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The study will be a non-blinded randomized controlled trial, consisting of two groups. Non-probability Convenience sampling will be used to recruit participants who will meet the inclusion criteria. Group allocation will be performed using the sealed envelope method to ensure randomization of participants into experimental and control groups. The sample size will be 38 (19 in each group). Group A will receive neurodynamic stretches while Group B will receive myofascial pain release technique.
The most prevalent endocrinopathy in women of reproductive age is polycystic ovarian disorder (PCOS), with notable clinical characteristics related to reproduction, metabolism, dermatology, and psychology. Among the most prominent gynecological disorders in women is dysmenorrhea, which has a major detrimental effect on one's quality of life. This randomized clinical study aims to evaluate and compare the effects of neurodynamic stretching combined with diaphragmatic breathing versus myofascial pain release therapy in reducing the intensity and duration of dysmenorrhea in girls with PCOS, to assess the impact of both interventions on improving the quality of sleep among girls with PCOS and to compare the effects of neurodynamic stretching with diaphragmatic breathing and myofascial pain release therapy on enhancing functional mobility in females with PCOS.
The study will be a non-blinded randomized controlled trial, consisting of two groups. Non-probability Convenience sampling will be used to recruit participants who will meet the inclusion criteria. Group allocation will be performed using the sealed envelope method to ensure randomization of participants into experimental and control groups. The sample size will be 38 (19 in each group). Group A will receive neurodynamic stretches which includes abdominal stretches, calf stretches, hamstring stretches. Group B will receive myofascial pain release technique. The study will be conducted over a period of 10 months at Shaikh Zayed Hospital Lahore. Ethical approval will be obtained. Individuals fulfilling the inclusion criteria will be selected, followed by written informed consent after explaining the study purpose. Participants will then be randomly allocated to one of the two groups. Comparative Training would be performed thrice a week on alternate days for a total duration of 6 weeks. Total sessions will be 18. All outcome measurements will be performed pre and after the 6 weeks' intervention period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Neurodynamic stretches | Active Comparator | Group A will receive neurodynamic stretches which includes abdominal stretches, calf stretches, hamstring stretches. |
|
| myofascial pain release technique | Experimental | Group B will receive myofascial pain release technique. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neurodynamic stretches | Other | Participants will receive neurodynamic mobilization techniques focused on improving the mobility of the lumbosacral plexus and peripheral nerves. Week 1-2:
Frequency: 3 sets of 10 repetitions per nerve. Emphasis: Gentle, pain-free movements with diaphragmatic breathing Week 3-4: Progression to sliders + tensioners. • Techniques: Dynamic slump with tensioning, prone femoral tensioner. Repetitions: 2 sets of 5-7 controlled repetitions. Emphasis: Slight neural load increase while ensuring patient comfort. Week 5-6:
|
| Measure | Description | Time Frame |
|---|---|---|
| Mc Gill Questionnaire | The short-form McGill Pain Questionnaire (SF-MPQ) is a shorter version of the original MPQ, and was developed later in 1987.The pain rating index has 2 subscales:
| 6 weeks |
| WaLIDD Score | The WaLIDD score, or Working ability, Location, Intensity, Days of pain, Dysmenorrhea score, is a tool used to assess and diagnose dysmenorrhea (menstrual cramps) and predict the likelihood of needing medical leave. It's a self-report scale where individuals rate their experience of dysmenorrhea based on four key aspects: pain location, pain range, duration of pain, and disability. The total score, ranging from 0 to 12, categorizes the severity of dysmenorrhea: 0 indicates no dysmenorrhea, 1-4 is mild, 5-7 is moderate, and 8-12 is severe. The reliability of the tool was measured using Cronbach's alpha value, and it was found to be 0.88. | 6 weeks |
| PSQI Scale | The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses sleep quality over a one-month time interval. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties. The reliability of the tool was measured using Cronbach's alpha value, and it was found to be 0.83. | 6 weeks |
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Inclusion Criteria:
• Age 18-35 years
Exclusion Criteria:
• History of endocrine disorders
Diagnosed cases of PCOS with irregular periods until 3 months and Presence of dysmenorrhea (Check WaLIDD Questionnaire)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Imran Amjad, PhD | Contact | 03324390125 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Hafiza Iqra Rubab, MSWHPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shaikh Zayed Hospital | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39913497 | Background | Nunez de Arenas-Arroyo S, Martinez-Vizcaino V, Torres-Costoso A, Reina-Gutierrez S, Bizzozero-Peroni B, Cavero-Redondo I. Immediate and short-term effects of neurodynamic techniques on hamstring flexibility: A systematic review with meta-analysis. PLoS One. 2025 Feb 6;20(2):e0318671. doi: 10.1371/journal.pone.0318671. eCollection 2025. | |
| 39351042 |
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| ID | Term |
|---|---|
| D011085 | Polycystic Ovary Syndrome |
| D004412 | Dysmenorrhea |
| D007319 | Sleep Initiation and Maintenance Disorders |
| ID | Term |
|---|---|
| D010048 | Ovarian Cysts |
| D003560 | Cysts |
| D009369 | Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 |
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| myofascial pain release technique Interventions: | Other | Participants will receive myofascial release therapy aimed at relieving fascial tightness, trigger points, and muscle stiffness in the abdominal, pelvic, and lumbar regions. Week 1-2:
Each hold: 90-120 seconds per site. Week 3-4:
Week 5-6:
|
|
| Lv Y, Yin Y. A Review of the Application of Myofascial Release Therapy in the Treatment of Diseases. J Multidiscip Healthc. 2024 Sep 26;17:4507-4517. doi: 10.2147/JMDH.S481706. eCollection 2024. |
| Background | Haider R, Geetha K. Das,(2024), Menstrual Problems: Menorrhagia and Primary Dysmenorrhagia. Biomedical Research and Clinical Trials.;3(1). |
| 37915863 | Background | Wang C, Liu L, Bai X. Knowledge Mapping of Primary Dysmenorrhea: Hotspots, Knowledge Structure, and Theme Trends. J Pain Res. 2023 Oct 27;16:3613-3624. doi: 10.2147/JPR.S435236. eCollection 2023. |
| 38514447 | Background | Teede HJ, Neven ACH, Pena A. Evolution of evidence-based diagnostic criteria in adolescents with polycystic ovary syndrome. Hum Reprod. 2024 May 2;39(5):876-877. doi: 10.1093/humrep/deae050. No abstract available. |
| Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |
| D008599 | Menstruation Disturbances |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017699 | Pelvic Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D001523 | Mental Disorders |