Table 2.
Characteristics of studies included in this systematic review
| Study (design) | N randomised/analysed | Intervention duration (assessment points) | Participant characteristics (PCOS diagnostic criteria) | Intervention | Outcome measures |
|---|---|---|---|---|---|
| Almenning et al. [32] (RCT) |
HIIT: 10/8 RT: 11/8 CON: 10/9 |
10 wks (baseline, 10 wks) | Age: 27.2 ± 5.5 y BMI: 26.7 ± 6.0 kg/m2 (Rotterdam) |
HIIT frequency: 3 times/wk HIIT intensity: 2 d/wk, 4 × 4 mins 90–95% HRmax/3 × 3 mins ~ 70% HRmax. 1 d/wk, 10 × 1 min ‘all-out’/10 × 1 min rest. RT frequency: 3 times/wk RT sets × reps: 3 × 10 RT load: 75% 1-RM |
HOMA-IR, FBG, FI, TG, TC, LDL-C, HDL-C VO2 max, RHR, BW, BMI, WC, BF%, FM, FFM, T, SHBG, FAI, hsCRP |
| Brown et al. [97] (RCT) |
EX: 21/8 CON: 16/12 |
20–24 wks due to varying length of ramp-up phase (baseline, immediately post) |
Age: 32.3 ± ns y BMI: 33.0 kg/m2 (NIH) |
Exercise: 12-wk moderate-intensity intervention preceded by 8–12-wk ramp-up. Aerobic duration: ~ 228 min/wk (≤ 60 bouts) Aerobic intensity: 40–60% VO2 max |
FBG, FI, HOMA-IR, TG, LDL-C, HDL-C, VO2 max, BW, BMI, WC, FT, SBP, DBP |
| Bruner et al. [98] (RCT) |
EX + DIET: 7/7 DIET: 5/5 |
12 wks (baseline, 12 weeks) |
Age: 30.7 ± 4.6 y BMI: 36.6 ± 6.0 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Aerobic intensity: 70–85% HRmax Aerobic duration: 30 mins (+ 10-min warm-up) RT sets × reps: 2–3 × 10–15 RT load: not specified Diet: 1 h/wk of nutritional counselling |
FI, QUICKI, VO2 max, BW, BMI, WC, T, SHBG, FAI |
| Guzick et al. [99] (RCT) |
EX + DIET: 6/6 CON: 6/6 |
12 wks (baseline, 12 weeks) |
Age: 31.7 ± 10.0 y BMI: ns (NIH) |
Exercise frequency: 5 times/wk Exercise intensity: 1050–4200 kJ/wk Diet: VLCD (8 wks) with calories increased over final 4 wks (4200–5040 kJ/d). ‘Optifast’ used to supplement diet |
FBG, FI, BW, WHR, T, SHBG, FT, LH, FSH |
| Hoeger et al. [100] (RCT) |
LS + PLA: 11/6 PLA: 9/7 LS + MF: 9/5 MF: 9/5 |
48 wks (baseline, 24 wks, 48 wks) |
Age: 28.5 ± 5.2 y BMI: 39.0 ± 6.1 kg/m2 (NIH) |
Exercise programme: Individualised to achieve 150 min per week Diet: Individualised healthy balanced meal plan to achieve 500–1000 kcal deficit per day Metformin: 850 mg 2 times/day |
BW, T, SHBG, FAI |
| Konopka et al. [102] (RCT) |
EX: 12/12 CON: 13/13 |
12 wks (baseline, 12 wks) |
Age: 35 ± 5.0 y BMI: 33.0 ± 5.0 kg/m2 (Rotterdam) |
Exercise frequency: 5 times/wk Exercise intensity: 65% VO2 peak Exercise duration: 60 min |
FBG, FI, HOMA-IR, BMI, BW, FM, FFM, E2 |
| Nasrekani et al. [104] (RCT) |
EX: 10/10 CON: 10/10 |
12 wks (baseline, 12 wks) |
Age: 30.4 ± 5.9 y BMI: 28.3 ± 6.2 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise intensity: 40–65% HRmax Exercise duration: 25–30 min |
VO2 max, BW, BMI, FSH, LH |
| Nybacka et al. [105, 106] (RCT) |
EX: 19/17 EX + DIET: 19/12 DIET: 19/14 |
4 months (baseline, 4 months) |
Age: 30.8 ± 5.2 y BMI: 36.0 ± 6.2 kg/m2 (Rotterdam) |
Exercise programme: Individualised to meet individuals’ capacity, goals and interest. Diet: ≥ 600 kcal/day reduction maintaining 55–60% CHO, 25–30% fat and 10–15% protein. |
FBG, FI, HOMA-IR, BW, BMI, WHR, BF%, FFM, T, SHBG, FT, E2, FSH, LH |
| Petranyi et al. [107] (QRCT) |
LS + MF: 29/29 MF: 27/27 |
6 months (baseline, 6 months) |
Age: 29 ± ns y BMI: 27.2 ± 6.9 kg/m2 (Rotterdam) |
Exercise programme: recommendation to increase physical activity levels. Specifics unclear. Diet: low glycaemic index diet with caloric restriction for those who are obese. Metformin: 500 mg 3 times/day |
BMI, WHR |
| Roessler et al. [34] (Randomised crossover) |
EX: 8/7 CON: 9/7 |
16 wks (baseline, 8 wks, 16 wks) |
Age: 31.7 ± 7.9 y BMI: 36.3 ± 7.2 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk (2 × cycle, 1 × walk) Exercise intensity: following 2-week ramp, cycling 20–180 s 80–100% HRmax/rest 25–180 s 45–65% HRmax. Walking 3–5 min 80–90% HRmax/1 min 50–60% HRmax. Exercise duration: 45 min (+ 10 min warm-up). Control: Group counselling sessions (2 h, 1 time/wk) focussing on barriers and motivation. |
VO2 max, BW, BMI, WC |
| Sa et al. [36, 108] (RCT) |
EX: 15/14 CON: 15/13 |
16 wks (baseline, 16 wks) |
Age: 26.0 ± 5.0 y BMI: 32.8 ± 4.6 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise intensity: 60–85% HRmax Exercise duration: 40 min (+ 5 min) |
SBP, DBP, FI, BMI, RHR, VO2 max, T, FSH, LH |
| Saremi et al. [109] (RCT) |
EX: 11/11 CON: 11/11 |
8 wks (baseline, 8 wks) |
Age: 35.2 ± 4.4 y BMI: 28.3 ± 4.3 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise intensity: 40–65% HRmax Exercise duration: 30 min |
FBG, FI, HOMA-IR, TG, TC, LDL-C, HDL-C, VO2 peak, BW, BMI, BF%, WC, WHR |
| Saremi et al. [110] (RCT) |
EX + PLA: 10/10 CON: 10/10 EX + CAL: 10/10 |
8 wks (baseline, 8 wks) |
Age: 27.1 ± 5.1 y BMI: 25.5 ± 2.7 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk RT sets x reps: 1–2 × 15–20 RT load: 40–60% 1-RM |
FBG, FI, HOMA-IR, TG, TC, LDL-C, HDL-C, BW, BMI |
| Stener-Victorin et al. [101, 103, 111–113] (RCT) |
EX: 34/22 CON: 17/13 ACU: 33/24 |
16 wks (baseline, 16 wks, 32 wks) |
Age: 30 ± 4.4 y BMI: 28.1 ± 7.3 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise intensity: HR ≥ 120 BPM Exercise duration: 30–45 min Low-frequency electroacupuncture: 14 × 30 min treatments over 16 wks |
SBP, DBP, FBG, FI, HOMA-IR, TG, TC, LDL-C, HDL-C, BMI, WHR, T, FT, SHBG, FAI, LH, FSH, VO2 max, BMI, E2 |
| Thomson et al. [33, 114–116] (RCT) |
AET + DIET: 31/18 AET + RT + DIET: 33/20 DIET: 30/14 |
20 weeks (baseline, 10 wks, 20 wks) | Age: 29.3 ± 6.8 y BMI: 36.1 ± 4.8 kg/m2 (Rotterdam) |
Exercise frequency: 5 times/wk (3 × aerobic, 2 × RT in combined exercise group) Aerobic intensity: 60–65% HRmax progressed to 75–80% HRmax by study end Aerobic duration: 25–30 min progressed to 45 mins by study end RT sets × reps: 3 × 12 RT load: 50–60% 1-RM progressed to 65–75% 1-RM after 2 wks Diet: energy restricted high protein diet (5000–6000 kJ/day) |
SBP, DBP, FBG, FI, HOMA-IR, TG, TC, LDL-C, HDL-C, BW, BF%, FM, FFM, WC, T, SHBG, FAI, PCOS-Q |
| Turan et al. [117] (RCT) |
EX: 16/14 CON: 16/16 |
8 wks (baseline, 8 wks) |
Age: 24.5 ± 2.8 y BMI: 21.9 ± 3.5 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise duration: 50–60 min Aerobic intensity: 65–70% HRmax RT sets x reps: 1 × 15 RT load: 5–6 on RPE for RT scale |
SBP, DBP, FBG, HOMA-IR, FI, TG, TC, HDL-C, LDL-C, BMI, WC, RHR, VO2 max, T, FT, E2, LH, FSH |
| Vigorito et al. [118] (RCT) |
EX: 45/45 CON: 45/45 |
3 months (baseline, 3 months) |
Age: 21.8 ± 2.1 y BMI: 29.4 ± 3.2 kg/m2 (Rotterdam) |
Exercise frequency: 3 times/wk Exercise intensity: 60–70% VO2 max Exercise duration: 30 min |
SBP, DBP, FBG, FI, TG, TC, LDL-C, HDL-C, VO2 max, RHR, BMI, WC, E2, T, FT, SHBG, FAI, LH, FSH, CRP |
| Vizza et al. [119] (RCT) |
EX: 8/7 CON: 7/6 |
12 wks (baseline, 12 wks) |
Age: 27 ± 5.0 y BMI: 37.8 ± 11.4 kg/m2 |
Exercise frequency: 4 times/wk (2 × RT, 2 home-based) RT sets × reps: 2–3 × 8–12 RT load: Progressed with strength gains Home-based: Callisthenics, 3 sets of 10 reps |
FBG, FI, HOMA-IR, BW, BMI, WC, FM, FFM, BF%, hsCRP, T, SHBG, FAI, PCOS-Q, SF-36 |
Studies presented by lead author and year of publication. Design; RCT randomised controlled trial, QRCT quasi-randomised controlled trial. N randomised the number of participants randomised into each study arm at the study initiation, analysed is the number of participants included within the analysis, HIIT high-intensity interval training, RT resistance training, CON control group, EX exercise group, DIET dietary intervention, LS lifestyle, PLA placebo, MF metformin, ACU acupuncture, AET aerobic exercise training, CAL calcium supplementation. Intervention duration length of the duration, assessment points the time-points at which researchers have assessed outcome measures. Participant characteristics presented as mean ± standard deviation (SD) or median in one study [97] for age (in years, y) and BMI (kg/m2) at study entry, ns not specified. Diagnostic criteria the specific criteria used to confirm a PCOS diagnosis, NIH National Institute of Health (1990) diagnostic criteria, Rotterdam European Society for Human Reproductive and Embryology/American Society for Reproductive Medicine (2003). Outcome measures refers to the outcomes from each study that are relevant to this systematic review. VO2 max maximum oxygen uptake, RHR resting heart rate, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, TC total cholesterol, TG triglycerides, FBG fasting blood glucose, FI fasting insulin, HOMA-IR homeostatic assessment of insulin resistance, QUICKI quantitative insulin sensitivity check index, FM fat mass, FFM fat-free mass, BF% body fat percentage, BW body weight, BMI body mass index, WC waist circumference, WHR waist-to-hip ratio, SHBG sex hormone binding globulin, FAI free androgen index, T testosterone, FT free testosterone, E2 oestradiol, LH luteinising hormone, FSH follicle stimulating hormone, SBP systolic blood pressure, DBP diastolic blood pressure, hsCRP high-sensitivity C-reactive protein, d day, mins minutes, wk week, reps repetitions, RM maximum number of repetitions, HRmax maximum heart rate, PCOS-Q PCOS health-related questionnaire, SF-36 Optum36-item Short Form Survey, VLCD very low calorie diet, CHO carbohydrate