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Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis

Martyn-St James, Marrissa; Carroll, Sean


Marrissa Martyn-St James


Our objective was to assess the effects of differing modes of impact exercise on bone density at the hip and spine in premenopausal women through systematic review and meta-analysis. Electronic databases, key journals and reference lists were searched for controlled trials investigating the effects of impact exercise interventions on lumbar spine (LS), femoral neck (FN) and total hip (TH) bone mineral density (BMD) in premenopausal women. Exercise protocols were categorised according to impact loading characteristics. Weighted mean difference (WMD) meta-analyses were undertaken. Heterogeneity amongst trials was assessed. Fixed and random effects models were applied. Inspection of funnel plot symmetry was performed. Trial quality assessment was also undertaken. Combined protocols integrating odd- or high-impact exercise with high-magnitude loading (resistance exercises), were effective in increasing BMD at both LS and FN [WMD (fixed effect) 0.009 g cm -2 95% CI (0.002-0.015) and 0.007 g cm -2 95% CI (0.001-0.013); P = 0.011 and 0.017, respectively]. High-impact only protocols were effective on femoral neck BMD [WMD (fixed effect) 0.024 g cm -2 95% CI (0.002-0.027); P < 0.00001]. Funnel plots showed some asymmetry for positive BMD outcomes. Insufficient numbers of protocols assessing TH BMD were available for assessment. Exercise programmes that combine odd- or high-impact activity with highmagnitude resistance training appear effective in augmenting BMD in premenopausal women at the hip and spine. High-impact-alone protocols are effective only on hip BMD in this group. However, diverse methodological and reporting discrepancies are evident in published trials. © The Japanese Society for Bone and Mineral Research and Springer 2009.


Martyn-St James, M., & Carroll, S. (2010). Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis. Journal of bone and mineral metabolism, 28(3), 251-267.

Journal Article Type Review
Acceptance Date May 31, 2010
Online Publication Date Dec 15, 2009
Publication Date 2010-05
Print ISSN 0914-8779
Electronic ISSN 1435-5604
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 28
Issue 3
Pages 251-267
Keywords Endocrinology, Diabetes and Metabolism; Endocrinology; Orthopedics and Sports Medicine; General Medicine
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