Effect of programmed exercise on perceived stress in middle-aged and old women: A meta-analysis of randomized trials

Objective To clarify the effect of programmed exercise (PE), performed for at least six weeks, on perceived stress (PS) in middle aged and old women. Methods A structured search was carried out in PubMed, Embase, Cochrane Library, Scielo, Web of Science and Scopus, from database inception through January 10, 2018, without language restriction. The US, UK, and Australian clinical trials databases were also searched. The search included a combination of the terms “programmed exercise”, “perceived stress”, “menopausal women” and “randomized controlled trial” (RCTs). PE was classified according to duration as “mid-term exercise intervention” (MTEI; mean duration 6 months), and “long-term exercise intervention” (LTEI; mean duration 12 months). Mean ± standard deviations of changes in PS scores, as assessed with different questionnaires, were calculated as standardized mean differences (SMDs) and used as effect size for meta-analysis. SMDs of PS after intervention were pooled using a random-effects model. Study quality and bias risk were assessed with the Cochrane tool. Results Five RCTs that studied midlife and older women (mean age 47.0 ± 1.7 years minimum to 71.8 ± 5.6 maximum) were included in the meta-analysis. There was no significant effect of PE on PS score (SMD: −0.16; 95% CI: −0.43 to 0.11). In subgroup analyses, there was no significant effect of PE on PS with mid-term interventions (SMD: − 0.17; 95% CI: −0.59 to 0.25) nor with long-term interventions (SMD: −0.02; 95% CI: −0.42 to 0.38) as compared with controls. Conclusion PE of low to moderate intensity does not improve PS in midlife and older women.