Effects of exercise on fracture reduction in older adults
Effects of exercise on fracture reduction in older adults
复制标题
运动对老年人骨折复位的影响
作者：
W. Kemmler;L. Häberle;S. Stengel
在这项荟萃分析中，我们评估了运动对老年人骨折复位的影响。我们的研究结果确定了一个显着的积极影响，整体骨折，而出版偏倚的可能性表明，需要精心设计的（多中心）试验，产生足够的权力，集中在pneumotic fractions.IntroductionThe预防效果的运动骨折发病率尚未明确确定。因此，本研究的目的是评估运动的有效性，在预防整体和椎骨骨折的老年人通过荟萃分析technique.MethodsThis study followed the PRISMA recommendations for systematic reviews and meta analyses.对1980年至2012年3月期间的英文文献进行了系统综述。使用的术语为：“运动”、“骨折”、“骨”、“福尔斯”、“骨质疏松症”、“BMD”、“BMC”、“骨转换”，而搜索仅限于“临床试验”和“人类”。对照运动试验，报告骨折数量为终点或观察对象45岁及以上increased.ResultsTen对照运动试验，报告整体骨折和三个运动试验，报告椎体骨折符合我们的纳入标准。运动组的总体骨折数量为36例（n = 754），而CG组为73例（n = 670）（相对风险[RR] = 0.49; 95%置信区间[CI]，0.31-0.76）。未确定试验结果的显著异质性（p = 0.28; I2 = 17）;然而，有一些证据表明存在发表偏倚。椎体骨折数量的总体RR（0.56; 95% CI，0.30-1.04）（EG：19例骨折/103例受试者vs. CG：31例骨折/102例受试者）是临界不显著的，而试验结果的异质性也不能排除。发表偏倚的可能性削弱了我们的结果，并证明了将骨折作为主要终点的专门运动方案的大型运动研究的必要性。
SummaryIn this meta-analysis, we evaluated the effect of exercise on fracture reduction in the elderly. Our results determined a significantly positive effect on overall fractures, whereas the possibility of a publication bias indicates the need for well-designed (multi-center) trials that generate enough power to focus on osteoporotic fractures.IntroductionThe preventive effect of exercise on fracture incidence has not been clearly determined yet. Thus, the purpose of this study is to evaluate the effectiveness of exercise in preventing overall and vertebral fractures in older adults by meta-analyses technique.MethodsThis study followed the PRISMA recommendations for systematic reviews and meta-analyses. A systematic review of English articles between 1980 and March 2012 was performed. Terms used were: “exercise”, “fractures”, “bone”, “falls”, “osteoporosis”, “BMD”, “BMC”, “bone turnover”, while the search was limited to “clinical trial” and “humans”. Controlled exercise trials that reported fracture number as endpoint or observation in subjects 45 years and older were included.ResultsTen controlled exercise trials that reported overall fractures and three exercise trials that reported vertebral fractures met our inclusion criteria. Overall fracture number in the exercise group was 36 (n = 754) compared with 73 fractures in the CG (n = 670) (relative risk [RR] = 0.49; 95 % confidence interval [CI], 0.31–0.76). No significant heterogeneity of trial results (p = 0.28; I2 = 17) was determined; however, there was some evidence to suggest a publication bias. The overall RR for vertebral fracture number (0.56; 95 % CI, 0.30–1.04) (EG: 19 fractures/103 subjects vs. CG: 31 fractures/102 subjects) was borderline non-significant while the heterogeneity of trial results also cannot be ruled out.ConclusionAlthough there is evidence that exercise reduces overall and, to a lesser degree, vertebral fractures in the elderly, the possibility of publication bias weakens our result and demonstrates the imperative for large exercise studies with dedicated exercise protocols that focus on fractures as a primary endpoint.