Effects of exercise on the cortical bone of the proximal femur in women: a systematic review and meta-analysis.

Abstract

The incidence of hip fractures is higher in women. Thus, preventive interventions (e.g., exercise) are important. According to research, the strength of the proximal femur, which affects hip fractures, is more important in the cortical bone than in the cancellous bone. This study aimed to evaluate the presence and quality of evidence of exercise on the cortical bone of the proximal femur in women. A literature search was performed using the following databases: PubMed, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials, and Scopus. Six articles that met the inclusion and exclusion criteria were selected for systematic review and meta-analysis. Only one study included premenopausal women, and the meta-analysis was performed only on studies in postmenopausal women. Exercise significantly improved the femoral neck cortical thickness in postmenopausal women (I² = 82 %, p < 0.01; random-effects model standardized mean difference [SMD] = 0.61 [95 % confidence interval {CI}: 0.07-1.15]). However, it did not significantly improve the femoral neck cross-sectional area (I² = 95 %, p < 0.01; random-effects model SMD = 0.72 [95 % CI: -0.43-1.87]). The meta-analysis revealed that high-intensity resistance training combined with high-impact training for 8 months or more improved the femoral neck cortical thickness in postmenopausal women.