Effectiveness of Exercise Loading on Bone Mineral Density and Quality of Life Among People Diagnosed with Osteoporosis, Osteopenia, and at Risk of Osteoporosis-A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aims to provide a detailed analysis of the current state of knowledge on Progressive Exercise Training (PET), encompassing its diverse modalities, effects on bone mineral density (BMD), quality of life outcomes, and implications for clinical practice. A structured search strategy was employed to retrieve literature from seven databases (PubMed, Web of Science, Scopus, MEDLINE, Science Direct, EBSCO, CINHAL, and PEDro) yielded twenty-four randomized controlled trials (RCTs) meeting the inclusion criteria. The methodological quality of studies was evaluated using the PEDro scale. Meta-analyses were carried out to comprehensively assess the collective impact of PET on bone mineral density outcomes. PET exhibited favorable effects on BMD across multiple anatomical sites, encompassing the femoral neck, total hip, lumbar spine, and others. This effect was observed across different age groups and genders, highlighting its potential benefits for diverse populations. PET encompasses a range of modalities, including resistance training, aerobic training, impact training, whole-body vibration, and tai chi, with a duration ranging from 4 to 24 months, with weekly sessions varying from two to five times. Some studies combined these modalities, reflecting the adaptability of PET to individual preferences and capabilities. Tailoring exercise prescriptions to individual needs emerged as a feasible approach within PET. A subset of studies assessed quality of life using validated instruments such as the 36-item short form survey (SF-36), shortened osteoporosis quality of life questionnaire (SOQLQ), and menopause quality of life instrument (MENQOL). This study provides strong evidence that PET represents a promising intervention for osteoporosis management, enhancing BMD and, to some extent, quality of life. PET offers a beacon of hope for better skeletal health and well-being in individuals grappling with osteoporosis, emphasizing the need for its incorporation into clinical practice.