Title: The effect of aerobic exercise on sleep disorder in menopausal women: A systematic
review and meta-analyses
Version: 0 Date: 03 May 2024
Reviewer's report:
This study examined the effects of aerobic exercise on sleep disorders in menopausal women.
The authors discuss the following aspects: “what to practice”, “how much to practice”, and
“how to practice”. There are more problems with this study. I suspect that the author didn't
check the entire text after writing it, to the point where there is a lot of repetition and incorrect
representation. The author's attitude is extremely unserious.
Abstract:
1 “The Cochran[]e Risk of Bias Assessment Tool was used……”. Please note that there is an
extra superscript here, please remove it.
2 “We used Review Manager 5.3 and Stata 16.0 software to evaluate the quality of the literature.”
Is the purpose of using these two software programs to assess the quality of the literature? Are
you referring to the risk of bias assessment?
3 “ intervention period of 8-10 weeks (SWD=-0.58, P=0.001)”. What is SWD, please?
Introduction:
1 “For a long time, many scholars have used subjective or objective sleep measurement tools
such as the Pittsburgh Sleep Index and polysomnography to confirm that hormone therapy
(hormone therapy) can significantly improve sleep disorders in menopausal women”. Hormone
therapy in parentheses is redundant, please delete.
2 “For example, Zong-Yan CAI et al. [17] (2014) found that the Pittsburgh Sleep Index Scale
scores of the intervention group were significantly lower compared with both the baseline and
the control group after a randomized controlled trial of 3/week”. Please replace “3/week” with
“3 times/week”.
3 “as follows) whether the intervention effects of aerobic exercise remain accurate and effective
for the menopausal female population; 2) what form of aerobic exercise is most effective; 3)
what dosage of aerobic exercise is optimal; and 4) what type of exercises are most effective
for aerobic exercise. Moreover, few studies systematize and explore their specific effects and
trainological factors”. Please add serial number 1.
Methods
1 “From October 2022 to November 2022, the research team searched the databases of Web of
Science, PubMed, Springer, Embase, Science Direct, China Knowledge, Wanfang, and Wipu,
etc.” Please check the English expression for the Wipu database, is it VIP?
2 "Jogging" or "Jogging" or "Jogging" or "Jogging". "jogging", "menopausal women" or
"menopausal women" or "menopausal women" or "menopausal women" or "menopausal
women" or "menopausal women". The words are repeated in the search formula. In short, this
search formula is so badly written that it needs to be rewritten.
3 What is the deadline for searching, please? Please write it out.
4 In the Exclusion Criteria, “(6)The literature can provide the sample size of the experimental
group and the control group”. Please check if you forgot to write “not”.
5 In the Assessment study risk of bias, “We assessed risks as low, unclear, and high in descending
order”. Isn't low to high an ascending order?
6 In the Statistical analysis, “The fixed-effects model was used if the I2 was < 50%, and
vice versa for the random-effects model”. Vice versa? Please use other wording to avoid
misunderstanding.
7 In the Statistical analysis, “in which SMD <0.2 is a small effect size, 0.2 # SMD # 0.5 is a
small effect size”. Are SMD <0.2 and 0.2 # SMD # 0.5 both small effect size?
8 In the Statistical analysis, “Note: In formula (2), the R coefficient is 0.5 [31]”. Isn't it equation
(1)?
Results:
1 “A total of 16 articles and 19 RCT studies that met the requirements of the systematic analysis
were finally included”. Please explain how 16 articles can have 19 RCTs?
2 “The subjects were menopausal women with a mean age of 47.8-69.7 years”. The mean age
should not be a range.
3 Page 6, “and combination of dynamic and static exercise (e.g., Ba Duan Jin fitness qigong,
etc.). such as Baduanjin fitness qigong, etc.).” Duplicate expressions, please delete one.
4 Page 6, “Among them, static exercise refers to the form in which a single movement pattern
is characterized by active or passive elongation or contraction of muscles, ligaments, etc., to the
maximum range of motion of the joints and maintained for a particular time; dynamic exercise
is based on the structure of periodic or non-periodic single or sets of movements, in the form
of repetitive muscular contraction-diastole. It involves many skeletal and muscular systems
involved in the form. Dynamic exercise is based on the structure of periodic or non-periodic
single or set movements in the form of repetitive muscle "contraction-diastole," involving many
skeletal and muscular systems”. The underlined sentences repeat expressions, please delete one.
5 In the Risk of bias within studies, the risk of bias is best described by describing the number
of studies rather than the percentage.
6 Page 13, “In addition, group heterogeneity in dynamic exercise forms also decreased
significantly after excluding 1 study by Tadayon et al. [18] (2016) (I2 = 0%, P = 0.55)”. It is
recommended to move “group” after “forms”.
7 Please provide forest plots or relevant data for the subgroups in the main text or in the
supplementary material.
8 In the sensitivity analysis, which study does serial numbers 1-19 represent? Please label the
figure.
Interpretation:
1  Page 18, line 7, “Finally, the combination of dynamic and static exercise can effectively
improve estrogen levels, relieve anxiety and depression, and improve sleep quality in
menopausal women because of the combination of dynamic and static exercise”. Because what
does a combination of dynamic and static workouts do?
Limitations
1 “(1) The included literature and the subjects are mainly concentrated in the countries or regions
where the research of aerobic exercise in intervening sleep disorders in menopausal women was
carried out, and the results of the study are limited”. Which countries and regions?
2 “( 2) The results of this study could be much representative due to the amount of literature”.
Is this a limitation?”
3 “(3) The results of this study are not representative of the study”. Points 2 and 3 are self-
contradictory.
4 “However, we think this may be related to the group characteristics of menopausal women.
However, we believe this may be related to the characteristics of the menopausal female
population and that the frequency of 1-3 times of exercise is more in line with the characteristics
of this population's time, energy, and disease”. The underlined sentences repeat expressions,
please delete one.
Conclusion:
1 “(3) Aerobic exercise in the form of static or dynamic exercise has better effects in improving
sleep disorders in menopausal women, of which static aerobic exercise has the best effects.
Aerobic exercise in static or dynamic exercise is more effective in improving sleep disorders
in menopausal women, of which static aerobic exercise is the most effective”. The underlined
sentences repeat expressions, please delete one.