Vibration-Assisted Core Exercises for Primary Dysmenorrhea

Keywords

• Vibration
• dysmenorrhea primary
• core exercise
• whole body vibration

Lead sponsor

Ebru Aloğlu Çiftçi is the lead sponsor of 4 studies on the registry; 2 are open to participants now.

Study arms

• Experimental
  Whole Body Vibration

  The vibration group performed core exercises with vibration at 8 mm amplitude and 14 Hz frequency, 3 days a week for 8 weeks (24 sessions). Each session lasted 45-60 minutes, including a 10-minute warm-up (walking) and a 5-minute cool-down (stretching). Vibration time started at 15 minutes and increased to 30 minutes. Eight core exercises (bridge exercise, plank, cat-camel exercise, crunches, side-bends, heel drops, squats, half push-ups) were applied, with repetitions increased every 2 weeks: 8 reps in weeks 1-2, 10 reps in weeks 3-4, 12 reps in weeks 5-6, and 15 reps in weeks 7-8. A 30-second rest was given between exercises.

  Behavioral: Core exercises performed simultaneously on a whole body vibration platform

• No intervention
  Control Group

  No intervention was applied to the control group.

Interventions

• BehavioralCore exercises performed simultaneously on a whole body vibration platform

  It's a method where individuals stand on a vibration-generating platform and the vibration is transmitted from the soles of their feet to the entire body. Its use in combination with exercise has become popular in recent years due to the hypergravity it creates, aiming to increase muscle strength and reduce pain. There is no standardized protocol for the frequency, amplitude, and frequency of vibration application. However, it is known that when applied at frequencies between 10-30 Hz, it has no negative side effects and is beneficial in managing pain. In our study, core exercises will be performed on a vibration platform at a frequency of 14 Hz with an amplitude of 8 mm.

Primary outcomes

1. Functional and Emotional Status Assessment (Functional and Emotional Dysmenorrhea Scale)

   The Functional and Emotional Dysmenorrhea Scale was used to assess participants' dysmenorrhea experiences functionally and emotionally. The scale is a Likert-type scale consisting of 14 items and two subscales. Each item can be scored from 1 to 5. Scoring criteria are: 1. Not at all like my situation, 2. Not at all like my situation, 3. Both similar and not like my situation, 4. Similar to my situation, 5. Very similar to my situation. As the total score on the scale increases, the extent to which individuals are functionally and emotionally affected by dysmenorrhea also increases.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

2. Menstruation Symptoms (Menstruation Symptom Scale)

   In our study, the Menstrual Symptom Scale, a useful tool for assessing menstrual symptoms in Turkish women and found to have adequate validity and reliability, was used to assess participants' symptoms. The scale consists of 22 items developed to assess dysmenorrhea and its symptoms. Each item can be scored from 1 to 5. Scoring criteria range from 1 (never) to 5 (always). It consists of three subscales: items 1-13 address negative effects/somatic complaints, items 14-19 address menstrual pain symptoms, and items 20-22 address coping strategies. The subscale score is calculated by calculating the total mean score of the items in the subscales. A higher mean score for a subscale indicates an increase in the severity of menstrual symptoms related to that subscale. The mean score calculated from the scale is directly proportional to the severity of menstrual symptoms.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

3. Menstruation Attitudes (Menstruation Attitude Questionnaire)

   In our study, we used the Menstruation Attitude Questionnaire to measure attitudes toward menstruation in individuals with dysmenorrhea and varying socio-demographic characteristics. The scale is a Likert-type scale consisting of 33 items and 5 subscales. Each item is scored from 1 to 5. Scoring criteria range from 1 (Strongly disagree) to 5 (Strongly agree). The subscales and number of items are as follows: 1. Menstruation as a debilitating phenomenon (12 items); 2. Menstruation as a disturbing phenomenon (6 items); 3. Menstruation as a natural phenomenon (5 items); 4. Precognition/Anticipation of menstruation (5 items); and 5. Denial of the effects of menstruation (7 items). A high mean score on the Menstruation Attitude Questionnaire is directly proportional to the positive attitude toward menstruation.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

Secondary outcomes

1. Pain Intensity (Visual Analog Scale)

   VAS is a frequently used assessment method for converting the intensity of pain, which cannot be measured numerically, into numerical data. Pain intensity is assessed on a scale from 0 to 10, with 0 indicating no pain and 10 indicating unbearable pain.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

2. Quality of Life Assessment (Short Form-36 Scale)

   The SF-36 is a self-assessment tool consisting of eight subscales and 36 questions. This tool is grouped to assess participants' physical functioning (10 items), physical limitations (4 items), emotional limitations (3 items), pain limitations (2 items), vitality (4 items), social functioning (2 items), mental health (5 items), and general health (5 items). Each subscale can be scored from 0 to 100. In this scoring system, 0 represents the lowest quality of life, and 100 represents the best.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

3. Trunk endurance assessment (Sorenson Test)

   In the Sorenson Test, participants were positioned prone, their pelvises positioned at the edge of the table, and their ankles were stabilized. The upper extremities were positioned next to the torso. The time the participant could maintain the horizontal position was measured with a stopwatch. The test was terminated if the position could not be maintained.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

4. Trunk endurance assessment (Sit-up testi)

   In the sit-up test, the maximum number of correct repetitions that the subjects perform within a 30-second time period is recorded.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

5. Trunk endurance assessment (Lateral Bridge Test-Right and Left)

   The Side Bridge Test was performed to assess the endurance of the spinal stabilizer muscles. Participants were positioned in a side-lying position. They were asked to lift their hips until the pelvis and trunk were horizontal. The time the position was maintained was measured with a stopwatch, and the assessment was performed on both sides.

   Time frame: First 48 hours of the menstrual cycle (pre-intervention), week 4 (post-intervention), week 8 (post-intervention)

Publications

• Lefebvre G, Pinsonneault O, Antao V, Black A, Burnett M, Feldman K, Lea R, Robert M; SOGC. Primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can. 2005 Dec;27(12):1117-46. doi: 10.1016/s1701-2163(16)30395-4. English, French. PubMed 16524531 ↗
• Hoseini, M., Gharahtapeh, S. R., Jahazi, A. 2015 "Effect Of Vibration And Heat Combination On Primary Dysmenorrhea" Bali Medical Journal, 4(1), 12-16.

Individual participant data

Plan to share: Yes — The study will share de-identified, summary-level outcome data, including group-level means, standard deviations, effect sizes, and p-values derived from statistical analyses.

Supporting information: Study protocol, Sap