Comparative Effects of Exercises Combined With Kinesio Taping and Electrotherapy in Women with Primary Dysmenorrhea: A Randomized Controlled Clinical Trial.

Background: Primary dysmenorrhea is a common gynecological problem characterized by menstrual pain without any pelvic pathology. It affects a significant portion of women of reproductive age, impacting their quality of life and daily activities. Physiotherapy interventions such as therapeutic exercise, manual therapy, electrotherapy, and kinesio taping reduce menstrual pain and symptoms. However, there is no study investigating the effects of combined physiotherapy interventions. Primary Study Objective: This study aimed to evaluate and compare the effects of exercises combined with either kinesio taping or electrotherapy on reducing menstrual pain and associated symptoms in women suffering from primary dysmenorrhea. Methods: The randomized controlled clinical trial. Setting: Biruni University Department of Physiotherapy and Rehabilitation Laboratory. Participants: Thirty-six women diagnosed with primary dysmenorrhea by a Gynecologist and Obstetrician were randomized into the kinesio-taping group (n=19) and the electrotherapy group (n=17). Intervention: A similar exercise program was carried out in both groups for eight weeks, two days a week and 40 minutes a day. To increase blood flow in the pelvic region and reduce pain mediators, taping was applied to the sacral and pubic regions using the ligament technique in the kinesio taping group, and a vacuum interferential current was applied to the lumbar and gluteal regions in the electrotherapy group. Primary Outcome Measures: The menstrual pain intensity and menstrual symptoms were assessed with valid and reliable the Visual Analogue Scale (VAS) and the Menstrual Symptom Questionnaire (MSQ). Results: The VAS (kinesio taping and electrotherapy group: P < .001), MSQ-pain symptoms (kinesio taping group: P = .014, electrotherapy group: P = .032), and MSQ-coping methods scores (kinesio taping group: P = .001, electrotherapy group: P = .005) decreased both statistically and clinically in both groups. In addition, a statistically significant improvement in MSQ-negative effects/somatic complaints (P = .047) and MSQ total scores (P = .030) was observed in the electrotherapy group. There was no statistically significant difference between the two groups regarding substantial changes (P > .05). Conclusion: The exercises combined with either kinesio taping or electrotherapy effectively reduced menstrual pain intensity and menstrual symptoms related to pain and coping methods in women with primary dysmenorrhea. Notably, exercises combined with electrotherapy also improved menstrual symptoms related to negative effects and somatic complaints. These findings suggest that both kinesio taping and electrotherapy, when combined with exercises, are viable options for managing primary dysmenorrhea, potentially offering clinicians flexible treatment approaches.

Using Cluster Analysis to Identify Metabolic Syndrome Components and Physical Fitness in Patients with Metabolic Syndrome.

Background: Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method. Aim: To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis. Methods: One hundred twenty-one patients (mean age = 51.4 ± 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined. Results: Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS. Conclusion: MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.

Pelvic floor symptoms and symptom-related quality of life in the mothers of children with cerebral palsy: a pilot cross-sectional study.

Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p > .05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p = .047) and PFIQ-7 (r = 0.427, p = .042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen.

Does multiple-component intensive pelvic floor muscle training decrease muscle fatigue and symptoms in women with urinary incontinence?

INTRODUCTION AND HYPOTHESIS: A multiple-component intensive pelvic floor muscle training (MCI-PFMT) protocol was developed as a neurophysiological-based rehabilitation model to improve neuroplasticity. This study aimed to investigate the effects of the MCI-PFMT protocol on muscle fatigue and symptoms in women with urinary incontinence. METHODS: This randomized controlled trial included 49 female patients with mixed urinary incontinence. Participants were divided into the MCI-PFMT group and the control group. The MCI-PFMT group performed supervised intensive pelvic floor muscle training, while the control group received bladder training and standard pelvic floor muscle training as a home program. Both training sessions were conducted 5 days a week for a single week. Participants' symptoms were evaluated with questionnaires, bladder diary, and pad tests. Superficial electromyography, ultrasonography, and the PERFECT scale were used to evaluate pelvic floor and abdominal muscle functions. RESULTS: In the post-treatment evaluation, symptoms were decreased in both groups, with a significant decrease in the MCI-PFMT group (p < 0.05). While average and peak work values of pelvic floor muscles, transversus abdominus, and internal oblique muscles increased in both groups, maximum voluntary contraction values of these muscles decreased (p < 0.05). A 12.7% decrease was observed in the maximum voluntary contraction values of pelvic floor muscles in the control group, while a 9.6% decrease was observed in the MCI-PFMT group. CONCLUSIONS: The MCI-PFMT protocol can lead to pelvic floor and abdominal muscle fatigue. However, it may be effective at decreasing symptoms in women with urinary incontinence. Additional studies on this issue are needed.

Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

INTRODUCTION AND HYPOTHESIS: Various positions for pelvic floor muscle (PFM) relaxation are recommended during PFM training in physiotherapy clinics. To our knowledge, there is no study addressing the most effective position for PFM and abdominal muscle relaxation. Therefore, the current study aimed to investigate the effect of different relaxation positions on PFM and abdominal muscle functions in women with urinary incontinence (UI). METHODS: Sixty-seven women diagnosed with UI were enrolled in the study. The type, frequency, and amount of UI were assessed with the International Incontinence Questionnaire-Short Form and bladder diary. Superficial electromyography was used to assess PFM and abdominal muscle functions during three relaxation positions: modified butterfly pose (P1), modified child pose (P2), and modified deep squat with block (P3). Friedman variance analyses and Wilcoxon signed rank test with Bonferroni corrections were used to evaluate the difference between positions. RESULTS: The most efficient position for PFM relaxation was P1 and followed by P3 and P2, respectively. The order was also the same for abdominal muscles (p < 0.001), P1 > P3 > P2. The rectus abdominis (RA) was the most affected muscle during PFM relaxation. The extent of relaxation of RA muscle increased as the extent of PFM relaxation increased (r = 0.298, p = 0.016). No difference was found between different types of UI during the same position in terms of PFM relaxation extents (p > 0.05). CONCLUSIONS: Efficient PFM relaxation is maintained during positions recommended in physiotherapy clinics. The extent of PFM and abdominal muscle relaxation varies according to the positions.