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The aim of this study is to investigate the effects of clinical Pilates exercises on pain, self-esteem, body image, depression, and quality of life in women with dyspareunia. The study addresses dyspareunia as a multifaceted health problem with psychological, social as well as physical implications. it evaluates the effects of pelvic floor-focused clinical Pilates interventions on physiological symptoms and psychosocial well-being. it also demonstrates this approach as effective, safe, and evidence-based method in the treatment of dyspareunia among women in Turkish society.
A total of 20 women with dyspareunia were included in the study. The participants were divided into two groups: the Pilates group (n = 10) and the control group (n = 10). The Pilates group underwent a clinical Pilates exercise program including pelvic floor exercises, supervised by a physiotherapist, 3 days per week for 8 weeks, while no intervention was applied to the control group. Assessments were conducted before and after the program using the Visual Analog Scale (VAS), the Carol Postpartum Sexual Function and Dyspareunia Evaluation Scale (CPCFDDÖ), the Female Sexual Function Index (FSFI), the Rosenberg Self-Esteem Scale (RSES), the Body Image Scale (BIS), the Beck Depression Inventory (BDI), and the SF-36 Quality of Life Scale.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group (Clinical Pilates Exercises) | Experimental | Clinical Pilates exercises were administered to strengthen the pelvic floor and core muscles, three times per week for 8 weeks, with each session lasting 50-60 minutes. The sessions included a warm-up phase, a main exercise program, and a cool-down phase. A total of 8 different exercises were performed in 3 sets of 10 repetitions, with progressively increased spring resistance.** |
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| Control Group | No Intervention | A group of 10 participants with dyspareunia received education on the fundamental principles of Pilates, pelvic floor anatomy, and dyspareunia. Assessments were conducted for both groups before the intervention and were repeated 8 weeks after the intervention.** |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clinical Pilates Exercise | Other | Pelvic Floor-Focused Clinical Pilates Exercises |
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| Measure | Description | Time Frame |
|---|---|---|
| Numeric Rating Scale (NRS) | The Numeric Rating Scale (NRS) is one of the most valid and reliable numerical scales used to assess an individual's pain intensity. Scores range from 0 to 10, with higher scores indicating greater pain intensity. A score of "0" represents "no pain," whereas "10" represents "the worst pain imaginable."** | Baseline and 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Female Sexual Function Index (FSFI) | The Female Sexual Function Index (FSFI) is a Likert-type scale consisting of 19 items that evaluates female sexual dysfunction over the past four weeks. The scale assesses six domains: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort. The maximum raw total score is 95 and the minimum is 4; after applying domain-specific weighting coefficients, the total score ranges from 2 to 36. The weighting factors used for scoring are 0.6 for desire; 0.3 for arousal and lubrication; and 0.4 for orgasm, satisfaction, and pain/discomfort. A total score below 26.55 is defined as indicative of sexual dysfunction. Higher scores indicate better sexual function. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emine ATICI, PhD, Assoc. Prof. | Contact | +90 532 478 86 48 | emine.atici@okan.edu.tr | |
| Kübra Nur Kavaklı, PT | Contact | +90 532 496 02 76 | kkavakli@stu.okan.edu.tr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Okan University | Istanbul | Tuzla | 34959 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D004414 | Dyspareunia |
| D012735 | Sexual Dysfunction, Physiological |
| D003863 | Depression |
| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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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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Two groups: intervention (clinical Pilates exercises) and control (no intervention but Information on the fundamental principles of Pilates, pelvic floor anatomy, and dyspareunia )
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| Baseline and 8 weeks |
| Carol Postpartum Sexual Function and Dyspareunia Assessment Scale | The Carol Postpartum Sexual Function and Dyspareunia Assessment Scale was developed to evaluate sexual function and the presence of dyspareunia in women who have resumed vaginal intercourse after vaginal delivery. The scale consists of a total of 11 items and classifies the severity of the disorder at different levels. The first seven items are rated using a five-point Likert scale: "never" (0 points), "almost never" (1 point), "sometimes" (2 points), "usually" (3 points), and "always" (4 points). The last four items assess pain intensity using a Numeric Rating Scale (NRS), with scores ranging from "no pain" (0 points) to "unbearable/maximum pain" (10 points).** | Baseline and 8 weeks |
| Short Form-36 (SF-36) | The Short Form-36 (SF-36) consists of 36 items and evaluates an individual's self-assessment across physical functioning, social functioning, role limitations (due to physical and emotional problems), mental health, vitality (energy), pain, and general perception of health. The assessment considers the previous four weeks. The SF-36 does not have absolute cutoff scores to define good or poor quality of life. However, according to commonly used classifications in the literature, scores are interpreted as follows: 80-100 indicates very good quality of life, 60-79 good, 40-59 moderate, and 0-39 poor quality of life.** | Baseline and 8 weeks |
| Beck Depression Inventory (BDI) | The Beck Depression Inventory (BDI) is a Likert-type scale developed by Beck to assess emotional, cognitive, and motivational components of depression. The scale evaluates symptoms over the past week and consists of 21 items. Each item has four response options ranging from 0 to 3. Total scores are interpreted as follows: 9 or below indicates "no depression," 10-16 indicates "mild depression," 17-23 indicates "moderate depression," and 24 or higher indicates "severe depression."** | Baseline and 8 weeks |
| Body Image Scale | The Body Image Scale was developed to assess individuals' satisfaction with their body image. It is a 10-item, five-point Likert-type scale with response options ranging from "1-Never," "2-Rarely," "3-Sometimes," "4-Often," to "5-Always." The total score ranges from 10 to 50, with lower scores indicating lower body satisfaction and higher scores indicating higher body satisfaction.** | Baseline and 8 weeks |
| Rosenberg Self-Esteem Scale | The Rosenberg Self-Esteem Scale consists of 10 items and is designed to measure self-esteem. The items are scored using the Guttman method. On the scale, responses eligible for scoring are marked with an asterisk (*). Scoring is performed as follows: items 1, 2, and 3 are evaluated together; items 4 and 5 together; and items 9 and 10 together. If a respondent scores on any two of the first three items (2/3), they receive one point for that set. If a respondent selects any scoring response for either item 4 or 5, they receive one point for that set. Items 9 and 10 are evaluated in the same way as items 4 and 5. Items 6, 7, and 8 are scored individually. Therefore, the maximum total score is 6. Scores are interpreted as follows: 0-1 indicates high self-esteem, 2-4 indicates moderate self-esteem, and 5-6 indicates low self-esteem.** | Baseline and 8 weeks |
| D000091662 | Genital Diseases |
| D005832 | Genital Diseases, Male |
| D052801 | Male Urogenital Diseases |
| D020018 | Sexual Dysfunctions, Psychological |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |