不同抗阻训练方案对绝经后女性骨密度影响的网状Meta分析

目的:抗阻运动可以有效增加绝经后女性的骨密度,但是对于运动强度及运动频率的选择上尚无一致结论。文章通过网状Meta分析的方式评价不同抗阻训练方案对绝经后女性骨密度的影响。方法:系统检索中国知网、万方数据库、中国生物医学数据库(CBM)以及ProQuest、PubMed、Cochrane Library、Embase、Web of Science数据库中关于抗阻训练方案提高绝经后女性骨密度的研究,检索时限为各数据库建库至2022年5月。由2位评审员对纳入文献进行独立筛选、提取相关数据,并运用Cochrane手册和PEDro量表对文献进行风险质量评估,运用Stata 16.0对数据进行Meta分析。结果:最终获得20项研究,共1087例受试者。网状Meta分析结果显示:(1)在提高腰椎和股骨颈骨密度方面,与对照组相比,中等强度抗阻运动更优,差异有统计学意义(P<0.05);而在提高全髋和股骨大转子骨密度方面,虽然中等强度更好,但各组间无统计学差异(P>0.05)。(2)此外,结合锻炼频率来看,在提高腰椎骨密度方面,3 d/周的中等强度抗阻运动优于2 d/周的中等强度运动,且3 d/周的锻炼频率下,中等强度优于低强度、高强度的抗阻训练,差异有统计学意义(P<0.05)。(3)累积概率排序结果显示:3 d/周中等强度的抗阻训练在提高腰椎、股骨颈、全髋和股骨大转子的骨密度方面均为最优。结论:基于当前证据显示,临床上可首选频率为3 d/周的中等强度抗阻锻炼来改善绝经后女性骨密度降低的情况。上述结论尚待更多高质量研究予以验证。

Effects of different resistance training programs on bone mineral density in postmenopausal women: a network Meta-analysis

OBJECTIVE: Resistive exercises can effectively increase bone mineral density in postmenopausal women, but there is no consensus on the choice of exercise intensity and exercise frequency. This paper evaluates the effect of different resistance training programs on bone mineral density in postmenopausal women based on a network Meta-analysis. METHODS: We systematically searched CNKI, WanFang, China Biomedical Database (CBM), ProQuest, PubMed, Cochrane Library, Embase, and Web of Science for literature regarding the use of resistance training programs to improve the bone mineral density of postmenopausal women. The search time was from database inception to May 2022. The two reviewers dependently screened the included literature, extracted relevant data, evaluated the risk quality of the literature using the Cochrane manual and the PEDro scale, and conducted a Meta-analysis using Stata 16.0. RESULTS: A total of 20 studies including 1 087 subjects were included. Results from the network Meta-analysis showed that (1) compared with the control group, the medium-intensity resistance training was significantly better in improving lumbar and femoral neck bone mineral density (P < 0.05). In terms of improving the bone mineral density of the total hip and femoral greater trochanter, the moderate-intensity resistance training was better, but there was no significant difference among the groups (P > 0.05). (2) In terms of exercise frequency, the 3 days/week moderate-intensity resistance exercise was better than 2 days/week moderate-intensity resistance exercise to improve the bone mineral density of the lumbar vertebra. Moreover, at the exercise frequency of 3 days/week, moderate-intensity exercise was significantly better than low-and high-intensity exercises (P < 0.05). (3) The cumulative probability ranking results showed that the moderate-intensity resistance training of 3 days/week was the best in improving the bone mineral density of the lumbar vertebra, femoral neck, total hip, and greater trochanter. CONCLUSION: Based on the current evidence, moderate-intensity resistance exercise with a frequency of 3 days per week can be selected to improve the reduced bone mineral density in postmenopausal women. The above conclusions need to be verified by more high-quality research. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.