Abstract | QUESTION: In women with primary dysmenorrhoea, what is the effect of physiotherapeutic interventions compared to control (either no treatment or placebo/ sham) on pain and quality of life? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: INTERVENTION: Any form of physiotherapy treatment. OUTCOME MEASURES: The primary outcome was menstrual pain intensity and the secondary outcome was quality of life. RESULTS: The search yielded 222 citations. Of these, 11 were eligible randomised trials and were included in the review. Meta-analysis revealed statistically significant reductions in pain severity on a 0-10 scale from acupuncture (weighted mean difference 2.3, 95% CI 1.6 to 2.9) and acupressure (weighted mean difference 1.4, 95% CI 0.8 to 1.9), when compared to a control group receiving no treatment. However, these are likely to be placebo effects because when the control groups in acupuncture/ acupressure trials received a sham instead of no treatment, pain severity did not significantly differ between the groups. Significant reductions in pain intensity on a 0-10 scale were noted in individual trials of heat (by 1.8, 95% CI 0.9 to 2.7), transcutaneous electrical nerve stimulation (2.3, 95% CI 0.03 to 4.2), and yoga (3.2, 95% CI 2.2 to 4.2). Meta-analysis of two trials of spinal manipulation showed no significant reduction in pain. None of the included studies measured quality of life. CONCLUSION: Physiotherapists could consider using heat, transcutaneous electrical nerve stimulation, and yoga in the management of primary dysmenorrhea. While benefits were also identified for acupuncture and acupressure in no-treatment controlled trials, the absence of significant effects in sham-controlled trials suggests these effects are mainly attributable to placebo effects.
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Authors | Priya Kannan, Leica Sarah Claydon |
Journal | Journal of physiotherapy
(J Physiother)
Vol. 60
Issue 1
Pg. 13-21
(Mar 2014)
ISSN: 1836-9561 [Electronic] Netherlands |
PMID | 24856936
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Copyright | Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved. |
Topics |
- Acupressure
- Acupuncture
- Adolescent
- Adult
- Dysmenorrhea
(therapy)
- Electric Stimulation Therapy
- Female
- Hot Temperature
- Humans
- Outcome Assessment, Health Care
- Physical Therapy Modalities
- Quality of Life
- Treatment Outcome
- Yoga
- Young Adult
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