A Systematic Review and Meta-Analysis to Examine the Effectiveness of Exercise Training in People With Osteoporosis or Osteopenia Compared to Other Rehabilitation Interventions on Fear of Falling and the Number of Falls
Notice bibliographique
Résumé
BACKGROUND AND PURPOSE: Fear of falling (FoF) and falls are significant concerns for community-dwelling older adults with osteoporosis or osteopenia, leading to decreased mobility and quality of life. Despite evidence suggesting the benefits of exercise training, its specific effects on the FoF and number of falls (NoF) in this population are not well-documented. This study aims to appraise research evidence on the effects of exercise training, including balance, resistance, and aerobic exercises, on the FoF and NoF in community-dwelling older adults with osteoporosis or osteopenia. METHODS: A comprehensive search was conducted on scientific databases, including EMBASE, MEDLINE, PEDRO, the Cochrane Library, Psych INFO, CINHAL, and Google Scholar, to identify relevant articles. Randomized controlled trials written in English and focusing on exercise training in older adults with osteoporosis or osteopenia were considered for inclusion in this study. Two independent authors conducted screening and reviewed articles. They extracted pertinent information, including authors' names, publication year, sample characteristics, intervention and comparison groups details, the FoF and NoF outcomes, intervention duration and dosage, and follow-up periods. We used the Cochrane Risk of Bias tool (RoB2) for the risk of bias assessment and the GRADE approach to evaluate the quality of evidence for each outcome. We calculated standardized mean difference, Incidence Rate Ratio, and 95% confidence intervals for the quantitative synthesis of the FoF and NoF. RESULTS AND DISCUSSION: We included 14 randomized controlled trials (8 for FoF, 5 for the NoF, and 1 with both outcomes) with 2797 participants. All studies but one (with some risk) had a high risk of bias. The primary sources of bias in the included studies were the measurement of outcomes and selective reporting of results. Meta-analyses demonstrated that exercise training including balance, resistance, and aerobic exercises reduced FoF measured using the Fall Efficacy Scale International (overall effect size: -2.15, 95% CI = -3.16 to -1.15, Z = -4.2, P = .001, and I 2 = 0.97) and NoF (IRR = 0.46, 95% CI: 0.14 to 0.78, Z = 2.79, P = .012, and I 2 = 96%) significantly. Exercise training may effectively reduce the FoF and fall incidence in patients with osteoporosis or osteopenia. However, the considerable variability, high risk of bias, and methodological limitations in most studies underscored the critical need for high-quality studies to inform evidence-based guidelines, optimize intervention protocols, and establish these programs' long-term effects and sustainability. CONCLUSION: Our study highlighted that exercise training including balance, resistance, and aerobic exercises can significantly decrease the FoF and NoF in older adults with osteoporosis or osteopenia. This issue supports the inclusion of tailored exercise prescriptions within fall prevention strategies for this group. Future research should aim to standardize these exercise interventions to enhance their effectiveness.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,057 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,029 | 0,040 |
| Bibliométrie | 0,010 | 0,009 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».