The Effect of Spinal Stabilization Training in Women With Dysmenorrhea: A Randomized Controlled Trial

The study, designed as a randomized controlled experimental trial, was conducted at Tonya Vocational School. Institutional approval was obtained to carry out the study at Tonya Vocational School (Appendix-). Participants who met the inclusion and exclusion criteria and voluntarily agreed to participate were required to sign an informed consent form prior to the initiation of the study. Following the acquisition of informed consent, 50 women with dysmenorrhea, identified based on the WaLIDD score, were randomly allocated into two groups using a simple randomization method (sealed envelope): 25 participants in the experimental group and 25 in the control group.Baseline assessments were performed by the same researcher within the first week immediately following the most recent menstrual period, prior to the commencement of the intervention. Participants' demographic characteristics and menstrual cycle information were recorded using a data collection form before the exercise intervention.

Pain intensity was evaluated using the Visual Analog Scale (VAS); menstrual symptom severity using the Menstrual Symptom Scale; body awareness using the Body Awareness Questionnaire; muscle endurance using the McGill trunk endurance tests; lumbopelvic mobility using the Modified Schober test; activities of daily living using the Lawton-Brody Instrumental Activities of Daily Living Scale; problem-solving skills using the Problem Solving Inventory; decision-making styles using the Melbourne Decision Making Questionnaire; quality of life using the SF-12 questionnaire; and physical activity levels using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). All measurements were conducted within the first week immediately following the most recent menstrual period, both before (baseline assessment) and after (post-intervention assessment) the exercise program.

The control group was provided with relaxation exercises and lifestyle recommendations, including avoidance of exposure to environmental tobacco smoke; reduction or cessation of smoking and alcohol consumption; limitation of the intake of caffeine, sugar, cold foods and beverages, and high-salt foods; preference for loose and cotton clothing; taking warm standing showers; and maintaining adequate and good-quality sleep (at least 6-8 hours). These recommendations were delivered to the control group .In addition to relaxation exercises and lifestyle recommendations, the experimental group received spinal stabilization training. A total of 16 sessions of spinal stabilization training were administered under the supervision of a physiotherapist, with two sessions per week over an 8-week period. Each session lasted approximately 45-50 minutes. The exercise program began with a 5-6 minute warm-up, followed by a 35-40 minute main program, and concluded with a 5-6 minute cool-down period. The warm-up and cool-down phases consisted of general stretching exercises and light jogging.The exercise program was designed to be progressive; accordingly, during the first week, participants performed a single set of 6-10 repetitions for each exercise. The number of repetitions and sets was increased every two weeks based on the participants' capacity. Progression in the exercise program was achieved by increasing the number of repetitions and sets, adding resistance, and extending the duration. The level of exertion was determined using the Borg Scale (6-20), and the exercise intensity was increased when participants reached a Borg rating of 11-14.