Wirkung von Bewegungstraining auf den Knochenmineralgehalt bei postmenopausalen Frauen: Eine systematische Übersicht und Meta-Analyse von Interventionsstudien

Background and Aims DRT defined as any kind of resistance exercise that involves joint movement and focuses on the development of musculoskeletal strength, which is considered an important component of osteoporosis prevention and therapy. This current study conducted to determine the effect of DRT on BMD in PMW and derive evidence-based recommendations for optimized training protocols. Material and Methods This review followed the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and was registered in advance in the International prospective register of systematic reviews (PROSPERO) (ID: CRD42018095097). Literature searches with no language restriction were conducted through eight electronic databases up to March 2019. Controlled trials with ≥ 6 months intervention duration among PMW that comprised DRT intervention with at least one exercise and one control group were included in this study. Meta-analyses were performed using random-effects models and effect sizes calculated using the SMD for BMD changes at LS, FN, and tHip. Moderators of the exercise effects, i.e., “intervention length,” “type of DRT,” “training frequency,” “exercise intensity,” and “exercise volume,” were addressed by sub-group analyses. P-values < 0.05 were considered statistically significant. Results Seventeen articles with 20 exercise and 18 control groups met our eligibility criteria. Results of the meta-analyses showed a significant effect for LS (SMD = 0.54, 95%-CI: 0.22–0.87), FN (SMD = 0.22, 95%-CI: 0.07–0.38), and tHip (SMD = 0.48, 95%-CI: 0.22–0.75) (all P ≤ 0.015). However, sub-group analysis revealed no differences within categories of moderators for FN. Lower training frequency (< 2 sessions/week) resulted in significantly higher BMD changes at LS and tHip compared to higher training frequency (≥ 2 sessions/week). Furthermore, our result demonstrated that free weight training had a greater effect than DRT devices for improving tHip-BMD. Unfortunately, sub-analysis results did not allow meaningful exercise recommendations to be derived. Conclusions This systematic review and meta-analysis revealed a significant low-moderate effect of dynamic resistance exercise on BMD in PMW. However, exercise characteristics did not allow us to derive meaningful exercise recommendations in the area of exercise and osteoporosis prevention or therapy. Hintergrund und Ziele Osteoporose ist ein wichtiges Thema für PMW. Bewegungstraining ist eine günstige und sichere nicht-pharmazeutische Strategie zur Osteoporose-Prävention bei Menschen mittleren Alters. Daher war es unser Ziel, in einer Meta-Analyse die Wirkung von Bewegung auf die BMD bei PMW zusammenzufassen. Methoden und Material Eine umfassende Suche in elektronischen Datenbanken wurde über PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest und Primo durchgeführt. BMD-Veränderungen (standardisierte Mittelwertunterschiede: SMD) der LS, des FN und/oder der tHip wurden als Ergebnismessung berücksichtigt. Nach der Kategorisierung der Untergruppen wurden statistische Methoden verwendet, um die Daten zu kombinieren und die Untergruppen zu vergleichen. Ergebnisse In die vorliegende Meta-Analyse wurden fünfundsiebzig Studien eingeschlossen. Die Gesamtzahl der Teilnehmer betrug 5.300 (Interventionsgruppe: n = 2.901, Kontrollgruppe: n = 2.399). Der gepoolte Schätzwert der Random-Effekt-Analyse lautete: SMD = 0,37, 95%-CI: 0,25-0,50; SMD = 0,33, 95%-CI: 0,23-0,43 und SMD = 0,40, 95%-CI: 0,28-0,51 für LS, FN und die tHip-BMD. Wir fanden einen signifikanten Effekt (SMD = 0,33-0,40, p < 0,001) des Trainings auf die BMD an LS und PF. Schlussfolgerung Es zeigte sich eine große Heterogenität zwischen den einzelnen Studienergebnissen, von hoch effektiven Studien bis hin zu kleinen signifikanten negativen Ergebnissen. Diese Unterschiede sind größtenteils auf Unterschiede zwischen den Trainingsprotokollen in verschiedenen Studien zurückzuführen. Die Ergebnisse zeigen, dass der tatsächliche Effekt von Bewegung auf die Knochendichte durch eine signifikante Anzahl von Studien mit ungeeigneten Trainingsprotokollen beeinflusst wird

Protocol for systematic review: peak bone mass pattern in different parts of the world

Copyright: © 2015 Mohammadi Z. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Peak bone mass, which can be defined as the amount of bone tissue present at the end of the skeletal maturation, and also it is an important determinant of osteoporotic fracture risk. The peak bone mass of a given part of the skeleton is directly dependent upon both its genetics and environmental factors. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the pattern of peak bone mass in different countries across the globe. The present article explains the protocol for conducting such a research

Effects of Different Types of Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis

Abstract In this sub-analysis of a comprehensive meta-analysis, we aimed to determine the effect of different types of exercise on (areal) bone mineral density (BMD) in postmenopausal women. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) with at least one exercise and one control group, (c) intervention ≥ 6 months, (d) BMD assessments at lumbar spine (LS), femoral neck (FN) or total hip (TH), (e) in postmenopausal women. Eight electronic databases were scanned without language restrictions up to March 2019. The present subgroup analysis was conducted as a mixed-effect meta-analysis with “type of exercise” as the moderator. The 84 eligible exercise groups were classified into (a) weight bearing (WB, n = 30) exercise, (b) (dynamic) resistance exercise (DRT, n = 18), (c) mixed WB&DRT interventions (n = 36). Outcome measures were standardized mean differences (SMD) for BMD-changes at LS, FN and TH. All types of exercise significantly affect BMD at LS, FN and TH. SMD for LS average 0.40 (95% CI 0.15–0.65) for DRT, SMD 0.26 (0.03–0.49) for WB and SMD 0.42 (0.23–0.61) for WB&DRT. SMD for FN were 0.27 (0.09–0.45) for DRT, 0.37 (0.12–0.62) for WB and 0.35 (0.19–0.51) for WB&DRT. Lastly, SMD for TH changes were 0.51 (0.28–0.74) for DRT, 0.40 (0.21–0.58) for WB and 0.34 (0.14–0.53) for WB&DRT. In summary, we provided further evidence for the favorable effect of exercise on BMD largely independent of the type of exercise. However, in order to generate dedicated exercise recommendations or exercise guideline, meta-analyses might be a too rough tool

The study of bone mineral density in postmenopausal women with rheumatoid arthritis

زمینه و هدف: کاهش تراکم مواد معدنی موجب بروز پوکی استخوان و عوارض ناشی از آن می شود. مطالعه حاضر با هدف بررسی وضعیت تراکم معدنی استخوان بر اساس رده های مختلف سنی در زنان یائسه مبتلا به آرتریت روماتوئید انجام شده است. روش بررسی: مطالعه توصیفی-تحلیلی حاضر، بر روی 98 زن یائسه مبتلا به آرتریت روماتوئید مراجعه کرده به بیمارستان آموزشی درمانی 5 آذر شهرستان گرگان که نتایج سنجش تراکم استخوانی آنان در پرونده موجود بود، انجام شد. اطلاعات لازم به وسیله پرسشنامه از پرونده های بیماران استخراج گردید. داده ها با استفاده از آزمون های آماری آماره های توصیفی (فراوانی نسبی و فراوانی مطلق، میانگین و انحراف معیار) و آزمون های تحلیلی (رگرسیون، کای دو، ضریب همبستگی اسپیرمن و ANOVA)، مورد بررسی قرار گرفت. یافته ها: در مجموع 98 زن یائسه مبتلا به آرتریت روماتوئید با میانگین سنی39/9 ± 88/57 سال مورد بررسی قرار گرفتند. شیوع کلی استئوپروز 3/13 گزارش شد که با افزایش سن به طور معنی‌داری افزایش یافت (001/0

Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women : A Systematic Review and Meta-Analysis of Intervention Studies

Osteoporosis is a major health problem in post-menopausal women (PMW). Exercise training is considered a cost-effective strategy to prevent osteoporosis in middle aged-older people. The purpose of this study is to summarize the effect of exercise on BMD among PMW. A comprehensive search of electronic databases was conducted through PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest, and Primo. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) femoral neck (FN) and/or total hip were considered as outcome measures. After subgroup categorization, statistical methods were used to combine data and compare subgroups. Seventy-five studies were included. The pooled number of participants was 5,300 (intervention group:n= 2,901, control group:n= 2,399). The pooled estimate of random effect analysis was SMD = 0.37, 95%-CI: 0.25-0.50, SMD = 0.33, 95%-CI: 0.23-0.43, and SMD = 0.40, 95%-CI: 0.28-0.51 for LS, FN, and total Hip-BMD, respectively. In the present meta-analysis, there was a significant (p<0.001), but rather low effect (SMD = 0.33-0.40) of exercise on BMD at LS and proximal femur. A large variation among the single study findings was observed, with highly effective studies but also studies that trigger significant negative results. These findings can be largely attributed to differences among the exercise protocols of the studies. Findings suggest that the true effect of exercise on BMD is diluted by a considerable amount of studies with inadequate exercise protocols.Peer reviewe