Entrenamiento físico y salud ósea en mujeres posmenopáusicas: revisión sistemática
DOI:
https://doi.org/10.47197/retos.v75.117282Palabras clave:
Ejercicio, terapia por ejecicio, densidad ósea, osteoporosis posmenopáusica, posmenopausiaResumen
Introducción: La osteoporosis es una enfermedad esquelética progresiva caracterizada por la reducción de la densidad mineral ósea (DMO), lo que aumenta el riesgo de fracturas, especialmente en la columna lumbar y el cuello femoral. Afecta principalmente a mujeres posmenopáusicas debido al descenso del estrógeno, hormona esencial en el metabolismo óseo. La pérdida de masa ósea compromete la funcionalidad y calidad de vida, incrementando la morbilidad en esta población. El ejercicio físico se ha propuesto como una estrategia no farmacológica para prevenir o revertir la pérdida ósea, aunque sus efectos específicos no están completamente dilucidados.
Objetivo: Analizar los efectos de distintas modalidades de ejercicio físico sobre la densidad mineral ósea en mujeres posmenopáusicas e identificar los rangos de intensidad más efectivos para su mejora.
Métodos: Se realizó una revisión sistemática siguiendo las directrices PRISMA 2020. Se incluyeron ensayos clínicos aleatorizados publicados entre 2016 y diciembre de 2023 que evaluaran programas de ejercicio (fuerza, impacto, aeróbico o combinados). El riesgo de sesgo se evaluó con la herramienta RoB 2 y la certeza de la evidencia con el enfoque GRADE.
Resultados: Se analizaron 16 ensayos (n = 1.186; edad media = 63 años). La mayoría reportó incrementos modestos en DMO lumbar (+1,4 % a +2,9 %) y femoral (+0,8 % a +3,5 %). Los programas de fuerza e impacto fueron más efectivos en cuello femoral, mientras que las intervenciones combinadas mostraron mejoras consistentes en columna lumbar.
Conclusiones: El ejercicio físico, especialmente el que integra fuerza e impacto, es una intervención eficaz para mejorar o mantener la DMO en mujeres posmenopáusicas, contribuyendo a la prevención de fracturas y a la salud ósea y funcional.
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