E-Poster Presentation ESA-SRB-ANZBMS 2021

Effects of Acute Exercise on Bone Turnover Markers in Middle-Aged and Older Adults: a Systematic Review   (#763)

Cassandra Smith 1 2 , Alexander Tacey 1 , Jakub Mesinovic 3 , David Scott 3 4 , Xuzhu Lin 1 , Tara C Brennan-Speranza 5 , Joshua R Lewis 6 7 , Gustavo Duque 2 8 , Itamar Levinger 1 2
  1. Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
  2. Australian Institute for Musculoskeletal Sciences (AIMSS), University of Melbourne, Melbourne, VIC, Australia
  3. School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
  4. Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, VIC, Australia
  5. Department of Physiology and Bosch Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
  6. School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
  7. Medical School, University of Western Australia, Perth, WA, Australia
  8. Department of Medicine- Western Health, University of Melbourne, Melbourne, VIC, Australia

Purpose: Long-term exercise improves bone health eliciting anabolic effects if characterised by progressive, dynamic, novel patterns and applied rapidly. Acute-exercise effects with varying mechanical stimuli is less clear. Bone turnover markers (BTMs), surrogate measures of bone health, are used to measure acute exercise-responses, but findings are contradictory possibly owing to factors (feeding, circadian-effects) modulating responses. This systematic review examines the effects of acute aerobic (AE), resistance (RE) and impact exercises on BTMs in middle and older-aged adults.

Methods: We searched PubMed, SCOPUS, Web of Science and EMBASE up to 22nd April 2020. Eligibility criteria: randomised controlled trials (RCTs) and single-arm studies; middle-aged (50 to 65 years) and older adults (>65 years); a single-bout, acute-exercise (AE, RE, impact) intervention with measurement of BTMs. PROSPERO registration number CRD42020145359

Results: Thirteen studies were included; 8 in middle-aged (n= 275, 212 women/63 men, mean age= 57.9 ± 1.5 years) and 5 in older-adults (n= 93, 50 women/43 men, mean age= 68.2 ± 2.2 years). Eleven studies included AE (7 middle-aged/4 older-adults), and two included RE (both middle-aged). AE significantly increased C-terminal telopeptide (CTX), alkaline phosphatase (ALP) and bone-ALP in middle-aged and older-adults. AE also significantly increased total osteocalcin (tOC) in middle-aged men and Procollagen I Carboxyterminal Propeptide and Cross‐Linked Carboxyterminal Telopeptide of Type I Collagen in older women. RE alone decreased ALP in older-adults. In middle-aged adults, RE with impact had no effect on tOC or BALP, but significantly decreased CTX. Impact (jumping) exercise alone increased Procollagen Type 1 N Propeptide and tOC in middle-aged women. Quality assessment results identifies a lack of RCTs, low quality evidence, small sample sizes and large variance in protocols.

Conclusions: Acute exercise is an effective tool to modify BTMs, however, responses appear to be exercise modality-, intensity-, age- and sex-specific. Higher quality and larger RCTs are needed.