Impact of multicomponent physical exercise and high-intensity interval training on osteoporosis in postmenopausal women - protocol for a systematic review and network meta-analysis of randomized controlled trials

Sep 30, 2026

Osteoporosis is a progressive degenerative bone condition that increases fracture risk, with roughly 200 million cases worldwide and about 70% occurring in postmenopausal women. Medication is commonly proposed, yet physical exercise is also essential. Existing evidence suggests multicomponent training and high-intensity/high-impact exercise may improve this population’s bone health, but systematic reviews rarely compare both interventions using metanalytic methods. This protocol defines a systematic review and network meta-analysis of randomized controlled trials.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods and analysis

Search strategy and eligibility

Risk of bias and analysis

Discussion

Ethics and dissemination

Systematic review registration

Introduction

Monteiro et al. Systematic Reviews (2026) 15:3 [https://doi.org/10.1186/s13643-025-02899-9](https://doi.org/10.1186/s13643-025-02899-9) Systematic Reviews PROTOCOL Open Access Impact of multicomponent physical exercise and high-intensity interval training on osteoporosis in postmenopausal women: protocol for a systematic review and network meta-analysis of randomized controlled trials António Miguel Monteiro 1,2,3,4*, André Schneider1* , Samuel Encarnação 1,5, Pedro Forte 1,6, Tiago Barbosa 1,2,3 and Daniel Pecos Martín4 Abstract Background Osteoporosis is a progressive degenerative bone condition leading to increased fracture risk. Therefore, osteoporosis acknowledges around 200 million cases, with about 70% of the cases occurring in postmenopausal women. Medicaments are often suggested to treat osteoporotic conditions, but physical exercise also plays an essential role. The current literature highlights multicomponent training (MCT) and high-intensity and high-impact exercises as physical exercise interventions that positively affect postmenopausal women’s bone health. Furthermore, there is prior evidence of systematic reviews about the positive effects of both methods on the bone health of this population. Despite this prior evidence, no systematic reviews with metanalytic methods compare the effectiveness of the two interventions. Methods and analysis. The study will follow the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number (CRD42024604930) . This systematic review and meta-analysis will include only randomized controlled clinical trials (RCTs), which have verified the effects of one or both physical exercise methods on postmenopausal women’s bone mineral density (BMD) . The systematic search will be implemented at eight electronic databases, namely PubMed/MEDLINE, Web of Science (WoS), EBSCO, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, CINAHL, and SPORTDiscus, which will be used to retrieve the data of interest. The RCTs’ risk of bias (RoB) will be assessed with the RoB 2 Cochrane tool, and between-study heterogeneity will be checked through the analysis of Half-Cauchy distribution. Additionally, a network meta-analysis will be applied to compare the between-studies dose–response on the patients’ bone health. The final database search was completed on January 18, 2025. *Correspondence: António Miguel Monteiro [mmonteiro@ipb.pt](mmonteiro@ipb.pt) André Schneider [andrecschneider@gmail.com](andrecschneider@gmail.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/.)[.](http://creativecommons.org/licenses/by-nc-nd/4.0/.) Monteiro et al. Systematic Reviews (2026) 15:3 Page 2 of 9 Discussion In this study, we hope

FAQs

What question does the protocol address?

It compares the effectiveness of multicomponent physical exercise and high-intensity interval training on osteoporosis outcomes in postmenopausal women using randomized controlled trials.

Which study type will be included?

Only randomized controlled clinical trials (RCTs) that evaluate one or both exercise methods on postmenopausal women’s bone mineral density (BMD) will be included.

How will the review be conducted and analyzed?

The review follows PRISMA guidelines, uses PROSPERO registration, searches eight databases, assesses risk of bias with the RoB 2 tool, and performs a network meta-analysis to examine dose–response relationships.

Sep 30, 2026

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