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01-06-2021 | Osteoporosis | Systematic Review

The Effect of Impact Exercise (Alone or Multicomponent Intervention) on Health-Related Outcomes in Individuals at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Isabel B. Rodrigues, Matteo Ponzano, Zeinab Hosseini, Lehana Thabane, Philip D. Chilibeck, Debra A. Butt, Maureen C. Ashe, Jackie Stapleton, John Wark, Lora M. Giangregorio

Published in: Sports Medicine | Issue 6/2021

Abstract

Background

Exercise is commonly recommended to prevent and manage osteoporosis. High magnitude strains at rapid rate and short bouts should theoretically elicit an osteogenic response; however, the effects of different levels of impact exercises on several outcomes in people at risk of fracture are still unknown.

Objective

To report the effect of impact exercise on falls, fractures, adverse events, mortality, bone mineral density (BMD), physical functioning, and health-related quality of life (QoL).

Methods

We included randomized controlled trials testing the effect of impact exercise compared with a non-exercise control on outcomes in adults ≥ 50 years with low BMD or fragility fractures. Two reviewers selected studies and extracted data. Where possible, we pooled outcomes using mean difference (MD) with a fixed-effects model and 95% confidence interval (CI). We reported risk of bias using Cochrane and certainty of evidence using GRADE.

Results

We included 29 trials; 19 studies evaluated impact exercise alone, and the remaining trials combined impact with resistance or balance training. Impact exercise alone or combined with resistance training improved Timed Up-and-Go values (MD − 0.95 s, 95% CI − 1.09 to − 0.81, low certainty evidence) and lumbar spine (MD 0.04 g/cm², 95% CI 0.02–0.06, low certainty evidence) and femoral neck BMD (MD 0.04 g/cm², 95% CI 0.02–0.07, low certainty evidence). Impact exercise did not improve health-related QoL assessed with QUALEFFO-41 (MD 0.06, 95% CI − 2.18 to 2.30, moderate certainty evidence). The effects of impact exercise on falls, fractures, and mortality are uncertain due to insufficient data. Many trials had a high risk of bias for two or more items.

Conclusions

There is low certainty evidence that impact exercise may improve physical function and BMD in people at risk of fracture. The effect of impact exercises on falls, fractures, and mortality remains unclear. Our findings should be interpreted with caution due to risk of bias and small sample sizes.

Trial Registration

Registered in Prospero (CRD42018115579) on January 30, 2019.

Available only for authorised users

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Title: The Effect of Impact Exercise (Alone or Multicomponent Intervention) on Health-Related Outcomes in Individuals at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Isabel B. Rodrigues
Matteo Ponzano
Zeinab Hosseini
Lehana Thabane
Philip D. Chilibeck
Debra A. Butt
Maureen C. Ashe
Jackie Stapleton
John Wark
Lora M. Giangregorio
Publication date: 01-06-2021
Publisher: Springer International Publishing
Keywords: Osteoporosis
Osteoporosis
Published in: Sports Medicine / Issue 6/2021
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.1007/s40279-021-01432-x

At a glance: The STEP trials

Springer Medicine

The Effect of Impact Exercise (Alone or Multicomponent Intervention) on Health-Related Outcomes in Individuals at Risk of Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background

Objective

Methods

Results

Conclusions

Trial Registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

Trial Registration

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