Abstract
Objective
To examine the effectiveness of exercises for improving forearm bone mass.
Data Sources
MEDLINE, EMBASE, CINAHL, AMED, Web of Science, and Cochrane CENTRAL were searched
from their inception until December 2018.
Study Selection
Eligibility included adults undertaking upper limb exercise interventions (≥12wk)
to improve bone mass.
Data Extraction
Screening of titles, abstracts, and full texts and data extraction were undertaken
independently by pairs of reviewers. Included studies were quality appraised using
Cochrane risk of bias tool.
Data Synthesis
Exercise interventions were classified into “resistance training” of high or low intensity
(HIRT/LIRT, respectively) or “impact.” Random-effects meta-analysis of the percentage
change in forearm bone mass from baseline was conducted. Twenty-six studies were included
in the review, of which 21 provided suitable data for meta-analysis. Methodological
quality ranged from “low” to “unclear” risk of bias. Exercise generally led to increases
(moderate-quality evidence) in forearm bone mass (standard mean difference [SMD],
1.27; 95% CI, 0.66-1.88; overall effect Z value=4.10; P<.001). HIRT (SMD, 1.00; 95% CI, 0.37-1.62; Z value=3.11; P=.002), and LIRT (SMD, 2.36; 95% CI, 0.37-4.36; Z value=2.33; P<.001) led to moderate increases in forearm bone mass. Improvements resulting from
impact exercises (SMD, 1.12; 95% CI, −1.27 to 3.50; Z value=0.92; P=.36) were not statistically significant (low-quality evidence).
Conclusions
There is moderate-quality evidence that exercise is effective for improving forearm
bone mass. There is moderate-quality evidence that upper body resistance exercise
(HIRT/LIRT) promotes forearm bone mass but low-quality evidence for impact exercise.
Current evidence is equivocal regarding which exercise is most effective for improving
forearm bone mass.
Keywords
List of abbreviations:
BMC (bone mineral content), BMD (bone mineral density), DXA (dual-energy x-ray absorptiometry), HIRT (high-intensity resistance training), LIRT (low-intensity resistance training), 1RM (1 repetition maximum), pQCT (peripheral quantitative computed tomography), RCT (randomized controlled trial), ROI (region of interest), SMD (standardized mean difference), SPA (single photon absorptiometry)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 26, 2019
Footnotes
Clinical Trial Registration No.: CRD42017069545.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
