Efectos del ejercicio terapéutico sobre el dolor pélvico en mujeres con endometriosis: revisión sistemática y metaanálisis
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Introduction: Endometriosis is a chronic gynecological condition characterized by pelvic pain, dysmenorrhea, and functional impairment. Although conventional treatments provide partial symptom relief, clinical limitations persist. Therapeutic exercise has emerged as an effective complementary intervention. Objective: To systematically evaluate the effect of therapeutic exercise and supervised physical interventions on pelvic pain in women with endometriosis. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar (1995–May 2025), including controlled trials, pre-post studies, and observational designs with objective pain assessment. Meta-analysis was performed using a random-effects model (Hedges' g), heterogeneity analysis (I²), and publication bias assessment (Egger’s test). Results: A total of 2,721 records were identified. After applying inclusion criteria, 7 studies were analyzed, of which 5 provided quantitative data (N = 226). The overall effect size was Hedges' g = -1.73 (95% CI: -2.42 to -1.04), indicating a significant reduction in pain. Heterogeneity was moderate to high (I² = 62.8%). Subgroup analysis showed greater benefits for supervised exercise (g = -2.90), manual therapy/hydrotherapy (g = -2.00), yoga (g = -1.56), and somatosensory psychotherapy (g = -1.17), while digital interventions showed smaller effects (g = -0.50). No publication bias was detected (Egger p = 0.73). Conclusions: Supervised therapeutic exercise significantly reduces pelvic pain in women with endometriosis, with multicomponent face-to-face interventions showing the greatest clinical efficacy.
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Efectos del ejercicio terapéutico sobre el dolor pélvico en mujeres con endometriosis: revisión sistemática y metaanálisis
DOI:
https://doi.org/10.47197/retos.v73.116828Palabras clave:
Endometriosis, dolor pélvico, ejercicio terapéutico, fisioterapia, calidad de vidaResumen
Introducción: La endometriosis es una enfermedad ginecológica crónica caracterizada por dolor pélvico, dismenorrea y deterioro funcional. Aunque los tratamientos convencionales logran alivio parcial, persisten limitaciones clínicas. El ejercicio terapéutico ha emergido como alternativa complementaria efectiva.
Objetivo: Evaluar sistemáticamente el efecto del ejercicio terapéutico y las intervenciones físicas supervisadas sobre el dolor pélvico en mujeres con endometriosis.
Métodos: Se realizó una búsqueda sistemática en PubMed, Scopus, Web of Science, Cochrane Library y Google Scholar (1995-mayo 2025), seleccionando ensayos controlados, estudios pre-post y observacionales con medición objetiva de dolor. El metaanálisis utilizó modelo de efectos aleatorios (Hedges' g), análisis de heterogeneidad (I²) y evaluación de sesgo de publicación (Egger test).
Resultados: Se identificaron 2.721 registros; tras aplicar los criterios de inclusión, se analizaron 7 estudios, 5 de los cuales aportaron datos cuantificables (N = 226). El tamaño de efecto global fue Hedges' g = -1.73 (IC 95%: -2.42 a -1.04), indicando reducción significativa del dolor. La heterogeneidad fue moderada-alta (I² = 62.8%). Los subgrupos mostraron mayores beneficios para ejercicio supervisado (g = -2.90), terapia manual/hidroterapia (g = -2.00), yoga (g = -1.56) y psicoterapia somatosensorial (g = -1.17), mientras que las intervenciones digitales presentaron efectos menores (g = -0.50). No se observó sesgo de publicación (Egger p = 0.73). Conclusiones: El ejercicio terapéutico supervisado reduce significativamente el dolor pélvico en mujeres con endometriosis, siendo especialmente efectivo en intervenciones presenciales multicomponente.
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