Table 1.
Synthesis of Evidence for Strength Exercises on Symptoms of Postmenopausal Women.
| Study | Country | Funding | Sample Size | Mean Age | Attrition | Diagnosis | Duration | Intervention | Outcome Measures | Results |
|---|---|---|---|---|---|---|---|---|---|---|
| Berin, E. et al., 2019 [7] | Sweden | Yes | N = 58 EG = 29 CG = 29 |
55.3 | NR | Postmenopausal women ≥12 months amenorrhea | 15 weeks | EG = R (three times/week, with 225 min as the maximum exercise per week). CG = no intervention |
Moderate to severe change in heart rate. HF change. Change between HF and minutes of physical activity. Physical activity tolerance (IPAQ) |
The moderate to severe heart failure decreased more in EG than in CG (difference of means: −2.7, 95% CI −4.2–−1.3). The mean percentage reduction was −43.6% (−56.0–−31.3) in EG versus no change in CG. |
| Hakestad, K.A. et al., 2015 [15] | Norway | Yes | N = 194 EG = 42 CG = 38 |
64.7 | NR | Postmenopausal women with low BMD + fracture of healed wrist > 2 years | 6 months | EG = ST + EQ CG = no intervention. Two group sessions and one at home (each 1 h) a week. |
Quadricep strength (dynamometer). Body anthropometry (BMI). Absolute mass, % fat and BMD (DXA). Dynamic balance (FSST). Ability to walk (6 min walk test). Physical activity level (PASE). Quality of life (SF-36). |
The means calculated for the EG improved or were stable during the follow-up, except for the reduction in right quadricep strength and the BMD in the lumbar spine and femoral trochanter. For CG, the mean values decreased during the follow-up, except for some of the variables for quadricep strength. There were no significant differences between the two groups during the 1-year follow-up for any of the outcome measures. |
| Hartley, C. et al., 2020 [22] | United Kingdom | Yes | N = 42 EG = 21 CG = 21 |
61.7 | NR | Postmenopausal women ≥12 months amenorrhea | 6 months | EG: EL CG: CL Both <15 min/day. One session/day. |
BMD, BMC and femoral neck Z (DXA) Biochemical composition of the cartilage joint and associated disease with OA (magnetic resonance imaging—T2 relaxometry). |
The BMD of the femoral neck, BMC and Z increased in EG (+0.81%, +0.69% and +3.18%, respectively) compared with CG (−0.57%, −0.71% and −0.75%: all interaction effects p < 0.05). There was no overall effect given that the mean T2 relaxation time (principal effect of time p = 0.011) did not differ between EL and CL. |
| Son, W.M. et al., 2020 [23] | South Korea | No | N = 20 EG = 10 CG = 10 |
67.7 | NR | Postmenopausal women ≥12 months amenorrhea and stage 1 hypertension | 12 weeks | EG = ERB CG = no intervention. Both three times/week for 60 min/session. |
Values for estradiol, GH, IGF-1, DHEA-S (blood sample), BP (automatic sphygmomanometer), body mass, % body fat and lean body mass (anthropometry and bioelectrical impedance). |
Significant group changes by time (p < 0.05) for estradiol, GH, IGF-1, DHEA-S and lean body mass, which increased significantly (p < 0.05), and systolic blood pressure, total body mass, body mass index and % body fat, which decreased significantly (p < 0.05) in EG, compared with no change in CG. There were no significant differences (p > 0.05) in diastolic blood pressure after 12 weeks. |
| Bittar, S.T. et al., 2015 [24] | Brazil | No | N = 60 EG = 30 CG = 30 |
67.3 | G1 = 14 G2 = 12 |
Postmenopausal women >12 months | 12 months | EG = SE (1 h, two times/week). CG = HE (two times/week). |
BMD (DXA). Body composition, fat and lean mass (absorptiometry). |
EG exhibited increased lean mass in the arms (p = 0.003) and legs (p = 0.011), total lean tissue (p = 0.015) and appendicular lean mass index (p = 0.001) compared with the baseline. CG showed no differences in lean mass. |
| Prado-Nunes, P.R. et al., 2016 [25] | Brazil | Yes | N = 32 CG= 13 EG1 = 13 EG2 = 12 |
61.3 | 6 | Postmenopausal women >12 months. FSH >40 mUl/mL |
16 weeks | CG = S (two times/week). EG1 = LV (three times/week). EG2 = HV (three times/week). |
Leg extension strength (dynamometer). Body anthropometry (measuring tape, adipometer). Metabolic and inflammatory indicators (blood test). |
EG2 experienced a reduction in total cholesterol and a smaller change in IL-6 compared with G1 (11.2% (P25–75, −7.6–28.4%) vs. 99.55% (P25–75 = 18.5–377.0%) for G3 and G1, respectively; p = 0.049) EG1 experienced a reduction in the percentage of HbA1c. There were positive correlations between WHR and IL-6 and between IL-6 and total cholesterol. |
| Martinho, N.M. et al., 2016 [26] | Brazil | Yes | N = 47 EG = 27 CG = 20 |
61.4 | NR | Postmenopausal women >12 months | 5 weeks | EG = RV. CG = M, S, ST and RE Both 30 min, two times/week. |
SP strength (vaginal palpation and dynamometer) | There were no significant differences between the groups in most of the analyzed parameters. The muscle resistance was increased in EG (p = 0.003; effect size, 0.89; difference of means, 1.37; 95% CI 0.46–2.28). |
| Multanem, J. et al., 2017 [27] | Finland | No | N = 80 EG = 40 CG = 40 |
58.3 | 4 | Postmenopausal women with knee pain in recent days | 12 weeks | EG = leaps (three times/week, lasting 55 min). CG = no intervention. |
Bone strength (femoral neck scanner). Knee cartilage (scanner). Physical activity (body movement monitors). Aerobic exercise load (number and intensity of leaps). Quality of life (SF-36). |
Significant difference between the groups in the strength of the femoral neck flexion in favor of EG at 12 months (p < 0.01). The change in resistance to the femoral neck flexion remained significant after adjusting the baseline value, age, height and body mass (p = 0.020). In all participants, the change in resistance to flexion was associated with the total physical activity load (p = 0.012). EG had no effect on knee cartilage composition. |
| Ganderton, C. et al., 2018 [28] | Australia | Yes | N = 94 EG = 46 CG = 48 |
61. 8 | NR | Postmenopausal women >52 weeks of amenorrhea with trochanteric pain | 52 weeks | EG = strengthening exercise program. GLoBE + HE CG = e.g., simulated + HE Both 12 weeks |
Gluteal tendon pain (VISA-G questionnaire). Perceived improvement in hip dysfunction (OHS and global rating of change). Quality of life (AQoL). Hip dysfunction and osteoarthritis (HOOS and lateral hip questionnaire). |
EG achieved a significantly higher score in VISA-G, HOOS, OHS and lateral hip pain compared with CG. However, the intent-to-treat analysis showed no differences between the groups. There were no differences between the groups in the global rating of change at 12 (p = 0.340) and 52 weeks (p = 0.746). There was a significant improvement in the VISA-G score for both groups at 12 and 52 weeks (p < 0.001). |
| Watson, S.L. et al., 2018 [29] | Australia | No | N = 101 EG = 49 CG = 52 |
65 | NR |
Postmenopausal women with low bone mass | 8 months | EG = W+ R CG = HE Both twice a week for 30 min. |
Physical activity level (IPAQ). Daily calcium intake (AusCal). FN and LS BMD (DXA). Dominant or nondominant heels (QUS). Leg extension strength (dynamometer). Leg neuromuscular performance (maximum vertical leap test in a force plate). |
Largest effects in EG for LS-BMD (2.9% and 2.8% vs. −1.2% and 2.8%, p < 0.001), FN-BMD (0.3% and 2.6% vs. −1.9% and 2.6%, p = 0.004), FN cortical thickness (13.6 16.6% vs. 6.3% and 16.6%, p = 0.014), height (0.2 and 0.5 cm versus −0.2, 0.2 and 0.5 cm p = 0.004) and all the performance measurements (p < 0.001). |
| Nunes, R.P.P. et al., 2019 [30] | Brazil | Yes | N = 38 CG = 13 EG1 = 13 EG2 = 12 |
60.9 | NR | Postmenopausal women ≥12 month amenorrhea + FSH >40 mIU·mL−1 + E2 ≤54.7 pg·mL−1 | 16 weeks | CG = control. No RT, only S two times/week. EG1 = W+ LV + E; 45 min x three times/week. EG2 = W+ HV + E; 90 min x three times/week. |
Strength performance (maximum strength test). Dietary intake E, CHO, LIP, PTN (food record). DHEA- S, TT, CO, TT:CO, IGF- 1 (blood sample). |
EG1 and EG2 increased the performance of 1RM in all exercises compared with CG. There were no differences in strength performance between EG1 and EG2, except with the bar curl, which only increased in EG1. EG1 and EG2 increased the lean mass compared with CG (CG = 0.8 (95% CI 20.1–1.8) kg; EG1 = 2.2 (95% CI 1.7–2.7) kg; EG2 = 2.4 (95% CI 1.2–3.6) kg; p ANOVA = 0.037). There were no differences for the food intake and hormonal responses. |
| Watson, S.L. et al., 2019 [31] | Australia | NR | N = 51 EG = 25 CG = 26 |
64 | NR | Postmenopausal women with low bone mass | 8 months | EG = W+ R. CG = HE. Both twice a week for 30 min. |
Magnitude of kyphosis (DXA, inclinometer and flexicurve) | EG obtained a high reduction in thoracic kyphosis in standing compared with G2 (−6.7 ± 8.2° vs. −1.6 ± 8.1°, p = 0.031). The two groups achieved an improvement within the group in kyphosis in the relaxed position, measured by the inclinometer and flexicurve (p < 0.05). There were no changes in the classification of vertebral fractures in EG after the intervention. |
Abbreviations: AQoL, Assessment of Quality of Life; AusCal, Australian Calcium-focused Questionnaire; BMC, bone mineral content; BMD, bone mineral density; BMI, body mass index; BPAQ, Bone-Specific Physical Activity Questionnaire; BP, blood pressure; CG, control group; CHO, carbohydrate intake; CL, contralateral leg; CO, cortisol; DHEA-S, dehydroepiandrosterone sulfate; DXA, dual-energy X-ray absorptiometry; E, energy intake; E2, baseline estradiol; EG, experimental group; EG1, experimental group 1; EG2, experimental group 2; EL, exercise leg; ERB, exercises with resistance band; FN, femoral neck; FSH, follicle-stimulating hormone; EQ, equilibrium; FSST, Four Square Step Test; GH, growth hormone; HbA1c, hypercholesterolemia and borderline values of glycated hemoglobin; HE, home exercises; HF, hot flashes; HOOS, scoring of osteoarthritis result; HV, high volume; IGF-1, insulin-like growth factor-1; IL-6, interleukin-6; IPAQ, International Physical Activity Questionnaire; LIP, lipid intake; LS, lumbar spine; LV, low volume; M, mobility; N, number of participants; NR, Not Reported; OHS, Oxford Hip Score; PASS, Physical Activity Scale for the Elderly; PTN, protein intake; QUS, quantitative ultrasound; R, resistance; RE, relaxation; RT, resistance training; S, stretching; SE, supervised exercises; SF-36, health-related quality-of-life questionnaire; ST, strength; TT, testosterone; TT:CO, testosterone–cortisol ratio; VISA-G, gluteal tendon questionnaire; VR, virtual reality; W, warmup; WHR, waist-to-hip ratio; Z, section modulus.