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. DISCUSSION: In this study, we hope to find consistent results about the effects of MCT and HIIT in postmenopausal women with osteoporosis. Therefore, we also expect to observe between-intervention effects after the network meta-analysis approaches. A Bayesian network meta-analysis will be conducted using Markov Chain Monte Carlo simulations. Exercise dose will be modeled in METs-min/week to explore dose-response relationships. The deviance information criterion (DIC) will be used to compare model fit. Confidence in the results will be evaluated using the CINeMA framework. This way, this study will significantly impact this field of knowledge. ETHICS AND DISSEMINATION: The design of this review protocol did not involve patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024604930.