The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials

In addition to a range of physiological and psychological symptoms, menopause causes a decrement to balance performance and risk of falls. This review aimed to determine the effects of exercise interventions on balance in perimenopausal and early postmenopausal women. Web of Science, PubMed, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials databases were searched. Randomised, controlled trials of exercise interventions in perimenopausal or early postmenopausal populations with an average age of 65 years or younger reporting balance measures were included. Risk of bias was assessed using Cochrane RoB 2. A random effects model network meta-analysis was performed to assess the effect of exercise on balance. Standardised mean differences with 95 % confidence intervals were used as the measure of effect. Twenty-six studies were included after screening. Network meta-analyses were conducted for 5 balance variables. Whole-body vibration (standardised mean difference: 2.25, confidence interval: 0.08; 4.43), balance (standardised mean difference: 1.84, confidence interval: 0.15; 3.53), balance + nutrition (standardised mean difference: 3.81, confidence in-terval: 1.57; 6.05) and resistance (standardised mean difference: 1.43, confidence interval: 0.41; 2.46) exercise improved Berg balance scale performance. Resistance + aerobic + balance exercise improved one-leg stance (standardised mean difference: 0.80, confidence interval: 0.39; 1.22) and whole-body vibration improved anterior-posterior (standardised mean difference:-0.89, confidence interval:-1.48;-0.31), medio-lateral (standardised mean difference:-0.58, confidence interval:-1.15;-0.01) postural sway and falls indices (standardised mean difference:-0.75, confidence interval:-1.45;-0.04). Exercise improved all balance mea-sures and should be considered as an adjunct therapy in perimenopausal and postmenopausal women. Whole-body vibration was most frequently the highest ranked intervention; resistance and balance training also improved balance.

Automated summary

In addition to various symptoms, menopause leads to decreased balance performance and increased risk of falls. This review aimed to assess the effects of exercise interventions on balance in perimenopausal and early postmenopausal women. Twenty-six studies were included in the analysis, and the results showed that exercise improved balance measures, with whole-body vibration being the most effective intervention. Resistance and balance training also showed improvement in balance. Exercise should be considered as an adjunct therapy for perimenopausal and postmenopausal women.