Engelke K, Kemmler W, Lauber D, Beeskow C, Pintag R, Kalender W A
Institute of Medical Physics, University of Erlangen, Henkestrasse 91, 91054, Erlangen, Germany,
Osteoporos Int. 2006 Jan;17(1):133-42. doi: 10.1007/s00198-005-1938-9. Epub 2005 Aug 12.
It is an important aim in the prevention of osteoporosis to stop or decelerate bone loss during the early postmenopausal years. Here we report on results of the 3-year EFOPS exercise trial in osteopenic women. The exercise strategy emphasized low-volume high-resistance strength training and high-impact aerobics. Forty-eight fully compliant women (55.1+/-3.3 years) with no medication or illness affecting bone metabolism participated in the exercise group (EG); 30 women (55.5+/-3.0 years) served as non-training controls (CG). At baseline there were no significant between-group differences with respect to physical fitness, bone mineral density, pain and nutritional status. The training consisted of two group training and two home training sessions per week. The study participants of both groups were individually supplemented with calcium and vitamin D (cholecalciferol). Bone mineral density (BMD) was measured by DXA at the lumbar spine, proximal femur and distal forearm and by QCT at the lumbar spine. Speed of sound and broadband ultrasound attenuation were determined at the calcaneus by quantitative ultrasound (QUS). Pain frequency and intensity at different skeletal sites were assessed via questionnaire. After 38 months, the following within-group changes were measured: DXA lumbar spine, EG: 0.8% n.s.; CG: -3.3% P<0.001; QCT trabecular ROI, EG: 1.1% n.s; CG: -7.7% P<0.001; QCT cortical ROI, EG: 5.3% P<0.001; CG: -2.6% P<0.001; DXA total hip: EG: -0.2% n.s; CG -1.9%, P<0.001; DXA distal forearm, EG: -2.8% P<0.001; CG: -3.8% P<0.001; BUA, EG: -0.3% n.s; CG -5.4% P<0.001; SOS, EG: 0.3% n.s; CG -1.0% P<0.001. At year 3 between-group differences relative to the exercise group were: DXA lumbar spine: 4.1% P<0.001; QCT trabecular ROI: 8.8% P<0.001; QCT cortical ROI: 7.9% P<0.001; DXA total hip: 2.1%, P<0.001; DXA distal forearm: 1.0% n.s.; BUA: 5.8% P<0.05; SOS: 1.3% P<0.001. Pain frequency and intensity in the spine significantly decreased in the exercise group and increased in the control group, while no between-group differences were detected in the main joints. In summary, over a period of 3 years our low-volume/high-intensity exercise program was successful to maintain bone mineral density at the spine, hip and calcaneus, but not at the forearm.
在绝经后早期阻止或减缓骨质流失是预防骨质疏松症的一个重要目标。在此，我们报告针对骨质减少女性进行的为期3年的EFOPS运动试验结果。该运动策略强调小运动量的高阻力力量训练和高强度有氧运动。48名完全依从、未服用影响骨代谢的药物且无相关疾病的女性（年龄55.1±3.3岁）参与了运动组（EG）；30名女性（年龄55.5±3.0岁）作为非训练对照组（CG）。基线时，两组在体能、骨密度、疼痛和营养状况方面无显著组间差异。训练包括每周两次团体训练和两次家庭训练。两组研究参与者均单独补充钙和维生素D（胆钙化醇）。通过双能X线吸收法（DXA）测量腰椎、股骨近端和前臂远端的骨密度，通过定量计算机断层扫描（QCT）测量腰椎骨密度。通过定量超声（QUS）测定跟骨处的声速和宽带超声衰减。通过问卷评估不同骨骼部位的疼痛频率和强度。38个月后，测量了以下组内变化：DXA测量的腰椎，运动组：0.8%，无显著性差异；对照组：-3.3%，P<0.001；QCT测量的小梁感兴趣区，运动组：1.1%，无显著性差异；对照组：-7.7%，P<0.001；QCT测量的皮质感兴趣区，运动组：5.3%，P<0.001；对照组：-2.6%，P<0.001；DXA测量的全髋部，运动组：-0.2%，无显著性差异；对照组：-1.9%，P<0.001；DXA测量的前臂远端，运动组：-2.8%，P<0.001；对照组：-3.8%，P<0.001；超声宽带衰减（BUA），运动组：-0.3%，无显著性差异；对照组：-5.4%，P<0.001；声速（SOS），运动组：0.3%，无显著性差异；对照组：-1.0%，P<0.001。在第3年，相对于运动组的组间差异为：DXA测量的腰椎：4.1%，P<0.001；QCT测量的小梁感兴趣区：8.8%，P<0.001；QCT测量的皮质感兴趣区：7.9%，P<0.001；DXA测量的全髋部：2.1%，P<0.001；DXA测量的前臂远端：1.0%，无显著性差异；BUA：5.8%，P<0.05；SOS：1.3%，P<0.001。运动组脊柱的疼痛频率和强度显著降低，而对照组则增加，主要关节未检测到组间差异。总之，在3年期间，我们的小运动量/高强度运动计划成功地维持了脊柱、髋部和跟骨的骨密度，但在前臂未成功。
