RT Journal Article
SR Electronic
T1 Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101032
DO 10.3399/bjgpopen20X101032
A1 Emma Pearce
A1 Kate Jolly
A1 Laura L Jones
A1 Gemma Matthewman
A1 Mandana Zanganeh
A1 Amanda Daley
YR 2020
UL http://bjgpopen.org/content/early/2020/06/08/bjgpopen20X101032.abstract
AB Background Exercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.Aim To systematically review the evidence for the effectiveness of exercise as a treatment for PMS.Design & setting This systematic review searched eight major databases, including MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), and two trial registries from inception until April 2019.Method Randomised controlled trials (RCTs) comparing exercise interventions of a minimum of 8-weeks duration with non-exercise comparator groups in women with PMS were included. Mean change scores for any continuous PMS outcome measure were extracted from eligible trials and standardised mean differences (SMDs) were calculated where possible. Random-effects meta-analysis of the effect of exercise on global PMS symptoms was the primary outcome. Secondary analyses examined the effects of exercise on predetermined clusters of psychological, physical, and behavioural symptoms.Results A total of 436 non-duplicate returns were screened, with 15 RCTs eligible for inclusion (n = 717). Seven trials contributed data to the primary outcome meta-analysis (n = 265); participants randomised to an exercise intervention reported reduced global PMS symptom scores (SMD = -1.08; 95% confidence interval [CI] = -1.88 to -0.29) versus comparator, but with substantial heterogeneity (I 2 = 87%). Secondary results for psychological (SMD = -1.67; 95% CI = -2.38 to -0.96), physical (SMD = -1.62; 95% CI = -2.41 to -0.83) and behavioural (SMD = -1.94; 95% CI = -2.45 to -1.44) symptom groupings displayed similar findings. Most trials (87%) were considered at high risk of bias.Conclusion Based on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.