What is this study about? Dysmenorrhea, commonly known as painful period, is a common gynecological symptom experienced by several women of reproductive age. This particular type of pain arises during the menstrual cycle, often negatively impacting the quality of life and ability to successfully carry out daily activities and academic or work performance. This is study will involve physiotherapy treatment in the form of a home-based exercise program for those experiencing dysmenorrhea. The purpose of this study is to determine how effective this exercise intervention is by assessing the pain score, menstrual symptoms, gait performance and cognitive-motor control.
single
18-25 years
meet the diagnostic criteria for PD as outlined in the Primary Dysmenorrhea Consensus Guidelines - first onset of menstrual pain 6-24 months after menarche, pain lasting 8-72h in a cycle, and the most severe pain on the 1st or 2nd day of menstruation
having a regular menstrual cycle (28 ± 7 days)
history of pelvic surgery
history and/or findings of secondary dysmenorrhea
history of mental or physical diseases
history of joint, motion, muscle, or bone diseases which reduce the abilities to exercise
Parallel
Home-exercise program
Other interventionThe participants will then be given a clear explanation of the exercises to be performed as part of the home-based exercise program. They will be provided with a demonstrations video that will guide each session. Each exercise session will last for 30 minutes, 3/week, for 8 weeks. Participants will perform 10 minutes of progressive muscle relaxation exercise, followed by 10 minutes of core exercises, and finally 10 mintes of stretching exercises. They will required to complete an exercise diary. Exercise progressions will be applied across weeks 3-4 and again at weeks 5-6 and 7-8 (e.g., increased hold durations, repetitions, and resistance band progression for core exercises).
Pain intensity
Pain intensity is self-reported on the Visual Analogue Scale for Pain (VAS Pain), which is a continuous scale in the form of a 100mm line, marked by "no pain" (score of 0) on one end and "pain as bad as it could be" (score of 100) on the other end. The participant is required to make a perpendicular line on the VAS scale that they feel best represent their pain intensity. Change in the pain intensity at baseline and after 8 weeks of intervention will be noted.
Cortical Silent Period
Cortical silent period (CSP) will be assessed using the transcranial magnetic stimulation (TMS) apparatus. Single-pulse TMS will be administered using a figure-of-eight coil positioned over the primary motor cortex. CSP duration (ms) will be measured from the MEP onset to return of voluntary EMG activity following cortical stimulation. The minimal effective stimulation intensity will be used to ensure participant safety. Changes at baseline and after 8 weeks of intervention will be noted.
Dual-Task Gait Performance
Gait performance, including speed, cadence, stride length and double support time, will be assessed comparatively for single-task walking and dual-task walking (during cognitive tasks). Gwalk g-sensors equipment will be used for gait analysis. Changes in parameters as baseline and after 8 weeks intervention will be noted.
Dual-Task Cognitive Performance
Cognitive Performance on three tasks (logistic, semantic verbal fluency and working memory) will assessed during walking, at baseline and after 8 weeks intervention.
Electroencephalography (EEG) data
Brain activity for cognitive-motor control (Theta/alpha coherence) will be assessed during dual-walking task, using the NeXus-Q32 equipment. Changes in parameters at baseline and after 8 week intervention will be noted.
Dysmenorrhea impact
The Working Ability, Location, Intensity, Days of pain, and Dysmenorrhoea (WaLIDD) questionnaire will assess the impact of dysmenorrhoea on work and daily functioning. It measures the severity of dysmenorrhea by a total scoring range of 0 to 12 points, where a higher score indicates greater severity. Changes in total score at baseline and following 8 week intervention will be noted.
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