A comparison of different exercise intensities for improving bone mineral density in postmenopausal women with osteoporosis: A systematic review and meta-analysis

• Published in: Bone Reports Vol. 17; p. 101631
• Main Authors: Kitagawa, Takashi, Hiraya, Kaede, Denda, Takumi, Yamamoto, Shuhei
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022; Elsevier
• Subjects: Bone mineral density; Exercise; Meta-analysis; Osteoporosis; Postmenopausal women; Resistance training; Review; RCT; CI; LS; FN; Postmenopausal women; SMD; MiRIT; Meta-analysis; Osteoporosis; Exercise; aBMD; Resistance training; BMD; Bone mineral density; HiRIT; RM; CI, confidence interval; HiRIT, high-intensity resistance and impact training; FN, femoral neck; LS, lumbar spine; aBMD, areal bone mineral density; MiRIT, moderate-intensity resistance and impact training; BMD, bone mineral density; RCT, randomized controlled trial; RM, repetition maximum; SMD, standardized mean difference
• ISSN: 2352-1872; 2352-1872
• DOI: 10.1016/j.bonr.2022.101631

This study aimed to compare the effects of moderate- and high-intensity resistance and impact training (MiRIT and HiRIT, respectively) on changes in bone mineral density (BMD) in postmenopausal women with osteoporosis. Randomized controlled trials that compared the intervention effects of MiRIT and HiRIT were used as selection criteria to assess study patients with osteoporosis or an osteoporotic condition. Database searches were conducted on August 25, 2022, using CENTRAL, PubMed, CINAHL Web of Science, EMBASE, and MEDLINE. A risk of bias assessment was performed using Revised Cochrane risk of bias tool for the assessment of randomized controlled trials. Point estimates and 95 % confidence intervals of change in BMD derived using dual-energy X-ray absorptiometry were collected as outcomes, and a meta-analysis was performed using the amount of change in BMD before and after the intervention. Adverse event data were also collected. The search yielded six studies (391 patients, mean age 53–65 years) that met the inclusion criteria. The intervention duration ranged from 24 weeks to 13 months. Compared with the MiRIT group, the HiRIT group showed significantly improved BMD of the lumbar spine (standardized mean difference 2.37 [0.10–4.65]). However, a high degree of heterogeneity was observed for three studies (154 patients, I2 = 98 %). Almost all studies reported minimal adverse events. The certainty of evidence was extremely low because of the risk of bias, inconsistency among studies, and imprecision in terms of sample size. Postmenopausal women with osteoporosis may achieve more significantly improved lumbar spine BMD with HiRIT than with MiRIT. •The effects of moderate versus high-intensity training on bone mineral density in postmenopausal woman were compared.•High-intensity training would be more beneficial for improving bone mineral density of the lumbar spine than moderate one.•Almost all studies reported minimal adverse events.•However, the lack of certainty associated with the evidence should be considered for clinical application.