Zusammenfassung
Einleitung
Die vorliegende Übersichtsarbeit hat das primäre Ziel, Evidenzen für ein körperliches
Training mit Endpunkt Knochendichte (BMD) unter Berücksichtigung der “Angemessenheit”
der Studienintervention bei Männern zusammenzufassen und idealerweise auf der Basis
dieser Daten Empfehlungen für ein optimiertes Körpertraining zu formulieren.
Methoden
Nach Literaturrecherche gemäß PRISMA konnten final acht Untersuchungen identifiziert
werden, die unsere Eligibilitätskriterien erfüllten. Alle Untersuchungen waren randomisierte
kontrollierte Trainingsstudien (RCT) mit einer Fallzahl von ≥ n = 8/Studienarm, die
die BMD bei gesunden Männern 50+ nach mindestens sechs Monaten Interventionsdauer
erfassten.
Ergebnisse
Die methodische und interventionsspezifische Qualität variiert zwischen den RCTs sehr
deutlich. Zusammenfassend berichten nur drei Studien signifikante Effekte auf die
BMD des proximalen Femurs, kein RCT erfasst signifikante Effekte an der LWS.
Fazit
Im vorliegenden Spannungsfeld liegt ein auffälliger Mangel an gut designten “state
of the art”-Trainingsstudien vor. Auch Untersuchungen, welche mögliche geschlechtsspezifische
Unterschiede in der ossären Adaption auf Körpertraining erfassen, erscheinen unbedingt
nötig.
Summary
Introduction
From a clinical perspective, the bone mineral density (BMD)-fracture association is
stronger in older men compared with older women; hence, the relevance of bone strengthening
within fracture prevention might be more notable in men. Unfortunately, only few studies
focus on the effect of exercise on BMD in men. Thus, the primary aim of this systematic
review is (a) to provide evidence for the effect of exercise on BMD in healthy older
men under special consideration of the appropriateness of the exercise intervention
and correspondingly (b) to provide recommendations for an optimum exercise training
to address BMD in men.
Methods
A systematic review of the literature according to the “Preferred Reporting Items
for Systematic reviews and Meta-Analyses” (PRISMA) statement included only trials
of exercise training ≥ 6 months with study groups of ≥ 8 healthy men 50 years+ with
no bonerelevant pharmacological therapy. We further included only randomized controlled
trials (RCT), nonrandomized controlled trials (NCT), and case series that specifically
examined the effect of exercise on bone mineral density for male cohorts. Two researchers
using standardized scores rated methodical and interventionspecific study quality
and the appropriateness of the study intervention to address bone.
Results
In summary, we identified eight exercise trials, with 13 exercise and nine control
groups, all RCTs that satisfied our eligibility criteria. The methodical and interventionspecific
study quality vary considerably between the RCTs. We considered six studies as being
appropriate to address successfully BMD in healthy men 50+. Unfortunately, within
group changes and between group changes differences (i. e. “effects”) for BMD along
with the corresponding significance level were not consistently given by the studies.
Only three studies reported significant exercise effects on BMD for total proximal
femur, one of them determined significant differences between the exercisegroups.
Further, none of the exercise trials determined significant BMD-effects at the LS.
Based on the present data we are finally unable to recommend dedicated exercise programs
for men.
Conclusion
We conclude, that apart from the need for more well designed studies that address
exercise effects on BMD changes in older men, it is important to evaluate whether
gender differences of bone adaption to exercise exist. The latter is of relevance
to decide whether exercise recommendation generated by the much more extensive amount
of studies with older female cohorts can be applied to their male peers. We further
conclude that the present position to barely provide further dedicated exercise trails
but progressively focus on meta-analytic results that consistently include the same
or almost the same pool of exercise studies might be, a step in the wrong direction.
Schlüsselwörter
Körperliches Training - Knochendichte - Männer - Übersicht
Keywords
Exercise - bone mineral density - men - review
