04/09/2025
Title: Effects of Exercise on Bone Density and Physical Performance in Postmenopausal Women: A Systematic Review and Meta-Analysis (PM&R, 2024)
Background: Postmenopausal women commonly experience bone loss and decreased physical performance, leading to a higher risk of fractures and reduced quality of life (QoL). Osteoporotic medications and supplements are typically used to maintain bone mineral density (BMD), but the role of exercise as an additional intervention remains unclear.
Objective: To determine whether adding exercise training to osteoporotic medication/supplements enhances bone mineral density (BMD) and physical performance in postmenopausal women.
Methods: Systematic review and meta-analysis of 19 studies (1,249 participants).
Databases searched: PubMed, Cochrane Library, Web of Science, Google Scholar (until December 2023).
Inclusion criteria: Clinical controlled trials comparing medicine/supplements alone vs. medicine/supplements + exercise.
Outcomes measured: BMD (lumbar spine, femoral neck, hip), physical performance (balance, strength, mobility), fear of falling, QoL.
Risk of bias assessed using the Cochrane Risk of Bias tool and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).
Key Findings: Bone Mineral Density (BMD) Outcomes:
No significant improvement in lumbar spine and hip BMD with exercise alone compared to medicine/supplements.
Subgroup analysis showed that combining multiple exercise types (aerobic + resistance) improved lumbar spine BMD (p = 0.04).
Physical Performance Improvements: Lower extremity muscle strength: Significant improvement (SMD = 1.77, p = 0.004). Balance (Berg’s Balance Scale): Significant improvement (SMD = 0.72, p = 0.02). Mobility (Timed Up and Go Test): Significant improvement (SMD = -1.07, p < 0.001). Fear of Falling: Significant reduction (SMD = 1.32, p < 0.001). Quality of Life (QoL): Significant enhancement (SMD = 1.39, p < 0.001). Exercise Types and Their Effects: Resistance training improved muscle strength. Balance training reduced fear of falling and improved stability. Combined aerobic and resistance training led to better overall outcomes.
