Impact of high-load resistance training on bone mineral density in osteoporosis and osteopenia: a meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 33851269 · doi:10.1007/s00774-021-01218-1
What was done
The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effect of high-load resistance training (HLRT) on bone mineral density (BMD) in individuals with osteoporosis and osteopenia. The primary endpoints were the standardized mean difference (SMD) in BMD changes at the lumbar spine (LS), femoral neck (FN), and total hip (TH). Subgroup analysis, meta-regression, and funnel plot assessments were performed.
What was found
Nine RCTs with 259 patients in the HLRT group (55.2% women) and 236 patients in the control group (62.7% women) were analyzed. HLRT led to statistically significant BMD increases across all sites: - Lumbar spine: SMD = 1.40 (95% CI: 0.68 to 2.12, p < 0.001, I² = 90%) - Femoral neck: SMD = 0.86 (95% CI: 0.05 to 1.67, p = 0.04, I² = 92%) - Total hip: SMD = 1.26 (95% CI: 0.45 to 2.08, p = 0.002, I² = 91%) Subgroup analysis confirmed robustness only for the lumbar spine. Total exercise sessions and high risk of bias were identified as significant factors of heterogeneity for FN and TH (p < 0.05). Funnel plots showed asymmetry across all sites.
Why it matters
This review shows that high-load resistance training can improve bone density in individuals with osteopenia or osteoporosis, with the strongest effect at the lumbar spine.
Limits
The findings are constrained by extreme statistical heterogeneity (I² ≥ 90%), funnel plot asymmetry suggesting publication bias, small aggregate sample size (495 participants), and high risk of bias driving non-spine outcomes. Fracture risk was not reported.
Cited by
- partial Lifting weights has a far larger positive effect on increasing bone mineral density than nutritional interventions.