Background/Objectives: Osteoporosis is a global health issue characterized by decreased bone mineral density (BMD), which increases the risk of fractures in adulthood. Adolescence, particularly the pubertal stage, is a critical period for maximizing BMD, and physical activity is a key modifiable factor in this process. The aim of this study was to conduct a systematic review of physical exercise interventions aimed at improving BMD in adolescents. Methods: The PRISMA methodology was applied, with searches conducted in PubMed, Web of Science, and SPORTDiscus. Included studies involved participants aged 11 to 18 years, structured physical activity interventions, and valid methods for assessing bone quality. Studies that included supplementation, lacked sufficient intervention details, or had no comparison group were excluded. Results: A total of 1464 articles were identified, of which 17 met the inclusion criteria and were analyzed. The results suggest that strength training programs and impact activities (such as football, volleyball, plyometric exercises, or running) appear to show benefits for bone development compared to control groups or non-osteogenic activities. The combination of strength and impact may reduce the time required to achieve measurable improvements. Non-osteogenic activities such as swimming and cycling showed no benefits on their own but may be beneficial when combined with resistance or impact training. The qualitative analysis indicates a certain risk of bias across the studies included. Conclusions: Although available evidence indicates that exercise programs involving strength or impact activities of around 8 months in duration and with a frequency of three sessions per week can be beneficial, these recommendations should be interpreted with caution due to the heterogeneity and limited number of studies, as well as the low certainty of the evidence. The combination of strength and impact exercises seems to shorten the intervention time required to achieve measurable improvements to approximately 6 months. These interventions appear to be most effective during early and middle adolescence, but current data do not consistently support sex-related differences.
Carlos Ma Tejero‐González (2025) studied this question.