Effect of Relaxation, Lumbopelvic Stabilization, and Strengthening on Pain, Quality of Life, and Lumbopelvic Impairments in Women With Endometriosis
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Abstract
Background: Endometriosis, a chronic gynecological disorder characterized by the presence of endometrial-like tissue outside the uterus, significantly impacts the quality of life and physical functioning of affected women. Conventional treatments involve pharmacological interventions and surgery, which may not always provide long-term relief and are often associated with side effects.
Objective: This study aimed to evaluate the effects of relaxation, lumbopelvic stabilization, and strengthening exercises on pain, quality of life, and lumbopelvic impairments in women with endometriosis in Faisalabad, Pakistan.
Methods: A quasi-experimental design was employed, involving 40 women diagnosed with endometriosis, recruited from local hospitals and fitness centers. Participants underwent a structured intervention consisting of relaxation techniques, lumbopelvic stabilization, and strengthening exercises, conducted three times per week for seven weeks. Data were collected using the Visual Analogue Scale (VAS) for pain, the Endometriosis Health Profile-30 (EHP-30) for quality of life, and specific physical performance tests for lumbopelvic impairments. Statistical analysis was performed using SPSS version 25, employing repeated measures ANOVA to assess changes from baseline to post-intervention.
Results: The intervention resulted in significant reductions in pain (VAS scores decreased, p<0.001), improvements in quality of life (EHP-30 scores improved in all domains, p<0.001 for most domains), and enhanced lumbopelvic function (endurance test scores increased, p<0.001).
Conclusion: The study findings suggest that structured physical therapy interventions can significantly improve pain, quality of life, and physical functioning in women with endometriosis. These results support the inclusion of physical therapy as a viable component of comprehensive endometriosis management.
Keywords: Endometriosis, Physical Therapy, Quality of Life, Pelvic Pain, Lumbopelvic Stabilization, Strengthening Exercises, Non-Pharmacological Treatment.
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References
Lebovic, D. I., Mueller, M. D., & Taylor, R. N. (2001). Immunobiology of endometriosis. Fertility and sterility, 75(1), 1-10.
.Symons, L. K., et al. (2018). "The immunopathophysiology of endometriosis." Trends in molecular medicine 24(9): 748-762.
Vercellini, P., Giudice, L. C., Evers, J. L., & Abrao, M. S. (2015). Reducing low-value care in endometriosis between limited evidence and unresolved issues: a proposal. Human Reproduction, 30(9), 1996-2004.
Bragatto, F. B., Barbosa, C. P., Christofolini, D. M., Peluso, C., dos Santos, A. A., Mafra, F. A., Cavalcanti, V., Hix, S., & Bianco, B. (2013). There is no relationship between Paraoxonase serum level activity in women with endometriosis and the stage of the disease: an observational study. Reproductive health, 10, 32. https://doi.org/10.1186/1742-4755-10-32
Gordts, S., et al. (2017). "Pathogenesis of deep endometriosis." Fertility and sterility 108(6): 872-885. e871.
Malvezzi, H., Marengo, E. B., Podgaec, S., & Piccinato, C. D. A. (2020). Endometriosis: current challenges in modeling a multifactorial disease of unknown etiology. Journal of translational medicine, 18, 1-21.
Ochoa Bernal, M. A., & Fazleabas, A. T. (2024). The Known, the Unknown and the Future of the Pathophysiology of Endometriosis. International Journal of Molecular Sciences, 25(11), 5815.
Giudice LC, Kao LC. Endometriosis. Lancet. 2004; 364: 1789–99
.ACOG practice bulletin. Medical management of endometriosis. Int J Gynaecol Obstet. 2000; 71:183-96.
Organization, W. H. (2023). "causes and risk factors of endometriosis." from https://www.who.int/news-room/fact-
.Kim MR, Kim YA, Jo MY, Hwang KJ, Ryu HS. High frequency of endometrial polyps in endometriosis. Journal of the American Association of Gynecologic Laparoscopists. 2003; 10(1):46–48. 15 13.
American Society for Reproductive Medicine. Myomas and reproductive function. Bull Am Soc Reprod Med 2001; (nov): 1-12.
Fauconnier, A., et al. (2013). "Comparison of patient-and physician-based descriptions of symptoms of endometriosis: a qualitative study." Human Reproduction 28(10): 2686-2694
Maroun, P., Cooper, M. J., Reid, G. D., & Keirse, M. J. (2009). Relevance of gastrointestinal symptoms in endometriosis. Australian and New Zealand Journal of Obstetrics and Gynaecology, 49(4), 411-414.
Ramin-Wright, A., et al. (2018). "Fatigue–a symptom in endometriosis." Human Reproduction 33(8): 1459-1465.
Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012,Sep;98(3):511-9. doi: 10.1016/j.fertnstert.2012.06.029. Epub 2012 Jul 20. PMID: 22819144
Lovering, N. (2020). "6 Risk Factors for Endometriosis
Sah, S. S., Amit & Ullah, Amin & Pervej, Sadaf & Ding, Yubin & Wang, Ying & Scholar (2020). "Other risk factors of endometriosis." from https://www.researchgate.net/publication/346410331_Discerning_Endometriosis_as_a_Multifaceted_Entity_A_Comprehensive_Review/citation/download.
Shrinkter, J. (2021). "Risk factors associated with endometriosis." from https://thehiddencures.com/category/natural-remedies/reproductive-system/page/6/
Bonocher, C. M., Montenegro, M. L., Rosa e Silva, J. C., Ferriani, R. A., & Meola, J. (2014). Endometriosis and physical exercises: a systematic review. Reproductive biology and endocrinology, 12, 1-5.
Abril‐Coello, R., Correyero‐León, M., Ceballos‐Laita, L., & Jiménez‐Barrio, S. (2023) Benefits of physical therapy in improving quality of life and pain associated with endometriosis: A systematic review and meta‐analysis. International Journal of Gynecology & Obstetrics, 162(1), 233-243.
Friggi Sebe Petrelluzzi, K., Garcia, M. C., Petta, C. A., Ribeiro, D. A., de Oliveira Monteiro, N. R., Céspedes, I. C., & Spadari, R. C. (2012). Physical therapy and psychological intervention normalize cortisol levels and improve vitality in women with endometriosis. Journal of Psychosomatic Obstetrics & Gynecology, 33(4), 191-198.
Tennfjord, M. K., Gabrielsen, R., & Tellum, T. (2021). Effect of physical activity and exercise on endometriosis-associated symptoms: a systematic review. BMC women's health, 21, 1-10.
Muñoz-Gómez, E., et al. (2023). "Effectiveness of a Manual Therapy Protocol in Women with Pelvic Pain Due to Endometriosis: A Randomized Clinical Trial." Journal of Clinical Medicine 12(9): 3310.
del Mar Salinas-Asensio, M., Ocón-Hernández, O., Mundo-López, A., Fernández-Lao, C., Peinado, F. M., Padilla-Vinuesa, C., ... & Artacho-Cordón, F. (2022). ‘Physio-EndEA’Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. International journal of environmental research and public health, 19(3), 1738.
Mansfield, C., et al. (2022). "Impact of Pelvic Floor Physical Therapy on Function in Adolescents and Young Adults with Biopsy-Confirmed Endometriosis at a Tertiary Children's Hospital: A Case Series." Journal of Pediatric and Adolescent Gynecology 35(6): 722-727.
Hansen, S., Sverrisdóttir, U. Á., & Rudnicki, M. (2021). Impact of exercise on pain perception in women with endometriosis: A systematic review. Acta obstetricia et gynecologica Scandinavica, 100(9), 1595-1601.
Mira, T. A., Buen, M. M., Borges, M. G., Yela, D. A., & Benetti‐Pinto, C. L. (2018). Systematic review and meta‐analysis of complementary treatments for women with symptomatic endometriosis. International Journal of Gynecology & Obstetrics, 143(1), 2-9.