運動介入對停經前婦女骨質疏鬆之預防與療效：系統性回顧與統合分析

Systematic Review and Meta Analysis of Exercise Effects on Osteoporosis Prevention and Treatment for Pre-menopausal Women

呂怡慧(Yi-Hui Lu) ； 陳瑋德(Wei-Te Chen) ； 林鈺惠(Yu-Hui Lin) ； 施怡芬(Yi-Fen Shih) ； 王子娟(Wendy TJ Wang) ； 李雪楨(Hsuei-Chen Lee) ； 陳文英(Wen-Yin Chen)

《物理治療》 31卷5期 (2006/10) Pp. 285-293

摘要

背景與目的：女性無論在停經前或停經後，都是骨質疏鬆與相關骨折的高危險群。文獻中以運動介入對停經前婦女骨質密度的研究較少，效果也不一致。本系統性回顧目地爲探討高衝擊式運動對於停經前婦女骨質密度之療效和影響因素。研究方法：收集資料庫中符合下列條件之研究：隨機控制實驗設計、發表於1997-2006年間、健康停經前成年女性、運動治療介入、測量結果含骨質密度。結果：有四篇研究報告，共269位受試者納入本次對腰椎、股骨頸與大轉子三處骨質密度的成效分析。結果顯示高衝擊性運動對股骨頸與大轉子兩處的骨質密度增加有顯著效果，但在腰椎的成效不顯著。以年齡層或日常活動量作分組分析並未能影響此結果；但是較長時間的運動或介入可顯著增加腰椎的骨質密度，較短時間的運動或介入則只能增加服骨頸與股肯大轉子兩部位的骨質密度。結論：高衝擊性運動對停經前婦女股骨近端的骨質密度改善有顯著成效，對腰椎骨質密度則可能需要做長時問的運動介入才有顯著成效。

關鍵字

骨質疏鬆 ； 停經前婦女 ； 骨質密度 ； 運動介入

並列摘要

Background and Purpose: Premenopausal females, like the postmenopausal ones, are at high risk of developing osteoporosis and related fractures. Exercise is known to help postmenopausal women to increase bone mineral density (BMD) and to delay the disease process. Its effect on premenopausal females is less researched with results not as consistent. We have already known high impact exercise can help fighting the process of osteoporosis, but we are not certain the best exercise parameters for the intervention. The purposes of this review and meta analysis were to investigate effectiveness of high impact exercise intervention and influencing factors on BMD in premenopausal females. Methods: Studies were identified by a systematic computer database and cross reference search. The inclusion criteria were: randomized control trials (RCTs), publish date within ten years (1997-2006), premenopausal human subjects ≥l8 years old, exercise intervention, outcome measurements containing at least one type of bone mineral density measurement at one body site, Results and discussion: Four RCTs were included with a total number of 269 subjects. Their average age was 34.7 yrs (20-39). We performed meta analysis of the high impact exercise on bone mineral density of the lumbar spine, femoral neck and greater trochanter. We found exercise intervention could improve the bone mineral density of the femoral neck and greater trochanter, but its effect on the lumbar spine was not significant. Age and daily activity level did not affect the results; however, longer exercise time or longer intervention duration appeared to significantly increase BMD in the lumbar spine, while shorter exercise time or intervention duration was more beneficial in increasing BMD in femoral neck and greater trochanter. Conclusions: There was sufficient evidence to support the efficacy of high impact exercise on BMD in the proximal femur for premenopausal women. Longer exercise time or intervention duration may be necessary to increase BMD in the lumbar spine. Further studies are needed to clarify the role of exercise intensity in different sites in premenopausal women.

並列關鍵字

Osteoporosis ； Premenopausal women ； Bone mineral density ； Exercise intervention