Optimization of high-intensity resistance exercise protocols for improving bone mineral density in the elderly without chronic diseases: a systematic review and network meta-analysis.
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引用次数: 0
Abstract
Objective: This study aims to explore the effects of high-intensity resistance exercise (HIRE) protocols on improving bone mineral density (BMD) in the elderly without chronic diseases by using a forest plot and network meta-analysis.
Methods: A systematic search was performed across seven databases including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wan Fang and VIP, to investigate the effects of HIRE on BMD in the elderly by December 9, 2024. The search strategy incorporated Boolean operators (AND, OR, NOT) to refine the selection of relevant studies. The methodological quality was assessed by using Risk of Bias tool 2 and Tool for the Assessment of Study Quality and Reporting in Exercise, and data analysis was performed using Stata 17.
Results: A total of 13 RCTs involving 616 participants were included. Among the various HIRE protocols, two demonstrated positive effects on lumbar spine and whole-body BMD, while four were positive in improving femoral neck BMD compared to the control group. The network meta-analysis revealed that 3M(9-10) was more effective than 2M(6-8), 3M(6-8) and 1M(6-8) in enhancing lumbar spine BMD. However, no significant differences were observed among the HIRE protocols for femoral neck and whole body BMD. According to the SUCRA rankings, 3M(9-10) was the most effective protocol for improving lumbar spine (94.7%) and femoral neck BMD (82.3%), while 2M(9-10) ranked highest for whole body BMD improvement (61.6%).
Conclusion: HIRE protocol is critical to ensure BMD improvement for elderly without chronic diseases, and not all HIRE protocols yield positive effects on BMD. Compared to other sites, lumbar spine BMD appears to be more responsive to HIRE. A 2-3 times, multiple-set regimen may be more beneficial for improving lumbar spine, whole-body, and femoral neck BMD in the elderly, and performing 9-10 repetitions per set is particularly important for improving BMD in older adults.
目的：本研究旨在通过森林样地和网络荟萃分析，探讨高强度阻力运动（HIRE）方案对改善无慢性疾病老年人骨密度（BMD）的影响。方法：系统检索PubMed、Web of Science、Embase、Cochrane Library、中国知识基础设施、万方、VIP等7个数据库，研究HIRE对2024年12月9日之前老年人骨量的影响。搜索策略结合了布尔运算符（AND， OR， NOT）来优化相关研究的选择。采用Risk of Bias tool 2和tool for Assessment of Study quality and Reporting in Exercise进行方法学质量评估，使用Stata 17进行数据分析。结果：共纳入13项随机对照试验，涉及616名受试者。在各种HIRE方案中，与对照组相比，两种方案对腰椎和全身骨密度有积极影响，而四种方案对改善股骨颈骨密度有积极影响。网络荟萃分析显示，3M（9-10）在增强腰椎骨密度方面比2M（6-8）、3M（6-8）和1M（6-8）更有效。然而，在股骨颈和全身骨密度方面，HIRE方案没有观察到显著差异。根据SUCRA排名，3M（9-10）是改善腰椎（94.7%）和股骨颈骨密度（82.3%）最有效的方案，而2M（9-10）在改善全身骨密度（61.6%）方面排名最高。结论：HIRE方案对于改善无慢性疾病老年人的骨密度至关重要，但并非所有的HIRE方案都能对骨密度产生积极影响。与其他部位相比，腰椎骨密度似乎对HIRE更敏感。2-3次、多组训练方案可能对改善老年人腰椎、全身和股骨颈骨密度更有益，每组9-10次重复对改善老年人骨密度尤其重要。系统评审注册号：https://www.crd.york.ac.uk/PROSPERO/，标识注册号。CRD42024543517。
期刊介绍：
Frontiers in Physiology is a leading journal in its field, publishing rigorously peer-reviewed research on the physiology of living systems, from the subcellular and molecular domains to the intact organism, and its interaction with the environment. Field Chief Editor George E. Billman at the Ohio State University Columbus is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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