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Meta-Analysis
. 2024 Dec;16(12):1358-1383.
doi: 10.1002/pmrj.13206. Epub 2024 Jul 20.

Effects of exercise on bone density and physical performance in postmenopausal women: A systematic review and meta-analysis

Hsin-Hui Hsu  1 , Ching-Ya Chiu  1 , Wei-Chen Chen  1 , Yea-Ru Yang  1 , Ray-Yau Wang  1
Affiliations
Meta-Analysis

Effects of exercise on bone density and physical performance in postmenopausal women: A systematic review and meta-analysis

Hsin-Hui Hsu et al. PM R. 2024 Dec.

Abstract

Background: Postmenopausal bone loss and decreased physical performance are commonly presented issues. This study aimed through systematic review and meta-analysis to examine the benefits of adding exercise to medicine/supplements in postmenopausal women.

Methods: A systematic search was conducted of four electronic databases for articles published from inception to December 2023. Clinical controlled trials comparing the effect of additional exercise and medicine/supplements alone in postmenopausal women were included. The outcomes studied were bone mineral density (BMD) and physical performance. The quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results: Nineteen articles with 1249 participants were included in this study for systematic review and meta-analysis. The results showed that additional exercise was not associated with significantly improved BMD at the lumbar spine and hip joint compared with medicine/supplements only. However, results of subgroup analysis of exercise types showed a significant improvement in lumbar spine BMD by combining multiple types of exercise training (SMD = 0.37; 95% confidence interval [CI] = 0.01-0.72; p = .04). Furthermore, additional exercise significantly improved lower extremity muscle strength (Standard Mean Difference [SMD] = 1.77; 95% CI = 0.56-2.98; p = .004), Berg's Balance Scale (SMD = 0.72; 95% CI = 0.12-1.32; p = .02), Timed Up and Go (SMD = -1.07; 95% CI = -1.35--0.78; p < .001), fear of falling (SMD = 1.32; 95% CI = 0.89-1.75; p < .001), and the quality of life (SMD = 1.39; 95% CI = 0.74-2.05; p < .001). The quality level of the evidence was between low to very low.

Conclusions: The significant value of the exercise was demonstrated through enhancing physical performance and quality of life. Moreover, combining various exercise training programs has shown a positive effect on BMD at the lumbar spine. Therefore, for postmenopausal women, combining exercise with medicine/supplements is recommended to further improve physical function and specific areas of BMD. (PROSPERO: CRD42023390633).

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Figures

FIGURE 1
FIGURE 1
PRISMA flow chart for the systematic review on the effect of additional exercise training on bone mineral density (BMD) and physical performance in postmenopausal women.
FIGURE 2
FIGURE 2
(A) Risk of bias graph (B) Risk of bias summary.
FIGURE 3
FIGURE 3
Forest plots illustrating the effects of additional exercise on bone mineral density (BMD) (A) Lumbar spine (B) Femoral neck BMD (C) Trochanter BMD (D) Total hip BMD.
FIGURE 4
FIGURE 4
Forest plots illustrating effects of additional exercise on physical performance (A) Postural control stability index (B) Berg's Balance Scale (C) Timed Up and Go test (D) Leg extensor strength (E) Handgrip strength.
FIGURE 5
FIGURE 5
Forest plots illustrating effects of additional exercise on quality of life (QoL), (A) Physical functioning (subscale of SF‐36) (B) Total scores of Osteoporosis Assessment Questionnaire (OPAQ) (C) Fear of falling (subscale of OPAQ).
See this image and copyright information in PMC

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