The quality of evidence is downgraded by inconsistency (variability in results).
A Cochrane review [Abstract] 1 included 34 studies with a total of 4 320 subjects. Meta-analyses showed significant differences between the exercise and control groups in favour of exercise for percentage change in bone mineral density (BMD) at the spine and trochanter, but not at femoral neck and total hip (table T1). The risk of fracture was not different between exercise and control groups. The most effective type of exercise intervention on bone mineral density (BMD) for the neck of femur was non-weight bearing high force exercise such as progressive resistance strength training for the lower limbs (MD 1.03, 95% CI 0.24 to 1.82; 8 studies, n=247). The most effective intervention for BMD at the spine was combination exercise programmes (comprising more than one exercise type; MD 3.22, 95% CI 1.80 to 4.64; 4 studies, n=258) compared with control groups.
| Outcome | Relative effect (95% CI) | Assumed risk (control) | Corresponding risk (exercise; 95% CI) | Participants (studies) |
|---|---|---|---|---|
| Fractures | OR 0.61(0.23 to 1.64) | 106 per 1000 | 67 per 1000(27 to 163) | 539 (4 studies) |
| Bone mineral density % change: spine | The mean BMD change ranged across control groups from-4.38 to 1.05% | 0.85% higher(0.62 to 1.07 higher) | 1 441 (24 studies) | |
| Bone mineral density % change: femoral neck | The mean BMD change ranged across control groups from-3.19 to 3.12% | 0.08% lower(1.08 lower to 0.92 higher) | 1 338 (19 studies) | |
| Bone mineral density % change: total hip | The mean BMD change ranged across control groups from-2.18 to 2.61% | 0.41% higher(0.64 lower to 1.45 higher) | 863 (13 studies) | |
| Bone mineral density % change: trochanter | The mean BMD change ranged across control groups from-1.62 to 2.94% | 1.03% higher(0.56 to 1.49 higher) | 815 (10 studies) |
Primary/Secondary Keywords