A comparison of different exercise intensities for improving bone mineral density in postmenopausal women with osteoporosis: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36310762 · doi:10.1016/j.bonr.2022.101631
What was done
Systematic review and meta-analysis of randomized controlled trials identified via CENTRAL, PubMed, CINAHL, Web of Science, EMBASE, and MEDLINE up to August 2022. The authors compared the effects of moderate-intensity resistance and impact training (MiRIT) versus high-intensity resistance and impact training (HiRIT) on bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in postmenopausal women with osteoporosis or osteoporotic conditions. Risk of bias was evaluated using the Revised Cochrane risk-of-bias tool.
What was found
Six studies involving 391 participants (mean age 53–65 years, intervention duration 24 weeks to 13 months) met inclusion criteria. HiRIT showed a statistically significant improvement in lumbar spine BMD compared to MiRIT (standardized mean difference 2.37, 95% CI [0.10, 4.65]). However, this pooled result from three studies (154 patients) exhibited substantial heterogeneity (I² = 98%). Minimal adverse events were reported across almost all included studies.
Why it matters
This review suggests higher-intensity loading may offer superior lumbar spine bone density gains compared to moderate-intensity exercise in postmenopausal osteoporosis without increasing adverse events.
Limits
The evidence certainty was graded as extremely low due to risk of bias, extreme inconsistency across trials (I² = 98%), and imprecision from small sample sizes. The abstract reports no data on hip/femoral neck BMD or fracture risk.