Table 3.

Summary of exercise and physical activity recommendations in the International Evidence-Based Guidelines for polycystic ovary syndrome (PCOS) [58, 59] (reproduced with permission)

Category	Recommendation	GRADEa
CCR	Health professionals should encourage and advise the following for prevention of weight gain and maintenance of health Adults (18–64 years), minimum of 150 min/week of moderate intensity physical activity or 75 min/week of vigorous intensity or an equivalent combination of both; includes muscle-strengthening activities on two non-consecutive days/wk Adolescents, at least 60 min of moderate to vigorous intensity physical activity/day, including those that strengthen muscle and bone at least 3 times weekly Perform activity in at least 10-min bouts or around 1,000 steps, aiming to achieve at least 30 min daily on most days	***
CCR	Health professionals should encourage and advise the following for modest weight loss, prevention of weight-regain and greater health benefits A minimum of 250 min/week of moderate intensity activities or 150 min/week of vigorous intensity or an equivalent combination of both, and muscle-strengthening activities involving major muscle groups on two non-consecutive days/week Minimized sedentary, screen, or sitting time	***
CPP	PCOS is a complex condition with numerous clinical features placing a significant burden on affected women. It is important that exercise and physical activity be included in the treatment plan for women with PCOS and supported by all members of the care team. The significant psychological burden associated with PCOS can impact the success of lifestyle therapy. Therefore, where appropriate referral to a certified professional should be considered as part of a chronic disease management plan. These certified exercise professionals should have a higher education (university) training (likely allied health practitioners) in developing personalized physical activity and formal exercise programs while addressing psychosocial barriers. The certified professionals are likely to be Certified Clinical Exercise Physiologist (ACSM; USA) Accredited Exercise Physiologist (ESSA; Australia) Certified Exercise Practitioner (BASES; UK) Physiotherapist or Physical Therapist (Europe)	N/A
CPP	Fitness instructors/personal trainers should be engaged after confidence and competence is established in exercise programs	N/A
CPP	Fitness devices and technologies could be used as an adjunct to support and promote active lifestyles and minimize sedentary behaviors (step counts and active minutes [79])	N/A

CCR Clinical Consensus Recommendation: In the absence of evidence, a clinical consensus recommendation (i.e. and agreed expert opinion) has been made by our guideline development group, CPP Clinical Practice Point: Evidence not sought. A practice point has been made by the guideline development group where important issues arose from discussion of evidence-based or clinical consensus recommendations, N/A not applicable

^*Conditional recommendation against the option

^**Conditional recommendation for either the option or the comparison

^***Conditional recommendation for the option

^****Strong recommendation for the option base GRADE frame work [61]

^aAs these recommendations are consensus statements evidence quality is considered low and no further assessment for quality was undertaken (see [58])