Araştırma Makalesi
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Effects of stretching and relaxation exercises with pain neuroscience education on emotional status, pain beliefs and quality of life in primary dysmenorrhea

Yıl 2025, Cilt: 12 Sayı: 2, 88 - 98, 01.08.2025
https://doi.org/10.15437/jetr.1655669

Öz

Purpose: The aim of this study was to investigate the effects of pain neuroscience education (PNE) and exercise training (ET) on emotional status, pain beliefs, and quality of life (QoL) in primary dysmenorrhea (PD).
Methods: In the study, individuals with PD diagnosis (n=19) were given ET (stretching and relaxation exercises) together with PNE during two menstrual cycles. Individuals were assessed at the baseline of the study, at the end of the interventions, and at 1-month follow-up after the interventions. As outcome measures, emotional status, pain beliefs and quality of life were assessed with the Depression Anxiety Stress Scale, the Pain Beliefs Questionnaire and the World Health Organization Quality of Life-Brief Form, respectively. Within-group comparisons were performed using Friedman test and post-hoc Conover test.
Results: After the intervention, it was determined that depressive symptoms, anxiety and stress levels and organic pain belief levels decreased and there was a significant improvement in the physical, social and environmental areas of QoL (p<0.05). However, it was observed that there was no change in the level of psychological pain beliefs and the psychological domain of QoL over time (p>0.05). In the 1st month follow-up, it was found that the improvements obtained in emotional symptoms, organic pain beliefs and the environmental domain of QoL were maintained (p>0.05).
Conclusion: It is seen that stretching and relaxation exercises together with PNE in PD improve emotional symptoms, pain beliefs and various areas of QoL. Randomized controlled studies that combine different PNE and exercise approaches and reveal long-term effects are needed.

Kaynakça

  • Burnett M, Lemyre M. No. 345-Primary Dysmenorrhea Consensus Guideline. J Obstet Gynaecol Can. 2017;39:585-595.
  • Itani R, Soubra L, Karout S, et al. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean J Fam Med. 2022;43:101.
  • Fernandez H, Barea A, Chanavaz-Lacheray I. Prevalence, intensity, impact on quality of life and insights of dysmenorrhea among French women: A cross-sectional web survey. J Gynecol Obstet Hum Reprod. 2020;49:101889.
  • Arendt‐Nielsen L, Morlion B, Perrot S, et al. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018;22:216-241.
  • Baird AJ, Haslam RA. Exploring differences in pain beliefs within and between a large nonclinical (workplace) population and a clinical (chronic low back pain) population using the pain beliefs questionnaire. Phys Ther. 2013;93:1615-1624.
  • Armour M, Ee CC, Naidoo D, et al. Exercise for dysmenorrhoea. Cochrane Database Syst Rev. 2019;19:22.
  • Celenay ST, Ozcelikel G, Bayrakli A. Efficacy of progressive muscle relaxation technique in primary dysmenorrhea: A randomized controlled trial. Taiwan J Obstet Gynecol. 2024;63:329-335.
  • Hamasaki H. Effects of diaphragmatic breathing on health: a narrative review. Medicines. 2020;7:65.
  • Upganlawar DS, Patil S, Dhage PP. Efficacy of Connective Tissue Therapy and Abdominal Stretching Exercises in Individuals With Primary Dysmenorrhea: A Review. Cureus. 2023;15: e46553.
  • Tianing NW, Nugraha MHS, Indrayani AW, et al. The difference in the effectiveness of warm compress and active stretching exercise in reducing dysmenorrhea pain. Bali Med J. 2021;10:1041-1044.
  • Schaffer SD, Yucha CB. Relaxation & pain management: the relaxation response can play a role in managing chronic and acute pain. Am J Nurs. 2004;104:75-82.
  • Louw A, Riera-Gilley V. Pain neuroscience education: Teaching people about pain. J Pain Palliat Care Pharmacother. 2024;38:292-301.
  • Gutke A, Sundfeldt K, De Baets L. Lifestyle and chronic pain in the pelvis: State of the art and future directions. J Clin Med. 2021;10:5397.
  • Nijs J, George SZ, Clauw DJ, et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021;3:e383-e392.
  • Zimney K, Van Bogaert W, Louw A. The biology of chronic pain and its implications for pain neuroscience education: state of the art. J Clin Med. 2023;12:4199.
  • Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. J Pain. 2015;16:807-813.
  • Barrenengoa‐Cuadra MJ, Muñoa‐Capron‐Manieux M, Fernández‐Luco M, et al. Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial. Eur J Pain. 2021;25:1137-1149.
  • Benedict TM, Nitz AJ, Gambrel MK, et al. Pain neuroscience education improves post-traumatic stress disorder, disability, and pain self-efficacy in veterans and service members with chronic low back pain: Preliminary results from a randomized controlled trial with 12-month follow-up. Mil Psychol. 2023;36:1-17.
  • Huysmans E, Goudman L, Coppieters I, et al. Effect of perioperative pain neuroscience education in people undergoing surgery for lumbar radiculopathy: a multicentre randomised controlled trial. Br J Anaesth. 2023;131: 572-585.
  • Lluch E, Dueñas L, Falla D, et al. Preoperative pain neuroscience education combined with knee joint mobilization for knee osteoarthritis. Clin J Pain. 2018;34:44-52.
  • Malfliet A, Kregel J, Coppieters I, et al. Effect of pain neuroscience education combined with cognition-targeted motor control training on chronic spinal pain: a randomized clinical trial. JAMA Neurol. 2018;75:808-817.
  • Ponce-Fuentes F, Cuyul-Vasquez I, Bustos-Medina L, et al. Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial. Physiother Theory Pract. 2023;39:1861-1870.
  • Orhan C, Lenoir D, Favoreel A, et al. Culture-sensitive and standard pain neuroscience education improves pain, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain: a pilot randomized controlled trial. Physiother Theory Pract. 2021;37:633-645.
  • Hush JM, Nicholas M, Dean CM. Embedding the IASP pain curriculum into a 3-year pre-licensure physical therapy program: redesigning pain education for future clinicians. Pain Rep. 2018;3:e645.
  • Aboushady R, El-saidy TMK. Effect of home based stretching exercises and menstrual care on primary dysmenorrhea and premenstrual symptoms among adolescent girls. IOSR J Nurs Health Sci. 2016;5:10-17.
  • López-Liria R, Torres-Álamo L, Vega-Ramírez FA, et al. Efficacy of physiotherapy treatment in primary dysmenorrhea: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18:7832.
  • Ortiz MI, Cortés-Márquez SK, Romero-Quezada LC, et al. Effect of a physiotherapy program in women with primary dysmenorrhea. EJOG. 2015;194:24-29.
  • Anderson AW, Soncini A, Lyons K, et al. The Effect of Myofascial Stretching on Mechanical Nociception and Contributing Neural Mechanisms. NeuroSci. 2024;5:158-168.
  • Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54:1451-1462.
  • Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335-343.
  • YILMAZ Ö, Hakan B, Arslan A. Depresyon Anksiyete Stres Ölçeğinin (Dass 21) Türkçe Kisa Formunun Geçerlilik-Güvenilirlik Çalişmasi. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2:78-91.
  • Edwards LC, Pearce SA, Turner-Stokes L, et al. The pain beliefs questionnaire: an investigation of beliefs in the causes and consequences of pain. Pain. 1992;51:267-272.
  • BERK HÖS, BAHADIR G. Kronik ağrı yaşantısı ve ağrı inançları. Ağrı. 2007;19:5-15.
  • World Health Organization Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551-558.
  • World Health Organization. Quality of Life group: WHOQOL-BREF Introduction. Administration and scoring Field trial version. 1996.
  • Eser E, Fidaner H, Fidaner C, et al. WHOQOL-100 ve WHOQOL-BREF'in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7:23-40.
  • Joseph K, Mills J. Unmet treatment needs in patients with chronic pelvic pain in a New Zealand gynaecology service. ANZJOG. 2019;59:856-860.
  • Holliday S, Hayes C, Jones L, et al. Prescribing wellness: comprehensive pain management outside specialist services. Aust Prescr. 2018;41:86.
  • Dams L, Van der Gucht E, Devoogdt N, et al. Effect of pain neuroscience education after breast cancer surgery on pain, physical, and emotional functioning: a double-blinded randomized controlled trial (educan trial). Pain. 2023;164:1489-1501.
  • Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, et al. A single preoperative pain neuroscience education: Is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50

Primer dismenorede ağrı nörobilim eğitimi ile birlikte uygulanan germe ve gevşeme egzersizlerinin emosyonel durum, ağrı inançları ve yaşam kalitesi üzerine etkileri

Yıl 2025, Cilt: 12 Sayı: 2, 88 - 98, 01.08.2025
https://doi.org/10.15437/jetr.1655669

Öz

Amaç: Bu çalışmanın amacı primer dismenore (PD)’de ağrı nörobilim eğitimi (ANE) ile birlikte verilen egzersiz eğitimi (EE)’nin emosyonel durum, ağrı inançları ve yaşam kalitesi üzerine etkilerini araştırmaktı.
Yöntem: Çalışmada PD tanısı olan bireylere (n=19) iki menstrual döngü süresince ANE ile birlikte EE (germe ve gevşeme egzersizleri) verildi. Bireyler çalışma başlangıcında, müdahalelerin bitimini takiben ve müdahaleler sonrası 1. ay takipte değerlendirildi. Sonuç ölçümleri olarak emosyonel durum Depresyon-Anksiyete ve Stres Ölçeği-21 ile, ağrı inançları Ağrı İnançları Ölçeği ile ve yaşam kalitesi Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği-Kısa Form ile değerlendirildi. Grup içi karşılaştırmalarda Friedman test ve post-hoc Conover testi kullanıldı.
Bulgular: Bireylerde müdahale sonrasında depresif belirti, anksiyete ve stres düzeylerinin ve ağrıya ilişkin organik inanç düzeylerinin azaldığı ve yaşam kalitesinin fiziksel, sosyal ve çevresel alanlarında anlamlı iyileşme olduğu tespit edildi (p<0,05). Bununla birlikte ağrıya ilişkin psikolojik inanç düzeyinde ve yaşam kalitesinin psikolojik alanında zamanla değişim olmadığı görüldü (p>0,05). 1. ay takipte ise emosyonel semptomlarda, organik ağrı inanışında ve yaşam kalitesinin çevresel sağlık alanında elde edilen iyileşmelerin korunduğu bulundu (p>0,05).
Sonuç: PD’de ANE ile birlikte germe ve gevşeme egzersizlerinin emosyonel semptomları, ağrı inançlarını ve yaşam kalitesinin çeşitli alanlarını iyileştirdiği görülmektedir. Farklı ANE ve egzersiz yaklaşımlarını kombine ederek uzun dönem etkileri ortaya koyan randomize kontrollü çalışmalara ihtiyaç vardır.

Etik Beyan

Bu araştırma protokolü Hacettepe Üniversitesi Klinik Araştırmalar Etik Kurulu (Karar no: 2022/15-02, Tarih:20.09.2022) tarafından onaylandı.

Destekleyen Kurum

Yok

Teşekkür

Yazarlar bu çalışmanın katılımcılarına teşekkür ederler.

Kaynakça

  • Burnett M, Lemyre M. No. 345-Primary Dysmenorrhea Consensus Guideline. J Obstet Gynaecol Can. 2017;39:585-595.
  • Itani R, Soubra L, Karout S, et al. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean J Fam Med. 2022;43:101.
  • Fernandez H, Barea A, Chanavaz-Lacheray I. Prevalence, intensity, impact on quality of life and insights of dysmenorrhea among French women: A cross-sectional web survey. J Gynecol Obstet Hum Reprod. 2020;49:101889.
  • Arendt‐Nielsen L, Morlion B, Perrot S, et al. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018;22:216-241.
  • Baird AJ, Haslam RA. Exploring differences in pain beliefs within and between a large nonclinical (workplace) population and a clinical (chronic low back pain) population using the pain beliefs questionnaire. Phys Ther. 2013;93:1615-1624.
  • Armour M, Ee CC, Naidoo D, et al. Exercise for dysmenorrhoea. Cochrane Database Syst Rev. 2019;19:22.
  • Celenay ST, Ozcelikel G, Bayrakli A. Efficacy of progressive muscle relaxation technique in primary dysmenorrhea: A randomized controlled trial. Taiwan J Obstet Gynecol. 2024;63:329-335.
  • Hamasaki H. Effects of diaphragmatic breathing on health: a narrative review. Medicines. 2020;7:65.
  • Upganlawar DS, Patil S, Dhage PP. Efficacy of Connective Tissue Therapy and Abdominal Stretching Exercises in Individuals With Primary Dysmenorrhea: A Review. Cureus. 2023;15: e46553.
  • Tianing NW, Nugraha MHS, Indrayani AW, et al. The difference in the effectiveness of warm compress and active stretching exercise in reducing dysmenorrhea pain. Bali Med J. 2021;10:1041-1044.
  • Schaffer SD, Yucha CB. Relaxation & pain management: the relaxation response can play a role in managing chronic and acute pain. Am J Nurs. 2004;104:75-82.
  • Louw A, Riera-Gilley V. Pain neuroscience education: Teaching people about pain. J Pain Palliat Care Pharmacother. 2024;38:292-301.
  • Gutke A, Sundfeldt K, De Baets L. Lifestyle and chronic pain in the pelvis: State of the art and future directions. J Clin Med. 2021;10:5397.
  • Nijs J, George SZ, Clauw DJ, et al. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021;3:e383-e392.
  • Zimney K, Van Bogaert W, Louw A. The biology of chronic pain and its implications for pain neuroscience education: state of the art. J Clin Med. 2023;12:4199.
  • Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. J Pain. 2015;16:807-813.
  • Barrenengoa‐Cuadra MJ, Muñoa‐Capron‐Manieux M, Fernández‐Luco M, et al. Effectiveness of a structured group intervention based on pain neuroscience education for patients with fibromyalgia in primary care: A multicentre randomized open‐label controlled trial. Eur J Pain. 2021;25:1137-1149.
  • Benedict TM, Nitz AJ, Gambrel MK, et al. Pain neuroscience education improves post-traumatic stress disorder, disability, and pain self-efficacy in veterans and service members with chronic low back pain: Preliminary results from a randomized controlled trial with 12-month follow-up. Mil Psychol. 2023;36:1-17.
  • Huysmans E, Goudman L, Coppieters I, et al. Effect of perioperative pain neuroscience education in people undergoing surgery for lumbar radiculopathy: a multicentre randomised controlled trial. Br J Anaesth. 2023;131: 572-585.
  • Lluch E, Dueñas L, Falla D, et al. Preoperative pain neuroscience education combined with knee joint mobilization for knee osteoarthritis. Clin J Pain. 2018;34:44-52.
  • Malfliet A, Kregel J, Coppieters I, et al. Effect of pain neuroscience education combined with cognition-targeted motor control training on chronic spinal pain: a randomized clinical trial. JAMA Neurol. 2018;75:808-817.
  • Ponce-Fuentes F, Cuyul-Vasquez I, Bustos-Medina L, et al. Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial. Physiother Theory Pract. 2023;39:1861-1870.
  • Orhan C, Lenoir D, Favoreel A, et al. Culture-sensitive and standard pain neuroscience education improves pain, disability, and pain cognitions in first-generation Turkish migrants with chronic low back pain: a pilot randomized controlled trial. Physiother Theory Pract. 2021;37:633-645.
  • Hush JM, Nicholas M, Dean CM. Embedding the IASP pain curriculum into a 3-year pre-licensure physical therapy program: redesigning pain education for future clinicians. Pain Rep. 2018;3:e645.
  • Aboushady R, El-saidy TMK. Effect of home based stretching exercises and menstrual care on primary dysmenorrhea and premenstrual symptoms among adolescent girls. IOSR J Nurs Health Sci. 2016;5:10-17.
  • López-Liria R, Torres-Álamo L, Vega-Ramírez FA, et al. Efficacy of physiotherapy treatment in primary dysmenorrhea: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18:7832.
  • Ortiz MI, Cortés-Márquez SK, Romero-Quezada LC, et al. Effect of a physiotherapy program in women with primary dysmenorrhea. EJOG. 2015;194:24-29.
  • Anderson AW, Soncini A, Lyons K, et al. The Effect of Myofascial Stretching on Mechanical Nociception and Contributing Neural Mechanisms. NeuroSci. 2024;5:158-168.
  • Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54:1451-1462.
  • Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335-343.
  • YILMAZ Ö, Hakan B, Arslan A. Depresyon Anksiyete Stres Ölçeğinin (Dass 21) Türkçe Kisa Formunun Geçerlilik-Güvenilirlik Çalişmasi. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2:78-91.
  • Edwards LC, Pearce SA, Turner-Stokes L, et al. The pain beliefs questionnaire: an investigation of beliefs in the causes and consequences of pain. Pain. 1992;51:267-272.
  • BERK HÖS, BAHADIR G. Kronik ağrı yaşantısı ve ağrı inançları. Ağrı. 2007;19:5-15.
  • World Health Organization Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551-558.
  • World Health Organization. Quality of Life group: WHOQOL-BREF Introduction. Administration and scoring Field trial version. 1996.
  • Eser E, Fidaner H, Fidaner C, et al. WHOQOL-100 ve WHOQOL-BREF'in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7:23-40.
  • Joseph K, Mills J. Unmet treatment needs in patients with chronic pelvic pain in a New Zealand gynaecology service. ANZJOG. 2019;59:856-860.
  • Holliday S, Hayes C, Jones L, et al. Prescribing wellness: comprehensive pain management outside specialist services. Aust Prescr. 2018;41:86.
  • Dams L, Van der Gucht E, Devoogdt N, et al. Effect of pain neuroscience education after breast cancer surgery on pain, physical, and emotional functioning: a double-blinded randomized controlled trial (educan trial). Pain. 2023;164:1489-1501.
  • Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, et al. A single preoperative pain neuroscience education: Is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Fizyoterapi
Bölüm Makaleler
Yazarlar

Büşra Nur Erol 0000-0002-8680-1081

Ceren Gürşen 0000-0002-9204-8364

Sezcan Mümüşoğlu 0000-0001-7000-7580

Serap Kaya 0000-0002-2362-6773

Yayımlanma Tarihi 1 Ağustos 2025
Gönderilme Tarihi 11 Mart 2025
Kabul Tarihi 25 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 12 Sayı: 2

Kaynak Göster

Vancouver Erol BN, Gürşen C, Mümüşoğlu S, Kaya S. Primer dismenorede ağrı nörobilim eğitimi ile birlikte uygulanan germe ve gevşeme egzersizlerinin emosyonel durum, ağrı inançları ve yaşam kalitesi üzerine etkileri. JETR. 2025;12(2):88-9.