Senderovich Helen, Kosmopoulos Andrew
Geriatrics & Palliative Care & Pain Medicine, Baycrest Health Sciences, Toronto, Ontario, Canada.
Assistant Professor of the University of Toronto, Department of Family and Community Medicine, Division of Palliative Care, Toronto, Ontario, Canada.
Rambam Maimonides Med J. 2018 Jan 29;9(1):e0005. doi: 10.5041/RMMJ.10325.
The purpose of this review was to investigate what type of exercises can potentially prevent osteoporosis (OP) and its associated fractures in high-risk populations. MEDLINE was searched for work relevant to various types of exercises used to prevent osteoporotic fractures in high-risk population, from the year 1995 onwards. Twelve articles were identified, and, from them, four were deemed suitable to the objective. The studies reviewed show that various types of exercise are effective and safe in preventing the onset of OP. For example, high-intensity progressive resistance training (HiPRT) has been shown to increase vertebral height and femoral neck bone mineral density (BMD), in addition to improving functional performance. Additional studies reviewed suggested that bone reabsorption levels may be positively impacted by low-impact exercise, such as walking. This review provides insight into the effectiveness of various types of exercise to combat and possibly prevent OP for high-risk individuals, which include postmenstrual Caucasian females, people with multiple comorbidities, individuals who smoke or consume alcohol, and the frail elderly population. The prevention of OP should reduce both the social (emotional) and economic burdens faced by patients, caregivers, and health-care systems. Moving forward, research that identifies and bridges pharmaceutical treatment and exercise should be conducted, in addition to the comparison of passive versus active forms of exercise to determine which treatment best prevents OP in high-risk populations.
本综述的目的是研究何种类型的运动可能预防高危人群中的骨质疏松症(OP)及其相关骨折。检索了MEDLINE数据库中自1995年起与用于预防高危人群骨质疏松性骨折的各类运动相关的研究。共识别出12篇文章,其中4篇被认为符合研究目的。综述的研究表明,各类运动在预防OP发病方面有效且安全。例如,高强度渐进性抗阻训练(HiPRT)已被证明除了能改善功能表现外,还可增加椎体高度和股骨颈骨密度(BMD)。其他综述研究表明,低冲击运动(如步行)可能对骨吸收水平产生积极影响。本综述深入探讨了各类运动对高危个体对抗并可能预防OP的有效性,这些高危个体包括绝经后白种女性、患有多种合并症的人群、吸烟或饮酒者以及体弱的老年人群。OP的预防应减轻患者、护理人员和医疗保健系统所面临的社会(情感)和经济负担。未来,除了比较被动运动与主动运动形式以确定哪种治疗方法最能预防高危人群的OP外,还应开展识别并衔接药物治疗与运动的研究。