運動改善更年期婦女骨質疏鬆之成效—系統性回顧暨統合分析

背景：骨質疏鬆症雖是人體老化的過程，但也是不易被察覺的骨骼代謝疾病，且好發於停經後婦女。國民平均餘命隨著社會經濟及醫療衛生的進步得以延長，這使得中老年人口比例不斷增加，也因此預防更年期婦女骨質疏鬆症是需被重視的重要健康議題。目的：分析不同結果測量變項對運動措施介入於骨質疏鬆更年期婦女的骨密度改善成效。方法：以系統性回顧法，使用「骨質疏鬆、停經、絕經、更年期、運動等關鍵字，搜尋發表於MEDLINE 、PubMed 、CINAHL 、CEPS 、中國期刊全文資料庫、台灣期刊論文索引系統及台灣博碩士論文資訊網等之研究文獻。並以統合分析法分析研究中介入運動措施之成效。結果：運動對更年期婦女的腰椎骨密度I（g／cm2）有改善成效，但此結果未發現於腰椎II（T-score）及端股骨的骨密度，其綜合效量分別為-0.212（95%CI：-0.4， -0.03）、-0.116（95%CI：-2.364， 2.132）、-0.18（95%CI：-0.59， 0.23）。結論：本研究結果發現太極拳、跑步機運動、階梯運動、抗阻或有氧運動及土風舞對更年期婦女之腰椎骨密度有改善成效。此結果可提供醫護專業者及骨質疏鬆症的更年期婦女族群，相關之客觀的運動研究改善骨密度成效之知識與訊息，以為運動選擇之參考。

關鍵字

更年期；運動；統合分析；腰椎骨密度；端股骨骨密度

並列摘要

Background: Osteoporosis is a phenomenon of human aging that often occurs in postmenopausal women. However, osteoporosis is difficult to detect effectively. Longer average life expectancies continue to increase the proportion of elderly in the overall population. Therefore, preventing osteoporosis in menopausal women is an issue that should be taken seriously. Purposes: This study analyzed the effect of exercise on improving bone mass density (BMD) in terms of different outcome measures for menopausal women with osteoporosis. Methods: This study conducted a systematic review of the literature and a meta-analysis of data. Keywords searched included osteoporosis, menopause, and exercise and databases used included MEDLIINE, PubMed, CINAHL, CEPS, the Chinese National Knowledge Infrastructure, Chinese Periodical Literature System, and National Digital Library of Theses and Dissertations in Taiwan. Results: Results found exercise improved BMD in lumbar I (g/cm(superscript2)) but not in either lumbar II (T-score) or the femur in menopausal women with osteoporosis. Summary effect sizes were -0.212 (95%CI:-0.4, -0.03), -0.116 (95%CI:-2.364, 2.132), -0.18 (95%CI:-0.59, 0.23), respectively. Conclusions: This study found tai chi, treadmill exercise, step exercise, resistance or aerobic exercise, and folk dance to improve lumbar BMD in menopausal women with osteoporosis. This result provides to health care professional groups and menopausal women with osteoporosis relevant, objective knowledge and information regarding the effect of exercise on BMD.

並列關鍵字

Menopause ； exercise ； meta-analysis ； lumbar bone mass density ； femur bone mass density

參考文獻

中華民國骨質疏鬆症學會 (2008)‧骨質疏鬆症對台灣人民健康之衝擊‧線上檢索日期：2011年1 月24 日，網址：http://www.toa1997.org.tw/index.php?page_id=9bf31c7ff062936a96d3c8bd1f8f2ff3&mod=bulletin_edit&id=34[The Taiwanese Osteoporosis Association.(2008). The impact of osteoporosis on health in Taiwan. Retrieved January 24, 2011, from http://www.toa1997.org.tw/index.php?page_id=9bf31c7ff062936a96d3c8bd1f8f2ff3&mod =bulletin_edit&id=34]

Google Scholar

內政部統計處 (2010)‧統計年報－人口年齡分配‧線上檢索日期：2011 年1 月24 日，網址：http://sowf.moi.gov.tw/stat/year/list.htm[Ministry of the Interior Department of Statistics.(2010). Statistics annual—National population and age distribution. Retrieved January 24, 2011from: http://sowf.moi.gov.tw/stat/year/list.htm]

Google Scholar

行政院衛生署 (2010)‧性別統計指標報表一覽表‧線上檢索日期：2011 年1 月24 日，網址：http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10229&class_ no=440&level_no=2 [Department of Health,Executive Yuan. (2010). Gender based statistical indicators. Retrieved January 24, 2011 from: http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10229&class_no=440&level_no=2]