Effects of exercise for older women with osteoporosis: A systematic review
Abstract
Aim: This study aimed to systematically review the existing evidence on the effects of physical exercise on muscle strength, balance, risk of falls, and fractures for older women with osteoporosis. Methods: MEDLINE (PubMed), Cochrane Central Register of Clinical Trials, Web of Science, PEDro, and Lilacs were searched, and the methodological qualities were measured using the Assessing risk of bias—Cochrane Collaboration’s tool scale. Results: Eight controlled clinical trials were included. Conclusion: Multicomponent physical exercise, not only balance, may be considered as an intervention for older women with osteoporosis due to its effects on balance, strength, and functional outcomes. Future new randomized controlled trials should focus on parameters to prescribe physical exercise as the progression of resistance and its effects on skeletal muscle function, balance, strength, risk, and number of falls and fractures for older women with osteoporosis.
References
1. Daly RM, Dalla Via J, Duckham RL, et al. Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Brazilian Journal of Physical Therapy. 2019; 23(2): 170-180. doi: 10.1016/j.bjpt.2018.11.011
2. Borgström F, Karlsson L, Ortsäter G, et al. Fragility fractures in Europe: burden, management and opportunities. Archives of Osteoporosis. 2020; 15(1). doi: 10.1007/s11657-020-0706-y
3. Oliveira CC, Borba VZC. Epidemiology of femur fractures in the elderly and cost to the state of paraná, braziL. Acta Ortopédica Brasileira. 2017; 25(4): 155-158. doi: 10.1590/1413-785220172504168827
4. Aziziyeh R, Amin M, Habib M, et al. The burden of osteoporosis in four Latin American countries: Brazil, Mexico, Colombia, and Argentina. Journal of Medical Economics. 2019; 22(7): 638-644. doi: 10.1080/13696998.2019.1590843
5. Harvey NC, Biver E, Kaufman JM, et al. The role of calcium supplementation in healthy musculoskeletal ageing. Osteoporosis International. 2016; 28(2): 447-462. doi: 10.1007/s00198-016-3773-6
6. Coronado-Zarco R, Olascoaga-Gómez de León A, García-Lara A, et al. Nonpharmacological interventions for osteoporosis treatment: Systematic review of clinical practice guidelines. Osteoporosis and Sarcopenia. 2019; 5(3): 69-77. doi: 10.1016/j.afos.2019.09.005
7. Kanis JA, Cooper C, Rizzoli R, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International. 2018; 30(1): 3-44. doi: 10.1007/s00198-018-4704-5
8. Linhares DG, Borba-Pinheiro CJ, Castro JBP de,et al. Effects of multicomponent exercise training on the health of older women with osteoporosis: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2022; 19(21): 14195. doi: 10.3390/ijerph192114195
9. Mohammad Rahimi GR, Smart NA, Liang MTC, et al. The impact of different modes of exercise training on bone mineral density in older postmenopausal women: A systematic review and meta-analysis research. Calcified Tissue International. 2020; 106(6): 577-590. doi: 10.1007/s00223-020-00671-w
10. Jepsen DB, Thomsen K, Hansen S, et al. Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis. BMJ Open. 2017; 7(12): e018342. doi: 10.1136/bmjopen-2017-018342
11. Sanchez-Trigo H, Rittweger J, Sañudo B. Effects of non-supervised exercise interventions on bone mineral density in adult women: a systematic review and meta analysis. Osteoporosis International. 2022; 33(7): 1415-1427. doi: 10.1007/s00198-022-06357-3
12. Olsen CF, Bergland A. The effect of exercise and education on fear of falling in elderly women with osteoporosis and a history of vertebral fracture: results of a randomized controlled trial. Osteoporosis International. 2014; 25(8): 2017-2025. doi: 10.1007/s00198-014-2724-3
13. Stanghelle B, Bentzen H, Giangregorio L, et al. Effects of a resistance and balance exercise programme on physical fitness, health-related quality of life and fear of falling in older women with osteoporosis and vertebral fracture: a randomized controlled trial. Osteoporosis International. 2020; 31(6): 1069-1078. doi: 10.1007/s00198-019-05256-4
14. Gordt K, Gerhardy T, Najafi B, et al. Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Gerontology. 2017; 64(1): 74-89. doi: 10.1159/000481454
15. Varahra A, Rodrigues IB, MacDermid JC, et al. Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis. Osteoporosis International. 2018; 29(2): 265-286. doi: 10.1007/s00198-017-4339-y
16. Ponzano M, Rodrigues IB, Hosseini Z, et al. Progressive Resistance Training for Improving Health-Related Outcomes in People at Risk of Fracture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Physical Therapy. 2020; 101(2). doi: 10.1093/ptj/pzaa221
17. Shojaa M, von Stengel S, Kohl M, et al. Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporosis International. 2020; 31(8): 1427-1444. doi: 10.1007/s00198-020-05441-w
18. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International journal of surgery. 2021; (88): 105906.
19. National Institute for Health and Care Research. Available online: https://www.crd.york.ac.uk/prospero/#loginpage (accessed on 2 April 2024).
20. Kanis JA. Assessment of osteoporosis at the primary health care level. WHO Collaborating Centre for Metabolic Bone Diseases; 2007.
21. Filipović TN, Lazović MP, Backović AN, et al. A 12-week exercise program improves functional status in postmenopausal osteoporotic women: randomized controlled study. European Journal of Physical and Rehabilitation Medicine. 2021; 57(1). doi: 10.23736/s1973-9087.20.06149-3
22. Conradsson D, Halvarsson A. The effects of dual-task balance training on gait in older women with osteoporosis: A randomized controlled trial. Gait & Posture. 2019; 68: 562-568. doi: 10.1016/j.gaitpost.2019.01.005
23. Mikó I, Szerb I, Szerb A, et al. Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial. Clinical Rehabilitation. 2016; 31(2): 217-224. doi: 10.1177/0269215516628616
24. Halvarsson A, Oddsson L, Franzén E, et al. Long-term effects of a progressive and specific balance-training programme with multi-task exercises for older adults with osteoporosis: a randomized controlled study. Clinical Rehabilitation. 2016; 30(11): 1049-1059. doi: 10.1177/0269215515605553
25. Halvarsson A, Franzén E, Ståhle A. Balance training with multi-task exercises improves fall-related self-efficacy, gait, balance performance and physical function in older adults with osteoporosis: a randomized controlled trial. Clinical Rehabilitation. 2014; 29(4): 365-375. doi: 10.1177/0269215514544983
26. Burke TN, França FJR, Meneses SRF de, et al. Postural control in elderly women with osteoporosis: comparison of balance, strengthening and stretching exercises. A randomized controlled trial. Clinical Rehabilitation. 2012; 26(11): 1021-1031. doi: 10.1177/0269215512442204
27. Burke TN, França FJR, Ferreira de Meneses SR, et al. Postural control in elderly persons with osteoporosis: efficacy of an intervention program to improve balance and muscle strength. American Journal of Physical Medicine & Rehabilitation. 2010; 89(7): 549-556. doi: 10.1097/phm.0b013e3181ddccd2
28. Madureira MM, Bonfá E, Takayama L, et al. A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: Improvement of quality of life. Maturitas. 2010; 66(2): 206-211. doi: 10.1016/j.maturitas.2010.03.009
29. Savvakis I, Adamakidou T, Kleisiaris C. Physical activity interventions to reduce fear of falling in frail and pre-frail older adults a systematic review of randomized controlled trials. European Geriatric Medicine. 2023. doi: 10.1007/s41999-024-00944-9
30. Devries MC, Giangregorio L. Using the specificity and overload principles to prevent sarcopenia, falls and fractures with exercise. Bone. 2023; 166: 116573. doi: 10.1016/j.bone.2022.116573
31. Ruzene JRS, Morcelli MH, Navega MT. Equilibrium in women with osteoporosis submitted to balance training with and without an oscillating vibratory pole. Journal of Bodywork and Movement Therapies. 2016; 20(1): 35-41. doi: 10.1016/j.jbmt.2015.03.005
32. Brandalize D, Almeida PHF de, Machado J, et al. Efeitos de diferentes programas de exercícios físicos na marcha de idosos saudáveis: uma revisão. Fisioterapia em Movimento. 2011; 24(3): 549-556. doi: 10.1590/s0103-51502011000300019
33. Rossi LP, Pereira R, Brandalize M, et al. The effects of a perturbation-based balance training on the reactive neuromuscular control in community-dwelling older women: a randomized controlled trial. Human Movement. 2018; 14(3): 238-246. doi: 10.2478/humo-2013-0029
34. Rodrigues EV, Gallo LH, Guimarães ATB, et al. Effects of dance exergaming on depressive symptoms, fear of falling, and musculoskeletal function in fallers and Nonfallers Community-Dwelling Older Women. Rejuvenation Research. 2018; 21(6): 518-526. doi: 10.1089/rej.2017.2041
Copyright (c) 2024 Lindomar Mineiro, Bianca Simone Zeigelboim, Christiano Francisco dos Santos, Michéli Rodrigues da Rosa, Silvia Valderramas, Anna Raquel Silveira Gomes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright on all articles published in this journal is retained by the author(s), while the author(s) grant the publisher as the original publisher to publish the article.
Articles published in this journal are licensed under a Creative Commons Attribution 4.0 International, which means they can be shared, adapted and distributed provided that the original published version is cited.
Submit a Paper
