Fang Zhao, Wenbo Su, Yaowei Sun, Jing Wang, Bin Lu, Hezhang Yun
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Two reviewers independently screened the studies, extracted data, assessed the risk of bias using the Cochrane Handbook, and performed the meta-analysis using RevMan 5.4 and Stata 18 software.</p><p><strong>Results: </strong>17 randomized controlled trials involving 690 subjects were included. The results indicate that resistance training significantly improves BMD at the LS (SMD = 0.88, 95% CI [0.21, 1.56], P = 0.01, I<sup>2</sup> = 91%), FN (SMD = 0.89, 95% CI [0.40, 1.39], P = 0.0004, I<sup>2</sup> = 87%) and TH (SMD = 0.30, 95% CI [0.10, 0.50], P = 0.003, I<sup>2</sup> = 25%). However, no significant effect was observed on Troch bone density (SMD = 0.23, 95% CI [-0.01, 0.47], P = 0.06, I<sup>2</sup> = 19%). Subgroup analysis further revealed that high-intensity training (≥ 70% 1RM) had a significant effect on the TH and FN (P < 0.05); training three times per week significantly improved bone mineral density at the LS, FN, TH, and Troch (P < 0.05); intervention durations of ≥ 48 weeks had a significant impact on FN and TH (P < 0.05); and sessions lasting 40 min had a significant effect on LS (P < 0.05).</p><p><strong>Conclusion: </strong>Resistance training can beneficially influence BMD in postmenopausal women, particularly at the LS, FN, and TH. A high-intensity training regimen (≥ 70% 1RM) performed three times per week with a longer training duration may be optimal. However, significant heterogeneity among the included studies for LS and FN bone density may affect the accuracy of the pooled results, thereby limiting the generalizability of these findings. 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Two reviewers independently screened the studies, extracted data, assessed the risk of bias using the Cochrane Handbook, and performed the meta-analysis using RevMan 5.4 and Stata 18 software.</p><p><strong>Results: </strong>17 randomized controlled trials involving 690 subjects were included. The results indicate that resistance training significantly improves BMD at the LS (SMD = 0.88, 95% CI [0.21, 1.56], P = 0.01, I<sup>2</sup> = 91%), FN (SMD = 0.89, 95% CI [0.40, 1.39], P = 0.0004, I<sup>2</sup> = 87%) and TH (SMD = 0.30, 95% CI [0.10, 0.50], P = 0.003, I<sup>2</sup> = 25%). However, no significant effect was observed on Troch bone density (SMD = 0.23, 95% CI [-0.01, 0.47], P = 0.06, I<sup>2</sup> = 19%). Subgroup analysis further revealed that high-intensity training (≥ 70% 1RM) had a significant effect on the TH and FN (P < 0.05); training three times per week significantly improved bone mineral density at the LS, FN, TH, and Troch (P < 0.05); intervention durations of ≥ 48 weeks had a significant impact on FN and TH (P < 0.05); and sessions lasting 40 min had a significant effect on LS (P < 0.05).</p><p><strong>Conclusion: </strong>Resistance training can beneficially influence BMD in postmenopausal women, particularly at the LS, FN, and TH. A high-intensity training regimen (≥ 70% 1RM) performed three times per week with a longer training duration may be optimal. However, significant heterogeneity among the included studies for LS and FN bone density may affect the accuracy of the pooled results, thereby limiting the generalizability of these findings. 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引用次数: 0
摘要
背景：本荟萃分析旨在探讨阻力训练对绝经后妇女骨密度（BMD）的影响，特别关注不同骨骼部位腰椎（LS）、股骨颈（FN）、全髋关节（TH）和粗隆（Troch）的不同训练强度、持续时间、频率和周期。方法：我们系统地检索PubMed、Embase、Web of Science和Cochrane Library，以评估阻力训练计划对绝经后妇女骨密度的影响，涵盖截至2025年3月的所有记录。两位审稿人独立筛选研究，提取数据，使用Cochrane手册评估偏倚风险，并使用RevMan 5.4和Stata 18软件进行meta分析。结果：纳入17项随机对照试验，690名受试者。结果表明，阻力训练显著改善了LS （SMD = 0.88, 95% CI [0.21, 1.56], P = 0.01, I2 = 91%）、FN （SMD = 0.89, 95% CI [0.40, 1.39], P = 0.0004, I2 = 87%）和TH （SMD = 0.30, 95% CI [0.10, 0.50], P = 0.003, I2 = 25%）的骨密度。但对股骨股骨骨密度无显著影响（SMD = 0.23, 95% CI [-0.01, 0.47], P = 0.06, I2 = 19%）。亚组分析进一步显示，高强度训练（≥70% 1RM）对绝经后妇女的TH和FN有显著影响(P结论：阻力训练对绝经后妇女的骨密度有有益影响，特别是在LS、FN和TH。高强度训练方案（≥70% 1RM）每周进行三次，较长的训练时间可能是最佳的。然而，所纳入的LS和FN骨密度研究之间的显著异质性可能影响汇总结果的准确性，从而限制了这些发现的普遍性。需要更多高质量的临床试验来证实这些发现。
Optimal resistance training parameters for improving bone mineral density in postmenopausal women: a systematic review and meta-analysis.
Background: This meta-analysis aims to explore the effects of resistance training on bone mineral density (BMD) in postmenopausal women, specifically focusing on different training intensities, durations, frequencies, and periods, across various skeletal sites lumbar spine (LS), femoral neck (FN), total hip (TH), and trochanter (Troch).
Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies evaluating the impact of resistance training programs on BMD in postmenopausal women, covering all records up to March 2025. Two reviewers independently screened the studies, extracted data, assessed the risk of bias using the Cochrane Handbook, and performed the meta-analysis using RevMan 5.4 and Stata 18 software.
Results: 17 randomized controlled trials involving 690 subjects were included. The results indicate that resistance training significantly improves BMD at the LS (SMD = 0.88, 95% CI [0.21, 1.56], P = 0.01, I2 = 91%), FN (SMD = 0.89, 95% CI [0.40, 1.39], P = 0.0004, I2 = 87%) and TH (SMD = 0.30, 95% CI [0.10, 0.50], P = 0.003, I2 = 25%). However, no significant effect was observed on Troch bone density (SMD = 0.23, 95% CI [-0.01, 0.47], P = 0.06, I2 = 19%). Subgroup analysis further revealed that high-intensity training (≥ 70% 1RM) had a significant effect on the TH and FN (P < 0.05); training three times per week significantly improved bone mineral density at the LS, FN, TH, and Troch (P < 0.05); intervention durations of ≥ 48 weeks had a significant impact on FN and TH (P < 0.05); and sessions lasting 40 min had a significant effect on LS (P < 0.05).
Conclusion: Resistance training can beneficially influence BMD in postmenopausal women, particularly at the LS, FN, and TH. A high-intensity training regimen (≥ 70% 1RM) performed three times per week with a longer training duration may be optimal. However, significant heterogeneity among the included studies for LS and FN bone density may affect the accuracy of the pooled results, thereby limiting the generalizability of these findings. More high-quality clinical trials are needed to confirm these findings.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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