Sally Bartholomew doesn't let osteoporosis keep her from being active. It's her reason for being active.

She and 10 other participants in the osteoporosis strength training class at Kapi'olani Women's Center meet once a week to beat back the degenerative condition using a routine of stretches and weights.

"There's a really good attitude or mood in the class," said Bartholomew, 72, of Hawai'i Kai. "When I found out I had osteoporosis, there are some things that (I heard) you can do and you can't do. So I wanted to find out what I can do. Just to keep going."

Osteoporosis is a decrease in density of the bones, leaving them porous and easily broken, which often occurs to women ages 50 and older. For that reason, many people with the condition become less active for fear of breaking a bone, said exercise physiologist Marcie Nowack.

And that's exactly where Nowack's osteocise class comes in — a 45-minute, once-a-week exercise routine that helps strengthen core muscles and stretch the body in a variety of ways. It was added to the more traditional strength training class just six months ago.

Nowack has led classes at the Kapi'olani Women's Center, Pali Momi medical center and Straub Pearlridge for the past few years.

"If you have osteoporosis, it's safe, it's what you could do, it's what you should be doing," said Nowack, who functions as the bone health coordinator at Kapi'olani Women's Center. "The worst thing you can do is become more sedentary. You need to be active, you need to keep stimulating the bone."

You don't need to have osteoporosis to register for the classes. In fact, the same exercises can help prevent the condition. Both classes run for six weeks, then start over again. Although it is possible to join in the middle of the course, Nowack recommends people wait until the next session startup date of March 6 to get the most knowledge and strength out of it.

Nowack directs participants through warm-ups on mats, a series of stretches on their backs and then their stomachs. The two courses — osteocise and osteoporosis strength training — differ when it comes to the parts of the body they focus on. The first deals with posture, balance, and stomach and back strengthening. The second and more traditional class deals with safe resistance exercises and uses lengthy rubber bands to strengthen arms and legs.

"The first one (osteocise) is the more educational," Nowack explained. "At the beginning of each class, we talk about calcium or medications, posture. Different topics, so that they get a bit more of an education on osteoporosis, then do the exercises."

Nowack tells the participants of both classes to breathe deeply while they perform their repetitions. It's not for benefit of increased oxygen circulation, but just to keep everyone from holding their breath.

Many members of the osteocise class are veterans of the osteoporosis strength training class, and vice versa. Bartholomew falls into the latter category.

"I wasn't particularly out of shape, but I had a lump on my back that goes along with osteoporosis and (my kids) said it had diminished (after going to the course)," she said. "I think paying for the class, knowing I have to be here at a certain time, that keeps me going."

Registering for the full six weeks costs $45 for the osteocise course, and about $55 for the strength training course.

Pat Ho, a retired city parks and recreation director, started going to the osteocise class three weeks ago with her friend to keep up her strength as a preventive measure.

"I thought it might be a good idea to come, my girlfriend and I, just to get prepared and strengthen our muscles now. We might not be so far gone later," said Ho, who was diagnosed with osteopenia, a less dangerous form of osteoporosis. "It's being proactive."

Men have joined the class in the past, though Nowack said she doesn't have any currently enrolled. Participants range in age from 45 to some in their 80s.

Nowack also offers an audio CD recording of herself leading exercises so participants can use it at home and stay on track during workouts.

"The recording really helps!" Bartholomew said emphatically. "I'll get started on something and then my mind drifts or I'll daydream and do something else, but when (Nowack's) there telling me what to do, then I don't have to keep referring back.

"Short-term memory here," she said with a laugh.

Ho appreciated the different exercises. "The first week was for the front part of your body, the second week was for the back, and (last week) we incorporated everything and (Nowack) included the ball."

The rubber ball exercises are done with a person's back against the wall, to help support the spine as the classmates elevate up and down, strengthening quadriceps.

That instrument makes a certain amount of sense, as the end goal of the courses, of course, is to get everything rolling smoothly.