From the Universidade Metropolitana de Santos, Santos, São Paulo, Brazil.
Menopause. 2023 Jan 1;30(1):108-116. doi: 10.1097/GME.0000000000002079. Epub 2022 Oct 25.
Numerous studies have been published assessing the effects of resistance muscle training to mitigate menopausal symptoms, given the endocrine muscle function and its metabolic regulation. Therefore, mapping and synthesizing high-quality studies are necessary to help clinical decisions.
The aim of this study was to assess the effects (benefits and harms) of resistance muscle training for postmenopausal women.
Electronic searches were conducted in MEDLINE (via PubMed), EMBASE, CENTRAL, PEDro, LILACS, and SPORTDiscus up to December 2021. Two independent reviewers selected the retrieved references and extracted relevant data from included studies. The methodological quality (risk of bias) using the Cochrane Risk of Bias table and the certainty of the evidence (GRADE approach) were assessed.
Twelve randomized clinical trials (n = 452) with unclear to high risk of bias were identified. Compared with no exercise, resistance training (up to 16 weeks) seems to promote an improvement in functional capacity (mean difference [MD], 2.90 points; 95% CI, 0.60-5.20) and bone mineral density (MD, 0.10; 95% CI, 0.10-0.10) and a reduction in the hot flash frequency (13/29 vs 1/29; risk ratio, 13.0; 95% CI, 1.82-93.01) and fat mass (MD, -3.15; 95% CI, -6.68 to 0.38), and no differences were observed between groups regarding abdominal circumference and body mass index. When compared with aerobic exercises, resistance training may result in a reduction of hot flash frequency (7/18 vs 14/18; risk ratio, 0.50; 95% CI, 0.27-0.94) and fat mass (MD, -7.80; 95% CI, -14.02 to -1.58) and no difference in the quality of life and body mass index. Regarding safety, no serious adverse events were reported. Based on the GRADE approach, the certainty of this evidence was graded as very low to low, leading to imprecisely estimated effects.
Resistance muscle training seems to improve postmenopausal symptoms and functional capacity. Given the low to very low certainty of the evidence, further randomized clinical trials with higher methodological quality and better reports are still needed. As an implication for clinical practice, health professionals should consider individualized aspects such as the previous history of exercise practice, physical capacity, and adaptation period.
已有大量研究评估了抗阻肌肉训练对缓解绝经症状的影响，这是因为肌肉的内分泌功能及其代谢调节。因此，有必要对高质量的研究进行分析和综合，以帮助临床决策。
本研究旨在评估抗阻肌肉训练对绝经后妇女的影响（益处和危害）。
截至 2021 年 12 月，通过 MEDLINE（PubMed）、EMBASE、CENTRAL、PEDro、LILACS 和 SPORTDiscus 进行了电子检索。两名独立的审查员从纳入的研究中选择了检索到的参考文献并提取了相关数据。使用 Cochrane 风险偏倚表评估了方法学质量（风险偏倚）和证据的确定性（GRADE 方法）。
共确定了 12 项随机临床试验（n = 452），其风险偏倚为不清楚至高。与不运动相比，抗阻训练（长达 16 周）似乎可改善功能能力（平均差值[MD]，2.90 分；95%CI，0.60-5.20）和骨密度（MD，0.10；95%CI，0.10-0.10），减少热潮红频率（13/29 与 1/29；风险比，13.0；95%CI，1.82-93.01）和脂肪量（MD，-3.15；95%CI，-6.68 至 0.38），且两组间的腰围和体重指数无差异。与有氧运动相比，抗阻训练可能会降低热潮红频率（7/18 与 14/18；风险比，0.50；95%CI，0.27-0.94）和脂肪量（MD，-7.80；95%CI，-14.02 至-1.58），但生活质量和体重指数无差异。关于安全性，未报告严重不良事件。基于 GRADE 方法，该证据的确定性等级为极低至低，导致对效果的估计不精确。
抗阻肌肉训练似乎可改善绝经后症状和功能能力。鉴于证据的确定性为低至极低，仍需要进行具有更高方法学质量和更好报告的进一步随机临床试验。对临床实践的影响是，卫生专业人员应考虑到个体方面，如既往运动实践史、身体能力和适应期。
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