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Exercise and Lumbar Spine Bone Mineral Density in Postmenopausal Women

A Meta-Analysis of Individual Patient Data

^a Clinical Investigation Program, MGH Institute of Health Professions, Boston, Massachusetts
^b Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver

George A. Kelley, FACSM, Associate Professor, Graduate Program in Clinical Investigation, Director, Meta-Analytic Research Group, MGH Institute of Health Professions, Charlestown Navy Yard, 36 First Avenue, Boston, MA 02129 E-mail: gakelley{at}bics.bwh.harvard.edu.

Background. Low bone mineral density (BMD) at the lumbar spine is a major public health problem among postmenopausal women. We conducted a meta-analysis of individual patient data (IPD) to examine the effects of exercise on lumbar spine BMD in postmenopausal women.

Methods. IPD were requested from a previously developed database of summary means from randomized and nonrandomized trials dealing with the effects of exercise on BMD. Two-way analysis of variance tests with pairwise comparisons (p .05) and 95% confidence intervals (CIs) were used to determine the statistical significance for changes in lumbar spine BMD.

Results. Across 13 trials that included 699 subjects (355 exercise, 344 control), a statistically significant interaction was found between test and group (F = 15.232, p = .000). Pairwise comparisons (Bonferroni t tests) revealed a statistically significant increase in final minus initial BMD for the exercise group ( ± SD = 0.005 ± 0.043 g/cm², t = 2.46, p = .014, 95% CI = 0.001–0.009) and a statistically significant decrease in final minus initial BMD for the control group ( ± SD = -0.007 ± 0.045 g/cm², t = -3.051, p = .002, 95% CI = -0.012–-0.002). Changes were equivalent to an approximate 2% benefit in lumbar spine BMD (exercise, +1%, control, -1%).

Conclusions. The results of this IPD meta-analysis suggest that exercise helps to improve and maintain lumbar spine BMD in postmenopausal women.

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