Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour.
Evidence on physical activity and osteoporosis prevention for people aged 65+ years: a systematic review to inform the WHO guidelines on physical activity and sedentary behaviour.
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DOI：
10.1186/s12966-020-01040-4
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发表时间：
2020-11-26
期刊：
影响因子：
--
通讯作者：
Sherrington C
中科院分区：
文献类型：
--
作者：
Pinheiro MB;Oliveira J;Bauman A;Fairhall N;Kwok W;Sherrington C
已经设计和评估了各种预防和治疗骨质疏松症的体力活动干预措施，但这些干预措施对预防老年人骨质疏松的效果尚不清楚。本综述的目的是在65岁及以上的 人群中调查体力活动和骨质疏松预防之间的关系。在PubMed(2010年1月至2020年3月)和PubMed、Embase、CINAHL和SPORTDiscus(2008年1月至2020年7月)进行了系统评价并检索了个别研究。根据以下资格标准对记录进行筛选：i)人口：65岁及以上的成年人；ii)暴露：较大的体力活动数量、持续时间、频率或强度；iii)比较：不进行体力活动或较少的体力活动、持续时间、频率或强度；iv)结果：骨质疏松症相关指标(例如，骨密度)。对纳入研究的方法学质量进行评估，荟萃分析总结研究效果。采用等级法对证据的确定性进行评分。我们共纳入59项研究，包括12项观察性研究和47项试验。在纳入的试验中，40人比较了体力活动与没有干预的对照组，11人比较了两种体力活动计划，6人调查了不同剂量的体力活动。纳入的研究表明，体力活动干预可能改善老年人的骨骼健康，从而预防骨质疏松症(标准化效应大小0.15，95%可信区间0.05至0.25，20项试验，中等确定性证据，为每项纳入研究选择的主要或最相关的结果)。体力活动干预可能会增加腰椎骨密度(标准化效应大小为0.17，95%可信区间为0.04至0.30，11项试验，中等确定性证据)，并可能改善髋部(股骨颈)骨密度(标准化效应大小为0.09，95%可信区间− 为0.03至0.21，14项试验，低确定性证据)。高剂量的体育活动和涉及多种运动类型或抗阻运动的计划似乎是最有效的。在试验中检测到显著干预影响的典型方案进行了60分钟以上，每周2-3次，持续7个月以上。观察性研究表明，长期的总运动量和计划的体力活动对骨骼健康有正相关关系。体力活动可能在预防骨质疏松症中起作用。体力活动对腰椎骨密度影响的证据水平高于髋关节。更高剂量的方案以及包括多次运动和阻力运动的方案似乎更有效。补充信息附于本文件10.1186/s12966-020-01040-4。
Various physical activity interventions for prevention and treatment of osteoporosis have been designed and evaluated, but the effect of such interventions on the prevention of osteoporosis in older people is unclear. The aim of this review was to investigate the association between physical activity and osteoporosis prevention in people aged 65 years and above. A systematic review was conducted and searches for individual studies were conducted in PubMed (January 2010 to March 2020) and for systematic reviews were conducted in PubMed, Embase, CINAHL and SPORTDiscus (January 2008 to July 2020). Records were screened according to the following eligibility criteria: i) population: adults aged 65 years and older; ii) exposure: greater volume, duration, frequency, or intensity of physical activity; iii) comparison: no physical activity or lesser volume, duration, frequency, or intensity of physical activity; iv) outcome: osteoporosis related measures (e.g., bone mineral density). The methodological quality of included studies was assessed and meta-analysis summarised study effects. The GRADE approach was used to rate certainty of evidence. We included a total of 59 studies, including 12 observational studies and 47 trials. Within the included trials, 40 compared physical activity with no intervention controls, 11 compared two physical activity programs, and six investigated different doses of physical activity. Included studies suggest that physical activity interventions probably improve bone health among older adults and thus prevent osteoporosis (standardised effect size 0.15, 95% CI 0.05 to 0.25, 20 trials, moderate-certainty evidence, main or most relevant outcome selected for each of the included studies). Physical activity interventions probably improve lumbar spine bone mineral density (standardised effect size 0.17, 95% CI 0.04 to 0.30, 11 trials, moderate-certainty evidence) and may improve hip (femoral neck) bone mineral density (standardised effect size 0.09, 95% CI − 0.03 to 0.21, 14 trials, low-certainty evidence). Higher doses of physical activity and programs involving multiple exercise types or resistance exercise appear to be most effective. Typical programs for which significant intervention impacts were detected in trials were undertaken for 60+ mins, 2–3 times/week for 7+ months. Observational studies suggested a positive association between long-term total and planned physical activity on bone health. Physical activity probably plays a role in the prevention of osteoporosis. The level of evidence is higher for effects of physical activity on lumbar spine bone mineral density than for hip. Higher dose programs and those involving multiple exercises and resistance exercises appear to be more effective. Supplementary information accompanies this paper at 10.1186/s12966-020-01040-4.
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影响因子：
12.7
作者：
de Jong, N;Paw, MJMCA;van Staveren, WA
通讯作者：
van Staveren, WA
影响因子：
6.2
作者：
Armamento-Villareal, Reina;Aguirre, Lina;Villareal, Dennis T.
通讯作者：
Villareal, Dennis T.
影响因子：
4
作者：
Abimanyi-Ochom, J.;Watts, J. J.;Borgstrom, F.;Nicholson, G. C.;Shore-Lorenti, C.;Stuart, A. L.;Zhang, Y.;Iuliano, S.;Seeman, E.;Prince, R.;March, L.;Cross, M.;Winzenberg, T.;Laslett, L. L.;Duque, G.;Ebeling, P. R.;Sanders, K. M.
通讯作者：
Sanders, K. M.
影响因子：
6.7
作者：
Duckham, Rachel L.;Masud, Tahir;Brooke-Wavell, Katherine
通讯作者：
Brooke-Wavell, Katherine
DOI：
10.1111/j.1532-5415.1991.tb02870.x
发表时间：
1991-11-01
影响因子：
6.3
作者：
BLUMENTHAL, JA;EMERY, CF;COLEMAN, RE
通讯作者：
COLEMAN, RE