Fani 2019.

Study characteristics
Methods	Study design: RCT Funding: Isfahan University of Medical Sciences Published protocol/trial registration: no
Participants	20 women with mild and moderate IBS enrolled in a controlled clinical trial performed at the Musculoskeletal Disorders Research Center of the rehabilitation faculty of Isfahan University of Medical Sciences Number randomised: 20 Age: intervention: mean 29.1 (SD 6.8) years; control: mean 32.7 (SD 10.3) years % Female: 100% SES and ethnicity: unmarried 45%; diploma or higher (educational status) 100% Inclusion criteria Women with mild and moderate IBS Being able to increase the level of physical activity Aged 18–65 years Stable baseline blood pressure Exclusion criteria Doing aerobic exercises History of rheumatic diseases in lower limb History of metabolic diseases; neurological disorders; cardiovascular problems; and respiratory, renal and lung problems that would prevent them from participating in aerobic exercises History of knee injury or knee surgery during past year History of joint replacement in any of the joints of the lower limb History of fracture in the lower limb during the past 6 months Having clinical symptoms of osteoarthritis in the joints of hip, knee, ankle and foot Major vision disorders Hereditary or acquired musculoskeletal disorders in lower limb Organic GI disorders Using drugs that would affect metabolism or balance Using assistive devices for walking Pregnancy Recruitment: referred to the centre by gastroenterologists from across the city Recruitment rate: not reported Region: Isfahan, Iran
Interventions	Number of experimental conditions: 2; exercise intervention and usual activities control Number of participants (analysed): intervention: 10; control: 10 Description of intervention: treadmill exercises 3 times per week for 6 weeks. Target and maximum heart rate were calculated (target heart rate = 70% maximum heart rate, maximum heart rate = 220 – age). Treadmill used was able to record heart rate by participant placing her hands on treadmill handles. Participants walked at slow speed for 5 minutes to warm‐up. Then increased speed until they reached the target heart rate and maintained it for 20 minutes. Then walked for 5 minutes at slow speed to cool‐down. Treadmill used with supervision of physiotherapist in all sessions. Duration: 6 weeks Number of contacts: 18 Setting: university Modality: supervised Interventionist: physiotherapist Integrity: – Date of study: not reported Description of control: usual daily activities
Outcomes	IBS symptoms (IBS‐SSS) IBS quality of life (IBS‐QOL) Primary or secondary not specified Outcome relating to reported adverse events: not reported Outcome assessment time points: 6 weeks – end of intervention Preplanned subgroup analyses: none Unplanned subgroup analyses: – Lost to follow‐up: none Analysis: 0 dropouts, therefore ITT
Notes	MCID is not specifically given for any measured outcomes but methods stated clinical severity of IBS symptoms was categorised into mild (40%), moderate (35%) and severe (25%) groups based on a score of 75–175 (mild), 175–300 (moderate) and > 300 (severe) from the IBS‐SSS questionnaire. No reference to severity in the results or discussion.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information.
Allocation concealment (selection bias)	Unclear risk	Insufficient information.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Group allocation not blinded to participants, clinicians or researchers. However, it was not possible to blind participants and personnel for this intervention.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Group allocation was not blinded to participants, clinicians or researchers.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No reported dropouts.
Selective reporting (reporting bias)	Unclear risk	No protocol or trial registration to determine whether outcomes reported were preplanned.
Other bias	Unclear risk	Insufficient details about baseline characteristics (e.g. other morbidities impacting on outcomes) and no information on covariate analysis.