Comparative Effects of Neurodynamic Stretch and Myofascial Pain Release in Polycystic Ovarian Syndrome.

Comparador Ativo: Neurodynamic stretches

Group A will receive neurodynamic stretches which includes abdominal stretches, calf stretches, hamstring stretches.

Outro: Neurodynamic stretches

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

Experimental: myofascial pain release technique

Group B will receive myofascial pain release technique.

Outro: myofascial pain release technique Interventions:

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

Mc 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

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.

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.