Network meta-analysis reveals optimal aerobic exercise frequency and intensity for improving bone mineral density in osteoporosis patients
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Key Takeaway
High-intensity aerobic exercise performed four to five times weekly for 24 weeks offers the greatest benefit for bone mineral density in osteoporosis patients.
This network meta-analysis evaluated aerobic exercise prescriptions for osteoporosis patients, involving a total sample of 2,183 individuals. The study compared various exercise regimens against a control group to determine the most effective protocols for enhancing bone health. Results indicated that every level of exercise intensity, from low to high, provided significant benefits over no exercise.
Further analysis highlighted that high-intensity exercise offered statistically significant advantages over moderate or low-intensity options. Additionally, the frequency of training played a crucial role, with four to five sessions per week showing the best outcomes. This frequency outperformed both two to three sessions and six to seven sessions per week.
Duration and specific session length also influenced efficacy, with a 24-week intervention period achieving the highest effectiveness. Sessions lasting between 30 and 59 minutes were found to be superior to those lasting 60 minutes or longer. These findings suggest a clear optimal window for exercise duration and program length.
Overall, the study provides actionable insights for clinicians managing osteoporosis. While all exercise intensities helped, the combination of high intensity and a frequency of four to five times weekly appears most beneficial. These data support tailored exercise prescriptions to maximize bone density improvements safely.
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View Original Abstract ↓
ObjectiveTo compare the effects of different doses of aerobic exercise on bone mineral density in osteoporosis patients through a network meta-analysis.MethodsThis study systematically retrieved and screened 7 databases (including PubMed, Web of Science, and Cochrane Library, etc.) for randomized controlled trials on aerobic exercise interventions for osteoporosis patients from database inception to June 2025. The study strictly followed the PRISMA guidelines, within the framework of frequency theory, we conducted a network meta-analysis using Stata 15.0 software, quality assessment of the literature using Cochrane bias risk assessment tool.ResultsA total of 27 randomized controlled trials involving 2,183 participants were included in this study. The network meta-analysis revealed that aerobic exercise regimens with the following parameter: intensity (High, medium, low-to-medium and medium-to-high intensity progressive loads), training duration (24 weeks), single-session duration (30-59min), and intervention frequency (2–3, 4–5times a week) all significantly improved bone density in osteoporosis patients compared to the control group. Indirect comparison results revealed statistically significant advantages of high-intensity exercise over moderate and low-intensity exercise. The frequency of 4–5 times a week showed a significant advantage compared to 2–3 times and 6–7 times per week. No significant differences were observed between intervention frequency and duration. The Surface Under the Cumulative Ranking Curve (SUCRA) demonstrated the following rankings: the efficacy was highest at the high intensity level, followed by the medium to high intensity level, then the low to medium intensity, the medium intensity, the Low intensity level, and the control group. For exercise duration, a 24-week intervention achieved the best efficacy, followed by a 12-week intervention, then the 48 weeks or longer, and the control group. Regarding single session intervention time, sessions lasting 30 to 59 minutes produced superior efficacy, followed by 60 minutes or longer, then the control group. In terms of weekly exercise frequency, training 4 to 5 times per week ranked first in efficacy, followed by 2 to 3 times per week, then 6 to 7 times per week, and the control group.ConclusionThe results showed that the optimal exercise dose for improving bone mineral density (BMD) in OP patients was aerobic exercise with high intensity, 30-59min per session, 4–5 times per week, and continue 24 weeks.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251155131, identifier CRD420251155131.
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