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Review
. 2018 Dec 1;3(4):155-178.
doi: 10.22540/JFSF-03-155. eCollection 2018 Dec.

Adverse events and safety issues associated with physical activity and exercise for adults with osteoporosis and osteopenia: A systematic review of observational studies and an updated review of interventional studies

Setor K Kunutsor  1   2 , Sarah Leyland  3 , Dawn A Skelton  4 , Laura James  5 , Matthew Cox  5 , Nicola Gibbons  5 , Julie Whitney  5 , Emma M Clark  6
Affiliations
Review

Adverse events and safety issues associated with physical activity and exercise for adults with osteoporosis and osteopenia: A systematic review of observational studies and an updated review of interventional studies

Setor K Kunutsor et al. J Frailty Sarcopenia Falls. .

Abstract

Objectives: We conducted a systematic review to identify adverse effects of physical activity and/or exercise for adults with osteoporosis/osteopenia. We synthesised evidence from observational studies, and updated three previously published systematic reviews.

Methods: We searched MEDLINE, EMBASE, CINAHL, Web of Science, grey literature and reference lists of relevant studies. Selection criteria were: (1) observational studies in patients with osteoporosis/osteopenia; and (2) in accordance with the criteria used in the previous reviews. A narrative synthesis was conducted for the observational data. Random effects meta-analysis was undertaken for the review updates.

Results: For the observational synthesis 14 studies were included. The majority of studies reported no adverse events, reduced incidence/improvement, or no significant change after physical activity or exercise. Activities that involved spinal flexion (certain yoga moves and sit-ups) were associated with a greater risk of vertebral fractures but these events were rare. For the update of reviews, 57 additional studies were identified. Exercise was generally associated with a greater number of minor adverse events including mild muscle/joint pain. Serious adverse events were rare and could not be attributed to the intervention.

Conclusion: Patients with osteoporosis/osteopenia can safely participate in structured exercise programmes, whether at home or in supervised facilities. Systematic review registration for observational studies: PROSPERO 2017: CRD42017070551.

Keywords: Adverse events; Exercise; Osteoporosis; Physical activity; Systematic review.

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Figures

Figure 1
Figure 1
Selection of studies included in the review of observational studies.
Figure 2
Figure 2
Common yoga poses associated with extreme spinal flexion (adapted from Sinaki MS 2013). (A) Paschimottasana (seated forward bend/fold); (B) Halasana (Plow yoga pose); and (C) Setu Bandha Sarvangasana (Bridge yoga pose).
Appendix 4
Appendix 4
Flow diagram of study selection process for updated Howe review
Appendix 5
Appendix 5
Flow diagram of study selection process for updated Giangregorio review.
Appendix 6
Appendix 6
Flow diagram of study selection process for updated Sherrington review.
See this image and copyright information in PMC

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