Effects of Stretching on Menopausal and Depressive Symptoms

Results

A total of 45 potential participants were recruited. Of these, one applicant was excluded on the basis of the above criteria, two declined to participate, and two were unable to participate (Fig. 1). Thus, in all, 40 participants were enrolled and randomized; 20 participants were allocated to the stretching group and 20 to the control group. Because of a change in personal circumstances, one participant in the stretching group dropped out of the study after the initial baseline survey, without receiving any intervention.

(Enlarge Image)

Figure 1.

Flow diagram for the trial.

Over half of the participants were postmenopausal (55.0%) and had depression (62.5%). In addition, most of the participants were inactive and did not participate in leisure-time physical activity. A minority of the participants regularly consumed alcohol (40%) or smoked (27.5%). Significant differences in the average age, menopausal status, depression, hot flashes, alcohol and cigarette consumption, job stress, leisure-time physical activity, SMI scores, and SDS scores were not observed between the groups at baseline (Table 1).

The average number of days per week that the stretching program was implemented at home was 5.1 ± 1.9 days for the first week, 5.4 ± 1.8 days for the second week, and 5.4 ± 1.9 days for the third week. The overall implementation rate for the 3-week intervention program was 75.8%.

The total SMI scores (effect size = -0.86) including the vasomotor (-0.78), psychological (-0.48), and somatic (-0.84) symptoms, and the SDS (-0.46) scores significantly decreased in the stretching group compared with that in the control group (Table 2). Five of the 12 participants (41.7%) who had depression at baseline recovered to the normal level after the intervention in the stretching group. In contrast, only 2 of the 13 participants (15.4%) recovered in the control group.

The frequency of hot flashes after the intervention was not significantly different between the stretching (25%) and control (45%) groups (P = 0.320). No adverse events, including an increased frequency of hot flashes, were reported by any of the participants during the study period.

Table 1. Baseline characteristics of the study participants
	Stretching group (n=20)	Control group (n=20)	P ^a
Age, y	51.0 (7.0)	51.2 (7.9)	0.95
Postmenopausal women, %	55.0	55.0	1.00
Total SMI score (points)	29.3 (17.5)	32.4 (19.4)	0.61
Vasomotor symptoms	11.0 (7.3)	11.6 (8.5)	0.81
Physiologic symptoms	11.1 (10.4)	12.4 (10.8)	0.69
Somatic symptoms	7.3 (4.2)	8.4 (4.0)	0.42
SDS score (points)	40.1 (8.6)	42.8 (7.4)	0.30
Depression, %^b	60.0	65.0	1.00
Hot flashes, %	20.0	30.0	0.72
Current drinker, %	40.0	40.0	1.00
Current smoker, %	30.0	25.0	1.00
Job strain score (points)^c	0.48 (0.11)	0.43 (0.08)	0.13
Leisure-time physical activity, min/wk	29.3 (107.5)	34.8 (90.5)	0.86
<30 min/wk, %	90.0	80.0	0.66

Values are mean (SD), except categorical data.
SMI, Simplified Menopausal Index; SDS, Self-Rating Depression Scale.
^a P value by unpaired t test for continuous data, χ² test for categorical data.
^bDepression was defined with an SDS score ≥40 points.
^cJob strain score was calculated using the Job Content Questionnaire.

Table 2. Menopausal and depressive symptoms at baseline (pre) and after the 3-week stretching program (post)
	Stretching group		Control group		Difference between groups
	Pre	Post	Pre	Post	P ^a	Effect size^b
Total SMI score (points)	29.3 (17.5)	15.7 (12.4)	32.4 (19.4)	32.2 (20.5)	0.001	−0.86
Vasomotor symptoms	11.0 (7.3)	5.8 (5.4)	11.6 (8.5)	13.4 (10.0)	0.003	−0.78
Physiologic symptoms	11.1 (10.4)	5.1 (5.1)	12.4 (10.8)	10.3 (8.4)	0.008	−0.48
Somatic symptoms	7.3 (4.2)	4.9 (3.4)	8.4 (4.0)	8.5 (4.3)	0.001	−0.84
SDS score (points)	40.1 (8.6)	35.8 (9.3)	42.8 (7.4)	41.6 (7.3)	0.025	−0.46

Values are mean (SD).
SDS, Self-Rating Depression Scale; SMI, Simplified Menopausal Index.
^a P value by generalized linear models, adjusted for job strain score and initial values.
^bEffect size by Cohen's d effect sizes calculated using the difference in change between both groups (stretching group and control group).