臺灣博碩士論文加值系統

背景：長距離跑步運動與骨質密度之間的關係在過去的研究結果中有明顯的歧異，使得長距離跑步運動對骨質密度的影響一直未能被確認。

目的：本研究希望透過整合分析 (meta-analysis) 方法來探討長距離跑步運動對骨質密度的影響。

方法：本研究根據Cochrane系統性回顧文獻操作手冊所制定的步驟執行此研究。經由PICO模型制定出選取標準：「成年男性」、「18至65歲」、「參與長距離跑步運動者」與「相同條件不運動者」。透過耐力、骨質密度相關的關鍵字從Embase、Medline、Scopus三個資料庫中，搜尋到988篇相關文獻，並依據選取標準，經由標題、摘要、全文、質性分析等步驟篩選後，最後剩餘23篇文獻使用Review Manager 5.3版本軟體進行整合分析，並依據結果進行敏感度分析。由於各文獻所測量的骨質密度部位不盡相同，因此本研究分為全身 (total body)、脊椎 (spine)、髖部 (hip)、上肢 (upper limb)、下肢 (lower limb) 五個部位進行整合分析，並取各文獻在前述五個部位所測量之最大區塊骨質密度歸為該部份之骨質密度，由於各研究所測量之部位不同，因此使用標準化平均數差異 (standardized mean difference) 計算綜合效應。為避免文獻間異質性影響結果判斷，本研究採用隨機式模型 (random-effects model)。

結果：長距離跑步運動能顯著增加成年男性長距離跑者全身（綜合效應95%信賴區間[0.05, 0.62]）、下肢骨質密度（綜合效應95%信賴區間[0.41, 0.74]）及髖部的骨質密度（綜合效應95%信賴區間[0.18, 0.69]），對上肢（綜合效應95%信賴區間[-0.47, 0.28]）、脊椎（綜合效應95%信賴區間[-0.23, 0.31]）則沒有顯著影響。

結論：長距離跑步運動對成年男性骨質密度有正面影響，但其效應有部位上的差異。未來探討相關議題時，需分部位討論。

Purpose: Use Meta-analysis to find out the relation between long-distance running and bone mineral density (BMD).

Method: Based on Cochrane’s systematic review handbook, we used the PICO model to identify our selection criteria as follows: adult males, aged 18 to 65, long-distance runner, and non-exercise males as a control group. By using keyword searching studies from Embase, Medline, and Scopus, 988 studies were found, of which twenty-three studies were selected according to their titles, abstracts, full texts and the agreement by all the researchers in the present study. In these twenty-three studies, analysis was conducted on BMD data from five categories: total body, spine, hip, upper limb, and lower limb. The random-effects model is used to avoid heterogeneity.

Result: Long-distance running significantly increases total BMD, lower limb BMD and hip BMD in elite male runners, but there is no difference between long-distance running group and control group in upper limb BMD and spine BMD.

Conclusion: Long-distance running shows positive effects on bone mineral density, but the effects are site-specific. Future research needs to be aware that different sites may have different effects.

中文摘要 I
SUMMARY II
謝誌 VI
目錄 VII
表目錄 IX
圖目錄 X
第壹章　緒論　1
　第一節　研究背景　1
　第二節　研究目的　2
　第三節　名詞操作型定義　2
第貳章　文獻探討　4
　第一節　骨質密度：評估骨頭健康的重要指標　4
　第二節　性別、年齡與運動和骨質密度之間的關係　5
　第三節　長距離跑者的骨質密度　6
　第四節　長距離跑的定義　8
　第五節　總結　9
第參章　研究方法　10
　第一節　PICO模型　10
　第二節　設定納入資訊與文獻篩選條件　11
　第三節　確立搜尋資料庫與關鍵字　11
　第四節　篩選文獻　13
　第五節　資料萃取與整理　14
　第六節　數據分析　16
第肆章　研究結果　17
　第一節　文獻檢索　17
　第二節　部位分類　18
　第三節　納入文獻偏差風險分析　18
　第四節　整合分析　30
　第五節　敏感度分析　33
　第六節　出版偏差　36
第伍章　討論　38
　第一節　長距離跑與全身骨質密度　38
　第二節　長距離跑與脊椎骨質密度　39
　第三節　長距離跑與髖部骨質密度　40
　第四節　長距離跑與上肢骨質密度　41
　第五節　長距離跑與下肢骨質密度　42
　第六節　綜合討論　44
　第七節　研究限制　46
第陸章　結論與建議　48
　第一節　結論　48
　第二節　未來研究建議　48
參考資料　50
附錄　56

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