Sports medicine (Auckland, N.Z.) · 2026 · 系統性回顧＋統合分析（依標題推測）

The Impact of Exercise on Intervertebral Disc Health: A Systematic Review and Meta-Analysis

腰椎 · 椎間盤退化

中文閱讀摘要

系統性回顧與統合分析顯示，直立雙足負載（主要為跑步）與較佳椎間盤健康相關，但綜合運動負載結果不一致，證據有限。

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原始摘要

Background

The structure and function of human tissue, such as bone, muscle and tendon, can be improved with targeted exercise training. However, the effects of exercise training on intervertebral disc tissue remain unclear.

Objective

We aimed to examine the impact of physical loading exposure (exercise training, sport and physical activity) on intervertebral disc (IVD) health compared to non-physical loading (or lower volume of the same physical loading) controls.

Methods

We conducted a systematic review and meta-analysis. Seven electronic databases (PubMed, CINAHL, SPORTDiscus, EMBASE, CENTRAL, Web of Science and Scopus) and two trial registries (World Health Organization International Clinical Trials Registry Platform and National Institutes of Health) were searched from inception to 3 June, 2025. Forward and backward citation tracking was conducted for included reports. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation criteria (GRADE). Risk of bias was assessed using Cochrane RoB2 and Johanna Briggs Institute critical appraisal checklists. We included randomised controlled trials (n = 2), cohort (n = 9) and cross-sectional studies (n = 28) of any physical loading compared to controls with continuous measurements of IVD health (e.g. T2-relaxation, IVD height) via magnetic resonance imaging and/or categorically graded measures of IVD degeneration (e.g. Pfirrmann grade).

Results

Forty-five reports of 39 studies (participants: 4152) were included. The pairwise random-effects meta-analysis estimated the standardised mean difference (Hedges' g) of continuous outcomes for combined physical loading and independent subgroups and odds ratios (Paule-Mandel estimator) of categorical outcomes for combined physical loading only. A meta-analysis revealed upright bipedal loading (mostly running; Hedges' g [95% confidence interval] 0.31 [0.12, 0.50]; P = 0.002; n = 7, GRADE: very low) was associated with better IVD health; however, no other subgroup of physical loading was associated with better or worse IVD health. Combined physical loading revealed greater odds of IVD degeneration via reduced signal intensity (odds ratio [95% confidence interval] 2.80 [1.53, 5.11], P = 0.001; n = 5, GRADE: low); however, no other measure of IVD degeneration was significant.

Conclusions

Running was the only physical loading exposure associated with better IVD health. The mixed results from the combined physical loading analyses suggest that the type of physical loading plays a role in IVD health. As our estimates rely on observational data, prospective running interventions that examine the causal effect on IVD health appear warranted.

Clinical trial registration

The review was prospectively registered with International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022366391]. See Supplement P of the Electronic Supplementary Material for protocol deviations since registration.

至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19

書目、來源與全文狀態

DOI: 10.1007/s40279-025-02336-w
PMID／PMCID: 41840183 / PMC13124787
作者: Samanna CL, Owen PJ, Mitchell UH, Ehrenbrusthoff K, Saueressig T, Moreira E, Arora NK, Mundell NL, Tait JL, Donath L, Karner V, Belavý DL
首次發表日期: 2026-03-16Europe PMC 提供，部分日期可能依年份或月份推定。
卷／期／頁碼或文章編號: 56 ／ 4 ／ 941-965
書目來源與查核日期: Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
全文與授權: 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。來源授權標示：cc by。

可回溯引用

Samanna CL, Owen PJ, Mitchell UH, Ehrenbrusthoff K, Saueressig T, Moreira E, Arora NK, Mundell NL, Tait JL, Donath L, Karner V, Belavý DL. The Impact of Exercise on Intervertebral Disc Health: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.). 2026;56(4):941-965. PMID: 41840183. PMCID: PMC13124787. doi:10.1007/s40279-025-02336-w

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