OBJECTIVE: To examine the effectiveness of exercises for improving forearm bone mass. DATA SOURCES: Medline, Embase, CINAHL, AMED, Web of Science, and Cochrane CENTRAL were searched from their inception until December 2018. STUDY SELECTION: Eligibility included adults undertaking upper limb exercise interventions (>= 12 wk) to improve bone mass. DATA EXTRACTION: Screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers. Included studies were quality appraised using Cochrane risk of bias tool. DATA SYNTHESIS: Exercise interventions were classified into "resistance training" of high or low intensity (HIRT/LIRT, respectively) or "impact". Random-effects meta-analysis of the percentage change in forearm bone mass from baseline was conducted. Twenty-six studies were included in the review, of which 21 provided suitable data for meta-analysis. Methodological quality ranged from "low" to "unclear" risk of bias. Exercise generally led to increases (moderate-quality evidence) in forearm bone mass (standard mean difference (SMD) 1.27; 95% CI 0.66 to 1.88; overall effect z value = 4.10; p < 0.001). HIRT (SMD 1.00; 95% CI 0.37 to 1.62; z value = 3.11; p = 0.002), and LIRT (SMD 2.36; 95% CI 0.37 to 4.36; z value = 2.33; p < 0.001) led to moderate increases in forearm bone mass. Improvements resulting from impact exercises (SMD 1.12; 95% CI -1.27 to 3.50; z value = 0.92; p = 0.36) were not statistically significant (low-quality evidence). CONCLUSIONS: There is moderate-quality evidence that exercise is effective for improving forearm bone mass. There is moderate-quality evidence that upper body resistance exercise (HIRT/LIRT) promotes forearm bone mass but low-quality evidence for impact exercise. Current evidence is equivocal regarding which exercise is most effective for improving forearm bone mass.

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