Trabecular density of the distal tibia declined only marginally , and cortical area of the tibial midshaft remained unchanged , while cortical density decreased about 2 % in both groups . After adjustment by age , height , weight , change in weight , and follow-up time , antiresorptive medication and high calcium intake accounted most for the maintenance of bone rigidity . Conclusions In spite of similar rates of decline in bone characteristics and physical performance , the recreational gymnasts ’ overall physical condition was comparable to the level that their less active referents had 
    Output:
    
Exercise effects appear to be modest , site-specific , and preferentially influence cortical rather than trabecular components of bone .
Exercise  type also plays a role , with the most prominent mass and geometric changes being observed in response to high-impact loading exercise .
Exercise appears to positively influence bone mass and geometry in postmenopausal women .