1Centre for Musculoskeletal Research, Griffith Health Institute, Gold Coast, Queensland, AUSTRALIA; 2School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, AUSTRALIA.
Med Sci Sports Exerc. 2014 Mar;46(3):610-21. doi: 10.1249/MSS.0b013e3182a6ab0d.
This study aimed to determine the effects of school-based, bone-focused exercise interventions on bone, fat, and lean mass in children by systematically reviewing and meta-analyzing the literature.
Potentially relevant articles were identified by searching electronic databases. Abstracts were included if they described the effects of an in-school exercise intervention for children 5-17 yr old compared with controls and presented baseline and follow-up results for bone, fat, and lean measures. Identified studies were systematically reviewed for methodological quality. Meta-analyses were performed for whole body, lumbar spine, and femoral neck bone mineral content (BMC), fat, and lean mass.
Sixteen eligible trials were identified including eight randomized controlled trials, three clinical controlled trials, and five nonrandomized, nonmatched studies. The quality analysis revealed two studies had low, nine had medium, and five had a high risk of bias. Meta-analyses revealed a small positive effect of bone-targeted exercise on whole body BMC (standardized mean difference [SMD] = 0.483, 95% CI = 0.132-0.833), femoral neck BMC (SMD = 0.292, 95% CI = -0.022 to 0.607), lumbar spine BMC (SMD = 0.384, 95% CI = 0.193-0.575), fat mass (SMD = -0.248, 95% CI = -0.406 to -0.089), and lean mass (SMD = 0.159, 95% CI = -0.076 to 0.394).
Beneficial effects of school-based, bone-targeted exercise were observed for bone and fat, but not for lean mass. Excluding trials with high risk of bias strengthened that effect. Considerable study heterogeneity may have obscured effects on lean mass. The effects observed for bone and fat support the pursuit of brief, jumping-focused interventions to reduce fat as well as enhance musculoskeletal tissue in school age children.
本研究旨在通过系统综述和荟萃分析文献，确定基于学校的骨骼焦点运动干预对儿童骨骼、脂肪和瘦体重的影响。
通过搜索电子数据库确定潜在相关文章。如果摘要描述了针对 5-17 岁儿童的校内运动干预对骨骼、脂肪和瘦体重的影响，并提供了基线和随访结果，则将其纳入研究。对确定的研究进行系统评价以评估方法学质量。对全身、腰椎和股骨颈骨矿物质含量（BMC）、脂肪和瘦体重进行荟萃分析。
确定了 16 项符合条件的试验，包括 8 项随机对照试验、3 项临床对照试验和 5 项非随机、非匹配研究。质量分析显示，有 2 项研究的偏倚风险较低，9 项研究的偏倚风险为中等，5 项研究的偏倚风险较高。荟萃分析显示，骨骼靶向运动对全身 BMC（标准化均数差 [SMD] = 0.483，95%置信区间 [CI] = 0.132-0.833）、股骨颈 BMC（SMD = 0.292，95% CI = -0.022 至 0.607）、腰椎 BMC（SMD = 0.384，95% CI = 0.193-0.575）、脂肪量（SMD = -0.248，95% CI = -0.406 至 -0.089）和瘦体重（SMD = 0.159，95% CI = -0.076 至 0.394）有有益影响。
在骨骼和脂肪方面，基于学校的骨骼靶向运动有有益效果，但对瘦体重没有影响。排除高偏倚风险的试验后，加强了这种效果。相当大的研究异质性可能掩盖了对瘦体重的影响。对骨骼和脂肪的影响支持追求短暂的、跳跃式的干预措施，以减少脂肪并增强学龄儿童的肌肉骨骼组织。
