Osteoporosis & Osteopenia

Osteoporosis Exercise Program in Hong Kong

Osteoporosis is a common condition affecting millions of people worldwide. It is a serious disease that causes our bones to become weak which results in a higher chance of a broken bone (or fracture) when we have a simple fall. Bone is a living tissue that is constantly being broken down and replaced. Osteoporosis happens when the creation of new bone no longer keeps up with the loss of old bone.

Osteopenia is a loss of bone mineral density (BMD). This means that that your bones are classified as weaker (or less dense) than normal, but not quite as weak as those with osteoporosis. However, people with osteopenia are at a higher risk of developing osteoporosis.

Generally, after age 35, our bones begin to break down faster than they build up. Even in healthy individuals, bone density decreases by less than 1% every year.

Key Statistics:

Osteoporosis affects around 200 million women worldwide

Menopause increases the risk of developing osteoporosis

Bones become less dense as we age leading to an increased risk of bone fracture

Most common bones to break are the wrist, hip, and spine

1 in 3 women over age 50 will experience osteoporosis fractures worldwide

1 in 5 men aged over 50 will have low bone density. For Asian and Caucasian men, the statistics is 1 in 3 men

How are Osteoporosis and Osteopenia diagnosed?

Osteopenia does not cause any signs or symptoms. Osteoporosis is known to be a “silent” disease because there are typically no symptoms until a bone is broken. Once your bones have been weakened by osteoporosis, you may experience symptoms of a vertebral fracture, such as back pain, loss of height, a stooped posture (kyphosis).

The bone mineral density scan (DXA) is the primary method to detect and diagnose osteoporosis. They can be ordered by your general practitioner (GP). The measurements, known as T-scores, can tell us if you have osteoporosis, osteopenia or normal bone density.

How Can We Help with Osteoporosis and Osteopenia?

Although osteoporosis is not reversible, weight-bearing exercise along with dietary changes can prevent or even stop further bone loss, reducing the risk of getting a fracture.

Our Bone Health Asia physiotherapists have the expertise and experience to ensure you manage your bone health safely. We are the first clinic in Asia that is certified to carry out Onero™, an evidence-based exercise programme specifically designed to prevent osteoporotic fracture, maximize bone density and prevent falls and fractures. Our Bone Health Asia team are highly experienced in delivering Onero™ to at-risk clients.

What is Onero™?

Onero™ is an evidence-based exercise programme designed to prevent osteoporotic fracture by stimulating bone development and preventing falls. It is appropriate for adults of any age with osteoporosis and those who are at risk of developing it.

The programme is based on the outcomes of the LIFTMOR and MEDEXOP trials that were published in the Journal of Bone and Mineral Research (JBMR):

The Research

The latest research from The Bone Clinic shows that significant improvement was observed in every measured parameter relevant to bone health:

Lumbar Spine Bone Mass Density (BMD): Increase of 4.0 to 4.1%

Total Hip BMD: Increase of 1.5 to 3.4%

Femoral Neck BMD:  2.4 to 4.5%

Lean Mass:  1.8 to 4.1% (P<.0001)

Functional Reach: 8.1 to 12.0%

Back Extensor Strength:  Increase of 27.8% to 49.1%

Previous fractures:  Decreased 91.7%

[1] Beck BR and Weis LJ: Translating high intensity loading for osteoporosis to the real world: Two year observations from The Bone Clinic. Research to Practice Annual Scientific Meeting of Exercise and Sports Science Australia, Brisbane, Australia, 27-29 March 2018 (Winner: Practitioner Award)

Why Is Onero™ Different?

Not all exercise improves bone mass. Research from the LIFTMOR study has demonstrated that only certain types of high intensity weight-bearing exercise can be safe and effective in improving bone health. This is why Onero™’s higher intensity exercise protocols have been specifically designed for bone health.

The exercise protocol of Onero™ is targeted specifically to bone, being brief but high intensity. One of the great features of Onero™ is that you don’t need to exercise five days of the week. Research has found that just twice a week is enough to stimulate bone, improve muscle and help prevent falls. In fact, the original research that underpins Onero™ included only 1 hour of exercise a week.

To be safe and effective the programme must be supervised by an accredited Onero™ practitioner (physiotherapist or exercise physiologist). Our Bone Health Asia physiotherapists are licensed and certified to deliver Onero™ to clients in Hong Kong.

How Do I Start?

Before your first session with us, please complete this free Osteoporosis Risk Test.

Send in your results prior to the initial assessment if possible.

While it isn’t necessary, it is advisable for you to have a DXA scan so that we have a baseline measurement of your bone density.

Furthermore, if you have a pronounced curve in your middle back (thoracic spine) then an EOS scan to determine the angle of your spine is recommended. The EOS scan is a low dose x-ray taken in a standing position and provides a 3D picture of your spine and lower limbs.

Book your Bone Health Onero™ Appointment Today

Onero™ at Bone Health Asia located in Central, Hong Kong provides one-on-one sessions, delivered by our clinically trained physiotherapists, driving you to better bone health. Our clinic is the first one in Asia that is licensed to safely deliver the Onero™ programme.


Rm. 1901, 19/F, Winway Building, 50 Wellington Street, Central

Any Questions? Contact Us Today

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Bones need exercise

“When it comes to bones we know exercise can benefit people throughout their life – by growing bigger stronger bones in childhood, improving bones throughout adulthood and preventing falls that can lead to fracture as we age.”

Professor Belinda Beck
Director, The Bone Clinic

Find out more about Osteoporosis

To learn more about osteoporosis, osteopenia and the Onero™ programme, please visit the following resources below:

About Osteoporosis & Osteopenia (English)

About Osteoporosis & Osteopenia (Chinese)

The Bone Clinic

The Bone Clinic, which are the developers of Onero™, disseminate this effective exercise program throughout Australia. They have an informative video explaining how the programme can increase bone density, strengthen your muscles and reduce the risk of falls and fractures.

To determine your risk of breaking a bone, please visit the Healthy Bones Australia website and fill out this free Osteoporosis & Fragility Fracture Risk Test questionnaire.

Our bone health needs change over time. We need to build maximum bone and strength in childhood and adolescence, maintain muscle and bone strength during our adulthood and reduce bone loss in our later years, while also maintaining muscle strength, balance, mobility and prevent falls.


What is Onero™?

Onero™ is an evidence–based exercise programme developed from the LIFTMOR randomized controlled trial, conducted at Griffith University, (Queensland Australia) under the supervision of Professor Belinda Beck and recently published in the Journal of Bone Mineral Research (2018). Since 2015, Onero™ has been implemented at The Bone Clinic in Brisbane, Australia and a growing number of licensed providers in Australia (currently over 30). and Bone Health Asia has been awarded the first international license to deliver the Onero™ programme in Hong Kong.

What is the benefit of participating in the Onero™ programme?

The LIFTMOR study found that Onero™ increases bone mass, improves posture and decreases falls in clinic patients. Results show that 86% of patients increased bone mass at the lumbar spine and 69% of patients increased bone mass at the hip. These results were presented at the annual scientific meeting of the American Society of Bone and Mineral Research in Montreal (2018).

Is Onero™ safe for someone with osteoporosis?

Yes, one of the biggest benefits of training with an accredited Onero practitioner is its safety for those with low bone density. Exercise is good for you, but people often underestimate the difference between one type of exercise and another. Having low bone mass places you at increased risk of fracture during exercise.

An accredited Onero™ practitioner will know how to safely deliver the Onero™ program, correctly assess your current health including any pre-existing injuries or conditions, and report your baseline assessment results and to you and your GP.

The program must be supervised by an accredited therapist who is trained and licensed to deliver the programme. Our Clinic is licensed to deliver Onero™ to our clients with or at risk of osteoporosis. The LIFTMOR trial and subsequent clinical data over the last 8 years reports extremely low rate of injury during the programme. While the Onero™ programme requires lifting weights, the loads applied are slowly increased and the weights are never increased unless your lifting form is perfect.

What sort of exercise does the Onero™ programme involve?

The exercise protocol is targeted specifically to stimulate bone, strengthen muscles and prevent falls, so it is comprised of low repetitions but high intensity, impact loading, mobility and balance.

How often do I need to attend the Onero™ programme?

One of the great features of Onero™ is that you don’t need to exercise five days of the week. Research has found that just 2 exercise sessions a week is enough to stimulate bone, improve muscle and help prevent falls. In fact, the original research that underpins Onero™ included only 1 hour of exercise a week.

Do I need special clothes and shoes?

No special clothing is required. Please wear comfortable clothing which allows you to squat without restriction and shoes with as little support or padding as possible to maximize the effect of the impact loading exercises.

Can I continue with my other treatments at the same time?

Yes. Onero is not a replacement for your current osteoporosis treatments.

Do I need to have a bone scan done before I start the programme?

If you are deemed to be at risk following the completion of the Risk assessment form then yes a baseline bone scan (DXA) is warranted before your initial assessment with us or before you start the Onero programme.

How long do I need to do the programme for?

The original study which Onero™ is based upon, took a group of individuals with low to very low bone density and put them through training for 30 minutes 2 times a week over an 8 month period. Bone production and resorption never stops so you must continue to load your bones. After our peak bone mass is achieved, our bone density tends to decline with age. So, the old saying is true – if you don’t use it – you will lose it!