Table 1_Efficacy and safety of therapeutic exercise for primary dysmenorrhea: a systematic review and meta-analysis.docx

ObjectiveA growing number of research papers have looked at the influence of exercise on pain severity in people with primary dysmenorrhea, but the findings have been inconsistent. The purpose of this research was to thoroughly evaluate the impact of exercise on pain severity in individuals with primary dysmenorrhea and to find the best exercise regimen for these patients.
MethodsAll randomized controlled trials (RCTs) of exercise for patients with primary dysmenorrhea were searched in the Embase, PubMed, Cochrane, Web of Science, EBSCO, and CINAHL databases. The search time limit was set from the establishment of each database to 28 January 2025. Control groups included those receiving usual care, only providing health education, or no intervention at all. The outcome measure was pain intensity. The effect size was aggregated using the mean difference (MD) and 95% confidence interval (CI). The methodological quality of the included studies was evaluated using the Cochrane risk-of-bias tool. Stata 15 software was used for meta-analysis, sensitivity analysis, and assessment of potential publication bias. R 4.4.1 software was used for network meta-analysis, area under curve ranking (SUCRA), league plot, and meta-regression.
ResultsThe analysis included a total of 29 studies that satisfied the criteria. Exercise decreased the visual analog scale (VAS, WMD = −2.62, 95% CI [−3.29, −1.95], p < 0.001) score in individuals with primary dysmenorrhea. Strength training (WMD = −1.76, 95% CI [−2.03, −1.48], p < 0.001), exercise duration of ≥8 weeks (WMD = −1.77, 95% CI [−1.87, −1.66], p < 0.001), frequency of >3 times per week (WMD = −1.60, 95% CI [−1.75, −1.45], p < 0.001), session length of >30 min (WMD = −2.20, 95% CI [−2.38, −2.02], p < 0.001), and a total of ≥90 min per week (WMD = −2.04, 95% CI [−2.19, −1.89], p < 0.001) showed superior efficacy in enhancing VAS (subgroup analyses).
ConclusionEngaging in physical activity may reduce the intensity of discomfort encountered by individuals afflicted with primary dysmenorrhea, with strength training potentially emerging as the most efficacious alternative. The meta-analysis presents evidence that supports clinicians’ advice to patients with primary dysmenorrhea, recommending that they exercise for a minimum of 8 weeks, with sessions occurring more than three times weekly and lasting longer than 30 min each. The goal is to achieve a minimum weekly total of 90 min by increasing the frequency of workouts.
Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024581879, CRD42024581879.

研究背景与目的：当前已有大量研究探讨运动对原发性痛经患者疼痛严重程度的影响，但相关研究结论尚存分歧。本研究旨在全面系统地评估运动对原发性痛经患者疼痛严重程度的干预效果，并筛选适用于该类患者的最优运动方案。
方法：本研究检索了Embase、PubMed、Cochrane、Web of Science、EBSCO及CINAHL数据库中所有针对原发性痛经患者实施运动干预的随机对照试验（randomized controlled trial, RCT），检索时限设置为各数据库建库起至2025年1月28日。对照组干预措施包括常规护理、仅提供健康教育或无任何干预措施。本研究的主要结局指标为疼痛强度。采用均数差（mean difference, MD）及95%置信区间（confidence interval, CI）合并效应量。采用Cochrane偏倚风险工具评价纳入研究的方法学质量。使用Stata 15软件开展元分析（meta-analysis）、敏感性分析及潜在发表偏倚评估；使用R 4.4.1软件完成网络元分析、累积排序曲线下面积（SUCRA）、league plot及元回归分析。
结果：本研究共纳入符合纳入标准的29项研究。运动干预可降低原发性痛经患者的视觉模拟评分法（visual analog scale, VAS）得分（加权均数差（weighted mean difference, WMD）= -2.62, 95%CI [-3.29, -1.95], p < 0.001）。亚组分析显示，力量训练（WMD = -1.76, 95%CI [-2.03, -1.48], p < 0.001）、运动干预时长≥8周（WMD = -1.77, 95%CI [-1.87, -1.66], p < 0.001）、每周运动频率>3次（WMD = -1.60, 95%CI [-1.75, -1.45], p < 0.001）、每次运动时长>30分钟（WMD = -2.20, 95%CI [-2.38, -2.02], p < 0.001）以及每周总运动时长≥90分钟（WMD = -2.04, 95%CI [-2.19, -1.89], p < 0.001）均能更有效地改善VAS评分。
结论：进行身体活动可减轻原发性痛经患者的疼痛不适程度，其中力量训练或为最优干预方式。本元分析结果可为临床医生向原发性痛经患者提供运动建议提供循证依据：建议患者坚持运动至少8周，每周运动次数超过3次，每次运动时长超过30分钟，通过提升运动频率实现每周总运动时长≥90分钟的目标。
系统评价注册信息：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024581879，注册号为CRD42024581879。