A systematic review and meta-analysis of the effects of high-intensity, impact, and strength training on bone mineral density in premenopausal and postmenopausal women.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 42578477 · doi:10.1097/GME.0000000000002839
What was done
A systematic review and meta-analysis of randomized controlled trials published between March 2018 and July 2025 (searched in PubMed and Cochrane Central) assessed the effects of high-intensity, impact, or strength training versus a control arm on bone mineral density in premenopausal and postmenopausal women. Included trials were assessed for quality with the PEDro scale and risk of bias with the Cochrane RoB 2 tool.
What was found
Eight randomized controlled trials with 379 participants were included: six in postmenopausal women (n = 267) and two in premenopausal women (n = 112). Pooled analysis showed small but significant increases in bone mineral density among postmenopausal women at the femoral neck (0.47, t[3] = 5.22, P = 0.014; n = 141) and lumbar spine (0.36, t[4] = 4.36, P = 0.012; n = 182). No significant effects were observed in premenopausal women.
Why it matters
This review provides updated evidence that high-intensity, impact, and strength training can preserve or enhance bone mineral density at critical fracture sites in postmenopausal women.
Limits
The total sample size was small across only eight trials, with premenopausal findings limited to two studies. Different exercise modalities were pooled together rather than analyzed separately, and the observed effect sizes were modest alongside noted methodological limitations.
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