Carnegie Faculty of Sport and Education, Leeds Metropolitan University, Leeds, UK.
J Bone Miner Metab. 2010 May;28(3):251-67. doi: 10.1007/s00774-009-0139-6. Epub 2009 Dec 15.
Our objective was to assess the effects of differing modes of impact exercise on bone density at the hip and spine in premenopausal women through systematic review and meta-analysis. Electronic databases, key journals and reference lists were searched for controlled trials investigating the effects of impact exercise interventions on lumbar spine (LS), femoral neck (FN) and total hip (TH) bone mineral density (BMD) in premenopausal women. Exercise protocols were categorised according to impact loading characteristics. Weighted mean difference (WMD) meta-analyses were undertaken. Heterogeneity amongst trials was assessed. Fixed and random effects models were applied. Inspection of funnel plot symmetry was performed. Trial quality assessment was also undertaken. Combined protocols integrating odd- or high-impact exercise with high-magnitude loading (resistance exercises), were effective in increasing BMD at both LS and FN [WMD (fixed effect) 0.009 g cm(-2) 95% CI (0.002-0.015) and 0.007 g cm(-2) 95% CI (0.001-0.013); P = 0.011 and 0.017, respectively]. High-impact only protocols were effective on femoral neck BMD [WMD (fixed effect) 0.024 g cm(-2) 95% CI (0.002-0.027); P < 0.00001]. Funnel plots showed some asymmetry for positive BMD outcomes. Insufficient numbers of protocols assessing TH BMD were available for assessment. Exercise programmes that combine odd- or high-impact activity with high-magnitude resistance training appear effective in augmenting BMD in premenopausal women at the hip and spine. High-impact-alone protocols are effective only on hip BMD in this group. However, diverse methodological and reporting discrepancies are evident in published trials.
我们的目的是通过系统评价和荟萃分析评估不同冲击运动模式对绝经前女性髋部和脊柱骨密度的影响。电子数据库、主要期刊和参考文献列表中检索了关于冲击运动干预对绝经前女性腰椎（LS）、股骨颈（FN）和全髋（TH）骨密度（BMD）影响的对照试验。根据冲击负荷特征对运动方案进行分类。进行了加权均数差值（WMD）荟萃分析。评估了试验之间的异质性。应用固定效应和随机效应模型。检查漏斗图对称性。还进行了试验质量评估。综合方案将奇数或高强度冲击与高强度负荷（阻力训练）相结合，有效增加 LS 和 FN 的 BMD[WMD（固定效应）0.009 g cm(-2)95%CI（0.002-0.015）和 0.007 g cm(-2)95%CI（0.001-0.013）；P = 0.011 和 0.017]。仅高强度冲击方案对股骨颈 BMD 有效[WMD（固定效应）0.024 g cm(-2)95%CI（0.002-0.027）；P < 0.00001]。漏斗图显示阳性 BMD 结果存在一些不对称性。评估 TH BMD 的方案数量不足。结合奇数或高强度活动与高强度阻力训练的运动方案似乎能有效增加绝经前女性髋部和脊柱的 BMD。仅高强度冲击方案对该组的髋部 BMD 有效。然而，发表的试验中存在明显的方法学和报告差异。
