The effects of differing resistance training modes on the preservation of bone mineral density in postmenopausal women: a meta-analysis

wbldb

Zhao, R.¹; Zhao, M.¹; Xu, Z.¹

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

©2015 International Osteoporosis Foundation and National Osteoporosis Foundation

Affiliations

¹College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
Abstract and keywords

Summary: This meta-analysis synthesized current evidence from 24 clinical trials to evaluate the impact of different resistance training modes on postmenopausal bone loss. Exercise interventions were categorized into two training modes, namely resistance-alone versus combined resistance training protocols. The combined resistance training protocols were defined as the combination of resistance training and high-impact or weight-bearing exercise. The results suggested that the combined resistance training protocols were effective in improving bone mineral density (BMD) at the femoral neck and lumbar spine.

Introduction: The current meta-analysis aimed to examine the effects of combined resistance and resistance-alone training protocols on the preservation of femoral neck and lumbar spine BMD in postmenopausal women.

Methods: An electronic database search was conducted in PubMed, EMBASE, SPORTDiscus, Web of Science, and ProQuest up to March 1, 2014 for the influence of resistance exercise on BMD in postmenopausal women. The study quality was evaluated. The effect sizes were estimated in terms of the standardized mean difference (SMD). A subgroup analysis was conducted by exercise categories.

Results: Twenty-four studies were included in the overall analysis of skeletal response to resistance exercise. The between-study heterogeneity was evident for the hip (I² = 46.5 %) and spine (I² = 62.3 %). The overall analysis suggested that resistance training significantly increased femoral neck BMD (SMD = 0.303, 95 % confidence interval (95 % CI) = 0.127–0.479, p = 0.001) and lumbar spine BMD (SMD = 0.311, 95 % CI = 0.115–0.507, p = 0.002) in postmenopausal women. However, subgroup analysis indicated that combined resistance training programs significantly affected both the hip BMD (SMD = 0.411, 95 % CI = 0.176–0.645, p = 0.001) and spine BMD (SMD = 0.431, 95 % CI = 0.159–0.702, p = 0.002), whereas resistance-alone protocols only produced nonsignificant positive effects both on the femoral neck and lumbar spine BMD.

Conclusions: Combined resistance exercise protocols appear effective in preserving femoral neck and lumbar spine BMD in postmenopausal women, whereas resistance-alone protocols only produced a nonsignificant positive effect.

Keywords: BMD; Meta-analysis; Postmenopausal women; Resistance training
Links

DOI: 10.1007/s00198-015-3034-0

PubMed: 25603795

WoS: 000352904000016
History

Received: 2014-04-01

Accepted: 2015-01-08

Online: 2015-01-21

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.
1999	Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH III, Brown J, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD; Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. JAMA. October 13, 1999;282(14):1344-1352.
1987	Lanyon LE. Functional strain in bone tissue as an objective, and controlling stimulus for adaptive bone remodelling. J Biomech. 1987;20(11-12):1083-1093.
2003	Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporos Int. March 2003;14(suppl 3):S13-S18.
2002	Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SAA, Howard BV, Johnson KC, Kotchen JM, Ockene J; Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative Randomized Controlled Trial. JAMA. July 17, 2002;288(3):321-333.
1994	Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures: a randomized controlled trial. JAMA. December 28, 1994;271(24):1909-1914.
2011	Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet. April 9, 2011;377(9773):1276-1287.
1994	Rubin CT, McLeod KJ. Promotion of bony ingrowth by frequency-specific, low-amplitude mechanical strain. Clin Orthop Relat Res. January 1994;298:165-174.
1993	Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Palmero L, Scott J, Vogt TM; Study of Osteoporotic Fractures Research Group. Bone density at various sites for prediction of hip fractures. Lancet. January 9, 1993;341(8837):72-75.
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.
1987	Frost HM. Bone "mass" and the "mechanostat": a proposal. Anat Rec. September 1987;219(1):1-9.
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 (15)

Year	Entry
2021	Smith C, Tacey A, Mesinovic J, Scott D, Lin X, Brennan-Speranza TC, Lewis JR, Duque G, Levinger I. The effects of acute exercise on bone turnover markers in middle-aged and older adults: a systematic review. Bone. February 2021;143:115766.
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	Daly RM, Dalla Via J, Fyfe JJ, Nikander R, Kukuljan S. Effects of exercise frequency and training volume on bone changes following a multi-component exercise intervention in middle aged and older men: secondary analysis of an 18-month randomized controlled trial. Bone. July 2021;148:115944.
2022	Abe S, Kouhia R, Nikander R, Narra N, Hyttinen J, Sievänen H. Effect of fall direction on the lower hip fracture risk in athletes with different loading histories: a finite element modeling study in multiple sideways fall configurations. Bone. May 2022;158:116351.
2022	Smith C, Hiam D, Tacey A, Lin X, Woessner MN, Zarekookandeh N, Garnham A, Chubb P, Lewis JR, Sim M, Herrmann M, Duque G, Levinger I. Higher bone remodeling biomarkers are related to a higher muscle function in older adults: effects of acute exercise. Bone. December 2022;165:116545.
2020	Rahimi GRM, Smart NA, Liang MTC, Bijeh N, Albanaqi AL, Fathi M, Niyazi A, Rahimi NM. The impact of different modes of exercise training on bone mineral density in older postmenopausal women: a systematic review and meta-analysis research. Calcif Tiss Int. June 2020;106(6):577-590.
2018	Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. J Bone Miner Res. February 2018;33(2):211-220.
2020	Rodríguez‐Gómez I, Mañas A, Losa‐Reyna J, Rodríguez‐Mañas L, Chastin SFM, Alegre LM, García‐García FJ, Ara I. Prospective changes in the distribution of movement behaviors are associated with bone health in the elderly according to variations in their frailty levels. J Bone Miner Res. July 2020;35(7):1236-1245.
2020	Shojaa M, von Stengel S, Kohl M, Schoene D, Kemmler W. Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporos Int. August 2020;31(8):1427-1444.
2020	Zhu K, Hunter M, James A, Lim EM, Cooke BR, Walsh JP. Relationship between visceral adipose tissue and bone mineral density in Australian baby boomers. Osteoporos Int. December 2020;31(12):2439-2448.
2021	Vehmanen L, Sievänen H, Kellokumpu-Lehtinen P, Nikander R, Huovinen R, Ruohola J, Penttinen HM, Utriainen M, Tokola K, Blomqvist C, Saarto T. Five-year follow-up results of aerobic and impact training on bone mineral density in early breast cancer patients. Osteoporos Int. March 2021;32(3):473-482.
2019	Harding A. LIFTMOR-M: Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation for Men [PhD thesis]. Brisbane, Australia: Griffith University; December 2019.
2019	Myers KB. Are Improvements in Bone and Physical Performance from an 8-Month High-Intensity Exercise Program Maintained in Postmenopausal Women With Low Bone Mass? 3-Year Follow-P of the LIFTMOR Trial [Master's thesis]. Brisbane, Australia: Griffith University; 2019.
2019	Watson S. LIFTMOR: Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation [PhD thesis]. Brisbane, Australia: Griffith University; January 2019.