Effect of adding diaphragmatic breathing to corrective exercises on kyphotic angle and diaphragmatic excursion in postmenopausal kyphotic women: A randomized controlled trial.

BACKGROUND: Age-related thoracic kyphosis can impair posture, diaphragmatic excursion, respiratory function, and overall quality of life (QoL). PURPOSE: This randomized controlled trial aimed to compare the effects of corrective exercises alone versus combined with diaphragmatic breathing exercises on thoracic kyphosis, diaphragmatic excursion, thoracic pain, and QoL in postmenopausal kyphotic women. METHODS: Forty postmenopausal women diagnosed with thoracic kyphosis were randomly divided into two groups. Group A received corrective exercises for 12 weeks (n = 20), while Group B received both diaphragmatic breathing exercises and corrective exercises for the same duration (n = 20). Primary outcome measures were thoracic kyphosis angle and diaphragmatic excursion, while secondary outcome measures were thoracic pain and QoL. Both groups were assessed pre- and post-intervention using a flexible curve ruler for the thoracic kyphosis angle, ultrasonography for the diaphragmatic excursion, the visual analog scale for thoracic pain, and the Arabic version of the QoL Questionnaire of the European Foundation for Osteoporosis for QoL. RESULTS: Both groups showed significant within-group improvements in all measures post-intervention (p < 0.05). Between-group comparisons post-intervention revealed no significant differences (p > 0.05) except for diaphragmatic excursion, where Group B showed significantly greater improvement (p < 0.05). CONCLUSIONS: A 12-week program of corrective exercises alone or combined with diaphragmatic breathing exercises significantly improved kyphosis angle, thoracic pain, and QoL in postmenopausal kyphotic women. The addition of diaphragmatic breathing exercises provided further benefits by increasing diaphragmatic excursion to a greater degree compared with corrective exercises alone.

Effect of visceral manipulation on menstrual complaints in women with polycystic ovarian syndrome.

CONTEXT: Research is lacking regarding osteopathic approaches in treating polycystic ovary syndrome (PCOS), one of the prevailing endocrine abnormalities in reproductive-aged women. Limited movement of pelvic organs can result in functional and structural deficits, which can be resolved by applying visceral manipulation (VM). OBJECTIVES: This study aims to analyze the effect of VM on dysmenorrhea, irregular, delayed, and/or absent menses, and premenstrual symptoms in PCOS patients. METHODS: Thirty Egyptian women with PCOS, with menstruation-related complaints and free from systematic diseases and/or adrenal gland abnormalities, prospectively participated in a single-blinded, randomized controlled trial. They were recruited from the women's health outpatient clinic in the faculty of physical therapy at Cairo University, with an age of 20-34 years, and a body mass index (BMI) ≥25, <30 kg/m2. Patients were randomly allocated into two equal groups (15 patients); the control group received a low-calorie diet for 3 months, and the study group that received the same hypocaloric diet added to VM to the pelvic organs and their related structures, according to assessment findings, for eight sessions over 3 months. Evaluations for body weight, BMI, and menstrual problems were done by weight-height scale, and menstruation-domain of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), respectively, at baseline and after 3 months from interventions. Data were described as mean, standard deviation, range, and percentage whenever applicable. RESULTS: Of 60 Egyptian women with PCOS, 30 patients were included, with baseline mean age, weight, BMI, and menstruation domain score of 27.5 ± 2.2 years, 77.7 ± 4.3 kg, 28.6 ± 0.7 kg/m2, and 3.4 ± 1.0, respectively, for the control group, and 26.2 ± 4.7 years, 74.6 ± 3.5 kg, 28.2 ± 1.1 kg/m2, and 2.9 ± 1.0, respectively, for the study group. Out of the 15 patients in the study group, uterine adhesions were found in 14 patients (93.3%), followed by restricted uterine mobility in 13 patients (86.7%), restricted ovarian/broad ligament mobility (9, 60%), and restricted motility (6, 40%). At baseline, there was no significant difference (p>0.05) in any of demographics (age, height), or dependent variables (weight, BMI, menstruation domain score) among both groups. Poststudy, there was a statistically significant reduction (p=0.000) in weight, and BMI mean values for the diet group (71.2 ± 4.2 kg, and 26.4 ± 0.8 kg/m2, respectively) and the diet + VM group (69.2 ± 3.7 kg; 26.1 ± 0.9 kg/m2, respectively). For the improvement in the menstrual complaints, a significant increase (p<0.05) in the menstruation domain mean score was shown in diet group (3.9 ± 1.0), and the diet + VM group (4.6 ± 0.5). On comparing both groups poststudy, there was a statistically significant improvement (p=0.024) in the severity of menstruation-related problems in favor of the diet + VM group. CONCLUSIONS: VM yielded greater improvement in menstrual pain, irregularities, and premenstrual symptoms in PCOS patients when added to caloric restriction than utilizing the low-calorie diet alone in treating that condition.

Effect of Low Versus High-Heeled Footwear on Spinopelvic Alignment at Different Phases of Menstrual Cycle in Young Adult Women: A Biopsychosocial Perspective.

High-heeled shoes adversely affect spinal curvature, increase the risk of low back pain, and disturb the normal gait pattern. The purpose of this study was to examine, from a biopsychosocial point of view, the combined effect of wearing two different heel heights and of hormonal oscillation throughout different phases of the menstrual cycle on spinopelvic alignment. Notably, 70 females with an average age of 20.42 ± 1.51 years participated in this study, wearing each female two different heel heights as follows: low (2.5 cm) and high (7 cm). Spinopelvic alignment was evaluated by rasterstereography formetric 3D analysis during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Statistical analysis showed that there was no significant difference (p > 0.05) on spinopelvic alignment [kyphotic angle (KA), trunk inclination (TI), and pelvic inclination] between wearing low- or high-heeled shoes during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Considering that high-heeled shoes are traditionally associated with femininity, body image, beauty, and charm, this research has important biopsychosocial implications that should be explored in detail in future studies.