Kemmler W, Bebenek M, Kohl M, von Stengel S
Institute of Medical Physics, University of Erlangen, Henkestrasse 91, 91052, Erlangen, Germany.
Department of Medical and Life Sciences, University of Furtwangen, Neckarstrasse 1, Furtwangen, Germany.
Osteoporos Int. 2015 Oct;26(10):2491-9. doi: 10.1007/s00198-015-3165-3. Epub 2015 May 12.
UNLABELLED: The EFOPS trial clearly established the positive effect of long-term exercise on clinical low-trauma fractures in postmenopausal women at risk. Bearing in mind that the complex anti-fracture exercise protocols also affect a large variety of diseases of increased age, we strongly encourage older adults to perform multipurpose exercise programs. INTRODUCTION: Physical exercise may be an efficient option for autonomous fracture prevention during increasing age. The aim of the study was to evaluate the effect of exercise on clinical overall fracture incidence and bone mineral density (BMD) in elderly subjects at risk. METHODS: In 1998 initially, 137 early-postmenopausal, osteopenic women living in Erlangen-Nuremberg, Germany, were included in the EFOPS trial. Subjects of the exercise group (EG; n = 86) conducted two supervised group and two home exercise sessions/week while the control group (CG; n = 51) was requested to maintain their physical activity. Primary study endpoints were clinical overall low-trauma fractures determined by questionnaires, structured interviews, and BMD at the lumbar spine and femoral neck assessed by dual-energy X-ray absorptiometry. RESULTS: In 2014, 105 subjects (EG: n = 59 vs. CG: n = 46) representing 1680 participant-years were included in the 16-year follow-up analysis. Risk ratio in the EG for overall low-trauma fractures was 0.51 (95% confidence interval (95% CI) 0.23 to 0.97, p = .046), rate ratio was 0.42 (95% CI 0.20 to 0.86, p = .018). Based on comparable baseline values, lumbar spine (MV -1.5%, 95% CI -0.1 to -2.8 vs. -5.8%, -3.3 to -7.2%) and femoral neck (-6.5%, -5.2 to -7.7 vs. -9.6%, -8.2 to 11.1%) BMD decreased in both groups; however, the reduction was more pronounced in the CG (p ≤ .001). CONCLUSION: This study clearly evidenced the high anti-fracture efficiency of multipurpose exercise programs. Considering furthermore the favorable effect of exercise on most other risk factors of increasing age, we strongly encourage older adults to perform multipurpose exercise programs.
未标注：EFOPS试验明确证实了长期运动对有风险的绝经后女性临床低创伤骨折具有积极作用。鉴于复杂的抗骨折运动方案也会影响多种老年疾病，我们强烈鼓励老年人进行多功能运动项目。 引言：体育锻炼可能是随着年龄增长自主预防骨折的有效选择。本研究的目的是评估运动对有风险的老年受试者临床总体骨折发生率和骨密度（BMD）的影响。 方法：1998年最初，137名居住在德国埃尔朗根 - 纽伦堡的绝经早期、骨质减少的女性被纳入EFOPS试验。运动组（EG；n = 86）的受试者每周进行两次有监督的小组运动和两次家庭运动，而对照组（CG；n = 51）被要求维持其体育活动水平。主要研究终点是通过问卷调查、结构化访谈确定的临床总体低创伤骨折，以及通过双能X线吸收法评估的腰椎和股骨颈骨密度。 结果：2014年，105名受试者（EG：n = 59 vs. CG：n = 46），代表1680人年，被纳入16年的随访分析。EG组总体低创伤骨折的风险比为0.51（95%置信区间（95%CI）0.23至0.97，p = 0.046），率比为0.42（95%CI 0.20至0.86，p = 0.018）。基于可比的基线值，两组的腰椎（平均变化-1.5%，95%CI -0.1至-2.8 vs. -5.8%，-3.3至-7.2%）和股骨颈（-6.5%，-5.2至-7.7 vs. -9.6%，-8.2至-11.1%）骨密度均下降；然而，CG组的下降更为明显（p≤0.001）。 结论：本研究清楚地证明了多功能运动项目具有很高的抗骨折效率。此外，考虑到运动对大多数其他老年风险因素的有利影响，我们强烈鼓励老年人进行多功能运动项目。
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