Comparison of Reflexology and Connective Tissue Manipulation in Participants with Primary Dysmenorrhea.

OBJECTIVE: The aim of this interventional correlational study is to compare the effects of foot reflexology (FR) and connective tissue manipulation (CTM) in subjects with primary dysmenorrhea. DESIGN: A total of 30 participants having primary dysmenorrhea completed the study. Data, including demographics (age, body-mass index), menstrual cycle (age at menarche, menstrual cycle duration, time since menarche, bleeding duration), and menstrual pain characteristics (intensity and duration of pain, type and amount of analgesics), were recorded. Effect of dysmenorrhea on participants' concentration in lessons and in sports and social activities was assessed by using the visual analog scale. Participants rated their menstruation-related symptom intensity through the Likert-type scale. FR was applied to 15 participants for 3 days a week and CTM was performed on 15 participants for 5 days a week. Treatments were performed during one cycle, which started at the third or fourth day of menstruation and continued till the onset of next menstruation. Assessments were performed before treatment (first menstruation), then after termination of the treatment because of the next menstruation's onset (second menstruation), and ∼1 month after at the consecutive menstrual period (third menstrual cycle). RESULTS: Time-dependent changes in duration and intensity of pain along with analgesic amount show that both treatments provided significant improvements (p < 0.05) and no superiority existed between the groups (p > 0.05). A similar result was obtained in terms of time-dependent changes in concentration in lessons and difficulty in sports and social activities due to dysmenorrhea. Menstruation-related symptoms were found to be decreased after treatment and in the following cycle with both treatments (p < 0.05) where no difference existed between the groups (p > 0.05). CONCLUSION: Both FR and CTM can be used in the treatment of primary dysmenorrhea and menstruation-related symptoms as these methods are free from the potentially adverse effects of analgesics, noninvasive, and easy to perform.

Interferential current versus biofeedback results in urinary stress incontinence.

BACKGROUND: Urinary stress incontinence is a common, disruptive and potentially disabling condition in which the subject complains of involuntary leakage on effort or exertion or on sneezing or coughing. AIM: This study was performed in order to compare the effects of interferential current and biofeedback applications on incontinence severity in patients with urinary stress incontinence. In addition, pelvic muscle strength and quality of life as important parameters in these subjects were investigated. METHODS: In this prospective, randomised, controlled study, forty women with moderate intensity of urinary stress incontinence as determined by one-hour pad test were included. Pelvic muscle strength was evaluated by a biofeedback device and quality of life was assessed by a 28-itemed questionnaire. All of the parameters were evaluated before and after the treatments. Twenty cases underwent interferential current therapy, while pelvic floor exercises via biofeedback were applied in the remaining cases. The treatments lasted 15 minutes per session, three times a week for a total of 15 sessions. RESULTS: All of the parameters improved after the treatments in each group (p <0.05) and both treatment modalities seemed to have similar effects on pad test (95% CI: -1.48 - 4.59), pelvic muscle strength (95% CI: -9.29 -1.78) and quality of life (95% CI: -11.91 - 5.31) outcomes. CONCLUSIONS: Physical therapy modalities used in this trial are applied easily and non invasive. Also, when the finding that no adverse effects were observed during the study period is taken into consideration, it can be concluded that both methods can be used effectively in patients with urinary stress incontinence.

Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea.

OBJECTIVE: To compare the effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. DESIGN: A prospective, randomized, and controlled study. SETTING: Hacettepe University School of Physical Therapy and Rehabilitation. PATIENTS: Thirty-four volunteer subjects with primary dysmenorrhea (mean age: 21.35 +/- 1.70 years) were included. Statistical analyses were performed in 32 subjects who completed all measures. INTERVENTIONS: Fifteen subjects received interferential current application for 20 minutes and 17 subjects received transcutaneous electrical nerve stimulation for 20 minutes when they were experiencing dysmenorrhea. OUTCOME MEASURES: Physical characteristics, years since menarche, length of menstrual cycle (days), and duration of menstruation (days) were recorded. Visual analog scale ( VAS) intensities of menstrual pain, referred lower limb pain, and low back pain were recorded before treatment, and immediately, 8 hours, and 24 hours after treatment. RESULTS: Intensities of the evaluated parameters decreased beginning from just after the applications in both groups (P<0.05). Intensity of referring low back pain in first three measurement times was different between the groups (P<0.05), but this difference is thought to be due to the baseline values of the groups. So, it can be said that no superiority existed between the methods (P>0.05). CONCLUSION: Both transcutaneous electrical nerve stimulation and interferential current appear to be effective in primary dysmenorrhea. As they are free from the potentially adverse effects of analgesics, and no adverse effects are reported in the literature nor observed in this study, a clinical trial of their effectiveness in comparison with untreated and placebo-treated control groups is warranted.

Short and long-term results of connective tissue manipulation and combined ultrasound therapy in patients with fibromyalgia.

OBJECTIVE: The aim of the study was to evaluate the short-term and 1-year follow-up results of connective tissue manipulation and combined ultrasound (US) therapy (US and high-voltage pulsed galvanic stimulation) in terms of pain, complaint of nonrestorative sleep, and impact on the functional activities in patients with fibromyalgia (FM). METHODS: This is an observational prospective cohort study of 20 female patients with FM. Intensity of pain, complaint of nonrestorative sleep, and impact of FM on functional activities were evaluated by visual analogue scales. All evaluations were performed before and after 20 sessions of treatment, which included connective tissue manipulation of the back daily, for a total of 20 sessions, and combined US therapy of the upper back region every other session. One-year follow-up evaluations were performed on 14 subjects. Friedman test was used to analyze time-dependent changes. RESULTS: Statistical analyses revealed that pain intensity, impact of FM on functional activities, and complaints of nonrestorative sleep improved after the treatment program (P < .05). CONCLUSION: Methods used in this study seemed to be helpful in improving pain intensity, complaints of nonrestorative sleep, and impact on functional activities in patients with FM.