Systematic Review of Randomized Trials of the Effect of Exercise on Bone Mass in Pre- and Postmenopausal Women

Wallace, Brian; Cumming, Robert G.

doi:10.1007/s00223001089

Cited by 384 publications

(212 citation statements)

References 42 publications

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“…Hypothetically, GRF values would double if only one leg supported the weight of the whole body, as happens during a hop, as opposed to body weight being distributed on two legs, as is (66) . †Wallace & Cumming (52) . ‡Wolff et al (67) §Kelley & Kelley (68) .…”

Section: Longitudinal Unilateral Studiesmentioning

confidence: 99%

Exercise for optimising peak bone mass in women

Bailey

Brooke‐Wavell

2008

Proc. Nutr. Soc.

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Physical activity is one of the major non-pharmacological methods for increasing and maintaining bone mineral density (BMD) and geometry. As such, it has an important role in maintaining peak bone mass and strength, thus reducing the risk of future osteoporotic fracture. However, not all exercise is effective, so a prescription in terms of optimal type, intensity, frequency and duration is required. Studies using animal models suggest that loading that is high in magnitude, rapidly applied and novel is most effective, whilst duration is less important beyond a threshold number of cycles. In human subjects cross-sectional studies comparing different athletic populations suggest that those who participate in high-or odd-impact sports have higher BMD; whilst impact exercise, strength training and brief high-impact-jump training interventions increase BMD in premenopausal women. In order to further elucidate exercise recommendations to optimise bone health in this population, the usefulness of brief high-impact unilateral exercises has been evaluated. Brief hopping exercises were shown to be feasible for sedentary premenopausal women, producing ground-reaction forces as high as those from jumping. Regularly performing these hopping exercises over 6 months was found to increase femoral-neck BMD of the trained leg relative to the control leg. Unilateral high-impact exercise may therefore improve bone strength of the trained limb and provide a useful model for comparing exercise prescriptions to help define the most efficient and effective exercise recommendations for the bone health of premenopausal women. Exercise: Bone mineral density: Premenopausal womenOsteoporosis is a condition of skeletal fragility whereby depleted bone mass and compromised bone structure weaken bone to such an extent that fractures occur from minimal trauma. The disease is a major public health problem with great social and economic importance. One in five men and one in two women in the UK > 50 years of age will suffer an osteoporosis-related fracture in their lifetime (1) and the annual cost for all fractures is £1 . 5 · 10 9(2) .Two mechanisms that principally determine adult bone health are peak bone mineral density (BMD) at skeletal maturity and the rate of bone loss with advancing age; thus, maximising premenopausal BMD is a critical strategy for the prevention of osteoporosis and resultant fractures later in life. A substantial body of literature has established that participating in regular physical activity can positively improve bone mineral status (3,4) . The advantage of exercise over methods such as dietary intervention is that it increases the skeleton's resistance to fracture by improving and maintaining both BMD and neuromuscular competency, thus reducing both skeletal fragility and predisposition to falls (4) .Exercise recommendations for cardiovascular fitness have already been precisely defined (5) , but it is unlikely that the same exercise prescription applies to cardiovascular health and skeletal health, and to both pre-a...

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Section: Longitudinal Unilateral Studiesmentioning

confidence: 99%

Exercise for optimising peak bone mass in women

Bailey

Brooke‐Wavell

2008

Proc. Nutr. Soc.

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“…PA and calcium intake have been shown to be beneficial in terms of DXA-derived BMD, (12,13,16,17) but their role in modulating the compensatory adaptation that attempts to maintain the mechanical competence of bone structure is not known. Therefore, the purpose of this cross-sectional study was to examine associations of PA and calcium intake with the volumetric bone density and size of non-weight-bearing radius and weight-bearing tibia among healthy pre-and postmenopausal women.…”

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confidence: 99%

Associations of Calcium Intake and Physical Activity With Bone Density and Size in Premenopausal and Postmenopausal Women: A Peripheral Quantitative Computed Tomography Study

Uusi‐Rasi

Sievänen

Pasanen

et al. 2002

Journal of Bone and Mineral Research

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The purpose of this cross-sectional study was to examine the impact of long-term physical activity (PA) and calcium intake on non-weight-bearing radius and weight-bearing tibia. ). The distal end and shaft regions of the radius and tibia were evaluated with peripheral quantitative tomography (pQCT). For the shaft regions, bone mineral content (BMC), cortical cross-sectional area (CoA), cortical density (CoD), and bone strength index, that is, 1-11.9% of the density-weighted section modulus (BSI) were determined. For the distal ends, BMC, total cross-sectional area (ToA), trabecular density (TrD), and BSI were determined. The BMC at the distal radius in the young PA ؉ group was 6.6% (95% CI, 1-to 11.9%) lower than that of the PA ؊ group. A similar nonsignificant trend was found for the radial shaft. The radial shaft showed a mechanically more competent structure among the older subjects with a BSI 8.5% (95% CI, 1.8 -15.6%) higher in the older PA ؉ group than in the older PA ؊ group. The associations between calcium intake and the radial bone characteristics were systematically positive in both age groups. PA seemed to benefit the distal tibia. In the younger age group the TrD was 6.9% (95% CI, 1.8 -12.4%) higher in the PA ؉ group, and in the elderly the BMC was 5% (95% CI, 0.3-9.9%) higher in the PA ؉ group than in the PA ؊ group. Note that in the younger age group the ToA was 5.1% (95% CI, 0 -9.1%) smaller in the PA ؉ group than in the PA ؊ group, and in the older age group the ToA was 4.2% (95% CI, ؊0.3-8.9%) greater in the PA ؉ group than in the PA ؊ group. The association of PA and bone characteristics at the tibial shaft was positive in both age groups (statistically significant for the older subjects). The tibial shaft BSI of the older PA ؉ group was 8.6% (95% CI, 2.6 -14.9%) better than that of the old PA ؊ group. There was no association between calcium intake and the tibial bone characteristics in either age group. In conclusion, high calcium intake was positively associated with a mechanically competent structure in the radius among both younger and older women, whereas the influence of PA did not become apparent until older ages. PA seemed to benefit particularly the weight-bearing tibia, whereas calcium intake was not associated with the tibia. (J Bone Miner Res 2002;17:544 -552)

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“…Since a systematic review of randomized trials showed that both impact and non-impact exercise have a positive effect on BMD at the lumbar spine in preand postmenopausal women [20], and exercise such as volley ball, swimming, walking and tennis was significantly associated with high bone mass in the present study (unpublished observation), there might be differing effects of exercise on BMD and fracture. Although details of this discrepancy between BMD and fracture were obscure, it is quite likely that exercise is linked to accidental falls, a risk of fracture.…”

Section: Outcome Assessmentmentioning

confidence: 59%