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Osteoporosis is characterized by a loss of bone density and strength resulting in increased risk of fracture. One promising method for preventing fractures is participation in bone-strengthening physical activity. While the importance of mechanical loading for bone health is understood, assessment strategies are limited. Most researchers measure metabolic loads rather than mechanical loads, but not all activities that improve metabolic health increase bone strength. The osteogenic properties of physical activity (e.g., magnitude of the load, rate at which the load is applied, dynamic and odd nature of the load, duration of loading session, and breaks between sessions) have not traditionally been directly measured in health outcomes and surveillance research. The lack of research in this area has slowed our understanding of exactly what dose of bone-strengthening physical activity to recommend to the public as well as how to prescribe exercise to reduce the risk of fractures. To understand the influence of mechanical loading on bone adaptation, measurement methods must capture multiple physical activity dimensions (intensity, frequency, and time). Advancements in accelerometer technology now allow for the measurement of these dimensions. It is time that the lessons learned from using accelerometers in cardiometabolic health outcomes research be applied to musculoskeletal health.

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