Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.

Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness of some physiotherapy techniques in the treatment of PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were "dysmenorrhea", "physical the-rapy", "physiotherapy", and "manual therapy". The search was performed in five databases: Scopus, PubMed, PEDro, Web of Science, and Medline, in February 2021. The inclusion criteria were randomized controlled trials over the last six years. Articles not related to the treatment of PD or using pharmacology as the main treatment were excluded. Nine articles met the objectives and criteria, with a total of 692 participants. The most used scale to measure pain was the VAS (visual analogue scale). The main techniques were isometric exercises, massage therapy, yoga, electrotherapy, connective tissue manipulation, stretching, kinesio tape, progressive relaxation exercises and aerobic dance. Meta-analysis shows benefits of physiotherapy treatment for pain relief compared with no intervention or placebo (MD: -1.13, 95% CI: -1.61 to -0.64, I2: 88%). The current low-quality evidence suggests that physiotherapy may provide a clinically significant reduction in menstrual pain intensity. Given the overall health benefits of physiotherapy and the low risk of side effects reported, women may consider using it, either alone or in conjunction with other therapeutic modalities.

The Influence of Teachers on Motivation and Academic Stress and Their Effect on the Learning Strategies of University Students.

Students often experience the university period as a very stressful time. The teacher is a key figure who can cushion this stressful experience for the student. This study therefore aims to analyse the influence of teachers from the Self-Determination Theory perspective on academic stress, motivation, critical thinking, metacognitive strategies and academic performance in university students. The study involved 2456 university students with an average age of 22.51 years. A structural equation model was created to analyse the causal relationships between the variables. The results showed that the psychological controlling of the teacher positively predicted academic stress while autonomy support negatively predicted academic stress. Academic stress negatively predicted motivation, metacognitive strategies, critical thinking and academic performance. Academic motivation positively predicted metacognitive strategies and critical thinking. Finally, metacognitive strategies and critical thinking positively predicted academic performance. These results highlight the importance of the role that the teacher adopts during classes and the protective factor of academic motivation in the presence of stress.