Cheng Yang, Yi Yue, Bo Shumin, Mao Jun, Ma Jing
School of Life Science, Beijing Institute of Technology, Beijing, China.
School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, China.
Front Physiol. 2025 Jun 10;16:1589200. doi: 10.3389/fphys.2025.1589200. eCollection 2025.
This study aims to explore the effects of high-intensity resistance exercise (HIRE) protocols on improving bone mineral density (BMD) in the elderly without chronic diseases by using a forest plot and network meta-analysis.
A systematic search was performed across seven databases including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wan Fang and VIP, to investigate the effects of HIRE on BMD in the elderly by December 9, 2024. The search strategy incorporated Boolean operators (AND, OR, NOT) to refine the selection of relevant studies. The methodological quality was assessed by using Risk of Bias tool 2 and Tool for the Assessment of Study Quality and Reporting in Exercise, and data analysis was performed using Stata 17.
A total of 13 RCTs involving 616 participants were included. Among the various HIRE protocols, two demonstrated positive effects on lumbar spine and whole-body BMD, while four were positive in improving femoral neck BMD compared to the control group. The network meta-analysis revealed that 3M(9-10) was more effective than 2M(6-8), 3M(6-8) and 1M(6-8) in enhancing lumbar spine BMD. However, no significant differences were observed among the HIRE protocols for femoral neck and whole body BMD. According to the SUCRA rankings, 3M(9-10) was the most effective protocol for improving lumbar spine (94.7%) and femoral neck BMD (82.3%), while 2M(9-10) ranked highest for whole body BMD improvement (61.6%).
HIRE protocol is critical to ensure BMD improvement for elderly without chronic diseases, and not all HIRE protocols yield positive effects on BMD. Compared to other sites, lumbar spine BMD appears to be more responsive to HIRE. A 2-3 times, multiple-set regimen may be more beneficial for improving lumbar spine, whole-body, and femoral neck BMD in the elderly, and performing 9-10 repetitions per set is particularly important for improving BMD in older adults.
https://www.crd.york.ac.uk/PROSPERO/, identifier registration number. CRD42024543517.
本研究旨在通过森林图和网状Meta分析，探讨高强度抗阻运动（HIRE）方案对改善无慢性病老年人骨密度（BMD）的影响。
截至2024年12月9日，在包括PubMed、Web of Science、Embase、Cochrane图书馆、中国知网、万方和维普在内的7个数据库中进行系统检索，以调查HIRE对老年人BMD的影响。检索策略采用布尔运算符（AND、OR、NOT）来优化相关研究的选择。使用偏倚风险工具2和运动研究质量评估与报告工具评估方法学质量，并使用Stata 17进行数据分析。
共纳入13项随机对照试验，涉及616名参与者。在各种HIRE方案中，两项方案对腰椎和全身骨密度有积极影响，而与对照组相比，四项方案在改善股骨颈骨密度方面呈阳性。网状Meta分析显示，3M(9 - 10)在提高腰椎骨密度方面比2M(6 - 8)、3M(6 - 8)和1M(6 - 8)更有效。然而，在股骨颈和全身骨密度的HIRE方案之间未观察到显著差异。根据累积排序曲线下面积（SUCRA）排名，3M(9 - 10)是改善腰椎（94.7%）和股骨颈骨密度（82.3%）最有效的方案，而2M(9 - 10)在改善全身骨密度方面排名最高（61.6%）。
HIRE方案对于确保无慢性病老年人的骨密度改善至关重要，并非所有HIRE方案都对骨密度产生积极影响。与其他部位相比，腰椎骨密度似乎对HIRE更敏感。2 - 3次、多组的训练方案可能对改善老年人的腰椎、全身和股骨颈骨密度更有益，每组进行9 - 10次重复对改善老年人的骨密度尤为重要。
