BACKGROUND: Osteoporosis is one of the most common diseases that develop with age and cause high morbidity and mortality among elderly people. OBJECTIVES: This study was set out to evaluate the influence of a program of modified Sinaki exercises, Nordic walking (NW) and a combination of these physical activities on people with osteoporosis. MATERIAL AND METHODS: A sample consisting of 91 women aged 65-98 years living in residential care facilities was randomized into 4 groups. The control group (group 1) received only pharmacological treatment. In the other 3 groups, the same drug therapy was enhanced by a program of modified Sinaki exercises (group 2), Nordic walking (group 3), and Sinaki exercises and Nordic walking applied together (group 4). At baseline and after 12 months of intervention, the participants were assessed for bone density, rib cage mobility, motor abilities, risk of falling (Timed Up and Go Test - TUG, Functional Reach Test - FRT), and locomotor activity (based on pedometer readings). The intervention was completed by 83 participants. RESULTS: Bone density (T-score) was higher in all intervention groups and in the control group (p < 0.003). The improvement in rib cage mobility was statistically significant in groups 2 (p < 0.001) and 4 (p < 0.002). Locomotor activity significantly improved in groups 3 (p < 0.000) and 4 (p < 0.000). The post-intervention results of the TUG and FRT tests showed a significantly lower risk of falling in group 4. In groups 1 and 2, the risk was higher, but not statistically significantly, and in group 3, it did not change. CONCLUSIONS: Modified Sinaki exercises and Nordic walking significantly improved the mobility of the rib cage, locomotor activity and motor abilities in the women comprising groups 2 and 3, but the best results of the intervention were noted in the group treated with both forms of physical activity.