Bae Seongryu, Lee Seungyong, Park Hyuntae, Ju Yongin, Min Seok-Ki, Cho Jinkyung, Kim Hyojin, Ha Yong-Chan, Rhee Yumie, Kim Young-Pyo, Kim Changsun
Department of Health Care and Science, Dong-A University, Busan, Korea.
Department of Physical Education, Incheon National University, Incheon, Korea.
J Bone Metab. 2023 May;30(2):149-165. doi: 10.11005/jbm.2023.30.2.149. Epub 2023 May 31.
The effectiveness of exercise for improving osteoporosis and fall prevention in patients diagnosed with osteoporosis or osteopenia has not been fully summarized. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology has developed exercise guidelines for patients with osteoporosis or osteopenia and provide evidence-based recommendations.
A systematic review identified randomized controlled trials (RCT) assessing the effect of resistance, impact, balance, aerobic training, and physical activity in osteoporosis and osteopenia on bone quality, physical performance, quality of life, and fall prevention. PubMed, Embase, KoreaMed, and RISS were searched from January 2000 to August 2022. Ten key questions were established to review the evidence and formulate recommendations.
The 50 RCTs reported that even with osteoporosis and osteopenia, resistance and impact training consistently maximized bone strength, improved body strength and balance, and eventually reduced fall incidences. Resistance exercise combining 3 to 10 types of free weight and mechanical exercise of major muscle groups performed with an intensity of 50% to 85% 1-repetition maximum, 5 to 12 repetitions/set, 2 to 3 days/week, for 3 to 12 months is recommended. Impact exercises such as jumping chin-ups with drop landings and jump rope performed 50 jumps/session for at least 6 months with 3 or more days/week are recommended.
A multi-component exercise mainly comprised of resistance and impact exercise seems to be an effective strategy to attenuate the risk factors of osteoporosis and osteopenia. The integration of exercise guidelines and individualized exercise plans has significant potential to reduce the morbidity and mortality of osteoporosis.
运动对改善已诊断为骨质疏松症或骨质减少症患者的骨质疏松状况及预防跌倒的有效性尚未得到充分总结。韩国骨与矿物质研究学会和韩国运动生理学会已制定了针对骨质疏松症或骨质减少症患者的运动指南，并提供基于证据的建议。
一项系统评价确定了随机对照试验（RCT），评估抗阻、冲击、平衡、有氧训练及身体活动对骨质疏松症和骨质减少症患者的骨质量、身体机能、生活质量及预防跌倒的影响。检索了2000年1月至2022年8月期间的PubMed、Embase、KoreaMed和RISS数据库。确立了10个关键问题以审查证据并制定建议。
50项随机对照试验报告称，即使患有骨质疏松症和骨质减少症，抗阻和冲击训练始终能最大程度增强骨强度，改善身体力量和平衡，并最终降低跌倒发生率。建议进行抗阻运动，结合3至10种自由重量训练和主要肌群的器械运动，强度为1次重复最大值的50%至85%，每组5至12次重复，每周2至3天，持续3至12个月。建议进行冲击运动，如带下落着地的引体向上和跳绳，每次训练50次，每周至少3天，持续至少6个月。
主要由抗阻和冲击运动组成的多成分运动似乎是减轻骨质疏松症和骨质减少症危险因素的有效策略。运动指南与个性化运动计划的整合具有降低骨质疏松症发病率和死亡率的巨大潜力。
