The impact of different modes of exercise training on bone mineral density in older postmenopausal women:​ a systematic review and meta-analysis research

Rahimi, Gholam Rasul Mohammad; Smart, Neil A.; Liang, Michael T. C.; Bijeh, Nahid; Albanaqi, Alsaeedi L.; Fathi, Mehrdad; Niyazi, Arghavan; Rahimi, Nasser Mohammad

Affiliations

¹Department of Exercise Physiology, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

²Department of Sport Sciences, Vahdat Institute of Higher Education, Torbat-e-Jam, Iran

³School of Science and Technology, University of New England, Armidale, Australia

⁴Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, USA

⁵Turaif General Hospital, Ministry of Health, Turaif, Kingdom of Saudi Arabia

⁶Department of Exercise Physiology, Sanabad Golbahar Institute of Higher Education, Golbahar, Iran

⁷Department of Sport Sciences, Imam Reza International University, Mashhad, Iran

Abstract and keywords

Effectiveness of exercise on bone mass is closely related to the mode of exercise training regimen, as well as the study design. This study aimed to determine the effect of different modes of exercise training on lumbar spine and femoral neck bone mineral density (BMD) in older postmenopausal women (PMW). PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched up until March 25, 2019 for randomized controlled trials (RCTs) that evaluated the effectiveness of various modes of exercise training in PMW. Sixteen RCTs with 1624 subjects were included. Our study found no significant change in both lumbar spine and femoral neck BMD following exercise training (MD: 0.01 g/cm²; 95% confidence interval (CI) [− 0.01, 0.02] and MD: 0.00 g/cm²; 95% CI [− 0.01, 0.01], respectively). However, subgroup analysis by type of exercise training revealed that lumbar spine BMD (MD: 0.01; 95% CI [0.00, 0.02]) raised significantly when whole-body vibration (WBV) was employed as intervention compared with RCTs that utilized aerobic (MD: − 0.01; 95% CI [− 0.02, − 0.01]), resistance (MD: 0.01; 95% CI [− 0.04, 0.06]), and combined training (MD: 0.03; 95% CI [− 0.01, 0.08]). On the other hand, lumbar spine BMD (MD: − 0.01; 95% CI [− 0.02, − 0.01]) reduced significantly when aerobic exercise training was used as intervention compared with RCTs that utilized resistance training, combined training, and WBV. By contrast, these analyses did not have significant effect on change in femoral neck BMD. WBV is an effective method to improve lumbar spine BMD in older PMW.

Keywords: Postmenopausal women; Exercise training; Bone mineral density; Meta-analysis; Randomized controlled trials

Links

DOI: 10.1007/s00223-020-00671-w

PubMed: 32055889

WoS: 000516088800002

History

Received: 2019-10-23

Accepted: 2020-02-06

Online: 2020-02-13

Cited Works (12)

Year	Entry
2004	Verschueren SMP, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S. Effect of 6‐month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study. J Bone Miner Res. March 2004;19(3):352-359.
2003	Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporos Int. March 2003;14(suppl 3):S13-S18.
2012	Al Nazer R, Lanovaz J, Kawalilak C, Johnston JD, Kontulainen S. Direct in vivo strain measurements in human bone: a systematic literature review. J Biomech. January 3, 2012;45(1):27-40.
2001	Kanis JA, Johnell O, Oden A, Dawson A, De Laet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos Int. December 2001;12(12):989-995.
2004	Rubin C, Recker R, Cullen D, Ryaby J, McCabe J, McLeod K. Prevention of postmenopausal bone loss by a low‐magnitude, high‐frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. J Bone Miner Res. March 2004;19(3):343-351.
1995	Pruitt LA, Taaffe DR, Marcus R. Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women. J Bone Miner Res. November 1995;10(11):1788-1795.
2003	Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. September 6, 2003;327(7414):557-560.
2005	Wainwright SA, Marshall LM, Ensrud KE, Cauley JA, Black DM, Hillier TA, Hochberg MC, Vogt MT, Orwoll ES; Study of Osteoporotic Fractures Research Group. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. May 2005;90(5):2787-2793.
2015	Zhao R, Zhao M, Xu Z. The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis. Osteoporos Int. May 2015;26(5):1605-1618.
2002	Robling AG, Hinant FM, Burr DB, Turner CH. Improved bone structure and strength after long‐term mechanical loading is greatest if loading is separated into short bouts. J Bone Miner Res. August 2002;17(8):1545-1554.
2006	Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. December 2006;17(12):1726-1733.
2011	Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Sys Rev. July 6, 2011;7:CD000333.

Cited By (6)

Year	Entry
2021	Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 1): a systematic review. Bone. February 2021;143:115696.
2021	Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 2): a meta-analysis. Bone. February 2021;143:115697.
2021	Miller T, Ying MTC, Hung VWY, Tsang CSL, Ouyang H, Chung RCK, Qin L, Pang MYC. Determinants of estimated failure load in the distal radius after stroke: an HR-pQCT study. Bone. March 2021;144:115831.
2020	Kemmler W, Shojaa M, Kohl M, Stengel Sv. Effects of different types of exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis. Calcif Tiss Int. November 2020;107(5):409-439.
2021	Rahimi GRM, Niyazi A, Alaee S. The effect of exercise training on osteocalcin, adipocytokines, and insulin resistance: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int. February 2021;32(2):213-224.
2022	Ng CATT. Getting the Jump on Healthy Bones: The Skeletal Effects of Impact Physical Activity Across the Lifespan [PhD thesis]. Monash University; 2022.