A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

BackgroundPaclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence.MethodsBiomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN.ResultsOf 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1).ConclusionCurrent evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.

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Compression Therapy Using Surgical Gloves Does Not Prevent Paclitaxel-induced Peripheral Neuropathy: Results From a Double-blind Phase 2 Trial

10.21203/rs.3.rs-77419/v1 ◽

2020 ◽

Author(s):

Haruru Kotani ◽

Mitsuo Terada ◽

Makiko Mori ◽

Nanae Horisawa ◽

Kayoko Sugino ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Primary Outcome ◽

Compression Therapy ◽

University Hospital ◽

Double Blind Study ◽

Double Blind ◽

Prophylactic Measure ◽

Weekly Chemotherapy ◽

Surgical Gloves ◽

And Control

Abstract Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of paclitaxel (PTX). There is no known prophylactic measure, although there are some reports of prevention with compression therapy using surgical gloves. On account of its predominantly subjective symptoms, it is difficult to exclude bias when assessing for CIPN. In this study, we assessed the effectiveness of the same procedure for the prevention of paclitaxel-induced PN based on a double-blind study design.Methods: The patients with early and recurrent breast cancer (with no prior PTX exposure) initiating weekly chemotherapy with PTX 80 mg/m2 were enrolled. Each patient donned two gloves on each hand at every PTX infusion. Two one-size-smaller gloves were donned on one hand (study side) and two normal-size gloves were donned on the other hand (control side) during 90 minutes from 30 minutes before the infusion to 30 minutes after the end of the infusion. Study side are blind for both patients and assessing physicians according to determination of the study side by research nurses in the chemotherapy unit.The primary outcome was the difference in the frequency of CIPN (motor/sensory) determined by the physician using the common terminology criteria for adverse events (CTCAE v4.0), with an evaluation at each cycle of PTX infusion. McNemar test was used to assess the primary outcome.Results: Between July 2017 and November 2018, 56 patients were enrolled and 49 patients were evaluated. Overall, Grade ≥ 2 PN (sensory) was observed in 30.6% and 36.7% in the study and control sides, respectively (McNemar p = 0.25). PN (motor) was observed in 4.1% and 6.1% in the study and control sides, respectively (McNemar p = 1.0). Conclusion: Surgical glove compression therapy showed no statistically significant effect on the incidence of PTX-induced PN.Trial registrations: This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry managed by the National University Hospital Council of Japan (UMIN000027944).

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Subclinical Atherosclerosis in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis

Angiology ◽

10.1177/0003319716652031 ◽

2016 ◽

Vol 68 (5) ◽

pp. 447-461 ◽

Cited By ~ 22

Author(s):

Guo-Cui Wu ◽

Rui-Xue Leng ◽

Qi Lu ◽

Yin-Guang Fan ◽

De-Guang Wang ◽

...

Keyword(s):

Systematic Review ◽

Inflammatory Bowel Diseases ◽

Meta Analysis ◽

Subclinical Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Current Evidence ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

And Control

We evaluated the differences in major markers of cardiovascular (CV) risk between inflammatory bowel diseases (IBDs) and controls by a systematic review and a meta-analysis. We searched PubMed, EMBASE, and Cochrane databases for literature comparing CV risk markers in IBDs and controls. The overall mean carotid intima–media thickness (CIMT), flow-mediated dilation (FMD%), and carotid–femoral pulse wave velocity (cfPWV) difference between patients with IBDs and control groups were calculated. Twenty-eight studies were included in the meta-analysis, including 16 studies with data on CIMT, 7 studies reporting FMD%, and 9 studies on cfPWV. Compared to controls, patients with IBDs showed significantly higher CIMT (standardized mean difference [ SMD]: 0.534 mm; 95% confidence interval [CI], 0.230 to 0.838; P = .001), significantly lower FMD% ( SMD, −0.721%; 95% CI, −1.020 to −0.421; P < .0001), and significantly increased cfPWV ( SMD, 0.849; 95% CI, 0.589 to 1.110; P < .0001). When analyzing subgroups with ulcerative colitis and Crohn disease (CD), all results were still significant except CIMT in CD. Our findings support the current evidence for an elevated CV burden in patients with IBD and support the clinical utility of markers of subclinical atherosclerosis in the management of these patients.

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A Meta-Analysis of Choroidal Thickness Changes in Unilateral Amblyopia

Journal of Ophthalmology ◽

10.1155/2017/2915261 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Yanli Liu ◽

Yi Dong ◽

Kanxing Zhao

Keyword(s):

Choroidal Thickness ◽

Primary Outcome ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Enhanced Depth Imaging ◽

Weighted Mean ◽

Cross Sectional ◽

Depth Imaging ◽

Imaging Optical Coherence Tomography ◽

And Control

Purpose. To date, the topic of amblyopic changes remains controversial. Therefore, a systematic review and meta-analysis were carried out to evaluate choroidal changes in unilateral amblyopia. Methods. Major literature databases were searched for amblyopia-relevant studies. Using enhanced depth imaging optical coherence tomography (EDI-OCT), the primary outcome parameters examined were subfoveal choroidal thickness (SFCT) and different choroidal thickness (CT) positions. Efficacy estimates were evaluated by weighted mean difference (WMD) and 95% confidence interval (CI) for choroidal-associated changes. We performed subgroup analysis and metaregression analysis to examine potential sources of heterogeneity. Results. Eleven cross-sectional studies that included a total of 768 participants were identified. The amblyopic eye SFCT was thicker than that of the fellow and control (normal) eyes (WMDamblyopia versus fellow=49.24, 95% CI of 30.22 to 68.27, p<0.001; WMDamblyopia versus control=54.51, 95% CI of 32.17 to 76.85, p<0.001). There were no differences between the fellow and control eyes (WMD=13.81, 95% CI of 1.16 to 28.77, p=0.071). Subgroup and metaregression analyses indicated that the OCT type was the main source of heterogeneity. Conclusions. The CT in the amblyopic eyes was thicker than that in the fellow and control eyes.

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Effects of Tea Consumption on Anthropometric Parameters, Metabolic Indexes and Hormone Levels of Women with Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Frontiers in Endocrinology ◽

10.3389/fendo.2021.736867 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wenjuan Shen ◽

Yujia Pan ◽

Bao Jin ◽

Zongyu Zhang ◽

Tianjiao You ◽

...

Keyword(s):

Systematic Review ◽

Body Weight ◽

Randomized Controlled Trials ◽

Green Tea ◽

Random Effects ◽

Meta Analysis ◽

Biomedical Literature ◽

Controlled Trials ◽

Random Effects Model ◽

Randomized Controlled

ObjectiveOur aim was to conduct a systematic review and meta-analysis to assess the effectiveness and safety of tea supplements for patients with polycystic ovary syndrome (PCOS).MethodsWe conducted searches of the published literature in PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), VIP database, and Wanfang Database in 1985 to September 2021. Data from randomized controlled trials (RCTs) were obtained to assess the effects of tea versus placebo in women with PCOS. Weighted mean differences (WMDs) were pooled using a random-effects model or risks ratios (RRs) using a random-effects model.ResultsSix RCTs (235 participants) were included in our systematic review. Tea supplements as adjuvant therapy led to greater improvement in body weight (WMD −2.71, 95% CI −4.95 to −0.46, P = 0.02, I2 = 0%), fasting blood glucose (FBG: WMD −0.40, 95% CI −0.59 to −0.20, P < 0.0001, I2 = 0%) and fasting insulin (FINS: WMD −3.40, 95% CI −4.76 to −2.03, P < 0.00001, I2 = 0%) when compared with placebo. There were no significant differences of body mass index, waist circumference, hip circumference, waist-to-hip ratio (WHR), body fat rate, total testosterone, free testosterone (FT), dehydroepiandrosterone, luteinizing hormone or follicular-stimulating hormone (FSH) between the two groups. In addition, subgroup analysis suggested that green tea was effective on body weight, FINS, FBG, FT, and FSH, and herbal tea can also reduce FT levels, tea supplements had a significant impact on FBG and FSH in trials with intervention duration ≥ 3 months, and intervention lasting less than 3 months can improve FINS. Tea had significant effect on reducing WHR, FBG and FSH in Asian PCOS patients, but not in Caucasians. And there was no statistically significant effect of tea on weight and FINS in Asians, but it was effective for Caucasian participants. Compared with placebo, tea supplements did not cause significant adverse reactions (RR 1.45, 95% CI 0.30 to 6.90, P = 0.65, I2 = 0%).ConclusionThis meta-analysis suggests that consumption of tea supplementation in women with PCOS could significantly decrease the levels of FBG and FINS as well as reduce body weight. Especially green tea, not only has the above effects, but also has a significant effect on improving a variety of reproductive hormone indexes. Furthermore, tea supplementation is a relatively safe therapy for PCOS patients. Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=212755, identifier CRD42021249196.

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Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-046966 ◽

2021 ◽

Vol 11 (10) ◽

pp. e046966

Author(s):

Nan Zhao ◽

Jingcan Xu ◽

Qiuhong Zhou ◽

Xinyi Li ◽

Jiarui Chen ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Neuropathy ◽

Sensitivity And Specificity ◽

Diabetic Peripheral Neuropathy ◽

Tuning Fork ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Traditional Methods ◽

Registration Number

ObjectiveDiabetic peripheral neuropathy (DPN) is one of the most important risk factors of diabetic foot ulcers, and early screening and treatment of DPN are crucial. The Ipswich Touch Test (IPTT) is a new method for screening for DPN and, compared with traditional methods, is more simple to operate and requires no equipment. However, the screening accuracy of IPTT in patients with DPN has not been well characterised. We aim to conduct a systematic review and meta-analysis to characterise the sensitivity and specificity of IPTT compared with traditional methods and to understand the potential screening value of IPTT.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database up to 16 April 2020.MethodsStata V.15.1 software was used for analysis, and the screening value of IPTT in DPN was described using 10 g monofilament (10g-MF), neuropathy disability scores (NDS), Pin prick, 128 Hz tuning fork, and ankle reflex as reference standards. Sensitivity, specificity and other measures of accuracy of IPTT for screening DPN were pooled based on a quality effects model. The protocol was registered with PROSPERO (42020168420).ResultsOf the 441 records retrieved, 7 studies were evaluated for the screening value of IPTT. Five studies with 10g-MF as the reference standard were included in the meta-analysis, and the pooled sensitivity and specificity were 0.77 (95％CI 0.69–0.84) and 0.96(95％CI 0.93–0.98), respectively, and the area under curve was 0.897. Compared with vibration perception threshold, IPTT showed a sensitivity between 0.76 and 1, and a specificity between 0.90 and 0.97. Compared with NDS, IPTT showed a sensitivity between 0.53 and 1, and a specificity between 0.90 and 0.97. Compared with Pin prick, IPTT showed a sensitivity and specificity of 0.8 and 0.88, respectively. Compared with 128 Hz tuning fork, IPTT showed a sensitivity and specificity of 0.4 and 0.27, respectively. Compared with ankle reflex, IPTT had a sensitivity of 0.2 and a specificity of 0.97.ConclusionsIPTT shows a high degree of agreement with other commonly used screening tools for DPN screening. It can be used clinically, especially in remote areas and in primary medical institutions, and by self-monitoring patients. More high-quality studies are needed to assess and promote more effective screening practices.PROSPERO registration numberRegistration Number is CRD (42020168420).

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Efficacy and Safety of Chaihu Jia Longgu Muli Decoction in the Treatment of Poststroke Depression: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/7604537 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Renhong Wan ◽

Ruiwen Song ◽

Yihua Fan ◽

Linhui Li ◽

Jiangxin Zhang ◽

...

Keyword(s):

Oral Administration ◽

Barthel Index ◽

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Biomedical Literature ◽

Current Evidence ◽

Efficacy And Safety ◽

Poststroke Depression ◽

Significant Difference

Objective. Chaihu Jia Longgu Muli decoction (CLMD) is widely used in the treatment of poststroke depression (PSD) in China. Some evidences show that it has advantages, but there lacks reliable evidence. This study aims to systematically evaluate the efficacy and safety of CLMD in the treatment of PSD. Methods. All randomized controlled trials (RCTs) of CLMD in the treatment of PSD were searched from the following databases: PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and Chinese Biomedical Literature Service System (CBM), from their inception to May 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software. Results. A total of 13 RCTs involving 1665 patients were finally included in this study, among which 5 RCTs were oral CLMD alone versus antidepressants, and 8 RCTs were oral CLMD with antidepressants versus antidepressants. Meta-analysis results showed that oral administration of CLMD could improve Hamilton’s Depression Scale (HAMD) and the Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, improve the Barthel index, and have a low rate of adverse reactions, but there was no significant difference in the total effective rate ( p = 0.21 > 0.05) and the National Institute of Health Stroke Scale (NIHSS) score ( p = 0.47 > 0.05) between the antidepressants group and the oral administration of the CLMD group. Oral CLMD combined with antidepressants could improve the total effective rate, HAMD, and MESSS score, but there was no significant difference in Barthel index ( p = 0.06 > 0.05) and the adverse reaction rate ( p = 0.14 > 0.05) between the two groups. Conclusion. Current evidence suggests that oral CLMD alone or with antidepressants is more effective and safer in the treatment of PSD than oral antidepressants. Due to the limitation of the quality and quantity of the included studies, more high-quality studies are needed to confirm the above conclusion.

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Effectiveness of Cognitive Behavioural Therapy for Suicide in Schizophrenia: A Systematic Review

Current Psychiatry Research and Reviews ◽

10.2174/2666082218666211220164527 ◽

2021 ◽

Vol 18 ◽

Author(s):

Rafael Penadés ◽

Florencia Forte ◽

Gisela Mezquida ◽

Alexandre González Rodríguez ◽

Clemente García-Rizo ◽

...

Keyword(s):

Suicide Prevention ◽

Cognitive Behavioural Therapy ◽

Primary Outcome ◽

Meta Analysis ◽

Scientific Evidence ◽

Behavioural Therapy ◽

Primary Outcome Measure ◽

Current Evidence ◽

Adherence To Medication ◽

Cognitive Behavioural

Background: Suicide is probably one of the worst potential complications for people with schizophrenia. Even though the use of antipsychotic medication is essential in reducing suicidal behaviour, the use of psychological treatments seems to be in the same way necessary. Cognitive Behavioural Therapy (CBT) is an evidence-based form of psychotherapy that is constantly trying to synchronise with the latest recommendations from the research. The goal of the present work is to systematically review the scientific evidence from published studies testing the effectiveness of CBT designed to deal with suicide in patients with schizophrenia. Methods: We searched using multiple terms related to suicide prevention based on CBT in schizophrenia. Two databases (Medline and SCOPUS) were scrutinised for the electronic search and different reference lists from previous reviews were also hand checked. Results: We identified 5 randomised and controlled trials of CBT that included suicide-related cognitions or behaviours as a primary outcome measure. CBT focusing on suicidal cognitions and behaviours was found to be effective in reducing suicidal ideation. As the number of studies fulfilling the inclusion criteria is small and the assessment of outcomes is heterogeneous, we did not perform a meta-analysis and we present results in a narrative way. Conclusion: Research on CBT focused on suicide prevention in patients with schizophrenia is promising but current evidence is notoriously insufficient. Although those therapies seemed to be efficacious in the prevention of suicide, scarcity of randomised clinical trials specifically focusing on suicide is probably the most important issue to be faced. Given the current evidence, clinicians should be familiar with CBT techniques focusing on suicidal cognitions. However, suicide prevention and treatment in those with schizophrenia is complex, and many other factors such as possible earlier use of clozapine, optimizing adherence to medication, and other psychosocial aspects should be addressed. Combination of different strategies appears to be mandatory.

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A Systematic Review and Meta-Analysis on the Association between Hypertension and Tinnitus

International Journal of Hypertension ◽

10.1155/2015/583493 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Pan Yang ◽

Wenjun Ma ◽

Yiqing Zheng ◽

Haidi Yang ◽

Hualiang Lin

Keyword(s):

Risk Factor ◽

Odds Ratio ◽

Prevention And Control ◽

Web Of Science ◽

Meta Analysis ◽

Sufficient Information ◽

Random Effects Model ◽

Hypertension Prevention ◽

Meta Regression ◽

And Control

Hypertension has been suggested to be one possible risk factor of tinnitus, but the association between hypertension and tinnitus remains uncertain. The authors performed a meta-analysis of the existing studies on the association between hypertension and tinnitus. We performed literature search of studies using SinoMed, CNKI, WanFang, PubMed, Scopus, Web of Science, and Google Scholar. Studies reported the odds ratio and 95% confidence interval (CI) (or provided sufficient information for calculation) of the association between hypertension and tinnitus were included. A total of 19 eligible studies with 20 effect estimates were used in this study. They included 63,154 participants with age ranging from 14 to 92. The pooled OR, which was pooled using a random effects model, was 1.37 (95% CI: 1.16 to 1.62). There was no evidence of publication bias (p=0.11for Begg’s test,p=0.96for Egger’s test). By meta-regression, we found that study design may be one possible factor of heterogeneity. Sensitivity analysis found that the result was stable. This study suggests that hypertension might be one risk factor of tinnitus, and hypertension prevention and control might be helpful in preventing tinnitus.

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Mesenchymal stem cell transplantation after acute myocardial infarction: a meta-analysis of clinical trials

Stem Cell Research & Therapy ◽

10.1186/s13287-021-02667-1 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Armin Attar ◽

Fateme Bahmanzadegan Jahromi ◽

Shahin Kavousi ◽

Ahmad Monabati ◽

Asma Kazemi

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Outcomes ◽

Primary Outcome ◽

Meta Analysis ◽

Cell Number ◽

Time Interval ◽

Mesenchymal Stem Cell Transplantation ◽

And Control

Abstract Background Trials investigating the role of mesenchymal stem cells (MSCs) in increasing ejection fraction (LVEF) after acute myocardial infarction (AMI) have raised some controversies. This study was conducted to find whether transplantation of MSCs after AMI can help improve myocardial performance indices or clinical outcomes. Methods Randomized trials which evaluated transplantation of MSCs after AMI were enrolled. The primary outcome was LVEF change. We also assessed the role of cell origin, cell number, transplantation time interval after AMI, and route of cell delivery on the primary outcome. Results Thirteen trials including 956 patients (468 and 488 in the intervention and control arms) were enrolled. After excluding the biased data, LVEF was significantly increased compared to the baseline among those who received MSC (WMD = 3.78%, 95% CI: 2.14 to 5.42, p < 0.001, I2 = 90.2%) with more pronounced effect if the transplantation occurred within the first week after AMI (MD = 5.74%, 95%CI: 4.297 to 7.183; I2 = 79.2% p < 0.001). The efficacy of trans-endocardial injection was similar to that of intracoronary infusion (4% [95%CI: 2.741 to 5.259, p < 0.001] vs. 3.565% [95%CI: 1.912 to 5.218, p < 0.001], respectively). MSC doses of lower and higher than 107 cells did not improve LVEF differently (5.24% [95%CI: 2.06 to 8.82, p = 0.001] vs. 3.19% [95%CI: 0.17 to 6.12, p = 0.04], respectively). Conclusion Transplantation of MSCs after AMI significantly increases LVEF, showing a higher efficacy if done in the first week. Further clinical studies should be conducted to investigate long-term clinical outcomes such as heart failure and cardiovascular mortality.

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Exercise for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials

BJGP Open ◽

10.3399/bjgpopen20x101032 ◽

2020 ◽

Vol 4 (3) ◽

pp. bjgpopen20X101032 ◽

Cited By ~ 1

Author(s):

Emma Pearce ◽

Kate Jolly ◽

Laura L Jones ◽

Gemma Matthewman ◽

Mandana Zanganeh ◽

...

Keyword(s):

Systematic Review ◽

Premenstrual Syndrome ◽

Randomised Controlled Trials ◽

Primary Outcome ◽

Meta Analysis ◽

Current Evidence ◽

Controlled Trials ◽

Cochrane Central Register ◽

Exercise Interventions ◽

Randomised Controlled

BackgroundExercise is recommended as a treatment for premenstrual syndrome (PMS) in clinical guidelines, but this is currently based on poor-quality trial evidence.AimTo systematically review the evidence for the effectiveness of exercise as a treatment for PMS.Design & settingThis 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.MethodRandomised 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.ResultsA 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 (I2 = 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.ConclusionBased on current evidence, exercise may be an effective treatment for PMS, but some uncertainty remains.

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