A Cochrane review «Armour M, Ee CC, Naidoo D, et al. Exercise for dys...»1 measured the impact of exercise in reducing menstrual pain intensity in primary dysmenorrhea. Types of exercise used varied between studies from high-intensity aerobic to low-intensity stretching, but none used resistance or strength training.
The pooled effect suggested a large impact (SMD -1.86 (95% CI -2.06 to -1.6).
Risk for adverse effects could not be assed due to very little and low-quality evidence.
The evidence certainty is downgraded two times due to a high risk of bias in included studies, and indirectness (short follow-up times and uncertain applicability). We increased the evidence certainty one time due to very large effect size.
Most studies done in Asia and Africa.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Armour M, Ee CC, Naidoo D, et al. Exercise for dys...»1 | SR/MA | Female patients in reproductive age but mostly under 25 years of age with clinically diagnosed primary dysmenorrhea in Iran, India, Korea, Egypt, New Zealand and USA | Exercise compared to no treatment | Menstrual pain intensity as continuous variable measured by validated scales | High |
| Reference | Comments |
|---|---|
| «Armour M, Ee CC, Naidoo D, et al. Exercise for dys...»1 | Possible sequence generation, allocation concealment, incomplete data and selective
reporting issues in multiple studies Blinding of participants and personnel on outcome assessment was not performed in any included study due to nature of the intervention and outcome reporting. Exercise interventions varied in their intensity, frequency and duration. None of the included studies included follow-up periods. Only one study reported on adverse effects and only two studies reported on additional analgesic medication usage. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | SMD (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate/low The quality of evidence is downgraded due to study limitations, indirectness (due to short/no follow-up, and imprecision I=intervention; C=comparison; CI=confidence interval |
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| «Armour M, Ee CC, Naidoo D, et al. Exercise for dys...»1 | 9 studies, 632 patients (349/283) | NA | NA | NA | -1.86 (-2.06, -1.66) |