Von Heideken Wågert Petra, Littbrand Håkan, Johansson Annette, Nordström Peter, Gustafson Yngve
Department of Community Medicine and Rehabilitation, Geriatric Medicine and Physiotherapy, Umeå University, Sweden.
J Bone Miner Metab. 2002;20(6):376-82. doi: 10.1007/s007740200054.
Several meta-analyses confirm that physical exercise can slow down postmenopausal bone loss, but it is not clear whether physical exercise alone can increase bone mass. Our intent was to evaluate high-impact exercises (including jumping) and combined balance and leg-strength training, with and without raloxifene treatment, in three healthy elderly women, age 68-71 years. The 40-week study period consisted of two 17-week exercise periods with a 6-week rest period in between. The jumping exercises were performed both vertically and in different directions. Effects were measured in bone mineral density (BMD), balance, maximal gait speed, and leg extensor strength. BMD (g/cm(2)) was measured with dual-energy X-ray photon absorptiometry (DXA) at the proximal femur, lumbar spine, and total body. After the first exercise period, large losses of trochanteric BMD (8.1%-10.8%) were seen in all subjects. After both 6 weeks of rest and the second exercise period, which included both exercise and raloxifene, BMD increased in all subjects. During both exercise periods, the balance, gait speed, and leg extensor strength increased in all subjects. The results show that this kind of high-impact exercise had limited effects on BMD, but had large positive effects on balance, gait speed, and leg extensor strength. In conclusion, high-impact exercise in elderly women improves their fall risk factors, but, at least without raloxifene treatment, the trochanteric fracture risk might even increase because of reduction in the regional bone mass.
多项荟萃分析证实，体育锻炼可减缓绝经后骨质流失，但仅靠体育锻炼是否能增加骨量尚不清楚。我们的目的是评估高强度运动（包括跳跃）以及平衡与腿部力量联合训练，同时评估在有或没有雷洛昔芬治疗的情况下，对三名年龄在68 - 71岁的健康老年女性的影响。为期40周的研究期包括两个为期17周的运动阶段，中间有6周的休息期。跳跃运动包括垂直跳跃和向不同方向跳跃。测量指标包括骨矿物质密度（BMD）、平衡能力、最大步态速度和腿部伸肌力量。使用双能X线吸收法（DXA）测量股骨近端、腰椎和全身的BMD（g/cm²）。在第一个运动阶段后，所有受试者的股骨转子间BMD均出现大幅下降（8.1% - 10.8%）。在6周的休息期以及包括运动和雷洛昔芬的第二个运动阶段后，所有受试者的BMD均有所增加。在两个运动阶段，所有受试者的平衡能力、步态速度和腿部伸肌力量均有所提高。结果表明，这种高强度运动对BMD的影响有限，但对平衡能力、步态速度和腿部伸肌力量有很大的积极影响。总之，老年女性进行高强度运动可改善其跌倒风险因素，但至少在没有雷洛昔芬治疗的情况下，由于局部骨量减少，股骨转子间骨折风险甚至可能增加。
