The effect of high- and low-impact physical activity on bone mineral density: A literature review

Abstract

Physical activity is often associated with increased bone mineral density and decreased osteoporosis. Low-impact sports, have been described as having a neutral or negative effect on bone mass. However, the literature is not consensual in this practice. The objective is to identify the effects of high- and low-impact physical exercises on bone remodeling. Research and selection of the most relevant bibliography, published in the electronic database Pubmed (from January 1990 to January 2018), using as keywords “sport”, “bone mass” and “osteoporosis”. Were included 24 articles in this review. In all studies, bone mineral density was calculated by bone densitometry (whole body, femoral neck and lumbar spine) in individuals between 18 and 30 years of age. The review demonstrates that high-impact exercises appear to be important for the prevention of osteoporosis by increasing bone mass. Studies also suggest that regular practitioners of low-impact exercise, particularly swimming, have bone mineral density similar to those who do not exercise, and values lower than those who practice high-impact sports. These data suggest that physicians and other professionals accompanying swimming athletes should implement high-impact exercises before or after training in aquatic environments in order to improve swimmers bone mineral density. The effects described should not discourage the practice of the modality, which undoubtedly also provides positive body effects, but rather encourage a close look of the doctor who recommends regular practice of this modality, given the increased risk of osteoporosis development. Considering that the increase in latitude, with a consequent decrease in the sun exposure of the practitioners of out-door modalities, has reduced the differences found in bone mass among swimmers (in-door) and those with high-impact modalities, it seems fundamental to do more studies in this area to evaluate possible bias and using new evaluation methods as biochemical markers of bone metabolism.