Exercise interventions for preventing and treating low bone mass in the forearm: A systematic review and meta-analysis
Abstract
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 till December 2018.
STUDY SELECTION
Eligibility included adults undertaking upper-limb exercise interventions [≥12 weeks] to improve bone mass.
DATA EXTRACTION
Screening of titles/abstracts/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 (RTHI/RTLI, 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% confidence interval [CI] =0.66, 1.88, overall effect Z-value=4.10, p<0.001). RTHI (SMD=1.00, 95% CI=0.37, 1.62, Z-value=3.11, p=0.002), and RTLI (SMD=2.36, 95% CI=0.37, 4.36, Z-value=2.33, p<0.001) led to moderate increases in forearm bone mass. Improvements due to impact exercises (SMD=1.12, 95%CI= -1.27, 3.50, Z-value=0.92, p=0.36) were not statistically significant (low-quality evidence).…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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