Effect of Aerobic Exercises in Improving Premenstrual Symptoms Among Healthy Women: A Systematic Review of Randomized Controlled Trials

Figures & data

Table 1 Search Strategy

Search Strategy Item	Search Strategy
Database	Cumulative Index for Nursing and Allied Health Literature, PubMed, Embase, PsyInfo, Opengrey and Google Scholar
Language filter	Studies published in English language
Time filter	From inception and up to February 2022
Keywords	Aerobic exercise or endurance exercise or swimming or walking or jogging or running or physical activity or physical exercise or exercise and premenstrual syndrome or premenstrual symptom or premenstrual tension and randomized controlled trial or comparative study

Figure 1 PRISMA flow diagram illustrating selection process.

Table 2 PEDro Scale Score of Included Studies

Author	Eligibility Criteria	Random Allocation	Concealed Allocation	Baseline Similarity	Blinded Subjects	Blinded Therapists	Blinded Assessors	Follow Up	Intention to Treat Analysis	Between Group Control	Point Measures	Total Score
Cicek 2018^Citation18	Yes	No	No	Yes	No	No	No	No	Yes	Yes	Yes	4/10
El-Lithy et al 2014^Citation19	Yes	Yes	No	Yes	No	No	No	No	Yes	Yes	Yes	5/10
Maged et al 2018^Citation23	Yes	Yes	No	Yes	No	No	No	No	Yes	Yes	Yes	5/10
Vaghela et al 2019^Citation21	Yes	Yes	Yes	Yes	No	No	No	No	Yes	Yes	Yes	5/10
Dehnavi et al 2018^Citation22	Yes	Yes	No	Yes	No	No	No	No	Yes	Yes	Yes	5/10

Figure 2 Risk of bias graph.

Figure 3 Risk of bias of included studies.

Table 3 Study Characteristics

Author	Aerobic Exercise			Comparison			Duration	Outcome	Result
	N	Mean Age (SD)	Intervention	N	Mean Age (SD)	Intervention
Cicek 2018^Citation18	100	23.07 (4.76)	Walk-running (3–5 days a week)	120	23.05 (4.77)	No exercises	16 weeks	Menstrual distress questionnaire	Premenstrual PMS scores were found higher in the non-exercising group than in the exercising group (P < 0.01). Water retention, negative affect, impaired concentration, behavioral change, arousal and control showed significant higher scores in the non-exercising group than in the exercising group for the premenstrual phase (P < 0.05 and P < 0.01)
El-Lithy et al 2014^Citation19	15	17.80 (1.47)	Treadmill walking (3 days per week)	15	18.14 (1.51)	Vitamin B6 and Ca supplement and instructed to avoid any major life-style changes	12 weeks	Modified premenstrual syndrome questionnaire, Haemoglobin, Red cell count, Haematocrit, MCV, MCH, MCHC, Platelet count	Aerobic exercise showed a significant decrease in all modified premenstrual syndrome questionnaire symptoms. Haemoglobin, hematocrit, red cell count and platelet were significantly increased, while MCV, MCH, MCHC and WBC showed no significant differences.
Maged et al 2018^Citation23	54	21.1 (2.33)	Swimming (30 min daily, 3 times/week)	46	21.15 (1.66)	Control	12 weeks	Premenstrual distress questionnaire, Daily Symptoms Report	Swimming is effective in improving physical and physiological symptoms of PMS
Vaghela et al 2019^Citation21	34	28.35 (8.57)	Aerobic exercises (40min, 3 times/week)	38	28.21 (6.91)	Yoga movements (40 min, 3 times a week)	4 weeks	Visual analogue scale, PMS scale	Significant reduction in PMS symptoms was found in patients treated with yoga compared to aerobic exercise; however, no significant difference was found in pain intensity between these two groups (P > 0.05).
Dehnavi et al 2018^Citation22	35	25.22 (4.41)	Swimming (20 min each session, 3 times/week)	35	24.06 (4.71)	Control group recorded their daily activities without having any exercises	8 weeks	Daily recorded physical symptoms of premenstrual syndrome	Aerobic exercise had significant improvement in improving headache (P = 0.001), nausea, constipation diarrhea (p = 0.01), swollen (p = 0/001), bloating (p = 0.01), Vomiting (p = 0.002), hot flashes (p = 0.04), increase in appetite (p = 0.008)

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Maged AM, Abbassy AH, Sakr HRS, et al. Effect of swimming exercise on premenstrual syndrome. Arch Gynecol Obstet. 2018;297(4):951–959. doi:10.1007/s00404-018-4664-1

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Cicek G. The effect of regular aerobic exercises on premenstrual syndrome in sedentary women. Balt J Health Phys Act. 2018;10(2):34–42. doi:10.29359/BJHPA.10.2.04

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El-Lithy A, El-Mazny A, Sabbour A, El-Deeb A. effect of aerobic exercise on premenstrual symptoms, haematological and hormonal parameters in young women. J Obstet Gynaecol. 2014;35(4):389–392. doi:10.3109/01443615.2014.960823

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