Transcutaneous electrical nerve stimulation for women with primary dysmenorrhea: Study protocol for a randomized controlled clinical trial with economic evaluation.

Primary dysmenorrhea (PD) is a common gynecological disorder characterized by cramping pain in the lower abdomen during menstruation, in the absence of identifiable pathology. While Transcutaneous Electrical Nerve Stimulation (TENS) is used to promote PD pain relief, there is still a need to understand the parameters and cost-effectiveness of this intervention. As such, this study aims to disclose a study that will evaluate the effectiveness and cost-effectiveness of TENS on pain intensity in women with PD. This is a protocol for an assessor-blinded randomized controlled trial that includes 174 women with PD, >18 years old, with menstrual pain greater than or equal to four points in the Numerical Rating Scale. Participants will be randomized into three groups (active TENS, placebo TENS, and educational booklet). Participants allocated to the active TENS group will receive electrical stimulation (F = 100 Hz, pulse duration = 200 µs, for 30 min). In contrast, the placebo TENS group will receive placebo stimulation (same parameters, but for only 30 s, and then the current will be ramped off over a 15-s time frame) for three consecutive months during menstruation. Participants allocated to the educational booklet group will receive instructions about health promotion and education actions related to PD. A blinded assessor will evaluate the pain intensity (Numerical Rating Scale), presenteeism (Stanford Presenteeism Scale), Health-Related Quality of Life (Short-Form 6 dimensions and SF-36), and health costs of menstrual pain. This is the first study to propose a health economic evaluation while assessing the benefits of using TENS to treat PD symptoms. It is hypothesized that active TENS will be more effective than placebo TENS or the educational booklet in improving clinical outcomes in the short-, medium- and long-term. The study will also provide information about the cost-effectiveness of TENS, which can be used by policy makers to improve PD care in public and private health systems.

Assessment of the Reliability of the Leg Lateral Reach Test to Measure Thoraco-Lumbo-Pelvic Rotation in Individuals With Chronic Low Back Pain.

PURPOSE: The purpose of this study was to evaluate the intrarater and interrater reliability of the Leg Lateral Reach Test (LLRT) to measure the mobility of the thoraco-lumbo-pelvic segment in individuals with nonspecific chronic low back and the correlations among pain intensity, kinesiophobia, and LLRT scores. METHODS: Thirty participants with nonspecific chronic low back pain were selected. The main variables were LLRT, pain intensity (measured with the Numeric Pain Rating Scale) and kinesiophobia (Tampa Scale of Kinesiophobia). The reliability of the LLRT was evaluated by means of intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change. RESULTS: Most participants were women (83.3%), young adults (mean = 30.86; standard deviation = 8.56), with overweight and nonspecific chronic low back for more than 59 months of duration. In the intrarater analysis, we observed reliability values ranging from substantial to excellent (ICC ≥ .889; SEM ≤ 7.97%). In the interrater analysis, we observed excellent reliability (ICC ≥ .947; SEM ≤ 5.62%). There was a weak and positive correlation between pain and LLRT, and no correlation between kinesiophobia and LLRT. CONCLUSION: LLRT is a reliable test to measure thoraco-lumbo-pelvic rotation in individuals with nonspecific chronic low back pain.

Health related quality of life, depression and climacteric symptoms in women from a lowincome community / Qualidade de vida relacionada à saúde, sintomas climatéricos e de depressão em mulheres de uma comunidade de baixa renda / Calidad de vida relacionada con la salud, síntomas climatéricos y de depresión en mujeres de una comunidad de bajos ingresos

Purpose: To evaluate health-related quality of life, depressive and climacteric symptoms in Southeastern low-income community-dwelling climacteric women from Brazil. Methods: A comparative cross-sectional study. Outcome measures were quality of life, depression and climacteric symptoms. Results and conclusion: Participants presented impaired quality of life, and an expressive number of them presented moderate and severe depression and moderate severity climacteric symptoms.

O objetivo é avaliar a qualidade de vida relacionada à saúde, sintomas climatéricos e de depressão em mulheres de uma comunidade de baixa renda do Sudeste do Brasil. Métodos: Um estudo comparativo transversal. Os desfechos foram qualidade de vida, sintomas depressivos e climatéricos. Resultados e conclusão: As participantes apresentaram prejuízos na qualidade de vida e um número expressivo delas apresentou depressão moderada a severa e sintomas climatéricos de intensidade moderada.

El objetivo es evaluar la calidad de vida relacionada con la salud, los síntomas de depresión y el climaterio en mujeres de una comunidad de bajos ingresos en el sureste de Brasil. Métodos: estudio comparativo transversal. Los resultados fueron calidad de vida, síntomas depresivos y climatéricos. Resultados y conclusión: Los participantes tenían una calidad de vida deteriorada y un número significativo tenía depresión moderada a severa y síntomas climatéricos de intensidad moderada.