-inglesEfectos de la actividad física en la calidad de vida de adulto mayor con osteopenia y osteoporosis.es.en

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REVISION
Effects of physical activity on quality of life related to health in
adults with osteopenia and osteoporosis: revision systematic and metaanalysis
M. Prieto-Peralta to , C. Sandoval-Cuellar b Y EA Cobo-Mejia c , *
to
Service Social Mandatory Corps Group, Medicine Program, Faculty of Health Sciences, University of Boyacá , Tunja, Boyacá, Colombia
b
Intervention Integral Athlete, Group Corps, Physical Therapy Program, Faculty of Health Sciences, University of Boyacá, Tunja, Boyacá, Colombia
c
History, Corps group, Program of Physiotherapy, Faculty of Health Sciences, University of Boyacá , Tunja, Boyaca, Colombia
Received 18 January 2016; accepted August 25, 2016
WORDS KEY
Summary
Activity physical;
Objective: Identify the effect of physical activity on quality of life related to health in adults with osteopenia and osteoporosis.
Osteoporosis; osteopenia;
Revision systematic;
Search strategy: the PubMed / MEDLINE, EMBASE, LILACS and the Cochrane Central Register of Controlled Trials
meta-analysis
(CENTRAL) data, and Scielo seekers were consulted, and Science Direct. These were identified randomized clinical trials.
results: Six studies (n = 371) after evaluation had low risk of bias and methodological quality they were found. No differences
between groups intervened with physical activity and usual care for both quality of life and for indicators observed bone
densitometry, what is assumed it is given by the fact that the usual care includes regular exercise coupled with the clinical
heterogeneity of the studies, including the type of participants and intervention times, which do not allow demonstrate the
impact physical activity.
conclusions: Physical activity is a safe no pharmacological strategy, with positive effects on adults with osteopenia and
osteoporosis. © 2016 Asociaci'
on Espa~ nola Physiotherapist. Published by Elsevier Espa~
na, SLU All
all rights reserved.
* author
to correspondence.
Mail electronic: [email protected] (EA Cobo-Mejia).
http://dx.doi.org/10.1016/j.ft.2016.08.002
0211-5638 / © 2016 Asociaci'
on Espa~ NOLA Physiotherapists. Published by Elsevier Espa~
na, SLU All rights reserved.
How cite this Article: Prieto-Peralta M, et al. Effects of physical activity on quality of life related health in adults with osteopenia and osteoporosis: systematic review and
meta-analysis. Physiotherapy. 2016.
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M. Prieto-Peralta et al.
two
KEYWORDS
Physical activity;
Osteoporosis; osteopenia;
Systematic review;
Meta-analysis
Effects of physical activity on health-related quality of life in Adults with osteopenia and osteoporosis: systematic
review and meta-analysis Abstract
Objective: To Identify the effect of physical activity on quality of life related to health in Adults with osteopenia and osteoporosis.
Search strategy: The PubMed / MEDLINE, EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL) data,
and Scielo seekers and Science Direct Were Consulted. In These randomized clinical trials They Were identified ed.
results: Six studies (n = 371) That assessment after ADH low risk of bias and methodological quality were found. No Differences
Between groups intervened With physical activity and usual care for Both quality of life as indicators of bone densitometry are
Observed, Which is Assumed is Given by the fact That the usual care regularly includes practice of combined exercise the clinical
heterogeneity of the studies, Including the type of participants and intervention times do not allow Demonstrate That the impact of
physical activity.
conclusions: Physical activity Represents a safe and positive effects in osteopenia and osteoporosis Adults with nonpharmacological
strategy. © 2016 Asociaci'
on Espa~ nola Physiotherapist. Published by Elsevier Espa~
na, SLU All rights
reserved.
Introduction
the score of the T-score, which is the number of standard deviations above or below
the average normal BMD of the young adult population of the same sex and race,
The diseases bone demineralization constitute a health problem public, why they are
thus compares different times are set in the progression of disease: osteopenia or
subject to study, to better understand the different factors that lead to loss of bone
low bone mineral density when the T-score is less than -1.0 and up -2.5, osteoporosis
mass with increased risk of fractures, so that his approach has proposed several
below -2.5 and severe osteoporosis: less than
strategies prevention and treatment one .
- 2.5 plus the presence of fracture 5 .
In state States, it is estimated that more than 9.9 million Americans have osteoporosis
and other 43.1 million They have low bone mineral density, addition of every two women
The main impact of this condition is the increased risk of fractures that occur
most frequently at the level of the hip, spine and mu~
neca because
and one in five white men have a fracture at some point in life two . To date Colombia does
a lower BMD increased risk of fracture 6 . After a fracture can give a complete recovery
not have direct statistics, however, Latin study American Vertebral Osteoporosis Study 2012,
or else stay with pain, disability or even cause death, which varies according to the
He calculated that 2,609,858 and 1,423,559 women 50 å~
affected segment, eg hip is associated with increased mortality to å~
not among the 8.4 and 36%, plus
us present osteopenia and osteoporosis respectively equal shape, projected
introduce oneself 2.5 times more risk of another fracture in the future; also in chronic
that the number of people with these terms increase to 2,884,150 with osteopenia and 1,573,173
spinal presents with pain and deformity generating disability, increased risk with up
with osteoporosis for å~
to 5 times further fracture column and 2 to 3 times to have fractures in other parts of
no 2020 3 .
The Osteoporosis is a condition asymptomatic, characterized by low bone mass
the body; and mu~
and impaired microarchitecture bone, it is leading to bone instability and an increased
NECA limitation is presented to perform activities of daily living 7.8 . These
risk of fractures of the hip, spine and mu~
neca
events directly affect the quality of life related to health (HRQOL), altering the
mainly. Is pathology is generated around the maintenance and bone metabolism by
physical, mental and social functions, in addition to pain management and changes
loss of balance between Formation and reabsorption thereof. The speed at which this
in health precepción 9 . Therefore, fractures in adults should be considered by health
process is generated changes along the lifetime, It is the slowest adulthood, appearing
personnel as an important event in the diagnosis and monitoring of osteoporosis 10 .
a higher decreased bone mass, affects men and women of all races presenting an
increased incidence with aging, in the case of women this process own accelerated by
hormonal factors postmenopause 4 .
Another important factor is spending on health services, because fractures
caused by osteoporosis represent 432,000 hospital admissions and 2.5 million doctor
visits in the United States eleven . According to Gonzalez in Colombia fractures in women
with osteoporosis show a high economic impact generated by the management of
The Organization World Health establishes densitometry bone mineral (DMO) as
fractures warning about the need for
the study of choice for diagnosis and Monitoring of this condition, it
How cite this Article: Prieto-Peralta M, et al. Effects of physical activity on quality of life related to health in adults with osteopenia and osteoporosis: a systematic review and
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Effects of physical activity on quality of life in adults with osteoporosis
3
priorization 12 . In addition, it is estimated that although it has strategies pharmacologic
Table 1 Selection criteria
and Pharmacological and effective for the prevention and treatment, few people Risk
Dise~do not
factors that use 6 . Among the strategies Preventive measures for the general
Randomized controlled trials
population are, the intake adequate calcium and vitamin D, the regular practice of exercise
for muscle strengthening, avoid consume of snuff and alcohol, and prevention
Participants
measures falls 1,5,6 .
Adults and seniors with osteopenia or osteoporosis (WHO classification
according to the first group å~ 18-64
we and the second largest of 65 å~
us)
Intervention
In As for the physical activity recommendations have reported benefits in programs
physical activity unrestricted mode speci fi c training and various
walking, jogging, dancing, Tai Chi, pilates or practicing a sport 13 --- 19 ,
interventions (eg, aerobic, strength, stretch, balance training)
example, Granacher et al. 18 and Gillespie et al. 14 , exhibit effects Muscle strengthening
and balance in reducing the risk of falls and fractures, likewise, Howe et al. 17 , They
highlighted that exercise is effective and safe for prevent waste of bone density in
Results measurement
postmenopausal women. By Finally, Caputo and Costa 19 They conclude that in women
Quality of life related to health (SF-36, QUALEFFO-41, OQLQ,
postmenopausal with osteoporosis exercise is a strategy that improves independence
OPCW AQoL, GHQ-20, MENQOL)
and a positive impact on the quality of life. Thus, the purpose of this review systematics
Bone mineral density (bone mineral densitometry of hip, femoral neck
literature is to identify the effect of activity physical quality of life related to health adults osteopenia
and lumbar / T Score column, x)
and osteoporosis.
physical activity (PAR LAPAQ, PASE)
comparisons
usual care as a daily intake of calcium, vitamin D and exercise regularly
Maintain current lifestyle
strategy search
methodological quality
Is revision systematics literature was reported according to the guidelines described in PRISMA Score equal to or greater than 5 as the PEDro scale AQoL: The Assessment of Quality
statement 20,21
of Life; GHQ-20 General Health Questionnaire; LAPAQ: LASA Physical Activity
Questionnaire; MENQOL: The Speci fi c-Menopause Quality of Life; OPCW: The
Y at Manual Cochrane for Driving Systematic Reviews interventions version 5.1.0 22 .
Osteoporosis Assessment Questionnaire; OQLQ: The Osteoporosis Quality of Life
Questionnaire; PAR: Seven-Day Physical Activity Recall; PASE: the Physical Activity Scale
The Search was performed by two blinded, independent authors against the results
in the months of March and April 2015. To search recommendations were followed Robinson
for the Elderly; QUALEFFO-41: Quality of Life Questionnaire of the European Foundation
for Osteoporosis; SF-36: The Short Form-36 Health Survey. Source: self made.
and Dickersin 2. 3 , with the purpose of obtaining Searches sensitive and speci fi c in compilation
of essays clinical Pubmed. He They considered as Boolean operators: [OR physical
exercise activity] AND [osteoporosis OR osteopenia] AND [quality of life OR health
related quality of life]. He made the search in PubMed / MEDLINE, EMBASE, LILACS
and the Cochrane Central Register essays controlled (CENTRAL), added to resources Additional
as Scielo seekers and Science Direct. I dont know they applied limitations language
with the aim of prevent possible bias idiomatic.
Data extraction
Two authors independently extraction data which were recorded on a sheet of
standard electronic spreadsheet. Process veri fi ed by a third author blinded against
the results of other authors. Data extracted from each study were: authors, å~
Is revision included systematic studies experimental that met the provisions established
in the Declaration of Helsinki approved by the Committees concerning Ethics, where the patients
fi rmed the informed consent. One author made the verification of the considerations ethics publication dise~
in studies included.
do not
no study sample and allocation,
intervention characteristics (intensity, frequency and duration), mode (s) of physical
activity implemented and measurement scales thereof, osteopenia or osteoporosis,
patient age and outcomes: HRQOL and bone mineral density.
Selection of studies
A time fi nished the analysis of search results two authors They blinded independently
Assessment of methodological quality and risk of bias
assessed the study eligibility collected veri fi ed that met the Selection criteria established
pursuant Acronym PICO (population, intervention, comparison results) 22 ( Table 1 ). The disagreements
resolved by consensus and participation of a third author.
Three authors conducted the evaluation of methodological quality and risk of bias of
included studies independently, for which the scale was used PEDro 24 ,
based on the Delphi list 25 . Proposed scale scores
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M. Prieto-Peralta et al.
from 0 to 10 for quality methodological controlled trials random. The score for each
model metaanalysis. The risk assessment showed an average score of 7 ± 0.75 in the
study were obtained from the information available from the published version. A
PEDro scale, indicating a methodological consistent quality and a low risk of bias ( table
score of 5/10 is It established as the minimum for inclusion in the this review 26 .
3 ). The A
not published
averaged 2010 ± 0.98. The studies were conducted in Australia 30.32 , Norway 31 , Brazil 33 , Netherlands
3. 4
and the United States 35 . The Figure 1 It presents the flow diagram PRISMA twenty .
Measures of result
The HRQOL was the measure of Primary outcome assessed in this study. Vinaccia,
defines it as a construct which includes different dimensions as including functional
status, functioning psychological and operation Social 27 . Based on the literature review,
Characteristics of Adult
The average age of adults was 66.7 ± 6.35 â~
we are
the following instruments were considered for measurement HRQOL: QUALEFFO-41,
intervention performed in a total of 191 adults with low bone mineral density and
of Life Instrument, Health Survey.
included studies are shown.
The Osteoporosis Quality of Life Questionnaire, Osteoporosis Assessment Questionnaire, osteoporosis, through exercise programs. In turn, the control group consisted of 180
adults, whom you were given usual care. In the table 2 The characteristics of the
Assessment of Quality of Life, The General Health Questionnaire, Menopause Quality
He They established as secondary outcome measures: DMO measure through bone Characteristics of interventions in physical activity
mineral densitometry, activity level Physical according to validated scales: The
physical activity Scale for the Elderly questionnaire, LASA Physical Activity Questionnaire,
Self-Reported physical activity.
Also in all randomized clinical trials aerobics, such as exercises we were conducted:
postural control, muscle strengthening 30.31 , balance, stretching 31 --- 33 ,
Analysis statistical
For him analysis of the heterogeneity, the dispersion was checked with diagram of forest,
subsequently the ratio was observed between the confidence intervals, and finally he
studied rates of heterogeneity. HRQOL was reported with data continuous, for which the
changes were recorded in the average and standard deviation from the line base and post
force, walk, weight bearing 3. 4 and taichí 35 .
For its part, physical activity interventions had an average duration of 60 ± 0 min
per session during
23.41 ± 22.24 weeks on average, where the sessions were held in March ± 0 times a
week. These sessions are usually developed in three stages: heating and cooling
core activity ( table 2 ).
intervention. For the analysis of statistical I two , he They considered the following cutoffs: 0-40%
mild heterogeneity, 40-70%, moderate heterogeneity 70-100% high heterogeneity 28 . In
Features usual care
turn, researchers take into account for the selection of statistical model that protocols Revised
intervention in studies including elements are not uniform such as the type of intervention,
Usual care, is described by investigators of the articles included in this review, as
time, frequency and duration of physical activity, in addition to finding the existence of various
shares in the care and treatment of osteopenia and osteoporosis among which are:
forms of measuring HRQL and levels physical activity ( table 2 ); This variability among studies,
causes Variances are changing so both are employs a random effects model for calculationdaily intake of calcium, vitamin
estimates of effect on each outcome assessed in the case where uniformity in the
protocols presented and measures the fixed effects model is applied. He they
D, regular exercise, fall prevention education and the development of everyday
calculated average mean differences and standardized with 95% CI as precision
activities.
measurement and a value of signification of p <0.05 22 . For calculating estimates effect
it used the software established by the Partnership Cochrane Review Manger 5.3 ( RevMan)
Adverse events
29 .
The included studies reported minor adverse events such as increased muscle
injuries and joint pain in 15 participants, which may be due to the underlying disease
and not properly follow the instructions 30,35 .
Estimates combined effects of outcomes
Of the six studies 30 --- 35 including, at the time of analysis of heterogeneity, should take
into account the aspects that contributed to the high levels of statistical
results
heterogeneity, such as: first, the different scales used for measuring HRQL and
physical activity level second, the use of various intervention protocols in physical
activity added at different times to monitor the primary and secondary variables to
Features studies included
identify outcomes and results, and the third,
Six studies 30 --- 35 ( n = 371) were included in the systematic review and They offered to
turn Valid estimates
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table 2 Characteristics of studies included in the systematic review and meta-analysis study
Condition
Participants (n)
Intervention
Results
measurement
Bennell
et al.,
2010 30
people with osteoporosis and history Male Female = 17 =
experimental group = postural control exercises
of fracture column vertebral
and muscle strengthening. Time = 10 weeks
3
Qualeffo-41
duration, frequency, intensity = established by
experimental group = 11 Age (â~
nos) = 66.2 (8.0)
each specialist. Which it was monitored by a
weekly self Control group = conventional care
Control = 9 Age Group
(â~
Bergland
et al.,
2011 31
nos) = 66.3 (11.8)
women with osteoporosis and history Female = 70
experimental group = balance exercises, postural
of fracture column vertebral
control and stretching. Time = 3 months Length =
experimental group = 38 Age (â~
nos) = 70.8 (5.9)
Qualeffo-41
60 min / session. Frequency, intensity = adjusted
according to the participant's ability. Care
conventional control group =
Control = 32 Age Group
(â~
Bolton
nos) = 72.0 (5.8)
Women postmenopausal with osteopenia
Female = 39
experimental group = muscle strengthening
SF36
exercises and stretching time = 52 weeks Duration
et al.,
2012 32
experimental group = 19 Age (â~
nos) = 60.3 (5.6)
= 60 min / session. Frequency = 3 times a week
Intensity = adjusted according to the participant's
ability. = control group conventional care
Age = 20 Control Panel
(â~
Madureira
women with senile osteoporosis
et al.,
2010 33
nos) = 56.3 (4.7)
Female = 60
experimental group = 30 Age (â~
nos) = 74.75 (4.82) = 30
Age Group Control (â~
experimental group = balance training time = 12
OPCW (Osteoporosis
months. Duration = 1 hour / session frequency = 3
Assessment
sessions / week Intensity = adjusted according to
Questionnaire)
the participant's ability Control group =
conventional care
nos) = 73.4 (4.61)
Smulders
et al.,
2010 3. 4
people with osteoporosis and falls related
Female = 106
experimental group = walking, weight-bearing
to this condition
exercises, correction of gait and falling techniques.
experimental group = 50 Age (â~
nos) = 70.5 (5.0)
Control group = 46 Age (å~
Qualeffo-41
time = 5.5 weeks. Duration, frequency, intensity =
they adjusted according to the participant's ability
Control group = conventional care
nos) = 71.6 (4.4)
Wayne
Women postmenopausal with osteopenia
Female = 86
experimental group = tai chi exercises. Time = 9
SF36
weeks. Duration, frequency, intensity = they
et al.,
2012 35
experimental group = 43 Age (å~
nos) = 58.8 (5.6) Control
adjusted according to the participant's ability
Control group = conventional care
= 43 Age Group (å~
nos) = 60.4 (5.3)
Source: own calculations.
the characteristics population, whereas are adults between 50 and 75 å~
Results of primary measures
We, who are also in differences
tes stadiums osteoporosis joined the comorbidities elements allow to speak of clinical
The analysis included studies showed a high level of statistical heterogeneity based
heterogeneity.
on the relationship
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M. Prieto-Peralta et al.
table 3 Quality assessment and methodological bias risk with PEDro scale (n = 6) Reference
P1
P2
P3
P4
P5
P6
P7
P8
P9
P10
Total
Bennell et al., 2010 30
+
+
+
-
-
+
+
+
+
+
8/10
Bergland et al., 2011 31
+
+
+
-
-
+
-
+
+
+
7/10
Bolton et al., 2012 32
+
+
+
-
-
+
+
-
+
+
7/10
Madureira et al., 2010 33
+
-
+
-
-
+
+
-
+
+
6/10
Smulders et al., 2010 3. 4
+
+
+
-
-
+
+
+
+
+
8/10
Wayne et al., 2012 35
+
-
+
-
-
+
+
+
+
+
7/10
Percentage of fulfillment
100%
66%
100%
0%
0%
100%
83%
66%
100%
100%
Pedro (Physiotherapy Evidence Database): + Yes; - do not. P1: assignment random; P2: allocation concealment; P3: Similar groups in baseline; P4: Blinding of participants; P5: Blinding of therapists;
Q6: assessor blinding; P7: dropouts <15%; Q8: intention to treat analysis; P9: reported differences between groups; P10: point estimate and variability reported. Source: own calculations.
Number of studies identified by the
Identified in other studies
search databases
sources (n = 2)
ID
(N = 520)
Number of studies after eliminating duplicates
screening
(N = 288)
Excluded studies (n = 191)
Number of studies evaluated in
(Publishing letters or other systematic reviews
title / abstract (n = 234)
studies, animal models)
Excluded studies after text analysis
full (n = 37) Intervention (n
= 11) Unsupervised (n = 1)
Studies included for analysis in text
Design (n = 7) evaluate outcome
full (n = 43)
Eligibility
(n = 12) High risk of bias (n = 5)
Presentation of results (n = 1)
Studies included in the systematic review and
Inclusion
metaanalysis
(N = 6)
Figure 1 PRISMA flow diagram.
Conversely I presented between I2 and Chi square function Social, Contrary to this
lumbar - hip and physical activity level ( table 4 ). In turn, the tama~
evidence homogeneity measurements primary and physical function, mental function, perceived
health, pain and global quality lifetime. In Regarding this secondary measures evidence
to bone densitometry column
no effect suggests that the practice of
physical activity and different activities included in the usual care have similar effects
on most dimensions of HRQOL ( Fig. two ).
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table 4 Estimates of tama~
7
no effect for comparisons and secondary outcomes included in meta-analysis
Result
Tama~ estimate
Effect size no effect random
A highly diversified
effects model --- DME - DM * (95% CI)
statistics (I two)
Function physical
- 0.00; 95% CI [-0.23 --- 0.23] ( p = 1.00)
33%
Function mental
0.10; 95% CI [-0.13 - 0.33] ( p = 0,41)
Four. Five%
Function Social
- 0.21; 95% CI [-0.66 --- 0.25]
67%
Perceived health
- 0.30; 95% CI [-8.75 --- 9.35] ( p = 0.95)
Pain
- 0.15; 95% CI [-0.46 --- 0.15] ( p = 0.32)
0%
Scale overall quality of life
- 0.10; 95% CI [-0.34 --- 0.13] ( p = 0,39)
17%
primary (HRQOL)
0%
secondary
DMO column lumbar
- 0.01; 95% CI [-0.08 --- 0.06] ( p = 0,77)
0%
DMO hip
0.02; 95% CI [-0.02 --- 0.06] ( p = 0.38)
0%
Level of physical activity
- 0.17; 95% CI [-0.44 --- 0.11] ( p = 0.23)
0%
HRQOL: quality of life health-related; DM *: mean difference; SMD standardized mean difference; BMD: mineral density that is; I two: differences statistically significant ( p < 0.05). Source: own
calculations.
results measurements high schools
parameters for prescribing physical activity and in turn varied responses to adapt to
it. The emphasis on these study groups may be due to hormonal effects of
Of same Thus, the effects are similar secondary measures for the two groups which no
menopause on BMD and increased incidence of fractures of the spine and hip in
esTabla tablece predominance of one of the two interventions (physical activity
women, without ignoring history as smoking, early menopause and not perform
physical activity 36 .
--- watch out usual) ( table 4 ). As evidenced in the analysis results primary and side for
the two groups, can be result of regular practice of exercise handles in the control
group, which makes the development of other physical activity does not show
differences statistically signi fi cant between groups.
The results show that adults with low BMD and osteoporosis intervention with
physical activity or usual care are equally safe and have effects on HRQOL and
indicators BMD spine, hip and physical activity level, this may due to the control
group practiced regularly exercise variable that does not really possible to determine
the effects of a program according to the procedures outlined in the studies, in
addition to the usual care education programs are added in disease, diet and healthy
Discussion
lifestyles taking into account the results of the eligible randomized trials to answer
the research question that had low risk of bias 30 --- 35 .
In relation to study subjects should be considered to be identi fi ed two groups of
women Postmenopausal and the women with osteoporosis and fracture spine, condition
that leads to think of a more advanced stage of the disease, which supports different
Figure 2 osteopenia, osteoporosis and related quality of life (HRQOL). Source: own calculations.
How cite this Article: Prieto-Peralta M, et al. Effects of physical activity on quality of life related health in adults with osteopenia and osteoporosis: systematic review and
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In turn, the studies where They worked with patients with osteoporosis report greater bone mass by å~
difficulties in carrying out the exercise, which is because mostly this group people are
not in lumbar spine and femoral neck
in pre- and postmenopausal women 42 .
older and more comorbidities and complications of the disease as fracture column vertebral,
which are not observed improvements in BMD, but as the gain is maintaining levels, observed
no improvement turn signi fi cant statistically combining when HRQOL studies from
Implications for practice
areas such as mobility, decreased pain and falls, the state of encouragement and social
The results reported in this study support the recommendations of management
relationships 33.34 , This contrasts with improvements signi fi cant individually reported in articles
guidelines for osteoporosis, as to the beneficent effects and insurance cos physical
example in pain 30.31 .
activity in adults with osteopenia and osteoporosis fi. Therefore the practice of
physical activity of at least 150 minutes a week, where strength training and
weight-bearing, work force and posture is done to improve outcomes and HRQOL,
pain management, risk of falls is indicated, BMD of spine and hip, as a point of
non-pharmacological treatment which eases symptoms and improves independence.
These findings to the comprehensive management of patients with this condition
In relation to duration times, frequencies and intensities handled in different
should be applied, settling in local management guidelines, which promote access to
protocols activity physics, one can say that variability is not possible decide really the
this therapeutic point to the entire population. 43 and prevention of disorders involving
effects on BMD and low osteoporosis, example some have a frequency less than three
the movement limitations in daily activities and movements like walking conducting,
times a week, less than two months duration and intensities that fail to represent
running and jumping 44 .
modifications signi fi cant in BMD, this type of activity is added made in the protocols
including from work resistance cardiovascular, to the work force strengthening muscular,
load bearing, work balance and position designed to prevent falls. These protocols respond
to what currently it proposed as Evidence-based recommendations for prescribing physical
activity, where among others, reinforcing the effect positive aerobic training like
strength training combined with balance training for preventing risk of falls and fractures 14.36
.
The above responds to physical activity it promotes the formation of bone and stimulates
osteogenic differentiation and activity osteoblasts and osteocytes by mechanical
effects and in turn inhibits osteoclastogenesis and resorption that is, improving BTMs,
the What is it promoted by activities such as training of resistance and impact exercise --jump additionally have described these same benefits with vibration therapy 37 --- 39 .
conclusion
The usual practice of physical activity and usual care lead to positive effects on
HRQOL, as well as improving biological indicators such as BMD. The results on
HRQOL may be awarded to the heterogeneity of the population and intervention
protocols and monitoring.
ethical responsibilities
Do not However, according to exercise prescription is recommended for obtain
Protection of people and animals. The authors state that this research has not
been experiments in humans or animals.
positive effects, work during the 2-3 months with a 40-70% intensity frequency heart maximum
for 20 to 30 min per session and 3 to 5 times week for aerobic training, while for the strength
training, it is recommended that a labor intensity of 50% of 1 RM (> 20 RM), the which
should increase progressively with a volume of 2 to 3 series 8 repetitions and two
Confidentiality of the data. The authors declare that this article does not appear
sessions per week for 20 to 40 min per session 39,40 .
patient data.
Right to privacy and informed consent. The authors declare that this article does
not appear patient data.
Also, for the balance training evidence shows that people who make ≥ 5,000 steps
per day present top health conditions and decreased falls 41 . Similarly, physical activity
produces excess effects that can decrease negative BMD 36 .
Financing
This work was fi nanced entirely by the University of Boyacá.
Continuing, is finds that high-intensity exercise reduces the incidence of hip fracture by
50% in tracking 12 women â~
I we, together with that
every time of brisk pace reduces the incidence of 6%, increases bone mineral density
With fl ict of interest
of the hip, spine and mu~
NECA, decreasing at least 1% of loss
The authors declare no con fl ict of interest.
How cite this Article: Prieto-Peralta M, et al. Effects of physical activity on quality of life related to health in adults with osteopenia and osteoporosis: a systematic review and
meta-analysis. Physiotherapy. 2016.
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Effects of physical activity on quality of life in adults with osteoporosis
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How cite this Article: Prieto-Peralta M, et al. Effects of physical activity on quality of life related to health in adults with osteopenia and osteoporosis: a systematic review and
meta-analysis. Physiotherapy. 2016.