Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China.
Pott College of Science, Engineering and Education, University of Southern Indiana, Evansville, IN, USA.
BMC Womens Health. 2024 Nov 16;24(1):610. doi: 10.1186/s12905-024-03453-w.
Exercise is increasingly being promoted as an effective treatment for primary dysmenorrhea (PD). This study aims to conduct a comprehensive network meta-analysis (NMA) of randomized controlled trials to identify the optimal types and dosages of exercise for managing PD in women.
Adhering to PRISMA-NMA guidelines, we systematically reviewed RCTs from the Cochrane Library, Web of Science, PubMed, and Embase databases up to May 23, 2024. Data analysis was performed using 'GEMTC' and 'BUGSnet' packages within a Bayesian framework in R and a hierarchy of exercise treatments was also calculated using surface under the cumulative ranking curve (SUCRA) values. Subgroup analyses were conducted to identify the most effective exercise regimens, including duration, frequency, and volume of the exercise interventions.
Forty-nine studies representing 3,129 participants (1,640 exercises and 1,489 controls) were included. The results showed that all exercise interventions significantly reduced menstrual pain of the PD patients. Of six exercise intervention modalities based on the study ranked effectiveness, statistically significant reductions in pain intensity were found for resistance exercise and multi-component exercise. Multi-component exercise and stretching exercise were ranked best for menstrual symptoms, while core-strengthening exercise and multi-component exercise had the greatest impact on reducing pain duration. Significant and clinically important reductions or reliefs in pain occurred with 4 to 8 weeks of exercise training from all exercises, with resistance exercise showing the best efficacy when the duration exceeded 8 weeks, followed by multi-component exercise and mind-body exercise. Multi-component exercise and aerobic exercise with 1 to 3 sessions per week induced greater benefit in performance improvements, while resistance exercise with increased frequency showed the enhanced performance. Resistance exercise could elicit better efficacy within` 30-minute training duration, and multi-component exercise was ranked the best if such a training over 30 min.
This study provided quantitative insight into efficacy and effectiveness of exercise interventions on PD treatments. All six different exercises are associated with positive influence on PD management. Our study indicates that this exercise training induced adaptation may have therapeutic benefits for PD patients; however, such alterations and improvements are affected by exercise regiments.
运动作为原发性痛经（PD）的有效治疗方法正日益受到推崇。本研究旨在通过系统综述和网络荟萃分析（NMA）来评估不同类型和剂量的运动对女性 PD 的治疗效果。
根据 PRISMA-NMA 指南，我们系统检索了 Cochrane 图书馆、Web of Science、PubMed 和 Embase 数据库，检索时间截至 2024 年 5 月 23 日。使用 R 中的“GEMTC”和“BUGSnet”包进行贝叶斯数据分析，并通过累积排序曲线下面积（SUCRA）值计算运动治疗的层级。进行亚组分析以确定最有效的运动方案，包括运动干预的持续时间、频率和强度。
共纳入 49 项研究，涉及 3129 名参与者（1640 次运动和 1489 名对照组）。结果表明，所有运动干预均能显著减轻 PD 患者的经期疼痛。在基于研究排名的 6 种运动干预方式中，抗阻运动和多组分运动的疼痛强度显著降低。多组分运动和伸展运动对经期症状的改善最佳，而核心力量训练和多组分运动对疼痛持续时间的影响最大。所有运动在 4 至 8 周的运动训练后均能显著减轻疼痛，抗阻运动在持续时间超过 8 周时效果最佳，其次是多组分运动和身心运动。每周 1 至 3 次的多组分运动和有氧运动改善效果更好，而增加运动频率则能提高抗阻运动的效果。抗阻运动在 30 分钟的训练时间内可以产生更好的效果，而多组分运动在训练时间超过 30 分钟时效果最佳。
本研究为运动干预治疗 PD 的疗效和有效性提供了定量见解。6 种不同的运动均对 PD 的管理有积极影响。我们的研究表明，这种运动训练引起的适应可能对 PD 患者有治疗益处；然而，这种改变和改善受到运动方案的影响。
