Table 3.
Effect of exercise on Bone Health in Breast Cancer patients undergoing AIs treatments. Abbreviation: PW, Postmenopausal Women; PreMW, Premenopausal Women; BC, Breast Cancer; RCT, Randomized Control Trial; BMD, Bone Mass Density, d, day; w, week; s, seconds; min, minutes; rep, repetitions; mo, months; ST, Supplementation Therapy; EX, Combined Training; SS, supervised; HBEX, Home Based Exercise; HR, Heart Rate; CON, Control; PEMFs, Pulsed Electromagnetic Field stimulation; PhT, Pharmacological Therapy; FU, Follow Up; FT, Flexibility Training; PA, Physical Activity; TAM, Tamoxifene; AIs, Aromatase Inibitors;
| Author | Type | Sample | Treatments | Intervention | Results |
|---|---|---|---|---|---|
| The effect of exercise in preventing fracture risk and loss of BMD | |||||
| Irwin et al. (2009) | RCT | PW (n = 75) Age:47–66 SS-HBEX (n = 37) CON (n = 38) |
AIs TAM Other Therapies |
6-mo SS-HBEX: Aerobic Training, 3 d/w and 2 d/w, 150 min/w CON: No intervention |
SS-HBEX ↔ BMD CON ↓ BMD |
| Saarto et al. (2012) | RCT | PreMW (n = 229) Age:35–58 SS-HBEX (n = 124) CON (n = 105) PW (n = 269) Age:46–68 SS-HBEX (n = 138) CON (n = 131) |
AIs ≥ 4-mo TAM ≥ 4-mo Other Therapies |
12-mo SS-HBEX SS: Step Aerobics Training and Impact Training, 1 d/w, 60 min at 118 bpm (14–16 RPE) HBEX: Endurance training and Impact training, 2–3 d/w CON: No intervention |
PreMW SS-HBEX and CON ↓Lumbar spine BMD ↑Femoral Neck SS-HBEX vs CON ↔ Femoral neck BMD PW SS-HBEX and CON ↓Lumbar spine, Femoral neck BMD PreMP and PW SS-HBEX ↑Lean Mass |
| Nikander et al. (2012) | RCT | Pre and PW (n = 77) Age:35–68 SS-HBEX (n = 37) CON (n = 40) |
AIs TAM Other Therapies |
12-mo SS-HBEX: Unsupervised 1 d/w Impact Aerobics Training, 40 min at 80 % HRmax, 100–150 jumps, hops and leaps, 2–3 d/w unsupervised Impact Aerobics Training, 100 hops, leaps and jumps Endurance training, 150 min/w at 14–16 RPE CON: No intervention |
PW SS-HBEX and CON Bone loss SS-HBEX vs CON ↑Bone structural strength SS-HBEX ↑Femoral Neck and Tibial Diaphysis BM Distribution PreMW SS-HBEX ↔BMD Femoral neck |
| Vehmanen et al. (2021) | RCT | PreMW and PW (n = 444) Age:35–68 |
FU-60-mo Saarto et al. (2012) |
PreMW SS-HBEX ↔ Femoral neck, Total hip BMD for 12-mo 24-mo SS-HBEX and CON ↓ Femoral neck, Total hip, Lumbar spine BMD at 60-mo PW SS-HBEX and CON ↓Femoral neck, Total hip, Lumbar spine BMD |
|
| Kwan et al. (2023) | Prospective RCT |
Pre and PW (n = 2152) Age (28–94) |
6-mo Self-reported PA with Arizona Activity Frequency Questionnaire to evaluate PA levels 6-mo before and 6-mo after BC diagnosis |
6-mo Before and After BC diagnosis of overall moderate-vigorous PA No association with Fracture Risk 6-mo Before BC diagnosis of none or infrequent overall moderate-vigorous PA ↑Osteoporosis risk 6-mo Before and After BC diagnosis of <150 min/w of Aerobic Training ↑Fracture risk |
|
| The effect of exercise in modulating bone metabolism markers | |||||
| Knobf et al. (2008) | Pilot Study |
PeriMPW and PW (n = 26) Age: 45–58 |
AIs TAM Other Therapies |
6-mo Walking Training with weight belt and backpack, 3 d/w, 45 min, at 65–75%HR, 5 lb |
↔ Osteocalcin, NTxserum ↔ BMD |
| Winters-Stone et al. (2011) | Single-Blind RCT |
PW (n = 106) Age:≥50 SS-HBEX (n = 52) FT (n = 54) |
AIs or SERM Other Therapies Bisphosphonates |
12-mo SS-HBEX SS-HBEX: Unsupervised Resistance Training and Impact Training, 2 d/w 45-60 min at 8–10 RM 1-2 × 8–12rep and 10 % of BW 6x10rep and supervised Resistance Training and Impact Training, 1 d/w FT: Stretching and Relaxation EX |
SS-HBEX vs FT ↔Lumbar Spine BMD ↑Osteocalcin ↑Deoxypyrodinoline SS-HBEX vs FT under AIs ↑FFM ↓Fracture Risk |
| De Paulo et al. (2018) | Single-Blind RCT | PW (n = 36) Age:50–80 EX (n = 18) FT (n = 18) |
9-mo EX: Combined Training, 3d/w, 40 min at 75 % 1-RM, 3 × 8-10rep and 30 min at 75–80%HRmax FT: 2d/w, 45 min, 10–15 s each position |
EX vs FT ↑ Osteocalcin ↓FM ↔BMD |
|
| Saito et al. (2020) | Observational Study |
PMW (n = 53) Age:59–76 |
Self-reported PA with BAECKE PA questionnaire to assess daily PA levels and Accelerometer parameters | Light PA ↑ Bone Formation Markers ↓ Bone Resorption Markers |
|
| The effect of exercise combined with osteoporosis supplementation therapy | |||||
| Waltman et al. (2010) | RCT | PW (n = 233) Age:35–75 EX-ST (n = 110) CON-ST (n = 113) |
AIs TAM |
24-mo ST: 1.200 mg Ca, 400 IU Vitamin D and 35 mg/w PhT: Biphosphonates EX-ST: 9-mo - Resistance Training at home, 2 d/w, 30-45 min 15-mo - Resistance Training, 2 × 8–12 rep + ST and PhT CON-ST+ PhT: ST + PhT only |
EX-ST ↑ Total hip, Femoral Neck, Spine and Total Radius BMD ↓Alkphase B ↓ NTx serum CON-ST ↑ Total hip and Spine BMD and femoral neck ↓Alkphase B ↓ NTx serum ↓BMD Radius EX-ST vs CON-ST ↑ BMD Total hip, Femoral Neck, Spine and Total Radius BMD But not statistically significant |
| Knobf et al. (2016) | RCT | PeriMP and/or Early-PW (n = 150) Age:45–61 SS-HBEX-ST (n = 76) CON (n = 74) |
AIs TAM Without AIs Without TAM Other Therapies |
12-mo ST: 1200 mg Ca, 400 IU Vitamin D SS-HBEX-ST: Combined Training, 6-mo, 3 d/w, 30 min at 65–70%HRmax and 5EX at 70 %1-RM, 1 × 8 rep, Combined Training, from 7-mo to 12-mo, 3 d/w, 30 min at 65–70%HRmax and 5EX at 70 %1-RM, 1 × 8 rep+ ST CON-ST Recommended 30 min of moderate intensity activity most days of the week+ ST |
SS-HBEX-ST under AIs ↓Lumbar spine and Greater Trochater BMD ↑ Osteocalcin CON under AIs ↓ Femoral neck BMD ↑Bone resorption SS-HBEX-ST under AIs vs CON under AIs ↑Bone resorption ↑Bone formation SS-HBEX-ST under TAM ↓ Femoral neck ↓ Bone resorption SS-HBEX-ST and CON under TAM and SS-HBEX-ST and CON Without AIs or Without TAM ↔Lumbar spine, Greater trochanter BMD - SS-HBEX-ST Without AIs or Without TAM vs CON Without AIs or Without TAM ↑Bone resorption |
| Kim et al. (2016) | RCT | PW Osteopenic (n = 43) Age:50–63 HBEX-ST (n = 23) CON-ST (n = 20) |
AIs or SERM Other Therapies |
6-mo ST: 500 mg Ca, 1000 IU Vitamin D HBEX-ST: 3 d/w unsupervised Walking Training, 150 min/w at 12–13 RPE, 2–3 d/w Resistance Training unsupervised 2 × 8-10rep with Progressive Resistance TheraBand+ ST CON-ST ST only |
HBEX-ST and CON-ST ↑NTx and 25-hidroxyvitaminD CON-ST vs HBEX-ST ↓Lumbar spine, Total Hip But not statistically significance |
| Thomas et al. (2017) | RCT | PW (n = 121) Age: 55–69 SS-HBEX (n = 61) CON (n = 60) BHs-SS-HBEX (n = 11) BHs -CON (n = 9) |
AIs ≥ 6-mo Other Therapies |
12-mo PhT: Biphosphonates -FT-SS-HBEX: Resistance Training, 2d/w, 6 EX, 3 × 8–12rep Aerobic Training, 150 min/w at 60–80%HRmax PhT- CON: No intervention |
PhT- SS-HBEX vs PhT-CON ↑FFM↓FM No difference in BMD PhT- SS-HBEX vs PhT-CON ↑ BMD |
| Ashem et al. (2019) | RCT | Osteoporotic (n = 45) Age (45–55) EX-ST (n = 15) PEMFs-ST (n = 15) CON-ST (n = 15) |
3-mo ST: 11.2 mg Ca, 0.5 mg/day Vitamin D EX-ST EX: Treadmill, weightbearing, 3d/w, 30 min at Moderate intensity PEMFs-ST PEMFs: Electromagnetic field, 3d/w, 30 min at 72 Hz + ST CON-ST ST only |
PEMFs-ST > EX and CON ↑ Lumbar spine BMD EX > CON ↑ Lumbar spine BMD PEMFs-ST, EX and CON ↑ Lumbar spine BMD BMD Lumbar Spine CON < EX < PEMFs-ST |
|