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(Meta-analysis of bone metabolism indicators in patients with primary osteoporosis under different forms of exercises) [Chinese - simplified characters]
Yuan Q, Kong H
Chinese Journal of Tissue Engineering Research 2020 Jun 18;24(17):2782-2788
systematic review

BACKGROUND: Physical exercise can significantly reduce bone mass loss, relieve pain and improve bone metabolism in osteoporosis patients, but there is no evidence-based evidence. OBJECTIVE(S): To investigate the effect of different physical exercises on the treatment of primary osteoporosis. METHOD(S): Randomized controlled clinical trials regarding the therapeutic effect of physical exercise on primary osteoporosis were screened. The physical exercise group was subjected to physical exercise, and the control group had no regular exercise during the test. The main outcome measures included bone mineral density of lumbar spine L2 to L4, visual analog scale score, bone metabolism index (osteocalcin, total type 1 procollagen amino terminal peptide, urine pyridinium/creatinine, blood calcium, blood phosphorus). The included outcome indicators were meta-analyzed using the Review Manager 5.3 software. RESULTS AND CONCLUSION(S): A total of 25 randomized controlled trials were included. Meta-analysis results showed that physical exercise could effectively improve the bone mineral density of L2 to L4 segments in primary osteoporosis patients (mean difference 0.06, 95% confidence interval 0.04 to 0.08, p < 0.000 01, I2 = 89%). Subgroup analysis results revealed significant differences in the control group and five-animal exercise and Yi-Jin-Jing group, setting-up exercise group, composite exercise group, and incremental exercise group compared with control group (p < 0.05), while there was no significant difference between other exercise groups and control group (p > 0.05). Physical exercise significantly reduced the pain as determined by the visual analog scale in osteoporosis patients (mean difference -0.93, 95% confidence interval -1.08 to -0.79, p < 0.00001, I2 = 83%). Exercise intervention could improve serum osteocalcin, total type 1 procollagen amino terminal peptide and blood phosphorus levels, and reduce urine pyridinium/creatinine and serum calcium levels. However, there was no significant difference between exercise groups and control group (p > 0.05). The results of Egger's and Begg's tests indicated that publication bias of the included studies was at a low level. All these findings indicate that physical exercise has significant interventional effects on bone mineral density and pain in patients with primary osteoporosis.

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