Study on the Exercise Strategy of Osteoporosis Prevention in Elderly Population
Sun Yuewan1, Wang Dongmei1*, Wang Wei1, Sun Jingchuan2
1.(School of Mechanical Engineering,Shanghai Jiao Tong University,Shanghai 200000,China) 2.(Department of Orthopedics, the Affiliated Changzheng Hospital of Second Military Medical University,Shanghai 200003,China)
Abstract:With the aggravation of aging in China,the incidence of osteoporosis is increasing rapidly. As one of the three major treatment and prevention methods of osteoporosis, sports therapy is being paid more and more attention and popularized by its reliable, convenient, safe and cheap features. At the same time, sports therapy also has the characteristics of improving the strength of the muscle, balance ability and the quality of life of the elderly population, so it is becoming the most important method to prevent osteoporosis. This paper systematically reviewed the methods, effects and characteristics commonly used in exercise therapy from three aspects: aerobic exercise, resistance exercise and vibration exercise, and compared and summarized the issues. In addition, this paper discussed and summarized the intensity and frequency used in the exercise prevention strategy. At the end of the article, we pointed out the problems that need to be solved in the exercise strategy of osteoporosis prevention, which would be helpful for researchers to further develop their investigations.
孙悦婉, 王冬梅, 王玮, 孙璟川. 老年人骨质疏松运动预防策略研究进展[J]. 中国生物医学工程学报, 2019, 38(2): 233-239.
Sun Yuewan, Wang Dongmei, Wang Wei, Sun Jingchuan. Study on the Exercise Strategy of Osteoporosis Prevention in Elderly Population. Chinese Journal of Biomedical Engineering, 2019, 38(2): 233-239.
[1] Howe TE, Shea B, Dawson LJ, et al. Exercise for preventing and treating osteoporosis in postmenopausal women[J]. Cochrane Database Syst Rev, 2011, 7(7):CD000333. [2] 朴俊红,庞莲萍,刘忠厚,等.中国人口状况及原发性骨质疏松症诊断标准和发生率[J].中国骨质疏松杂志,2002(1):5-11. [3] Black D, Bonjour JP, Dequeker J, et al. Prevention and management of osteoporosis: Report of a WHO scientific group[M]//Prevention and treatment. Geneva:World Health Organization, 2003: 86-96. [4] Wilhelm M, Roskovensky G,Emery K, et al. Effect of resistance exercises on function in older adults with osteoporosis or osteopenia: a systematic review[J]. Physiotherapy Canada, 2012, 64(4): 386-394. [5] Beck BR, Daly RM, Singh MAF, et al. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis[J]. Journal of Science and Medicine in Sport, 2017, 20(5): 438-445. [6] Varahra A, Rodrigues IB, MacDermid JC, et al. Exercise to improve functional outcomes in persons with osteoporosis: A systematic review and meta-analysis[J]. Osteoporosis International, 2018,29(2):265-286. [7] Yuan Yu, Chen Xi, Zhang Lingli, et al. The roles of exercise in bone remodeling and in prevention and treatment of osteoporosis[J]. Progress in Biophysics and Molecular Biology, 2016, 122(2): 122-130. [8] Nguyen VH. Osteoporosis prevention and osteoporosis exercise in community-based public health programs[J]. Osteoporosis and Sarcopenia, 2017, 3(1): 18-31. [9] 王春燕,何成奇.骨质疏松症治疗中的运动疗法[J].中国组织工程研究,2013,17(37):6657-6663. [10] 邓士琳.体力活动与绝经后骨质疏松症的关系及运动干预模式的研究[D].武汉:华中科技大学,2008. [11] Campanha-Versiani L, Pereira DAG, Ribeiro-Samora GA, et al. The effect of a muscle weight-bearing and aerobic exercise program on the body composition, muscular strength, biochemical markers, and bone mass of obese patients who have undergone gastric bypass surgery[J]. Obesity Surgery, 2017, 27(8): 2129-2137. [12] Yeh ML, Liao RW, Hsu CC, et al. Exercises improve body composition, cardiovascular risk factors and bone mineral density for menopausal women: A systematic review and meta-analysis of randomized controlled trials[J]. Applied Nursing Research, 2018, 40: 90-98. [13] 徐中华.有氧训练和力量训练对男性中老年体成分和骨密度的影响[J].体育科技文献通报,2013,21(7):103-105. [14] 周小银. 太极柔力球锻炼对中老年女性身体形态及骨密度的影响[D].西安:西安体育学院,2015. [15] 虞定海,王会儒,谢业雷,等.太极健骨操练习对绝经期女性骨密度的影响[J].上海体育学院学报,2014,38(6):100-104. [16] 徐世民,刘鹏.太极对预防绝经后女性骨密度的荟萃分析[J].中国骨质疏松杂志,2012,18(10):932-936. [17] Liu Fenghu, Wang Shen. Effect of Tai Chi on bone mineral density in postmenopausal women: A systematic review and meta-analysis of randomized control trials[J]. Journal of the Chinese Medical Association, 2017, 80(12): 790-795. [18] Lee MS, Pittler MH, Shin BC, et al. Tai chi for osteoporosis: A systematic review[J]. Osteoporosis International, 2008, 19(2): 139-146. [19] 张林.太极拳作为运动处方对老年人 PWC130 测试前后 STI 和血液动力学参数的影响[J].中国运动医学杂志, 1994,13(3):167-170. [20] Martyn-St James M, Carroll S. Meta-analysis of walking for preservation of bone mineral density in postmenopausal women[J]. Bone, 2008, 43(3): 521-531. [21] Bergström I, Landgren BM, Brinck J, et al. Physical training preserves bone mineral density in postmenopausal women with forearm fractures and low bone mineral density[J]. Osteoporosis International, 2008, 19(2): 177-183. [22] 陈荣,李世昌.太极拳和快走对老年女性跟骨骨密度和骨代谢的影响研究[J].吉林体育学院学报,2011,27(1):87-88. [23] 沈华.不同形式的健身运动和体成分对中老年女性骨密度的影响[J].成都体育学院学报,2008,34(12):71-74. [24] 孙威,王疆娜,杨春荣,等.太极拳和快走练习对老年女性骨密度和骨代谢影响的跟踪研究[J].中国骨质疏松杂志,2017,23(8):1034-1040. [25] Fung Yuanzhen. Biomechanics: mechanical properties of living tissues[M]//Bone and Cartilage. New York:Springer-Verlag New York, 1993:500-544. [26] Kawano KI, Ogata N, Chiano M, et al. Klotho gene polymorphisms associated with bone density of aged postmenopausal women[J]. Journal of Bone and Mineral Research,2002,17(10): 1744-1751. [27] Watson SL, Weeks BK, Weis LJ, et al. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: Novel early findings from the LIFTMOR trial[J]. Osteoporosis International, 2015, 26(12): 2889-2894. [28] Kelley GA, Kelley KS, Tran ZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials[J].Physical Medicine & Rehabilitation,2001,80(1): 65-77. [29] Bolam KA, Van Uffelen JGZ, Taaffe DR. The effect of physical exercise on bone density in middle-aged and older men: A systematic review[J]. Osteoporosis International, 2013, 24(11): 2749-2762. [30] 申潇竹,张玲,田昌荣,等.阻抗训练对老年缺血性卒中患者预防骨质疏松的作用[J].实用医学杂志,2012,28(21):3592-3593. [31] Pruitt LA, Jackson RD, Bartels RL, et al. Weight-training effects on bone mineral density in early postmenopausal women[J]. Journal of Bone and Mineral Research, 1992, 7(2): 179-185. [32] 胡煜,郑健,邱习勤.有氧运动联合渐进式抗阻运动治疗老年人骨质疏松症临床疗效观察[J].南京体育学院学报(自然科学版),2017,16(4):23-27. [33] Marques EA, Wanderley F, Machado L, et al. Effects of resistance and aerobic exercise on physical function, bone mineral density, OPG and RANKL in older women[J]. Experimental Gerontology, 2011,46(7): 524-532. [34] 张军. 有氧运动结合抗阻力量练习对中年人身体成分和骨密度的影响[D].上海:上海体育学院,2017. [35] Mark W, Gregory R, Karla E. Effect of resistance exercises on function in older adults with osteoporosis or osteopenia:A systematic review[J].Physiotherapy Canada, 2012, 64(4):386-394. [36] Barry PL. Good Vibrations: A new treatment under study by NASA-funded doctors could reverse bone loss experienced by astronauts in space[J]. Science@ NASA, 2002, 4(1):1-7. [37] Rubin C, Turner AS, Bain S, et al. Anabolism: Low mechanical signals strengthen long bones[J]. Nature, 2001, 412(6847): 603-604. [38] Rubin C, Recker R, Cullen D, et al. Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: A clinical trial assessing compliance, efficacy,and safety[J]. Journal of Bone and Mineral Research, 2004, 19(3): 343-351. [39] Ma Chiyuan, Liu An, Sun Miao, et al. Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review[J]. Journal of Orthopaedic Surgery and Research, 2016, 11(1): 24-34. [40] Lam FMH, Lau RWK, Chung RCK, et al. The effect of whole body vibration on balance, mobility and falls in older adults: A systematic review and meta-analysis[J]. Maturitas, 2012, 72(3): 206-213. [41] 方斌,易春智,陈雷雷,等.全身机械振动对老年男性骨质疏松症患者骨密度和生活质量的影响[J].广东医学,2014,35(16):2548-2551. [42] 李志香,张春林,谈诚. 30Hz全身振动对骨质疏松的影响[J].航天医学与医学工程,2007(2):116-119. [43] Verschueren SMP, Roelants M, Delecluse C, et al. Effect of 6‐month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: A randomized controlled pilot study[J]. Journal of Bone and Mineral Research, 2004,19(3): 352-359. [44] Skerry TM. The response of bone to mechanical loading and disuse: fundamental principles and influences on osteoblast/osteocyte homeostasis [J]. Arch Biochem Biophys, 2008, 473(2): 117-123. [45] Bacabac RG, Smit TH, Van Loon JJWA, et al. Bone cell responses to high-frequency vibration stress: does the nucleus oscillate within the cytoplasm?[J]. The FASEB Journal, 2006, 20(7): 858-864. [46] 邓轩赓. 复合振动仪防治骨质疏松的实验研究[D].广州:南方医科大学,2008. [47] 王颖.机械振动疗法及其在康复治疗中的应用[J].中国康复医学杂志,2004(8):73-76. [48] Rubin C, Pope M, Fritton JC, et al. Transmissibility of 15-Hz to 35-Hz vibrations to the human hip and lumbar spine: determining the physiologic feasibility of delivering low-level anabolic mechanical stimuli to skeletal regions at greatest risk of fracture because of osteoporosis[J]. Spine, 2003, 28(23): 2621-2627. [49] Stengel SV, Kemmler W, Pintag R, et al. Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women[J]. Journal of Applied Physiology, 2005, 99(1): 181-188. [50] Rockwell JC, Sorensen AM, Baker S, et al. Weight training decreases vertebral bone density in premenopausal women: A prospective study[J]. The Journal of Clinical Endocrinology & Metabolism,1990,71(4): 988-993. [51] 杨路昕,郭郡浩,蔡辉.运动干预原发性骨质疏松症:不同运动方式、强度及频率对骨密度的影响[J].中国组织工程研究,2014,18(38):6200-6204. [52] 王沛,刘春,黄欣加.骨质疏松的运动防治研究[J].南京体育学院学报(自然科学版),2003,4(1):30-33. [53] 郭宏焘.户外负重有氧运动结合局部肌力训练在老年骨质疏松预防中的效果研究[J].中国骨质疏松杂志,2015,21(8):941-944. [54] Feigenbaum MS, Pollock ML. Prescription of resistance training for health and disease[J]. Medicine and Science in Sports and Exercise, 1999, 31: 38-45. [55] De Zepetnek JOT, Giangregorio LM, Craven BC. Whole-body vibration as potential intervention for people with low bone mineral density and osteoporosis: A review[J]. Journal of Rehabilitation Research & Development, 2009, 46(4):529-542. [56] 张军. 有氧运动结合抗阻力量练习对中年人身体成分和骨密度的影响[D].上海:上海体育学院,2017. [57] 李俊成. 运动预防绝经女性骨质疏松的进展研究[D].重庆:重庆大学,2011. [58] Ebeling PR. Osteoporosis in men[J]. New England Journal of Medicine, 2008, 358(14): 1474-1482.