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The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies

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Abstract

The cumulative risk of fracture for a postmenopausal woman over the age of 50 can reach up to 60%. Exercise has the potential to modify fracture risk in postmenopausal women through its effects on bone mass and geometry; however, these effects are not well characterized. To determine the effects of exercise on bone mass and geometry in postmenopausal women, we conducted a systematic review of the literature. We included all randomized controlled trials, cross-sectional studies, and prospective studies that used peripheral quantitative computed tomography to assess the effects of exercise on bone mass and geometry in this population. Exercise effects appear to be modest, site-specific, and preferentially influence cortical rather than trabecular components of bone. Exercise type also plays a role, with the most prominent mass and geometric changes being observed in response to high-impact loading exercise. Exercise appears to positively influence bone mass and geometry in postmenopausal women. However, further research is needed to determine the types and amounts of exercise that are necessary to optimize improvements in bone mass and geometry in postmenopausal women and determine whether or not these improvements are capable of preventing fractures.

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References

  1. Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381

    Article  CAS  PubMed  Google Scholar 

  2. Cooper C (1993) The epidemiology of fragility fractures: is there a role for bone quality? Calcif Tissue Int 53(Suppl 1):23–26

    Article  Google Scholar 

  3. Cummings SR, Black DM, Rubin SM (1989) Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 149:2445–2448

    Article  CAS  PubMed  Google Scholar 

  4. Cryer B, Bauer DC (2002) Oral bisphosphonates and upper gastrointestinal tract problems: what is the evidence? Mayo Clin Proc 77:1031–1043

    Article  PubMed  Google Scholar 

  5. Rossouw JE, Anderson GL, Prentice RL et al (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333

    Article  CAS  PubMed  Google Scholar 

  6. Wiktorowicz ME, Goeree R, Papaioannou A et al (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12:271–278

    Article  CAS  PubMed  Google Scholar 

  7. Weycker D, Marcarios D, Edelsberg J et al (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 17:1645–1652

    Article  CAS  PubMed  Google Scholar 

  8. Bonaiuti D, Shea B, Iovine R et al (2002) Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 3:CD000333

    Google Scholar 

  9. Shea B, Bonaiuti D, Iovine R et al (2004) Cochrane Review on exercise for preventing and treating osteoporosis in postmenopausal women. Eura Medicophys 40:199–209

    CAS  PubMed  Google Scholar 

  10. Wallace BA, Cumming RG (2000) Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Calcif Tissue Int 67:10–18

    Article  CAS  PubMed  Google Scholar 

  11. Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3–S7

    Article  PubMed  Google Scholar 

  12. Adami S, Gatti D, Braga V et al (1999) Site-specific effects of strength training on bone structure and geometry of ultradistal radius in postmenopausal women. J Bone Miner Res 14:120–124

    Article  CAS  PubMed  Google Scholar 

  13. Chan K, Qin L, Lau M et al (2004) A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil 85:717–722

    Article  PubMed  Google Scholar 

  14. Ito M, Nakamura T, Ikeda S et al (2001) Effects of lifetime volleyball exercise on bone mineral densities in lumbar spine, calcaneus and tibia for pre-, peri- and postmenopausal women. Osteoporos Int 12:104–111

    Article  CAS  PubMed  Google Scholar 

  15. Karinkanta S, Heinonen A, Sievanen H et al (2008) Maintenance of exercise-induced benefits in physical functioning and bone among elderly women. Osteoporos Int . doi:10.1007/s00198-008-0703-2

    PubMed  Google Scholar 

  16. Karinkanta S, Heinonen A, Sievanen H et al (2007) A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial. Osteoporos Int 18:453–462

    Article  CAS  PubMed  Google Scholar 

  17. Liu-Ambrose TY, Khan KM, Eng JJ et al (2004) Both resistance and agility training increase cortical bone density in 75- to 85-year-old women with low bone mass: a 6-month randomized controlled trial. J Clin Densitom 7:390–398

    Article  PubMed  Google Scholar 

  18. Qin L, Au S, Choy W et al (2002) Regular Tai Chi Chuan exercise may retard bone loss in postmenopausal women: a case–control study. Arch Phys Med Rehabil 83:1355–1359

    Article  PubMed  Google Scholar 

  19. Shedd KM, Hanson KB, Alekel DL et al (2007) Quantifying leisure physical activity and its relation to bone density and strength. Med Sci Sports Exerc 39:2189–2198

    Article  PubMed  Google Scholar 

  20. Uusi-Rasi K, Kannus P, Cheng S et al (2003) Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial. Bone 33:132–143

    Article  CAS  PubMed  Google Scholar 

  21. Uusi-Rasi K, Sievanen H, Heinonen A et al (2006) Long-term recreational gymnastics provides a clear benefit in age-related functional decline and bone loss. A prospective 6-year study. Osteoporos Int 17:1154–1164

    Article  CAS  PubMed  Google Scholar 

  22. Uusi-Rasi K, Sievanen H, Pasanen M et al (2002) Associations of calcium intake and physical activity with bone density and size in premenopausal and postmenopausal women: a peripheral quantitative computed tomography study. J Bone Miner Res 17:544–552

    Article  CAS  PubMed  Google Scholar 

  23. Uusi-Rasi K, Sievanen H, Vuori I et al (1999) Long-term recreational gymnastics, estrogen use, and selected risk factors for osteoporotic fractures. J Bone Miner Res 14:1231–1238

    Article  CAS  PubMed  Google Scholar 

  24. Kannus P, Haapasalo H, Sankelo M et al (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31

    CAS  PubMed  Google Scholar 

  25. Kohrt W, Snead D, Slatopolsky E et al (1995) Additive effects of weight-bearing exercise and estrogen on bone mineral density in older women. J Bone Miner Res 10:1303–1311

    Article  CAS  PubMed  Google Scholar 

  26. Atkinson PJ, Weatherell JA (1967) Variation in the density of the femoral diaphysis with age. J Bone Joint Surg Br 49:781–788

    CAS  PubMed  Google Scholar 

  27. Ruegsegger P, Durand EP, Dambacher MA (1991) Differential effects of aging and disease on trabecular and compact bone density of the radius. Bone 12:99–105

    Article  CAS  PubMed  Google Scholar 

  28. Smith RW Jr, Walker RR (1964) femoral expansion in aging women: implications for osteoporosis and fractures. Science 145:156–157

    Article  PubMed  Google Scholar 

  29. Wapniarz M, Lehmann R, Reincke M et al (1997) Determinants of radial bone density as measured by PQCT in pre- and postmenopausal women: the role of bone size. J Bone Miner Res 12:248–254

    Article  CAS  PubMed  Google Scholar 

  30. Martin RB (1991) Determinants of the mechanical properties of bones. J Biomech 24(Suppl 1):79–88

    Article  PubMed  Google Scholar 

  31. Lauretani F, Bandinelli S, Griswold ME et al (2008) Longitudinal changes in BMD and bone geometry in a population-based study. J Bone Miner Res 23:400–408

    Article  PubMed  Google Scholar 

  32. Szulc P, Seeman E, Duboeuf F et al (2006) Bone fragility: failure of periosteal apposition to compensate for increased endocortical resorption in postmenopausal women. J Bone Miner Res 21:1856–1863

    Article  PubMed  Google Scholar 

  33. Silcox D (2008) Updates on bisphosphonates for treatment of osteoporosis. Available via: http://www.opocenter.com/updates/update3.html Accessed 15 Oct 2008

  34. Singh M (2004) Exercise and bone health. In: Holick M, Dawson-Hughes B (eds) Nutrition and bone health. Humana, Totowa, pp 515–548

    Google Scholar 

  35. U.S. Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. Office of the Surgeon General. Available via: http://www.surgeongeneral.gov/library/bonehealth/content.html Accessed 3 Nov 2008

  36. Ensrud KE, Palermo L, Black DM et al (1995) Hip and calcaneal bone loss increase with advancing age: longitudinal results from the study of osteoporotic fractures. J Bone Miner Res 10:1778–1787

    CAS  PubMed  Google Scholar 

  37. Nilas L, Christiansen C (1988) Rates of bone loss in normal women: evidence of accelerated trabecular bone loss after the menopause. Eur J Clin Invest 18:529–534

    Article  CAS  PubMed  Google Scholar 

  38. Bassey EJ, Rothwell MC, Littlewood JJ et al (1998) Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 13:1805–1813

    Article  CAS  PubMed  Google Scholar 

  39. Rolland Y, Czerwinski S, Abellan Van Kan G et al (2008) Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 12:433–450

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Osteoporosis Research Program, Women’s College Hospital, 818E - 76 Grenville Street, Toronto, ON, M5S 1B2, Canada

    C. J. Hamilton & V. J. D. Swan

  2. Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada

    C. J. Hamilton

  3. Osteoporosis Research Program, Women’s College Hospital, 805E-76 Grenville Street, Toronto, ON, M5S 1B2, Canada

    S. A. Jamal

  4. Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto, ON, Canada

    S. A. Jamal

Authors
  1. C. J. Hamilton
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  2. V. J. D. Swan
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  3. S. A. Jamal
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Correspondence to C. J. Hamilton.

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Hamilton, C.J., Swan, V.J.D. & Jamal, S.A. The effects of exercise and physical activity participation on bone mass and geometry in postmenopausal women: a systematic review of pQCT studies. Osteoporos Int 21, 11–23 (2010). https://doi.org/10.1007/s00198-009-0967-1

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  • DOI: https://doi.org/10.1007/s00198-009-0967-1

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