不同运动对老年人骨密度影响的网状Meta分析

A network meta⁃analysis of the effect of different exercise on bone mineral density in elderly population

目的通过网状Meta分析法比较太极、八段锦、五禽戏、易筋经、核心稳定训练、振动训练、抗阻训练、健步走、广场舞、毽球运动、综合训练对老年人骨密度的干预效果。方法检索数据知识服务平台搜集应用运动对老年人骨密度影响的随机对照试验(RCT),搜集建库至2023年4月1日发表的不同运动方式对老年人骨密度影响的相关文献。收集第一作者、发表时间、总样本量、年龄、运动干预措施、运动干预时间、运动干预周期、结局指标(腰椎BMD、股骨颈BMD、Ward三角BMD)等信息。采用Revman 5.3和Stata 16软件进行统计学分析。结果共纳入了37个研究,涉及研究总样本量2922人。网状Meta分析结果显示,与对照组相比易筋经(MD=-0.13,95%CI:-0.18~-0.07,P<0.05)改善腰椎BMD和股骨颈BMD最有效,其次为核心稳定训练(MD=-0.08,95%CI:-0.12~-0.04),P<0.05);振动训练(MD=-0.10,95%CI:-0.14~-0.06),P<0.05)改善Ward三角BMD最有效,其次为太极(MD=-0.03,95%CI:-0.05~-0.02),P<0.05)。聚类分层结果显示,易筋经、核心稳定训练、振动训练是改善老年人骨密度最优运动干预。结论30~60 min易筋经、30~60 min核心稳定训练、10~30 min振动训练对老年人骨密度改善更为显著。

Objective To compare the intervention effects among Taiji,Batuanjin,Wuqinxi,Yijinjing,core stability training,vibration training,resistance training,brisk walking,square dance,shuttlecock,and comprehensive training on bone mineral density(BMD)in the elderly with mesh Mate analysis.Methods The literature of randomized controlled trials(RCTs)on the effects of exercise from the establishment to 1 April 2023 was collected by searching the database.The data of the first author,publication time,total sample size,age,exercise intervention time,exercise intervention period,outcome indicators(lumbar BMD,femoral neck BMD,Ward triangle BMD),and other information were collected.Statistical analysis was performed using Revman 5.3 and Stata 16 software.Results A total of 37 studies which involving a total sample size of 2922 people were involved.The result of mesh Mate analysis showed that compared with the control group,Yijinjing(MD=-0.13,95%CI-0.18,-0.07,P<0.05)was effective in improving lumbar BMD and femoral neck BMD,followed by core stability training(MD=-0.08,95%CI-0.12,-0.04,P<0.05).Vibration training(MD=-0.10,95%CI-0.14,-0.06,P<0.05)was most effective in improving Ward triangle BMD,followed by Tai Chi(MD=-0.03,95%CI-0.05,-0.02,P<0.05).The result of cluster stratification showed that Yijinjing,core stability training and vibration training were the best exercise interventions to improve BMD in the elderly.Conclusion The exercise prescription composed of 30-60 min Yijinjing,30-60 min core stability training,and 10-30 min vibration training may improve BMD in the elderly more significantly.