Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Curr Opin Rheumatol. 2012 Sep;24(5):561-6. doi: 10.1097/BOR.0b013e3283570238.
With the recent emergence of associations of bisphosphonate therapy with atypical fractures and osteonecrosis of the jaw, there is renewed interest among clinicians and patients for nonpharmacological approaches to bone health. Here, we review the new studies published in the past year or two that advance our knowledge of the effect of mechanical stimuli on bone health.
Physical activity is associated with serum sclerostin levels; the most physically active individuals have the lowest serum sclerostin levels. Observational trials suggest that physical activity participation results in higher bone mass, but clinical trials suggest that the effects of exercise on areal bone mineral density are small, and vary with the site measured and the type of exercise. Based on current data, it may be best to combine progressive resistance training with interventions such as walking or aerobic dancing if the desire is to improve both spine and hip in postmenopausal women. Low-magnitude high-frequency whole body vibration does not improve bone mineral density and bone structure in postmenopausal women.
Physical activity and exercise are important for the maintenance of musculoskeletal health as we age. Future studies need to investigate the effects of exercise in older populations with rheumatological diseases and those with a history of fragility fractures.
随着双膦酸盐治疗与非典型骨折和颌骨骨坏死之间关联的新近出现，临床医生和患者对骨骼健康的非药物干预方法重新产生了兴趣。在这里，我们回顾了过去一两年发表的新研究，这些研究增进了我们对机械刺激对骨骼健康影响的认识。
身体活动与血清硬骨素水平相关；最活跃的个体血清硬骨素水平最低。观察性试验表明，身体活动参与可导致骨量增加，但临床试验表明，运动对面积骨密度的影响较小，并且因所测量的部位和运动类型而异。根据目前的数据，如果希望改善绝经后妇女的脊柱和臀部，最好将渐进式抗阻训练与散步或有氧运动等干预措施结合起来。低幅度高频全身振动并不能改善绝经后妇女的骨密度和骨结构。
随着年龄的增长，身体活动和运动对于维持肌肉骨骼健康非常重要。未来的研究需要调查患有风湿病和脆性骨折病史的老年人群中运动的效果。
