Meta-analysis ; Exercise ; Osteoporosis ; Middle aged ; Women
Abstract
Purpose: This study was to examine the effectiveness of exercise for bone mineral density (BMD). Methods: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges'g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. Results: Weight bearing exercise was effective(Q=20.1, p>.05, ES=0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q=4.15, p=.98, ES=0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q=19.5, p>.05, ES=0.33). In contrast, marked heterogeneity (Q=33.3, p<0.01) was apparent in 7 study groups evaluating trochanter. Conclusion: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women