Heinonen A, Kannus P, Sievänen H, Pasanen M, Oja P, Vuori I
UKK Institute for Health Promotion Research, Tampere, Finland.
J Bone Miner Res. 1999 Jan;14(1):125-8. doi: 10.1359/jbmr.1999.14.1.125.
The purpose of this study was to evaluate whether premenopausal women's voluntary unsupervised aerobic and step training could maintain the skeletal benefits obtained by an 18-month supervised high-impact training, and if so, to what extent. Thirty women of the original 39 study subjects (i. e., persons who completed the preceding 18-month randomized training intervention and who volunteered to continue the training on their own for a further 8 months) and 19 women of the 45 original control subjects (i.e., persons who volunteered to continue as controls) were included. The study group trained an average of twice per week and the training consisted of regular aerobic and step classes provided by local fitness centers. Areal bone mineral density (BMD, g/cm2) was measured from the lumbar spine, femoral neck, trochanter area of the femur, distal femur, patella, proximal tibia, calcaneus, and dominant distal radius at baseline and after 18 and 26 months. During the extended 8-month follow-up, the BMD of the study group increased more at the femoral neck (the intergroup change was +0.9% at 18 months and +2.8% at 26 months, p = 0.004 for the change between 18 and 26 months) and remained at the 18-month level at the distal femur, patella, proximal tibia, and calcaneus. In these sites, the statistically significant changes during the entire 26 months of training were 1.7-4.0% in the training group as compared with the changes of -0.9-1.5% in the control group. In the lumbar spine, BMD decreased from the 18-month level in both groups. In conclusion, the significant BMD increases that were obtained by supervised 18-month high-impact training were effectively maintained with subsequent unsupervised regular aerobic and step classes (twice per week). The finding emphasizes the effectiveness and feasibility of self-controlled aerobic and step exercises in the primary prevention of osteoporosis among healthy premenopausal women.
本研究的目的是评估绝经前女性的自愿无监督有氧和踏板训练是否能够维持18个月有监督的高冲击训练所获得的骨骼益处，若能维持，程度如何。原始的39名研究对象中有30名女性（即完成了之前18个月随机训练干预且自愿继续自行训练8个月的人）以及45名原始对照对象中有19名女性（即自愿继续作为对照的人）被纳入研究。研究组平均每周训练两次，训练内容包括当地健身中心提供的常规有氧和踏板课程。在基线、18个月和26个月时，测量腰椎、股骨颈、股骨转子区、股骨远端、髌骨、胫骨近端、跟骨以及优势侧桡骨远端的面积骨密度（BMD，g/cm²）。在延长的8个月随访期间，研究组的股骨颈骨密度增加更多（组间变化在18个月时为+0.9%，在26个月时为+2.8%，18至26个月间变化的p = 0.004），股骨远端、髌骨、胫骨近端和跟骨处维持在18个月时的水平。在这些部位，训练组在整个26个月训练期间的统计学显著变化为1.7 - 4.0%，而对照组的变化为 -0.9 - 1.5%。在腰椎，两组的骨密度均从18个月时的水平下降。总之，18个月有监督的高冲击训练所获得的显著骨密度增加通过随后的无监督常规有氧和踏板课程（每周两次）得到了有效维持。这一发现强调了自我控制的有氧和踏板运动在健康绝经前女性骨质疏松症一级预防中的有效性和可行性。
