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The aim of this study is to compare the effects of aerobic exercise and yoga exercises on menstrual pain parameters (pain severity and duration, analgesic usage), uterine artery blood flow, menstrual stress level, physical fitness, anxiety/depressive symptom level, quality of life and sleep quality in individuals with primary dysmenorrhea. This study is a prospective, parallel group, randomized study. Three days a week for eight weeks, the participants in this study will receive individualized yoga and aerobic exercise.
In the literature, there are no studies comparing the effectiveness of aerobic exercise and yoga in the management of PD, which is a public health problem that seriously affects women's lives. Especially when aerobic exercise and yoga exercises are considered, there is no study on how much the features such as uterine artery blood flow and physical fitness sub-parameters have changed with these two commonly used exercise types separately in the management of PD.
The aim of this study is to compare the effects of aerobic exercise and yoga exercises on menstrual pain parameters (pain severity and duration, analgesic usage), uterine artery blood flow, menstrual stress level, physical fitness, anxiety/depressive symptom level, quality of life and sleep quality in individuals with primary dysmenorrhea. This study is a prospective, parallel group, randomized study.
It was planned to enroll 44 individuals with Primary Dysmenorrhea in this randomized study. A physical therapist is responsible for all assessments.
Participants were included in one of two treatment groups (G1: Aerobic exercise; G2: Yoga exercise).
In the literature, there are no studies comparing the effectiveness of aerobic exercise and yoga in the management of PD, which is a public health problem that seriously affects women's lives. Especially when aerobic exercise and yoga exercises are considered, there is no study on how much the features such as uterine artery blood flow and physical fitness sub-parameters have changed with these two commonly used exercise types separately in the management of PD.
The results of our study show that norm values can be established by evaluating uterine arterial blood flow and physical fitness, instead of focusing on pharmacological treatment and classical nonpharmacological approaches (warm application, transcutaneous electrical nerve stimulation (TENS), acupuncture, etc.) in individuals with PD. It is aimed to develop new exercise protocols that can be done easily. It is expected that our results, which we will obtain in the light of the original values of our research, will contribute to the literature and guide future studies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aerobic Exercise | Experimental | Aerobic exercise group with 8 weeks of individualized exercise according to the Karvonen protocol (heart rate reserve percentage-% HR). Exercise training will be 30 minutes at 50% of HR between weeks 0-2, 45 minutes at 50% of HR between weeks 2-4, 45 minutes at 60% of HR between weeks 4-6 and 6-8 weeks It will be done on the treadmill 3 days a week, for 60 minutes at 60% of HR between weeks. The treadmill speed will be adjusted during exercise to maintain the set target heart rate level. |
|
| Yoga Exercise | Active Comparator | Yoga exercise group with 8 weeks of individualized exercise program. Exercise training will be done 3 days a week. The duration of the exercise will be adjusted to be the same as the aerobic exercise group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aerobic exercise | Other | Individuals in this group will be given 8-week individualized exercise according to the Karvonen protocol (heart rate reserve percentage-% HR). Exercise training will be 30 minutes at 50% of HR between weeks 0-2, 45 minutes at 50% of HR between weeks 2-4, 45 minutes at 60% of HR between weeks 4-6 and 6-8 weeks It will be done on the treadmill 3 days a week, for 60 minutes at 60% of HR between weeks. The treadmill speed will be adjusted during exercise to maintain the set target heart rate level. |
| Measure | Description | Time Frame |
|---|---|---|
| Menstrual pain severity | As primary outcome measures, the highest menstrual pain severity perceived by the participants in their last menstruation and the average of the pain severity in the first 3 days of their menstruation will be evaluated. A 10-cm VAS from zero (no pain at all) to 10 (the worst pain I have ever felt) will be used to determine the severity of menstrual pain. Individuals will be asked to mark the severity of pain they felt in the first 3 days of their last menstruation on 3 separate VAS lines. | Change in severity of menstrual pain from baseline up to end of 8th week, 3rd month, and 6th month. |
| Measure | Description | Time Frame |
|---|---|---|
| Uterine artery blood flow | Determination of uterine artery blood flow changes will be made with Doppler US imaging device. Uterine arterial blood flow will be determined by recording the systole / diastole ratios (S / D), pulsatility indices (PI) and resistance indices (RI) values in the first 3 days of the menstrual cycle of individuals. | Change in uterine artery blood flow from baseline up to end of 8th week. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Serap Özgül, Prof | Hacettepe University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gamze Nalan Çinar | Ankara | 06100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28844356 | Background | Wickstrom K, Edelstam G. Minimal clinically important difference for pain on the VAS scale and the relation to quality of life in women with endometriosis. Sex Reprod Healthc. 2017 Oct;13:35-40. doi: 10.1016/j.srhc.2017.05.004. Epub 2017 May 25. | |
| 12890299 | Background | Enright PL. The six-minute walk test. Respir Care. 2003 Aug;48(8):783-5. |
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| ID | Term |
|---|---|
| D004412 | Dysmenorrhea |
| D014592 | Uterine Hemorrhage |
| ID | Term |
|---|---|
| D008599 | Menstruation Disturbances |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017699 | Pelvic Pain |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Yoga exercise | Other | Individuals in this group will be given 8-week individualized yoga exercise including stretching, relaxing, strength training. Exercise training will be done 3 days a week. The duration of the exercise will be adjusted to be the same as the aerobic exercise group. |
|
| Body mass index | Evaluation of body mass index will be done by weighing scale. Results will be presented in kg/m2. | Change in body mass index from baseline up to end of 8th week, 3rd month, and 6th month. |
| body fat percentage | Evaluation of body fat percentage will be done by weighing scale. Results will be presented in %. | Change in body fat percentage from baseline up to end of 8th week, 3rd month, and 6th month. |
| body fat amount | Evaluation of body fat amount will be done by weighing scale. Results will be presented in kg. | Change in body fat amount from baseline up to end of 8th week, 3rd month, and 6th month. |
| lean body weight ratio | Evaluation of lean body weight ratio will be done by weighing scale. Results will be presented in %. | Change in lean body weight ratio from baseline up to end of 8th week, 3rd month, and 6th month. |
| Lean body weight | Evaluation of lean body weight ratio will be done by weighing scale. Results will be presented in kg. | Change in lean body weight ratio from baseline up to end of 8th week, 3rd month, and 6th month. |
| Cardiovascular fitness | Cardiovascular fitness will be evaluated with the "6-minute walk test". For this test, which evaluates functional performance; Marking will be made at both starting points of a distance of 30 meters in the corridor. Individuals will be asked to walk for 6 minutes at the highest speed without running, and at the end of 6 minutes, the distance they walked will be recorded in meters. During the exercise test, vital signs such as blood pressure, heart rate, fatigue, shortness of breath, oxygen saturation of all individuals will be recorded before and immediately after the test. | Change in cardiovascular fitness from baseline up to end of 8th week, 3rd month, and 6th month. |
| Muscular static endurance | For the abdominal static endurance test, a board will be used to position the patient in 60º flexion. The subjects will be positioned with the trunk at 60°, the hips and knees flexed at 90°, and the hands on the opposite shoulders, leaning against the board. The board will be pulled back 10 cm and the patient will be asked to keep his isometric position as much as possible by contracting his abdominal muscles. As soon as the subject's body touches the board, the test will be terminated and the time to hold the position will be recorded in seconds. The test is continued for a maximum of 120 seconds and after 120 seconds the test will be stopped. | Change in muscular static endurance from baseline up to end of 8th week, 3rd month, and 6th month. |
| Muscular dynamic endurance | 30 seconds sit-up test will be used for dynamic endurance. In the 30-second sit-up test, individuals will be asked to stand up to the level of the lower angle of the scapula and return to the starting position, with the knees flexed at 90 degrees, the hands on the back of the neck and the soles of the feet on the ground, with the command to start in the supine position to evaluate the dynamic endurance of the abdominal muscles. The exact and correct number of starts during 30 seconds will be recorded as the test score. | Change in muscular dynamic endurance from baseline up to end of 8th week, 3rd month, and 6th month. |
| Muscle strength (for lower extremity) | Dominant side knee extension strength for the lower extremity will be measured with the Nicholas Manual Muscle Tester. | Change in muscular strength from baseline up to end of 8th week, 3rd month, and 6th month. |
| Muscle strength (for upper extremity) | For upper extremity muscle strength, the grip strength of the dominant hand will be measured with a Hand grip dynamometer. | Change in muscular strength from baseline up to end of 8th week, 3rd month, and 6th month. |
| Flexibility | It will be evaluated with the sit-reach test. Individuals will be asked to perform maximum trunk flexion with both hands on top of each other in a long sitting position with legs straight. The distance between the tip of the hand and the board against the soles of the feet will be measured. The distance will be recorded in +/- centimeters (cm). | Change in flexibility from baseline up to end of 8th week, 3rd month, and 6th month. |
| Menstrual stress level | The complaints of individuals in the menstrual, premenstrual and intermenstrual periods will be evaluated in the Menstrual Distress Complaint List. | Change in menstrual stress level from baseline up to end of 8th week, 3rd month, and 6th month. |
| Anxiety/depressive symptom level | Anxiety and depressive symptom levels of individuals will be evaluated with the Depression Anxiety Stress Scale. | Change in anxiety/depressive symptom level from baseline up to end of 8th week, 3rd month, and 6th month. |
| Quality of life level | The quality of life of individuals will be evaluated with the World Health Organization Quality of Life Scale-Short Form. In the scale consisting of 5 subsections, each section score varies between 4 and 20. Higher scores indicate higher quality of life. | Change in quality of life level from baseline up to end of 8th week, 3rd month, and 6th month. |
| Sleep quality | Sleep quality of individuals will be evaluated with the Women's Health Initiative Insomnia Scale. The higher the score, the higher the degree of insomnia. | Change in sleep quality level from baseline up to end of 8th week, 3rd month, and 6th month. |
| Perception of improvement | A 3-point Likert-type scale will be used to evaluate the subjective perception of improvement of individuals. An increase in the score indicates that the perception of improvement increases. | Change in perception of improvement from baseline up to end of 8th week, 3rd month, and 6th month.. |
| 1836517 | Background | Guimaraes AC, Vaz MA, De Campos MI, Marantes R. The contribution of the rectus abdominis and rectus femoris in twelve selected abdominal exercises. An electromyographic study. J Sports Med Phys Fitness. 1991 Jun;31(2):222-30. |
| 26155448 | Background | Bianco A, Lupo C, Alesi M, Spina S, Raccuglia M, Thomas E, Paoli A, Palma A. The sit up test to exhaustion as a test for muscular endurance evaluation. Springerplus. 2015 Jul 2;4:309. doi: 10.1186/s40064-015-1023-6. eCollection 2015. |
| 19661831 | Background | Arnold CM, Warkentin KD, Chilibeck PD, Magnus CR. The reliability and validity of handheld dynamometry for the measurement of lower-extremity muscle strength in older adults. J Strength Cond Res. 2010 Mar;24(3):815-24. doi: 10.1519/JSC.0b013e3181aa36b8. |
| 5749738 | Background | Moos RH. The development of a menstrual distress questionnaire. Psychosom Med. 1968 Nov-Dec;30(6):853-67. doi: 10.1097/00006842-196811000-00006. No abstract available. |
| 7726811 | Background | Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995 Mar;33(3):335-43. doi: 10.1016/0005-7967(94)00075-u. |
| 12847774 | Background | Levine DW, Kripke DF, Kaplan RM, Lewis MA, Naughton MJ, Bowen DJ, Shumaker SA. Reliability and validity of the Women's Health Initiative Insomnia Rating Scale. Psychol Assess. 2003 Jun;15(2):137-48. doi: 10.1037/1040-3590.15.2.137. |
| 2691207 | Background | Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989 Dec;10(4):407-15. doi: 10.1016/0197-2456(89)90005-6. |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D006470 | Hemorrhage |