The study will be a non-blinded randomized controlled trial, consisting of two groups. Non-probability Convenience sampling will be used to recruit participants who will meet the inclusion criteria. Group allocation will be performed using the sealed envelope method to ensure randomization of participants into experimental and control groups. The sample size will be 38 (19 in each group). Group A will receive neurodynamic stretches while Group B will receive myofascial pain release technique.
The most prevalent endocrinopathy in women of reproductive age is polycystic ovarian disorder (PCOS), with notable clinical characteristics related to reproduction, metabolism, dermatology, and psychology. Among the most prominent gynecological disorders in women is dysmenorrhea, which has a major detrimental effect on one's quality of life. This randomized clinical study aims to evaluate and compare the effects of neurodynamic stretching combined with diaphragmatic breathing versus myofascial pain release therapy in reducing the intensity and duration of dysmenorrhea in girls with PCOS, to assess the impact of both interventions on improving the quality of sleep among girls with PCOS and to compare the effects of neurodynamic stretching with diaphragmatic breathing and myofascial pain release therapy on enhancing functional mobility in females with PCOS. The study will be a non-blinded randomized controlled trial, consisting of two groups. Non-probability Convenience sampling will be used to recruit participants who will meet the inclusion criteria. Group allocation will be performed using the sealed envelope method to ensure randomization of participants into experimental and control groups. The sample size will be 38 (19 in each group). Group A will receive neurodynamic stretches which includes abdominal stretches, calf stretches, hamstring stretches. Group B will receive myofascial pain release technique. The study will be conducted over a period of 10 months at Shaikh Zayed Hospital Lahore. Ethical approval will be obtained. Individuals fulfilling the inclusion criteria will be selected, followed by written informed consent after explaining the study purpose. Participants will then be randomly allocated to one of the two groups. Comparative Training would be performed thrice a week on alternate days for a total duration of 6 weeks. Total sessions will be 18. All outcome measurements will be performed pre and after the 6 weeks' intervention period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
38
Participants will receive neurodynamic mobilization techniques focused on improving the mobility of the lumbosacral plexus and peripheral nerves. Week 1-2: * Introduction to neural sliders only. * Techniques: Supine straight leg raise (SLR) with ankle dorsiflexion, femoral nerve glide, and seated slump position. Frequency: 3 sets of 10 repetitions per nerve. Emphasis: Gentle, pain-free movements with diaphragmatic breathing Week 3-4: Progression to sliders + tensioners. • Techniques: Dynamic slump with tensioning, prone femoral tensioner. Repetitions: 2 sets of 5-7 controlled repetitions. Emphasis: Slight neural load increase while ensuring patient comfort. Week 5-6: * Continuation of advanced techniques with full-range tensioners. * Integration of posture correction and relaxation techniques. Emphasis: Endurance and mobility with symptom monitoring. Frequency: 3 sessions per week Duration: 20-30 minutes per session Total duration: 6 weeks
Participants will receive myofascial release therapy aimed at relieving fascial tightness, trigger points, and muscle stiffness in the abdominal, pelvic, and lumbar regions. Week 1-2: * Light pressure applied to abdominal fascia and lower back region. * Techniques: Cross-hand fascial release, skin rolling, and gentle pressure on trigger points. Each hold: 90-120 seconds per site. Week 3-4: * Increased pressure depth depending on patient tolerance. * Targeting deeper pelvic structures and sacroiliac area. * Use of foam roller introduced for myofascial self-release. Week 5-6: * Maintenance of deeper myofascial techniques with added pelvic stretching. * Integration of postural awareness and relaxation breathing. * Focus on combining manual release with functional mobility. Frequency: 3 sessions per week Duration: 20-30 minutes per session Total duration: 6 weeks
Shaikh Zayed Hospital
Lahore, Punjab Province, Pakistan
RECRUITINGMc Gill Questionnaire
The short-form McGill Pain Questionnaire (SF-MPQ) is a shorter version of the original MPQ, and was developed later in 1987.The pain rating index has 2 subscales: * Sensory subscale with 11 words, and * Affective subscale with 4 words from the original MPQ. These words or items are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate and 3 = severe. Version includes 7 additional symptoms related to neuropathic pain, for a total of 22 items with 0-10 numerical response options. The reliability of the tool was measured using Cronbach's alpha value, and it was found to be 0.91
Time frame: 6 weeks
WaLIDD Score
The WaLIDD score, or Working ability, Location, Intensity, Days of pain, Dysmenorrhea score, is a tool used to assess and diagnose dysmenorrhea (menstrual cramps) and predict the likelihood of needing medical leave. It's a self-report scale where individuals rate their experience of dysmenorrhea based on four key aspects: pain location, pain range, duration of pain, and disability. The total score, ranging from 0 to 12, categorizes the severity of dysmenorrhea: 0 indicates no dysmenorrhea, 1-4 is mild, 5-7 is moderate, and 8-12 is severe. The reliability of the tool was measured using Cronbach's alpha value, and it was found to be 0.88.
Time frame: 6 weeks
PSQI Scale
The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses sleep quality over a one-month time interval. Each component score of the PSQI ranges from 0 to 3, with 3 indicating the greatest dysfunction or disturbance. The seven component scores are then summed to obtain a global PSQI score, which ranges from 0 to 21. Higher scores indicate poorer sleep quality, with a score greater than 5 suggesting significant sleep difficulties. The reliability of the tool was measured using Cronbach's alpha value, and it was found to be 0.83.
Time frame: 6 weeks
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