Abstract

Aims To evaluate the efficacy of exercise-based interventions and mind-body therapies on quality of life, menopausal symptoms, and depression among Asian perimenopausal women.Design A systematic review, meta-analysis, and synthesis without meta-analysis (SWiM).Data sources Six electronic databases were systematically searched: PubMed, CINAHL, Embase, PsycINFO, Scopus, and ProQuest.Review methods The point of inception of each database to 15 November 2018 were systematically searched. A meta-analysis and SWiM were used to present the results. Review Manager 5.3 and The Cochrane Risk of Bias tool were used for meta-analyses and assessing of risk of bias, respectively.Results In all, 23 studies were reviewed. Significant effects in exercise-based interventions and mind-body therapies were found for quality of life, menopausal symptoms, and depression but not for hot flashes. Limitations of this review include insufficient blinding of participants and/or researchers found in most of the included studies and high levels of heterogeneity in the meta-analyses. Evidence found in this review is to be interpreted with caution.Conclusion Healthcare professionals can consider exercise-based interventions or mind-body therapies to manage menopausal symptoms. Future trials of good quality can examine the cost-effectiveness and optimal intervention duration. Intervention effects on specific menopausal symptoms such as sleeplessness in Asia can be examined in future.Impact Exercise-based interventions and mind-body therapies suggest effectiveness on quality of life, menopausal symptoms, and depression among Asian perimenopausal women. Exercise-based interventions and mind-body therapies improve quality of life, menopausal symptoms, and depression but not hot flashes. Long-term exercise-based interventions is effective in managing depression. Due to varied limitations in the review and included studies, firm conclusions cannot be reached. Healthcare professionals in Asia can consider implementing exercise-based interventions and mind-body therapies for symptomatic perimenopausal Asian women.


Authors

Shorey, Shefaly;  Ang, Lina;  Lau, Ying

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  • pre-publication peer review (FINAL ROUND)
    Decision Letter
    2020/01/07

    07-Jan-2020

    Re: JAN-2019-0512.R3: Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis

    Dear Dr Shorey,

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  • pre-publication peer review (ROUND 3)
    Decision Letter
    2019/12/13

    13-Dec-2019

    Re: JAN-2019-0512.R2: Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis

    Dear Dr Shorey,

    Thank you for sending us the above manuscript. It has been considered with care and the editor and reviewer comments are shown at the end of this email. As these comments indicate, the paper does need revision before we can consider it further, and I look forward to receiving your revised version as soon as possible, and no later than 13-Jan-2020. If this poses any problems, please contact me at jan@wiley.com.

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    EDITOR'S COMMENTS: Thank you for your revised manuscript. The amendments are acknowledged thank you.

    WE suggest that you move the new figure 2 to a supplemental online only file to avoid being charged a colour image processing charge. In addition, REVMan usually produces two visual displays of the risk on bias outcome. Currently there is only one.

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  • pre-publication peer review (ROUND 2)
    Decision Letter
    2019/11/15

    15-Nov-2019

    Re: JAN-2019-0512.R1: Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis

    Dear Dr Shorey,

    Thank you for sending us the above manuscript. It has been considered with care and the editor and reviewer comments are shown at the end of this email. As these comments indicate, the paper does need revision before we can consider it further, and I look forward to receiving your revised version as soon as possible, and no later than 16-Dec-2019. If this poses any problems, please contact me at jan@wiley.com.

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    EDITOR'S COMMENTS: Thank you for resubmitting your manuscript. the amendments are acknowledged. Some amendments have not been attended to fully.

    We previously asked:

    1. Table 2 is too big for a print journal. (print pages are expensive and each volume has to accommodate a minimum number of articles). Please move the current table 2 (which is helpful) to an additional online only file and produce a new very brief included study table for the print manuscript. Suggest no more than 3 lines per paper and the essential study characteristics.

    The large table has been moved to an additional online only file but a new small summary table has not be produced for the print journal. Please address.

    In addition - thank you for reporting the risk of bias assessments in a summary table. The usual convention is to display these assessments using coloured graphs and infographics produced in REVMan. Please add these coloured figures and graphs alongside the current table as this provides additional information needed to interpret risk of bias. There is REVMan guidance (see the help) on how to adapt the RoB bias domains for specific reviews.

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    Reviewer: 1

    Comments to the Author
    The text continues to be long and wordy, but the writing is more clear in this version of the paper.

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    Yours sincerely,

    Professor Jane Noyes
    Editor
    Journal of Advanced Nursing

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    Reviewer report
    2019/11/07

    The text continues to be long and wordy, but the writing is more clear in this version of the paper.

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  • pre-publication peer review (ROUND 1)
    Decision Letter
    2019/08/30

    30-Aug-2019

    Re: JAN-2019-0512: Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review and meta-analysis

    Dear Dr Shorey,

    Thank you for sending us the above manuscript. It has been considered with care and the editor and reviewer comments are shown at the end of this email. As these comments indicate, the paper does need revision before we can consider it further, and I look forward to receiving your revised version as soon as possible, and no later than 30-Sep-2019. If this poses any problems, please contact me at jan@wiley.com.

    Please take care to ensure that your revised manuscript addresses all of the editor and reviewer comments. Please also see the sections on general points to remember and search engine optimisation (SEO) at the end of the email.

    EDITOR'S COMMENTS: Thank you for submitting your interesting review. In addition to the referee comments below - please attend to the following:

    1. The word count. There are several opportunities to reduce the manuscript word count by moving content to additional online only files (such as the long list of search terms and description of the search strategy).

    2. Please refer to The Cochrane Risk of Bias tool (not Cochrane's).

    2.1 Please refer to the Cochrane EPOC risk of bias crieria for specific study types and make sure that you have selected the appropriate RoB criteria for each of the diverse study types in your review. See: https://epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/Resources-for-authors2017/suggested_risk_of_bias_criteria_for_epoc_reviews.pdf

    1. Insert a subheading 'Data extraction and synthesis'

    2. A PRISMA extension is in the publication pipeline for 'Synthesis without meta-analysis (SWiM). Following publication, authors will be discouraged from using terms such as narrative synthesis and narrative summary to avoid confusion with other similar sounding methods of synthesis in the qualitative evidence synthesis sphere. So that your manuscript does not seem immediately obsolete on the publication of the new PRISMA extension, it would be a good move to use the new terminology in all relevant places (title, abstract, main manuscript, PRISMA flow diagram etc).

    3. Table 2 is too big for a print journal. (print pages are expensive and each volume has to accommodate a minimum number of articles). Please move the current table 2 (which is helpful) to an additional online only file and produce a new very brief included study table for the print manuscript. Suggest no more than 3 lines per paper and the essential study characteristics.

    4. Please take another opportunity to cross check reporting against PRISMA and the JAN template for reporting reviews.

    For attention if sent for revision:

    Note:

    abstract count should be 300 or lower (to include impact)
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    main paper word count 5374

    REVIEWER COMMENTS:

    Reviewer: 1

    Comments to the Author
    The paper mostly relies on descriptive summaries. The statistical methods and data analyses summarized are suitable and sound. Yet I have a couple of comments that need to be addressed to improve the statistical presentation, as indicated below.

    • Pages 32-39, Table 2: The notation “mean (SD)” should be used throughout instead of “mean plus/minus SD,” since this is not a confidence interval. In other words, the SD should be indicated in parentheses.

    Additionally, the test upon which each p-value is based should be stated. A p-value without associated statistical test cannot be interpreted.

    Reviewer: 2

    Comments to the Author
    The paper used the PRISMA guidelines consistent with the use of a systematic review and meta-analysis. This paper is well written and clear and provides the reader a thorough understanding of how the methods were operationalized to determine the impact of mind-body therapies and excercise based interventions on menopause symptoms among Asian perimenopausal women. The extensive review of the literature netted 23 appropriate articles that were individually evaluated for use. The studies covered women who were Chinese, Japanese, South Korean, Thai, and Taiwan. Other women included were Iranian, Turkish and Indian. It would be helpful to provide an understanding of the Asian categorization method as those who are Iranian, Turkish and Indian may not identify as Asian versus another categorization such as as Middle Eastern, Indian, Mediterranean or Persian. This could be a minor revision or clarification.

    Reviewer: 3

    Comments to the Author
    Please refer to the attachment.

    To revise your manuscript, log on to ScholarOne Manuscripts: http://mc.manuscriptcentral.com/jan

    Please use red font to indicate the revised portions of your manuscript (no tracked changes or strike-through please).

    Please ensure that you detail the changes you have made in the 'comments to decision letter' section of the submission process. I would be grateful if you could also upload your response as a separate, anonymous file (in the 'upload files' stage of the submission process) when you submit your revised paper.

    GENERAL POINTS TO REMEMBER:

    • It is essential that you format your manuscript using the author guidelines for the type of paper you submitted: https://onlinelibrary.wiley.com/page/journal/13652648/homepage/forauthors.html

    • Use APA style for citations and references – please see the author guidelines: https://www.apastyle.org/learn/faqs/index.

    • Your revised word count must not exceed 5000 words for the text, exclusive of the abstract, references, tables and figures.

    • Format the headings like this: main headings upper case, major sub-headings lower case, subsidiary sub-headings italics.

    • The international relevance of the topic should be indicated in the Introduction section of the paper.

    • Please ensure your Background and Discussion include up-to-date literature.

    • The Conclusion section should not be a summary or repetition of previous content. This section should provide a discussion of the implications for practice or policy and recommendations for further work.

    • For Review and Discussion papers, provide the inclusive years of literature searched in both the abstract and the text (not the year(s) when the literature was searched).

    • The abstract should not include abbreviations or references.

    • Please include up to 10 key words, including nurse or nursing, which should follow the abstract. Please note these do not have to match the keywords selected in ScholarOne, which are to assist with assigning reviewers.

    SEARCH ENGINE OPTIMISATION:

    Tips for making sure articles can be easily found online are available in the attached PDF.

    Please ensure that your keywords accurately reflect the content of your manuscript.

    I look forward to receiving your revised paper. Please do not hesitate to contact me at jan@wiley.com if there is anything in this letter that needs more explanation.

    Thank you choosing JAN for your paper.

    Yours sincerely,

    Professor Jane Noyes
    Editor
    Journal of Advanced Nursing

    Decision letter by
    Cite this decision letter
    Reviewer report
    2019/07/29

    Please refer to the attachment.

    Reviewed by
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    Reviewer report
    2019/07/01

    The paper used the PRISMA guidelines consistent with the use of a systematic review and meta-analysis. This paper is well written and clear and provides the reader a thorough understanding of how the methods were operationalized to determine the impact of mind-body therapies and excercise based interventions on menopause symptoms among Asian perimenopausal women. The extensive review of the literature netted 23 appropriate articles that were individually evaluated for use. The studies covered women who were Chinese, Japanese, South Korean, Thai, and Taiwan. Other women included were Iranian, Turkish and Indian. It would be helpful to provide an understanding of the Asian categorization method as those who are Iranian, Turkish and Indian may not identify as Asian versus another categorization such as as Middle Eastern, Indian, Mediterranean or Persian. This could be a minor revision or clarification.

    Reviewed by
    Cite this review
    Reviewer report
    2019/06/10

    The paper mostly relies on descriptive summaries. The statistical methods and data analyses summarized are suitable and sound. Yet I have a couple of comments that need to be addressed to improve the statistical presentation, as indicated below.

    • Pages 32-39, Table 2: The notation “mean (SD)” should be used throughout instead of “mean plus/minus SD,” since this is not a confidence interval. In other words, the SD should be indicated in parentheses.

    Additionally, the test upon which each p-value is based should be stated. A p-value without associated statistical test cannot be interpreted.

    Reviewed by
    Cite this review
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