Faculty of Sports Science, Ningbo University, Ningbo, China.
Research Academy of Grand Health, Ningbo University, Ningbo, China.
Front Public Health. 2024 Sep 12;12:1430608. doi: 10.3389/fpubh.2024.1430608. eCollection 2024.
OBJECTIVE: To evaluate the optimal choice of traditional Chinese exercise (TCE) for improving bone mineral density in postmenopausal women through a network meta-analysis. METHODS: The Chinese and English databases were searched, including China National Knowledge Infrastructure, Chongqing VIP, PubMed, Web of Science and Cochrane Library. The outcomes included BMD of lumbar L2-L4, femoral neck, ward triangle, and greater trochanter. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to assess the correlation between each group of interventions, and surface under the cumulative ranking (SUCRA) was used to rank the best interventions. RESULTS: A total of 20 randomized controlled trials (RCTs) including 1933 subjects and six interventions: [Tai Chi (TC), Baduanjin (BDJ), Wuqinxi (WQX), Yijinjing (YJJ), TA (Tai chi plus calcium supplementation), BA (Baduanjin plus calcium supplementation)] and three control measures: [Calcium supplementation (CA), Aerobic exercise (AE), Not exercise intervention (NEI)] were analyzed. Regarding BMD of lumbar L2-L4: TC [SMD = 0.99 (0.62, 1.37)], BDJ [SMD = 2.12 (1.39, 2.85)], TA [SMD = 1.12(0.17, 2.07)], BA [SMD = 2.24 (1.16, 3.31)] were superior in increasing BMD of lumbar L2-L4 relative to NEI. Regarding BMD of femoral neck: TC [SMD = 1.24 (0.70, 1.78)], BA [SMD = 3.77 (1.98, 5.56)] were superior in increasing BMD of femoral neck relative to NEI. Regarding BMD of ward's triangle: TC [SMD = 1.63 (1.09, 2.17)] was superior in increasing BMD of ward's triangle relative to NEI. Regarding BMD of greater trochanter: TC [SMD = 0.98 (0.28, 1.68)] were superior in increasing BMD of greater trochanter relative to NEI. TC topped the SUCRA with BMD of lumbar L2-L4: 53.8, femoral neck: 74.9, ward's triangle: 86.9 and greater trochanter: 77.7. CONCLUSION: Four TCE (TC, BDJ, TA and BA) are all effective in partially improving BMD indicators in postmenopausal women, while TC was effective on all four BMD indicators, which seems to be recommended as the most suitable exercise modality for postmenopausal women. SYSTEMATIC REVIEW REGISTRATION: This research follows the PRISMA Network statement. The protocol for this study has been registered in the International Prospective Registry of Systematic Reviews (PROSPERO). CRD42023414944.
目的：通过网状meta 分析评估传统中医运动（TCE）改善绝经后妇女骨密度的最佳选择。
方法：检索中国知网、重庆维普、PubMed、Web of Science 和 Cochrane 图书馆等中英文数据库。结局指标包括腰椎 L2-L4、股骨颈、 wards 三角和大转子的骨密度。使用标准化均数差（SMD）和 95%置信区间（CI）评估每组干预措施之间的相关性，并用排序概率曲线下面积（SUCRA）对最佳干预措施进行排名。
结果：共纳入 20 项随机对照试验（RCT），包括 1933 名受试者和 6 种干预措施：[太极拳（TC）、八段锦（BDJ）、五禽戏（WQX）、易筋经（YJJ）、太极加钙补充剂（TA）、八段锦加钙补充剂（BA）]和 3 种对照措施：[钙补充剂（CA）、有氧运动（AE）、不运动干预（NEI）]。关于腰椎 L2-L4 的骨密度：TC [SMD=0.99（0.62，1.37）]、BDJ [SMD=2.12（1.39，2.85）]、TA [SMD=1.12（0.17，2.07）]、BA [SMD=2.24（1.16，3.31）]相对于 NEI 增加腰椎 L2-L4 的骨密度更优。关于股骨颈的骨密度：TC [SMD=1.24（0.70，1.78）]、BA [SMD=3.77（1.98，5.56）]相对于 NEI 增加股骨颈的骨密度更优。关于 wards 三角的骨密度：TC [SMD=1.63（1.09，2.17）]相对于 NEI 增加 wards 三角的骨密度更优。关于大转子的骨密度：TC [SMD=0.98（0.28，1.68）]相对于 NEI 增加大转子的骨密度更优。TC 在腰椎 L2-L4 的 SUCRA 排名最高：53.8，股骨颈：74.9，wards 三角：86.9，大转子：77.7。
结论：四种 TCE（TC、BDJ、TA 和 BA）均能有效部分改善绝经后妇女的骨密度指标，而 TC 对所有四个骨密度指标均有效，似乎更适合绝经后妇女。
系统评价注册：本研究遵循 PRISMA 网络声明。本研究的方案已在国际前瞻性系统评价注册库（PROSPERO）中注册。CRD42023414944。
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