Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
BC Matthews Hall and Lyle S Hallman Institute, Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
Lancet Diabetes Endocrinol. 2020 Feb;8(2):150-162. doi: 10.1016/S2213-8587(19)30351-1. Epub 2019 Nov 20.
The purpose of this Review is to examine the associations between physical activity and skeletal health, with an emphasis on observational studies with fracture outcomes and randomised controlled trials (RCTs) of physical activity interventions in adults older than 40 years. In general, increased physical activity-primarily leisure time activity or moderate or vigorous physical activity-is associated with a 1-40% lower risk of hip and all fractures. The primary limitation of these studies relates to health status; healthy people are more likely to exercise and less likely to fracture. Although there is no sufficiently powered RCT of exercise with a fracture outcome, there is evidence that some types of exercise prevent falls and bone loss, and meta-analyses support the anti-fracture effectiveness of exercise. RCTs and meta-analyses suggest that programmes combining impact exercise with moderate or high-intensity progressive resistance exercise might maintain or improve bone mass and prevent fractures, and that functional strength and balance training prevents falls.
本文旨在探讨体力活动与骨骼健康之间的关联，重点关注具有骨折结局的观察性研究和 40 岁以上成年人体力活动干预的随机对照试验（RCT）。一般来说，体力活动增加——主要是休闲时间活动或中等强度或剧烈体力活动——与髋部和所有骨折的风险降低 1-40%相关。这些研究的主要局限性与健康状况有关；健康的人更有可能锻炼，骨折的可能性更小。虽然没有足够大的关于运动与骨折结局的 RCT，但有证据表明某些类型的运动可以预防跌倒和骨质流失，荟萃分析也支持运动的抗骨折效果。RCT 和荟萃分析表明，将冲击运动与中等强度或高强度渐进式抗阻运动相结合的方案可能有助于维持或改善骨量并预防骨折，而功能性力量和平衡训练则可以预防跌倒。
