| Title: |
Beyond Bone Density: The Impact of Structured Exercise Training on Bone Metabolism and Fracture Risk Prevention in the Postmenopausal Period |
| Authors: |
Anna Polakowska; Alicja Pyzik; Wiktoria Laura Sobczak; Tomasz Kamil Pielusiński |
| Source: |
Quality in Sport, Vol 52 (2026) |
| Publisher Information: |
Nicolaus Copernicus University in Toruń |
| Publication Year: |
2026 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
osteoporosis; bone density; bone mineral density; Resistance Training; Exercise benefits; postmenopausal women; Sports; GV557-1198.995; Sports medicine; RC1200-1245 |
| Description: |
Background: Postmenopausal osteoporosis, driven by oestrogen deficiency and low-grade inflammation, is a primary cause of skeletal fragility. While exercise is a critical non-pharmacological intervention, the hierarchy of exercise efficacy and its direct impact on clinical outcomes remain under debate. Objective: To synthesise evidence regarding different exercise modalities on bone mineral density (BMD) and bone turnover markers (BTMs) in postmenopausal women, while evaluating the certainty of fracture reduction data. Methods: A systematic review with narrative synthesis was conducted following PRISMA 2020 guidelines was conducted for 21 high-quality source documents. Analysis focused on site-specific BMD changes, biochemical markers, and the moderation effects of supervision and detraining. Results: High-intensity resistance training (HI-RT; $\ge$ 70–80% of one-repetition maximum [1RM]) and high-impact loading consistently yielded the greatest increases in BMD at the lumbar spine (LS) and femoral neck (FN). High-intensity interval training (HIIT) protocols demonstrated synergistic effects on BTMs—specifically osteocalcin (OC), bone-specific alkaline phosphatase (s-BAP), and procollagen type 1 N-terminal propeptide (P1NP)—when combined with Vitamin D. Epidemiological data suggest regular exercise is associated with a 24% lower risk of developing osteoporosis. Importantly, BMD served as the primary surrogate outcome in the majority of included studies. While bone gains are well-documented, direct evidence for fracture reduction remains a secondary, less certain endpoint. Conclusions: Supervised, high-intensity exercise is the first-line prescription for improving BMD. However, clinicians should exercise caution in over-interpreting these gains as definitive fracture prevention. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://apcz.umk.pl/QS/article/view/69425; https://doaj.org/toc/2450-3118; https://doaj.org/article/73f5e57558824152805f1fb3d97b80f6 |
| DOI: |
10.12775/QS.2026.52.69425 |
| Availability: |
https://doi.org/10.12775/QS.2026.52.69425; https://doaj.org/article/73f5e57558824152805f1fb3d97b80f6 |
| Accession Number: |
edsbas.B62DA2F8 |
| Database: |
BASE |