Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of controlled trials
PubMed 32399891 · doi:10.1007/s00198-020-05441-w
What was done
Authors conducted a systematic review and random-effects meta-analysis following PRISMA guidelines to assess the effect of dynamic resistance training (DRT) on areal bone mineral density (aBMD) in postmenopausal women. Eight databases were searched through March 2019 for controlled trials of isolated DRT lasting at least 6 months with aBMD assessed at the lumbar spine, femoral neck, or total hip. Standardized mean differences (SMD) were calculated, and subgroup analyses examined exercise parameters (intervention length, type of DRT, training frequency, exercise intensity, and volume).
What was found
Seventeen articles (20 exercise groups and 18 control groups) met inclusion criteria. DRT resulted in statistically significant BMD increases across all measured sites (all p ≤ 0.015): - Lumbar spine BMD: SMD 0.54 (95% CI 0.22 to 0.87) - Femoral neck BMD: SMD 0.22 (95% CI 0.07 to 0.38) - Total hip BMD: SMD 0.48 (95% CI 0.22 to 0.75) Subgroup analysis for femoral neck BMD showed no differences across moderator categories. Lower frequency (< 2 sessions/week) was associated with significantly higher BMD changes at lumbar spine and total hip than higher frequency (≥ 2 sessions/week). Free weights were superior to DRT devices for total hip BMD. Subgroup analyses were insufficient to formulate optimized exercise recommendations.
Why it matters
This meta-analysis demonstrates that dynamic resistance exercise provides modest, significant bone density benefits at key osteoporotic fracture sites in postmenopausal women. However, variable trial parameters currently prevent the establishment of definitive exercise prescription guidelines.
Limits
The abstract does not state the total participant count. Inclusion permitted controlled trials rather than exclusively randomized controlled trials. Subgroup analyses revealed counterintuitive findings (such as lower frequency outperforming higher frequency) and failed to clarify optimal dosing parameters, while clinical fracture outcomes were not reported.
Cited by
- partial Weight-bearing resistance training reverses osteoporosis in women.