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The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis

Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Densit...

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Autores principales: Schinzel, Eileen, Kast, Stephanie, Kohl, Matthias, von Stengel, Simon, Jakob, Franz, Kerschan-Schindl, Katharina, Kladny, Bernd, Lange, Uwe, Peters, Stefan, Thomasius, Friederike, Clausen, Jürgen, Uder, Michael, Kemmler, Wolfgang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042290/
https://www.ncbi.nlm.nih.gov/pubmed/36994417
http://dx.doi.org/10.3389/fphys.2023.1135663
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author Schinzel, Eileen
Kast, Stephanie
Kohl, Matthias
von Stengel, Simon
Jakob, Franz
Kerschan-Schindl, Katharina
Kladny, Bernd
Lange, Uwe
Peters, Stefan
Thomasius, Friederike
Clausen, Jürgen
Uder, Michael
Kemmler, Wolfgang
author_facet Schinzel, Eileen
Kast, Stephanie
Kohl, Matthias
von Stengel, Simon
Jakob, Franz
Kerschan-Schindl, Katharina
Kladny, Bernd
Lange, Uwe
Peters, Stefan
Thomasius, Friederike
Clausen, Jürgen
Uder, Michael
Kemmler, Wolfgang
author_sort Schinzel, Eileen
collection PubMed
description Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults. Methods: A systematic literature search of five electronic databases (PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data. Results: Excluding an outlier study with an exceptionally high effect size for LS-BMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11–0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06–1.46). Of importance, heterogeneity between the trial results was negligible for LS (I(2): 7%) but substantial for FN-BMD (I(2): 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD. Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend water-based exercise for people unable, afraid or unmotivated to conduct intense land-based exercise programs.
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spelling pubmed-100422902023-03-28 The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis Schinzel, Eileen Kast, Stephanie Kohl, Matthias von Stengel, Simon Jakob, Franz Kerschan-Schindl, Katharina Kladny, Bernd Lange, Uwe Peters, Stefan Thomasius, Friederike Clausen, Jürgen Uder, Michael Kemmler, Wolfgang Front Physiol Physiology Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults. Methods: A systematic literature search of five electronic databases (PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data. Results: Excluding an outlier study with an exceptionally high effect size for LS-BMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11–0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06–1.46). Of importance, heterogeneity between the trial results was negligible for LS (I(2): 7%) but substantial for FN-BMD (I(2): 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD. Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend water-based exercise for people unable, afraid or unmotivated to conduct intense land-based exercise programs. Frontiers Media S.A. 2023-03-13 /pmc/articles/PMC10042290/ /pubmed/36994417 http://dx.doi.org/10.3389/fphys.2023.1135663 Text en Copyright © 2023 Schinzel, Kast, Kohl, von Stengel, Jakob, Kerschan-Schindl, Kladny, Lange, Peters, Thomasius, Clausen, Uder and Kemmler. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Schinzel, Eileen
Kast, Stephanie
Kohl, Matthias
von Stengel, Simon
Jakob, Franz
Kerschan-Schindl, Katharina
Kladny, Bernd
Lange, Uwe
Peters, Stefan
Thomasius, Friederike
Clausen, Jürgen
Uder, Michael
Kemmler, Wolfgang
The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title_full The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title_fullStr The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title_full_unstemmed The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title_short The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis
title_sort effect of aquatic exercise on bone mineral density in older adults. a systematic review and meta-analysis
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042290/
https://www.ncbi.nlm.nih.gov/pubmed/36994417
http://dx.doi.org/10.3389/fphys.2023.1135663
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