Exercise training and reproductive outcomes in women with polycystic ovary syndrome: A pilot randomized controlled trial

Abstract

Objective: Exercise is recommended for polycystic ovary syndrome (PCOS), but the most effective exercise prescription is unclear. This trial compared effects of highintensity interval training (HIIT), continuous aerobic exercise training (CAET) and noexercise control on reproductive, anthropometric and cardiometabolic outcomes in PCOS. Design: Pilot randomized controlled trial. Participants: Previously inactive women aged 18-40 years with PCOS. Measurements: Feasibility outcomes included recruitment, retention, adherence to exercise and daily ovulation prediction kit (OPK) testing. Preliminary efficacy outcomes included reproductive, anthropometric and cardiometabolic health markers.Results: Forty-seven women were randomized to no-exercise control (n = 17), HIIT (n = 16), or CAET (n = 14). Forty (85%) participants completed the trial. Median exercise adherence was 68% (IQR 53%, 86%). Median daily OPK-testing adherence in the first half of the intervention was 87% (IQR 61%, 97%) compared with 65% (IQR 0%, 96%) in the second half. Body mass index decreased significantly in CAET compared with control (−1.0 kg/m 2 , p = .01) and HIIT (−0.9 kg/m 2 , p = .04). Mean waist circumference decreased in all groups (−7.3 cm, −6.9 cm, −4.5 cm in HIIT, CAET and control) with no significant between-group differences. Mean LDL-C was significantly reduced for HIIT compared to CAET (−0.33 mmol/L, p = .03). HDL-C increased in HIIT compared with control (0.18 mmol/L, p = .04).Conclusions: There were feasibility challenges with adherence to daily ovulation assessment limiting the ability to analyse the effect of the exercise interventions on ovulation. CAET and HIIT were both effective at improving anthropometrics and some cardiometabolic health markers. Further studies need to determine optimal and acceptable exercise prescriptions for this population.

HIIT'ing or MISS'ing the Optimal Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of High- Versus Moderate-Intensity Exercise Prescription

“…Exercise modality varied between cycle ergometer (Roessler et al, 2013) treadmill walking/running and outdoor walking/running (Roessler et al, 2013;Faryadian et al, 2019;Ribeiro et al, 2020). Two studies (Almenning et al, 2015;Benham et al, 2021) allowed for participants to select their desired aerobic equipment to complete the exercise. Two studies reported partial supervision of the exercise intervention (at least 1 session supervised) (Almenning et al, 2015;Benham et al, 2021), one reported full supervision (Ribeiro et al, 2020) and two studies did not report supervision status (Roessler et al, 2013;Faryadian et al, 2019).…”

“…Two studies (Almenning et al, 2015;Benham et al, 2021) allowed for participants to select their desired aerobic equipment to complete the exercise. Two studies reported partial supervision of the exercise intervention (at least 1 session supervised) (Almenning et al, 2015;Benham et al, 2021), one reported full supervision (Ribeiro et al, 2020) and two studies did not report supervision status (Roessler et al, 2013;Faryadian et al, 2019). Exercise intensity was prescribed using HR max in four studies (Roessler et al, 2013;Almenning et al, 2015;Faryadian et al, 2019;Ribeiro et al, 2020), and HRR was utilized in a single study (Benham et al, 2021).…”

“…Exercise modality across MISS interventions varied, with cycle ergometer (Giallauria et al, 2008;Orio et al, 2016;Wu et al, 2021) and treadmill (Covington et al, 2016;Al-Eisa et al, 2017;Aye et al, 2018;Kirthika et al, 2019;Ribeiro et al, 2020) most frequently utilized. Two studies allowed participants to select their desired modality to complete the exercise (Jedel et al, 2011;Benham et al, 2021), while one reported using marching on the spot (Tiwari et al, 2019) and one did not report modality (Sprung et al, 2013). Eight studies indicated full supervision of the exercise intervention (Giallauria et al, 2008;Sprung et al, 2013;Covington et al, 2016;Orio et al, 2016;Aye et al, 2018;Kirthika et al, 2019;Wu et al, 2021), two studies indicated partial supervision (Tiwari et al, 2019;Benham et al, 2021) and two studies indicated no formal supervision (Randeva et al, 2002;Jedel et al, 2011).…”

“…Two studies allowed participants to select their desired modality to complete the exercise (Jedel et al, 2011;Benham et al, 2021), while one reported using marching on the spot (Tiwari et al, 2019) and one did not report modality (Sprung et al, 2013). Eight studies indicated full supervision of the exercise intervention (Giallauria et al, 2008;Sprung et al, 2013;Covington et al, 2016;Orio et al, 2016;Aye et al, 2018;Kirthika et al, 2019;Wu et al, 2021), two studies indicated partial supervision (Tiwari et al, 2019;Benham et al, 2021) and two studies indicated no formal supervision (Randeva et al, 2002;Jedel et al, 2011). Exercise intensity was prescribed using %VO 2max in four studies (Giallauria et al, 2008;Covington et al, 2016;Orio et al, 2016;Aye et al, 2018), HRR in three studies (Sprung et al, 2013;Al-Eisa et al, 2017;Benham et al, 2021) and %HR max in one study (Ribeiro et al, 2020).…”

“…Eight studies indicated full supervision of the exercise intervention (Giallauria et al, 2008;Sprung et al, 2013;Covington et al, 2016;Orio et al, 2016;Aye et al, 2018;Kirthika et al, 2019;Wu et al, 2021), two studies indicated partial supervision (Tiwari et al, 2019;Benham et al, 2021) and two studies indicated no formal supervision (Randeva et al, 2002;Jedel et al, 2011). Exercise intensity was prescribed using %VO 2max in four studies (Giallauria et al, 2008;Covington et al, 2016;Orio et al, 2016;Aye et al, 2018), HRR in three studies (Sprung et al, 2013;Al-Eisa et al, 2017;Benham et al, 2021) and %HR max in one study (Ribeiro et al, 2020). Two studies utilized a minimum working heart rate of 120 bpm (Randeva et al, 2002;Tiwari et al, 2019), one study using a set treadmill speed of 6 km/h (Kirthika et al, 2019) and one used the individualsVO 2 achieved at anaerobic threshold (VO 2AT ) (Wu et al, 2021).…”