title: Quantitative Ultrasound and bone's response to exercise: a meta analysis.
abstract: The utility of Quantitative Ultrasound (QUS) for assessing and monitoring changes in bone health due to exercise is limited for lack of adequate research evidence. Restrictions to bone density testing and the enduring debate over repeat dual energy absorptiometry testing spells uncertainty over clinical and non-clinical evaluation of exercise for prevention of osteoporosis. This study, via systematic review and meta-analysis, aimed to paint a portrait of current evidence regarding QUS' application to monitoring bone's adaptive response to exercise interventions.
  
  
  METHODS
  Structured and comprehensive search of databases was undertaken along with hand-searching of key journals and reference lists to locate relevant studies published up to December 2011. Twelve articles met predetermined inclusion criteria. The effect of exercise interventions for improving bone health, as measured by QUS of the calcaneum, was examined across the age spectrum. Study outcomes for analysis: absolute (dB/MHz) or relative change (%) in broadband ultrasound attenuation (BUA) and/or os calcis stiffness index were compared by calculating standardised mean difference (SMD) using fixed- and random-effects models.
  
  
  RESULTS
  Quality of included trials varied from low to high on a scale of one to three. Four to 36months of exercise led to a significant improvement in calcaneum BUA (0.98 SMD, 95% CI 0.80, 1.16, overall effect Z-value=10.72, p=0.001) across the age spectrum.
  
  
  CONCLUSIONS
  The meta-analysis attests to the sensitivity of QUS to exercise-induced changes in bone health across the age groups. QUS may be considered for use in exercise-based bone health interventions for preventing osteoporosis.
authors.affiliation: School of Psychology, Sport and Exercise, Staffordshire University, Stoke on Trent, UK. o.babatunde@staffs.ac.uk
authors.forename: O O
authors.initials: OO
authors.lastname: Babatunde
authors.forename: J J
authors.initials: JJ
authors.lastname: Forsyth
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D014463:Ultrasonography