Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
권호 표지

A Meta Analysis on the Effects of Exercise on Bone Mineral Density among Middle-aged and Older Women

운동이 중년이후 여성의 골밀도에 미치는 효과에 대한 메타 분석

  • Published : 2009.09.30
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Abstract

Purpose: This study was to examine the effectiveness of exercise for bone mineral density (BMD). Methods: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges'g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. Results: Weight bearing exercise was effective(Q=20.1, p>.05, ES=0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q=4.15, p=.98, ES=0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q=19.5, p>.05, ES=0.33). In contrast, marked heterogeneity (Q=33.3, p<0.01) was apparent in 7 study groups evaluating trochanter. Conclusion: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.

Keywords

References

  1. Beck, B. R., & Snow C. M. (2003). Bone health across the lifespan exercise our options. Exercise Sports Science Reviews, 31(3), 117-122. https://doi.org/10.1097/00003677-200307000-00003
  2. Berand, A., Bravo, G., & Gauthier, P. (1997). Meta-analysis of the effectiveness of physical activity for the prevention of bone loss in postmenopausal women. Osteoporosis International, 7, 331-337. https://doi.org/10.1007/BF01623773
  3. Bloomfield, S., Williams, N., Lamb, D., & Jackson, R. (1993) Non-weightbearing exercise may increase lumbar spine bone mineral density in healthy postmenopausal women. American Journal of Physical Medicne and Rehabilitation, 72, 204-209. https://doi.org/10.1097/00002060-199308000-00006
  4. Bonaiuti, D., Shea, B., Iovine, R., Negrini, S., Robinson, V., Kemper, H. C., et al. (2002). Exercise for preventing and treating osteoporosis in postmenopausal women(Cochrane Review). The Cochrane Library, Issue 3; 2003. Oxford: Update Software .
  5. Caplan, G. A., & Wald, J. A. (1993). The benefits of exercise in postmenopausal women. Australian Journal of Public Health, 17, 23-26. https://doi.org/10.1111/j.1753-6405.1993.tb00099.x
  6. Cooper, H. C., & Hedges, L. V. (Eds.). (1994). The handbook of research synthesis (pp. 3-14.). New York: Russell Sage.
  7. Hedges, L. V., & Olkin, I. (1985). Statistical methods for metaanalysis. San Diego, CA: Academic, p. 13, 78, 122, 130, 149, 165.
  8. Howe, T. E., Rochester, L., Jackson, A., Banks, P. M. H., & Blair, V. A. (2007). Exercise for improving balance in older people. Cochrane database of systematic reviews, 4, CD004963.
  9. International Osteoporosis Foundation (2003). The facts about osteoporosis and its impact (ref type:report). 1-3.
  10. Jeon, M. Y., Jeong, H. C., & Choe, M. A. (2001). A study on the elderly patients hospitalized by the fracture from the fall, Journal of Korean Academy of Nursing, 31(3), 443-453.
  11. Judge, J., Kleppinger, A., Kenny, A., Smith, J., Biskup, B., & Marcella, G. (2005). Home-based resistance training improves femoral bone mineral density in women on hormone therapy. Osteoporos International, 16, 1096-1108. https://doi.org/10.1007/s00198-004-1816-x
  12. Karlsson, M. (2004). Has exercise and antifracture efficacy in women? Scandinavian Journal of Medicine & Science in Sports, 14, 2-15 https://doi.org/10.1111/j.1600-0838.2003.00322.x
  13. Kelley, G. A., Kelley, K. S., & Tran, Z. V. (2001). Resistance training and bone mineral density in women: A meta-analysis of controlled trials. American Journal of Physical Medicine & Rehabilitation, 80, 65-75 https://doi.org/10.1097/00002060-200101000-00017
  14. Lee, S. H., Dargent-Molina, P., & Breart, G. (2002). Risk factors for fractures of the proximal humerus: results from the EPIDOS prospective study. Journal of Bone and Mineral Research, 17, 817-825. https://doi.org/10.1359/jbmr.2002.17.5.817
  15. Liu-Ambrose, T., Khan, K., Eng, J., Heinonen, A., & McKay, H. (2004). Both resistance and agility training increase cortical bone density in 75- to 85-year-old women with low bone mass. Journal of Clinical Densitometry, 7(4), 390-398. https://doi.org/10.1385/JCD:7:4:390
  16. Ministry for Health Welfare and Family Affairs (2001). Report of national health and diet. Retrieved November 10, 2008, from http://knhanes.cdc.go.kr/result/Result_03.aspx.
  17. Moher, D., Schulz, K. F., Altman, D., & CONSORT Group (2001). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database System Review, 3, CD000333
  18. Orces, C. H., Casas, C., Lee, S., Garci-Cavazos, R., & White, W. (2003). Determinants of osteoporosis prevention in low-income Mexican-American women. Southern Medical Journal, 96(5), 458-464. https://doi.org/10.1097/01.SMJ.0000051905.38128.B4
  19. Park, I. H. (2008). The aspects of patients with osteoporosis and treatment in Korea. retrieved November 10, 2008, from http://www.docdocdoc.co.kr/news/view_contents.php? bid = news_27&news_id = 34577&newscontents_id = 34577& opt = .
  20. Peterson, J. A. (2001). Osteoporosis overview. Geriatric Nursing, 22(1), 17-23. https://doi.org/10.1067/mgn.2001.113534
  21. Soeken, K. L., Lee, W., Bausell, R. B., Agelli, M., & Berman, B. M. (2002). Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis. Journal of Family Practice, 51(5), 425-430.
  22. Stengel, S. V., Kemmler, W., Pintag, R., Beeskow, C., Weineck, J., & Lauber, D., et al. (2005). Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. Journal of Applied Physiology, 99, 181-188. https://doi.org/10.1152/japplphysiol.01260.2004
  23. Verschueren, S., Roelants, M., Delecluse, C., Swinnen, S., Vanderschueren, D., & Boonen, S. (2004). Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: A randomized controlled pilot study. Journal of Bone and Mineral Research, 19(3), 352-359. https://doi.org/10.1359/JBMR.0301245
  24. World Health Organization (2004). WHO Scientific Group of the assessment of osteoporosis at primary health care level. Retrieved December 7, 2007, from http://www.who.int/chp/topics/Osteoporosis.pdf.
  25. Wolff, I., van Croonenborg, J. J., Kemper, H. C., Kostense, P. J., & Twisk, J. W. (1999). The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and post-menopausal women. Osteoporosis International, 9, 1-12. https://doi.org/10.1007/s001980050109