目的:分析不同运动剂量对骨质疏松(OP)患者腰椎及股骨颈骨密度(BMD)的影响。设计:在四个电子数据库中进行了系统的检索,即,PubMed,Embase,WebofScience,还有Cochrane,主题是运动对OP患者骨密度的影响。确定了比较运动干预与无干预的随机对照试验,腰椎和股骨颈BMD的变化采用标准化均差(SMD)和95%置信区间(95%CI)进行报告和评估.对研究中的干预措施进行了评估,并将其归类为美国运动医学学院(ACSM)开发的OP患者的运动测试和处方建议的高依从性或ACSM建议的低/不确定依从性。使用随机效应模型进行荟萃分析并比较亚组之间的结果。结果:共有32项涉及2005年参与者的研究被纳入分析,根据ACSM建议,14项研究被归类为高依从性,18项研究被归类为低依从性或不确定依从性.在腰椎BMD的分析中,纳入了27项研究,包括1,539名参与者。高依从性组的组合SMD为0.31,而低或不确定依从性组的组合SMD为0.04。在股骨颈骨密度的分析中,纳入了23项研究,涉及1,606名参与者。高依从性组的组合SMD为0.45,而低或不确定依从性组的组合SMD为0.28。在阻力运动中,与ACSM依从性低或不确定的亚组相比,ACSM依从性高的亚组对腰椎BMD的影响更大(SMD:0.08>-0.04).同样,股骨颈BMD,与低或不确定ACSM依从性的运动相比,高ACSM依从性的抗阻运动具有更高的SMD(SMD:0.49>0.13).结论:结果表明,与对ACSM建议依从性低或不确定的干预措施相比,对ACSM建议依从性高的运动干预措施在改善OP患者腰椎和股骨颈BMD方面更有效。系统审查注册:PROSPERO,标识符CRD42023427009。
Purpose: To analyze the effects of different exercise dose on lumbar spine and femoral neck bone mineral density (BMD) in individuals with osteoporosis (OP). Design: A systematic search was conducted in four electronic databases, namely, PubMed, Embase, Web of Science, and Cochrane, with the topic of the impact of exercise on BMD in individuals with OP. Randomized controlled trials comparing exercise intervention with no intervention were identified, and changes in lumbar spine and femoral neck BMD were reported and evaluated using standardized mean difference (SMD) and 95% confidence interval (95% CI). The intervention measures in the studies were evaluated and categorized as high adherence with the exercise testing and prescription recommendations for individuals with OP developed by the American College of Sports Medicine (ACSM) or low/uncertainty adherence with ACSM recommendations. A random effects model was used to conduct meta-analyses and compare the results between subgroups. Results: A total of 32 studies involving 2005 participants were included in the analyses, with 14 studies categorized as high adherence with ACSM recommendations and 18 studies categorized as low or uncertain adherence. In the analyses of lumbar spine BMD, 27 studies with 1,539 participants were included. The combined SMD for the high adherence group was 0.31, while the combined SMD for the low or uncertain adherence group was 0.04. In the analyses of femoral neck BMD, 23 studies with 1,606 participants were included. The combined SMD for the high adherence group was 0.45, while the combined SMD for the low or uncertain adherence group was 0.28. Within resistance exercise, the subgroup with high ACSM adherence had a greater impact on lumbar spine BMD compared to the subgroup with low or uncertain ACSM adherence (SMD: 0.08 > -0.04). Similarly, for femoral neck BMD, resistance exercise with high ACSM adherence had a higher SMD compared to exercise with low or uncertain ACSM adherence (SMD: 0.49 > 0.13). Conclusion: The results suggest that exercise interventions with high adherence to ACSM recommendations are more effective in improving lumbar spine and femoral neck BMD in individuals with OP compared to interventions with low or uncertain adherence to ACSM recommendations. Systematic Review Registration: PROSPERO, identifier CRD42023427009.