An Up-Date of the Muscle Strengthening Exercise Effectiveness in Postmenopausal Women with Osteoporosis: A Qualitative Systematic Review.

Jose Luis Alonso Pérez,Andrea Battaglino,Alexandra Alonso-Sal,Sebastián Martín Pérez,Eleuterio A Sánchez Romero,Jorge H Villafañe

doi:10.3390/jcm10112229

Abstract

Background: Osteoporosis (OP) is a systemic disease that is characterized by decreased bone density and quality. Purpose: The purpose of this systematic review was to determine the effects of muscle strengthening exercise in postmenopausal women with OP. Methods: A literature search was conducted systematically in MEDLINE, CINAHL, EMBASE databases for human studies up to 31 March 2021. Two researchers screened the articles against predefined inclusion criteria; a third resolved discrepancies. Articles were included if they assessed the effects of muscle strengthening exercise in postmenopausal women with OP. The protocol for this systematic review was registered on PROSPERO (CRD42021207917) and a qualitative systematic review was carried out following the PRISMA statement. Methodological quality was evaluated through the scientific validity scales PEDro. Finally, RTCs and NRCTs risk of bias was assessed with the Cochrane risk of bias tool (Risk of Bias-ROB 2.0) and ROBINS-1, respectively. Results: A total of 16 studies (1028 subjects) that met the different eligibility criteria previously established were selected. There is evidence of good methodological quality and a low to moderate risk of bias that supports that muscle strengthening exercise alone or in combination with other therapeutic modalities improves BMD (9, n = 401) in proximal femur and lumbar vertebra body, muscle strength (10, n = 558), balance (4, n = 159), functionality (7, n = 617), and quality of life (5, n = 291). Conclusions: Exercise programs focused on muscle strengthening have benefits for all variables studied in postmenopausal women with OP.

Highlights

Osteoporosis (OP) represents a pathology of important health implications, which identifies its clinical significance in the fracture that occur as a consequence of increased bone fragility [1]
After first screening based on title, abstracts and duplicates, 46 articles have been submitted to a second screening
The feasibility, the safety and the positive effect of the proposed exercise protocol on quality of life, fear of falling, balance and functional exercise capacity show that APA programs should be extended to patients whit OP and a history of vertebral fracture

Summary

Introduction

Osteoporosis (OP) represents a pathology of important health implications, which identifies its clinical significance in the fracture that occur as a consequence of increased bone fragility [1]. The standard treatment is fundamentally pharmacological and aims to reduce the incidence of fractures through the interruption of the resolution mechanism [3] It appears that the benefits outweigh the risks, the association between the combination of sequential antiresorptive/anabolic pharmacotherapeutic cycles and the reduction of fracture risk using aminobisphosphonates, selective estrogen receptor modulators, denosumab and teriparatide has not been demonstrated. Muscle strengthening exercise would be effective because it is believed to increase muscle mass and decrease fat mass, especially in osteoporotic menopausal women in whom, by stimulating osteogenesis, it would reduce falls and fractures [6,7]. Purpose: The purpose of this systematic review was to determine the effects of muscle strengthening exercise in postmenopausal women with OP. Articles were included if they assessed the effects of muscle strengthening exercise in postmenopausal women with OP.

Methods

Results

Discussion

Conclusion