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
