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Study aim
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1.determine pain intensity in lower abdomen according to VAS in case and control groups before and after manipulation in first, second and third cycles
2.determine pain intensity in pelvicaccording to VAS in case and control groups before and after manipulation in first, second and third cycles
3.determine pain intensity in low back according to VAS in case and control groups before and after manipulation in first, second and third cycles
4.detemine NSAIDs tablet consumption in case and control groups before and after manipulation in first, second and third cycles
5. detemine bleeding in case and control groups before and after manipulation in first, second and third cycles
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Design
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Two arm parallel group randomised trial with blinded outcome assessment
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Settings and conduct
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we explain study planning for all patients, based on patient satisfaction, she enters one of two groups.Patients are examined by a researcher number two who is blind to the grouping of patients, and measure spinal range of motion in Emam reza hopital. Patients in intervention group havr been manipulated in lumbosacral region and thoracolumbar junction at 15,21 and 28 days after menstruation onset. streching and strengthening exercise are thaught to both groups that they start at 15th cycle and stop with menstruation.all patien can take diclofenac 50 mg.
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Participants/Inclusion and exclusion criteria
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inclusion criteria:
age 18-45 years, regular menstrual cycles , moderate to severe pain , dysmenorrhea symptom during 1 year ago , VAS more than 5 for pelvic pain , low back pain ,no manipulation 2 month before
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Intervention groups
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Intervention group:manipulate lumbosacral and thoracolumbar junction +6 type strengthening and streching abdominal exercises
Controm grouo:the same intervention group exercise
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Main outcome variables
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pain (VAS) in low back , pelvic , lower abdomen
determine bleeding , diclofenac intake