Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil.
Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal.
Int J Environ Res Public Health. 2023 Aug 7;20(15):6537. doi: 10.3390/ijerph20156537.
The current study analysed whether the osteogenic stimuli of exercises and sports have an independent effect on bone mineral density (BMD). Studies with a design having two different cohorts were searched and selected to distinguish the effect due to long-term involvement (i.e., athletes vs. non-active young with good bone health) and due to the planning of intervention (i.e., pre- vs. post-training) with exercises and sports. Moreover, only studies investigating the bone sites with a body-weight support function (i.e., lower limb, hip, and spine regions) were reviewed, since the osteogenic effects have incongruous results. A meta-analysis was performed following the recommendations of PRISMA. Heterogeneity () was determined by combining Cochran's Q test with the Higgins test, with a significance level of α = 0.05. The studies reporting the effect of involvement in exercise and sports showed high heterogeneity for the lower limb, total hip, and spine ( = 90.200%, 93.334%, and 95.168%, respectively, with < 0.01) and the effect size on sports modalities (Hedge's = 1.529, 1.652, and 0.417, respectively, with < 0.05) ranging from moderate to high. In turn, the studies reporting the effect of the intervention planning showed that there was no heterogeneity for the lower limb ( = 0.000%, = 0.999) and spine ( = 77.863%, = 0.000); however, for the hip, it was moderate ( = 49.432%, = 0.054), with a low effect between the pre- and post-training moments presented only for the hip and spine (Hedge's = 0.313 and 0.353, respectively, with < 0.05). The current analysis supported the effect of involvement in exercise and sports by evidencing the effect of either weight-bearing or non-weight-bearing movements on BMD at the femoral, pelvic, and lumbar bones sites of the athletes when comparing to non-athletes or non-active peers with healthy bones. Moreover, the effect of different exercise and sports interventions highlighted the alterations in the BMD in the spine bone sites, mainly with long-term protocols (~12 months) planned with a stimulus with high muscle tension. Therefore, exercise and sport (mainly systematic long-term practice) have the potential to increase the BMD of bones with body-weight support beyond the healthy values reached during life phases of youth and adulthood.
本研究分析了运动对骨密度（BMD）的成骨刺激是否具有独立影响。搜索并选择了具有两种不同队列的研究，以区分由于长期参与（即运动员与骨骼健康良好的非活跃年轻人）和由于计划干预（即训练前与训练后）而导致的影响。此外，仅回顾了研究骨骼部位具有体重支撑功能（即下肢、臀部和脊柱区域）的研究，因为成骨效果的结果不一致。根据 PRISMA 的建议进行了荟萃分析。通过结合 Cochrane's Q 检验和 Higgins 检验来确定异质性（），显著性水平为 α = 0.05。报告运动参与影响的研究显示，下肢、全髋关节和脊柱的异质性很高（=90.200%、93.334%和 95.168%，均<0.01），运动方式的效应大小（Hedge's =1.529、1.652 和 0.417，均<0.05）范围从中等至高。相反，报告干预计划影响的研究显示，下肢（=0.000%，=0.999）和脊柱（=77.863%，=0.000）无异质性；然而，对于髋关节，其为中度（=49.432%，=0.054），仅在髋关节和脊柱中显示出训练前和训练后之间的低效应（Hedge's =0.313 和 0.353，均<0.05）。目前的分析支持运动参与的效果，通过证明负重或非负重运动对运动员股骨、骨盆和腰椎骨骼部位的 BMD 产生影响，与非运动员或骨骼健康的非活跃同龄人相比。此外，不同运动和运动干预的效果突出了脊柱骨部位 BMD 的变化，主要是在具有高肌肉张力刺激的长期方案（~12 个月）中。因此，运动和运动（主要是系统的长期实践）具有增加骨骼 BMD 的潜力，使其超过青年和成年生命阶段达到的健康值。
