Muscle Energy Technique and Myofascial Chain Training for Menstrual Pain in Primary Dysmenorrhea (METPD-25)

Shanjiao Luo30 enrolled

Overview

This prospective clinical trial evaluates the effects of a non-pharmacological intervention combining muscle energy technique (MET) and myofascial chain (MFC)-based pelvic stabilization training in women with primary dysmenorrhea (PD). The study aims to determine whether this combined approach can improve pelvic alignment, reduce menstrual pain, and enhance static balance. Participants are assigned to either an experimental group receiving MET + MFC-based training or a control group receiving conventional physiotherapy. Outcomes include radiographic pelvic parameters, pain intensity, and balance performance.

Primary dysmenorrhea (PD) is a common gynecological condition characterized by cyclic lower abdominal pain without an identifiable organic cause. Biomechanical factors such as pelvic misalignment and myofascial imbalance are increasingly recognized as contributing to the persistence and severity of PD. This prospective non-randomized controlled trial investigates whether a combined intervention of muscle energy technique (MET) and myofascial chain (MFC)-based pelvic stabilization training can improve pelvic structure and reduce clinical symptoms in women with PD. Participants are women aged 18-45 years with moderate-to-severe PD and radiographic evidence of pelvic misalignment. They are assigned to one of two groups: Experimental group: MET plus MFC-based core stabilization exercises. Control group: Interferential current therapy and deep friction massage. Interventions are administered three times per week for four weeks. The primary outcomes include changes in pelvic sagittal parameters (pelvic tilt, sacral slope, pelvic incidence), pelvic symmetry, menstrual pain (measured by VAS), and static balance (eyes-closed single-leg stance). Assessments are conducted at baseline, 4 weeks, and 12 weeks post-intervention. The study aims to explore whether biomechanical correction of pelvic alignment contributes to pain modulation and functional improvement in women with PD, providing a basis for non-pharmacological rehabilitation strategies.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Interventions

Combined MET and MFC-Based Pelvic Stabilization TrainingBEHAVIORAL

This intervention consisted of a combination of Muscle Energy Technique (MET) for iliac and sacral dysfunctions (20 minutes per session) and myofascial chain-based pelvic stabilization training (including curl-ups, planks, and anti-rotation exercises; 30 minutes per session), targeting pelvic alignment and neuromuscular control. Sessions were conducted 3 times per week, 50 minutes per session, for 4 consecutive weeks.

Interferential current therapy (ICT)DEVICE

Interferential current therapy (ICT) was applied to the lumbar (lower back), sacroiliac, and iliac crest regions, 3 sessions per week, 20 minutes per session, for 4 weeks.

Deep Friction Massage (DFM)BEHAVIORAL

Deep friction massage was administered to the lumbar, sacroiliac, and iliac crest regions for 30 minutes per session, 3 sessions per week, for 4 weeks.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Females aged 18-45 years * Regular menstrual cycles * Clinically diagnosed with primary dysmenorrhea * Visual Analog Scale (VAS) score ≥ 4 during menstruation for at least six consecutive months * Radiographic evidence of pelvic tilt, sacral slope deviation, or frontal pelvic asymmetry Exclusion Criteria: * Secondary dysmenorrhea or diagnosed gynecological pathologies (e.g., endometriosis, ovarian cysts) * Pregnancy or lactation * Current use of hormonal contraceptives or hormone therapy * Ongoing or recent physical therapy targeting the pelvis * History of pelvic or spinal surgery * Congenital or structural musculoskeletal disorders affecting the lumbopelvic region

Outcomes

Primary Outcomes

Change in menstrual pain intensity measured by Visual Analog Scale (VAS)

The primary outcome was the change in pain intensity before and after intervention, assessed using the Visual Analog Scale (VAS，0-10). Participants rated their average menstrual pain during the most painful day of menstruation. A reduction in VAS score indicated improvement in dysmenorrhea symptoms.

Time frame: Baseline (pre-intervention), Week 4 (immediate post-intervention), and Week 12 (telephone follow-up to assess sustainability of treatment effects)