Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany.
Department of Medical and Life Sciences, University of Furtwangen, Furtwangen im Schwarzwald, Germany.
Osteoporos Int. 2018 Jul;29(7):1493-1504. doi: 10.1007/s00198-018-4482-0. Epub 2018 Apr 5.
This systematic review detected only limited positive effects of exercise on bone mineral density in older men. Further, based on the present literature, we were unable to suggest dedicated exercise prescriptions for this male cohort that might differ from recommendations based on studies with postmenopausal women. The primary aim of this systematic review was to determine the effect of exercise on bone mineral density (BMD) in healthy older men. A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement included only randomized or non-randomized controlled trials of exercise training ≥ 6 months with study groups of ≥ eight healthy men aged 50 years or older, not using bone-relevant pharmacological therapy, that determined BMD by dual-energy X-ray absorptiometry. We searched PubMed, Scopus, Web of Science, Cochrane, Science Direct, and Eric up to November 2016. Risk of bias was assessed using the PEDro scale. We identified eight trials with 789 participants (PEDro-score, mean value 6 of 10) which satisfied our eligibility criteria. Studies vary considerably with respect to type and composition of exercise. Study interventions of six trials were considered to be appropriate for successfully addressing BMD in this cohort. Between-group differences were not or not consistently reported by three studies. Three studies reported significant exercise effects on BMD for proximal femur; one of them determined significant differences between the exercise groups. None of the exercise trials determined significant BMD effects at the lumbar spine. Based on the present studies, there is only limited evidence for a favorable effect of exercise on BMD in men. More well-designed and sophisticated studies on BMD in healthy older men have to address this topic. Further, there is a need to define intervention quality standards and implement a universal scoring system that allows this pivotal determinant to be addressed much more intensively.
本系统评价仅发现运动对老年男性骨密度有有限的积极影响。此外，根据目前的文献，我们无法为这一男性队列提出专门的运动处方，这些处方可能与基于绝经后妇女研究的建议有所不同。本系统评价的主要目的是确定运动对健康老年男性骨密度（BMD）的影响。根据系统评价和荟萃分析的首选报告项目进行文献系统评价，仅包括运动训练≥6 个月的随机或非随机对照试验，研究组为≥8 名年龄≥50 岁的健康男性，不使用与骨骼相关的药物治疗，通过双能 X 线吸收法测定 BMD。我们检索了 PubMed、Scopus、Web of Science、Cochrane、Science Direct 和 Eric，截至 2016 年 11 月。使用 PEDro 量表评估偏倚风险。我们确定了 8 项试验，共有 789 名参与者（PEDro 评分，平均值为 10 分中的 6 分）符合我们的入选标准。这些研究在运动类型和组成方面差异很大。六项研究的干预措施被认为能够成功解决该队列的 BMD 问题。三项研究没有或没有一致报告组间差异。三项研究报告了股骨近端 BMD 的显著运动效应；其中一项研究确定了运动组之间的显著差异。没有一项运动试验确定腰椎 BMD 的显著效应。根据目前的研究，运动对男性 BMD 的有益影响只有有限的证据。需要进行更多设计良好、复杂的关于健康老年男性 BMD 的研究来解决这个问题。此外，需要定义干预质量标准并实施通用评分系统，以便更深入地解决这一关键决定因素。
