運動介入對停經前婦女骨質疏鬆之預防與療效: 系統性回顧與統合分析

Premenopausal females, like the postmenopausal ones, are at high risk of developing osteoporosis and related fractures. Exercise is known to help postmenopausal women to increase bone mineral density (BMD) and to delay the disease process. Its effect on premenopausal females is less researched with results not as consistent. We have already known high impact exercise can help fighting the process of osteoporosis, but we are not certain the best exercise parameters for the intervention. The purposes of this review and meta analysis were to investigate effectiveness of high impact exercise intervention and influencing factors on BMD in premenopausal females. Methods: Studies were identified by a systematic computer database and cross reference search. The inclusion criteria were: randomized control trials (RCTs), publish date within ten years (1997-2006), premenopausal human subjects ≥l8 years old, exercise intervention, outcome measurements containing at least one type of bone mineral density measurement at one body site, Results and discussion: Four RCTs were included with a total number of 269 subjects. Their average age was 34.7 yrs (20-39). We performed meta analysis of the high impact exercise on bone mineral density of the lumbar spine, femoral neck and greater trochanter. We found exercise intervention could improve the bone mineral density of the femoral neck and greater trochanter, but its effect on the lumbar spine was not significant. Age and daily activity level did not affect the results; however, longer exercise time or longer intervention duration appeared to significantly increase BMD in the lumbar spine, while shorter exercise time or intervention duration was more beneficial in increasing BMD in femoral neck and greater trochanter. Conclusions: There was sufficient evidence to support the efficacy of high impact exercise on BMD in the proximal femur for premenopausal women. Longer exercise time or intervention duration may be necessary to increase BMD in the lumbar spine. Further studies are needed to clarify the role of exercise intensity in different sites in premenopausal women.