Publications

Objectives: To determine the effect of structured myofascial release techniques on symptoms in individuals with primary dysmenorrhea.

Material and methods: Based on an expected effect size (d = 0.25), α = 0.05, β = 0.20, a minimum of 36 participants was calculated using G*Power for 80 % power. Although 52 were targeted considering 30 % attrition, 41 completed the study. We enrolled 41 participants with PD who were randomly classified into three groups: Structured myofascial release (MFG), transcutaneous electrical nerve stimulation (TENS) and training. All participants were evaluated 3 times: 1st measurement on the first day of the menstrual cycle (pre), 2nd measurement after treatment (post) and 3rd measurement 4 weeks after treatment (follow-up). Outcome measures; demographic information, McGill Pain Questionnaire Short Form, Menstruation Symptom Questionnaire (MSQ), Functional and Emotional Measure of Dysmenorrhea (FEMD), and VAS questionnaire were applied. Pain threshold and muscle tension were measured.

Results: While a significant difference was detected between the pre-post and pre-follow-up values in the pairwise comparisons of MC-1, MC-2, MC-3, and MC-4 values in the MFG group, a significant difference was detected between the pre-post and pre-follow-up MC-1, MC-2, and MC-4 values in the TENS and training groups (p < 0.05). Key outcome differences included a 30 % reduction in MPQ-SF scores in the MFG group (p < 0.001). In all groups, a significant difference was found between the three time-dependent measurements of the MSQ and FEMD values (Pre, Post, Follow-up) (p < 0.05). The mean Follow-up MyotonPRO values were 3.63 ± 0.33 in the MFG group, 4.49 ± 0.49 in the TENS group and 4.89 ± 0.57 in the Training group. A significant difference was found between the three time-dependent measurements of MyotonPRO and VAS values (Pre, Post, and Follow-up of the individuals in the MFG group) (*F = 46.600; *χ2 = 25.739; p < 0.001).

Conclusions: The MFG group demonstrated superior efficacy to the TENS and training groups in alleviating dysmenorrheic pain, enhancing pain threshold, reducing dysmenorrhea symptoms, and decreasing lower abdominal tension. This effect persisted during the follow-up period, 4 weeks post-treatment.

Figure 3. Myotonometry (MyotonPRO).

Keywords: primary dysmenorrhea, myofascial release TENS, menstrual symptom, pain intensity

The MFR was more effective than the TENS and training groups in improving dysmenorrhea pain, pain threshold, dysmenorrhea symptoms, and in lowering abdominal tension. Especially in the MFR group, it was found that the effect of decreasing the intensity of dysmenorrhea pain, dysmenorrhea symptoms, and tension and increasing the pain threshold continued in the follow-up period of 4 weeks after treatment. MFR treatment provided more effective results than the other methods by inducing neural and mechanical relaxation. We suggest that studies investigating prostaglandin and hormone levels are recommended to assess treatment effects on PD.