Article type
Year
Abstract
Introduction: Osteoporosis. is a condition resulting in an increased risk of skeletal fractures due to a reduction in the volume of bone tissue. Prevention of osteoporotic-related fractures is dependent on the ability to detect individuals with low bone mass, including those women who are asymptomatic. Treatment of osteoporosis involves the use of either anti-resorptive (estrogen) or bone formation agents (e.g. fluoride). The value of exercises as an intervention for the prevention of postmenopausal bone loss is still a controversial subject.
Objectives: We conducted a Cochrane systematic review to determine the efficacy of exercise therapy at preventing bone loss and fractures in postmenopausal women.
Methods: We searched the Cochrane Musculoskeletal Group's specialised register, Medline, Embase, Current Contents and the Cochrane Controlled Trials Registry up to December 1998 according to the methods suggested by Haynes et al. Two independent reviewers selected all randomized controlled trials (RCTs) which met our predetermined inclusion criteria. These two reviewers independently abstracted the data using predetermined forms and assessed trial quality using a validated scale. For dichotomous outcomes, relative risks were calculated using fixed effects models. For continuous data, weighted mean differences (WMD) of the percentage change from baseline were calculated. Where heterogeneity existed (determined by a chi square test), random effect's models were used.
Results: Fifteen RCTs met the inclusion criteria. A small effect of physical activity was detected on the bone mineral density at the L2 - L4 level of the lumbar column. This was not statistically significant. Further subgroup analysis (i.e. Age, years postmenopausal, type of exercises) will be carried out to examine the statistically significant heterogeneity . The trials had a mean methodological score of 2.53. For primary prevention the WMD was 0.636 (95% CI. -0.059, 1.33) for the lumbar spine.
Discussion: Exercise therapy does not appear effective at increasing bone density at the lumbar spine in early postmenopausal women. The quality of the reporting of the trials in this meta-analysis was low.
Objectives: We conducted a Cochrane systematic review to determine the efficacy of exercise therapy at preventing bone loss and fractures in postmenopausal women.
Methods: We searched the Cochrane Musculoskeletal Group's specialised register, Medline, Embase, Current Contents and the Cochrane Controlled Trials Registry up to December 1998 according to the methods suggested by Haynes et al. Two independent reviewers selected all randomized controlled trials (RCTs) which met our predetermined inclusion criteria. These two reviewers independently abstracted the data using predetermined forms and assessed trial quality using a validated scale. For dichotomous outcomes, relative risks were calculated using fixed effects models. For continuous data, weighted mean differences (WMD) of the percentage change from baseline were calculated. Where heterogeneity existed (determined by a chi square test), random effect's models were used.
Results: Fifteen RCTs met the inclusion criteria. A small effect of physical activity was detected on the bone mineral density at the L2 - L4 level of the lumbar column. This was not statistically significant. Further subgroup analysis (i.e. Age, years postmenopausal, type of exercises) will be carried out to examine the statistically significant heterogeneity . The trials had a mean methodological score of 2.53. For primary prevention the WMD was 0.636 (95% CI. -0.059, 1.33) for the lumbar spine.
Discussion: Exercise therapy does not appear effective at increasing bone density at the lumbar spine in early postmenopausal women. The quality of the reporting of the trials in this meta-analysis was low.