Effect of lumbar proprioception training on females with primary dysmenorrhea: a review of current evidence

Nehal G. Omran, Amel M. Yousef, Hamada A. Hamada, Hosam Eldeen H. Kamel, Doaa A. Osman

Nehal G. Omran, Amel M. Yousef, Hamada A. Hamada, Hosam Eldeen H. Kamel, Doaa A. Osman – Effect of lumbar proprioception training on females with primary dysmenorrhea: a review of current evidence –  Fizjoterapia Polska 2025; 25(4); 220-224

DOI: https://doi.org/10.56984/8ZGA4318HQZ

Abstract
Background. Primary dysmenorrhea (PD) is a leading cause of menstrual pain in reproductive-age women. While traditionally associated with prostaglandin-driven uterine contractions, emerging research highlights neuromuscular contributions—particularly lumbar sensorimotor dysfunction.
Aim. This narrative review synthesizes current evidence on lumbar sensorimotor control in PD, with emphasis on repositioning accuracy, associated neuromuscular deficits, and the potential of proprioceptive training as a non-pharmacological intervention.
Methods. A literature review was conducted through June 2025 across eight databases using MeSH terms including “primary dysmenorrhea,” “lumbar proprioception,” “repositioning accuracy,” and “sensorimotor control.” Studies were eligible if they assessed trunk proprioception or interventions targeting lumbar sensorimotor function in PD or related pain conditions.
Results. Six studies met inclusion criteria: two RCTs (one ongoing), one pilot case study, one observational study in PD, one cross-sectional low back pain study, and one systematic review. Across all studies, findings consistently indicate impaired proprioceptive control in pain-related populations. While core-based exercise interventions appear to improve proprioceptive accuracy and reduce pain, direct evidence specific to lumbar repositioning in PD remains limited and methodologically inconsistent.
Conclusion. Preliminary evidence supports lumbar proprioception training as a novel adjunct in PD. High-quality RCTs with objective neuromuscular metrics are needed to validate these findings and inform clinical practice.
Key words
primary dysmenorrhea, proprioception, repositioning accuracy, trunk stability, lumbopelvic control, sensorimotor dysfunction
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Effect of myofascial release of cesarean scar on neck pain and range of motion in females with nonspecific neck pain

Asmaa K. Mohamed, Dalia M. Kamel, Hamed M. ELkhaozamy, Amel M. Yousef, Reham H Saad

 

Asmaa K. Mohamed, Dalia M. Kamel, Hamed M. ELkhaozamy, Amel M. Yousef, Reham H Saad – Effect of myofascial release of cesarean scar on neck pain and range of motion in females with nonspecific neck pain –  Fizjoterapia Polska 2025; 25(1); 389-394

DOI: https://doi.org/10.56984/8ZG007D4HBJ

Abstract
Purpose. To investigate the effect of myofascial release (MFR) of the cesarean scar on neck pain and range of motion (ROM) in women suffering from chronic nonspecific neck pain.
Methods. Thirty female patients with chronic nonspecific neck pain and a history of cesarean section (CS) were selected from the outpatient clinic of the orthopedic department at the faculty of physical therapy, Cairo University, to participate in this study. Their ages ranged from 20 to 35 years, and their body mass index was between 20 and 30 kg/m2. They had undergone CS at least two years prior. All participants received myofascial release sessions targeting the CS scar (30 minutes, two sessions per week for two weeks). Pain intensity, cervical ROM, and scar mobility were assessed before and after treatment using a numerical rating scale, an inclinometer, and an adheremeter, respectively.
Results. The study results demonstrated a significant post-treatment reduction in pain intensity (p < 0.05) as well as significant increases in cervical ROM and scar mobility (p < 0.05).
Conclusion. Myofascial release of the CS scar is an effective technique for reducing neck pain and improving ROM in patients with a history of CS.
Key words
cesarean section, cesarean scar, myofascial release, neck pain, neck dysfunction
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Correlation between spinopelvic alignment and uterine dimensions in primary dysmenorrhea: A case-control study

Randa G. Mohamed, Amel M. Yousef, Hamada Ahmed Hamada, Doaa A. Osman

 

Randa G. Mohamed, Amel M. Yousef, Hamada Ahmed Hamada, Doaa A. Osman – Correlation between spinopelvic alignment and uterine dimensions in primary dysmenorrhea: A case-control study –  Fizjoterapia Polska 2024; 24(3); 23-29

DOI: https://doi.org/10.56984/8ZG020AEL0

Abstract

Background. The high prevalence of primary dysmenorrhea (PD) among young females has prompted interest in exploring its multifactorial causes. One area of investigation is the relationship between musculoskeletal posture and gynecological health. Purpose. To examine the potential correlation between spinopelvic alignment and uterine dimensions in females with and without PD. Methods. This case-control observational study included 40 females with regular menstrual cycles, divided into two groups: 20 with PD (study group) and 20 without PD (control group). Spinopelvic alignment parameters, including thoracic kyphosis, lumbar lordosis, pelvic tilt, and pelvic torsion, were assessed using a 4D formetric device. Uterine dimensions, including corpus length and width, as well as cervix length and width, were measured by ultrasonography. Results. No significant correlations were found between the spinopelvic alignment and uterine dimensions in the study group with PD (p > 0.05). However, in the control group without PD, there were significant moderate negative correlations between uterine corpus width and thoracic kyphotic angle (p < 0.05), as well as between cervix length and pelvic tilt (p < 0.05). Conclusion. In females with PD, there are no significant correlations between spinopelvic alignment and uterine dimensions. In contrast, in females without dysmenorrhea, there are significant correlations between uterine corpus width and thoracic kyphotic angle, and between cervix length and pelvic tilt.

Keywords:

primary dysmenorrhea, spinopelvic alignment, uterine dimensions

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Postural response and behavioral habits in adolescent girls at public and international schools. An observational case control study

Doaa S. Mohamed, Hamada A. Hamada, Amel M.Yousef, Wael O. A. Abd El-khalek, Noha A.F Abd-Elrahman

Doaa S. Mohamed, Hamada A. Hamada, Amel M.Yousef, Wael O. A. Abd El-khalek, Noha A.F Abd-Elrahman – Postural response and behavioral habits in adolescent girls at public and international schools. An observational case control study –  Fizjoterapia Polska 2024; 24(2); 101-107

DOI: https://doi.org/10.56984/8ZG5608G1D

Abstract
Background. The impact of behavioral risk factors, specifically postural habits and the presence of postural changes, has been identified as a significant concern for adolescent females, particularly in public school settings. Purpose of the study. This study aims to conduct a comparative analysis of postural changes, behavioral postures, back pain, and behavioral habits between adolescent females in public and international schools. Methods. A case-control study was executed, involving 200 adolescent females aged 13–17 years. The participants were divided into two groups: Group (A) from public schools and Group (B) from international schools. The evaluation process employed a combination of video and image analysis using Kinova and the Back Pain and Body Posture Evaluation Instrument. Results. Statistical analysis revealed a lack of significant difference between Groups (A&B) concerning forward head posture (cranio-vertebral angle by Kinova). However, a notable distinction was observed between the groups in terms of back pain, behavioral habits, hereditary factors, and socioeconomic status. Conclusion. While both groups exhibited a prevalence of forward head posture among adolescent females, Group (A) from public schools demonstrated a higher incidence of back pain, associated with behavioral habits, socioeconomic factors and hereditary influences on back pain. Postural changes and back pain in public schools were attributed to factors such as load, duration of TV watching, lack of exercise, backpack-carrying duration, hereditary factors, and socioeconomic status (parents’ education level up to secondary schools).
Keywords
postural response, behavioral habits, adolescent females, public schools, international schools
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Influence of visceral manipulation on hormonal profile in women with polycystic ovarian syndrome: A randomized trial

Eman E. Kamel, Hamada A. Hamada, Amel M. Yousef, Fahima M. Okeel, Mohamed Hassan, Hatem M. Hassan

Eman E. Kamel, Hamada A. Hamada, Amel M. Yousef, Fahima M. Okeel, Mohamed Hassan, Hatem M. Hassan – Influence of visceral manipulation on hormonal profile in women with polycystic ovarian syndrome: A randomized trial –  Fizjoterapia Polska 2024; 24(1); 279-284

DOI: https://doi.org/10.56984/8ZG2EF8860

Abstract
Background. Polycystic ovary syndrome (PCOS) is the most common endocrine condition in women of reproductive age and has been suggested as a risk factor for cardiometabolic disease. Depending on which diagnostic criteria are applied, approximately 10–15% of the women of reproductive age are affected by PCOS.Objective. To examine how viscera manipulation Influences hormonal profile in women with PCO. Design. A prospective randomized single-blind controlled trial. Setting. Outpatient clinics of Sadat General Hospital.
Methods. Thirty patients of PCO females were recruited and randomized into two equal groups: the control group received a diet guidelines therapy in the form of the hypocaloric Mediterranean diet for 12 weeks, and the study group received the same control group interventions in addition to visceral manipulation (VM). biochemical analysis (FSH & LH) and BMI was the primary outcome. All variables were measured at the baseline and after 12 weeks of the intervention.
Results. Statistical analysis was done by using paired’ test which showed significant improvement in both groups. Therefore, using mixed design MANOVA and multiple pairwise comparison tests (Post hoc tests) for the BMI and LH/FSH ratio post-treatment revealed that there were significant decreases in LH/FSH ratio (p =0.007)  in favor to group B when compared with group A, with no significant differences in BMI between both groups (p = 0.443), showing that VM group (B) is more effective than group (A) on biochemical analysis (p < 0.05).
Conclusion. Using visceral manipulation with a standard program of hypocaloric Mediterranean diet has more beneficial effects on hormonal profile in women with PCO.
Keywords
polycystic ovarian syndrome, visceral manipulation, hypocaloric diet, luteinizing hormone, follicle stimulating hormone
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Impact of different types of anaesthesia for cesarean delivery on subacute low back pain intensity and disability: A retrospective cohort study

Mohamed G. Ali, Mohammed A. Soliman, Amel M. Yousef, Fahima M. Okeel, Mohammed A.M. Sarhan


Mohamed G. Ali, Mohammed A. Soliman, Amel M. Yousef, Fahima M. Okeel, Mohammed A.M. Sarhan – Impact of different types of anaesthesia for cesarean delivery on subacute low back pain intensity and disability: A retrospective cohort study. Fizjoterapia Polska 2022; 22(3); 116-121

DOI: https://doi.org/10.56984/8ZG142IT9

Abstract
Background. Low back pain (LBP) is common after cesarean delivery. So, this study was conducted to assess and compare the intensity of subacute LBP and disability among women who underwent cesarean delivery with different anaesthetic types.
Methodology. This retrospective cohort study was conducted to 38 women “26 of them underwent cesarean delivery, assessed after 6 to 12 weeks from delivery, they were classified into: [epidural anaesthetic group (Group A) n = 6, spinal anaesthetic group (Group B) n = 13, general anaesthetic group (Group C) n = 7], they were either primiparous or multiparous who did not receive anaesthesia for at least one year prior to the last delivery, the other 12 women were the control group (Group D) who didn’t experience pregnancy or anaesthesia”.
Results. The mean values of visual analogue scale (VAS) in Group A, Group B, Group C, and Group D were 5.00 ± 1.67, 4.62 ± 1.12, 5.14 ± 1.21, and 2.17 ± 0.71, respectively. The ANOVA test revealed a significant difference in VAS (P = 0.0001; P < 0.05) among the four groups. while the post-hoc test revealed non-significant differences (P = 1.000; P > 0.05) between the three anaesthetic groups. Also, the mean values of Oswestry Disability Index (ODI) in the same four groups were 26.00 ± 16.68, 27.00 ± 11.72, 30.00 ± 6.87, and 25.00 ± 9.33, respectively. The ANOVA test revealed non-significant difference in ODI (P = 0.838; P < 0.05) among the four groups.
Conclusion. Epidural, spinal and general anaesthesia for cesarean delivery are associated with increased intensity of subacute LBP, but without significant differences between these anaesthetic types. However, they do not increase the disability.

Key words:
neuraxial anaesthesia, general anaesthesia, cesarean delivery, subacute period, low back pain

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Effect of whole body vibration versus high intensity interval training on interleukin-6 in obese post-menopausal women

Fayka E Ali, Fahima M Okeel, Amir A Gabr, Amel M Yousef, Abdullah M. Al-Shenqiti, Mohamed Ahmed Elbedewy


Fayka E Ali, Fahima M Okeel, Amir A Gabr, Amel M Yousef, Abdullah M. Al-Shenqiti, Mohamed Ahmed Elbedewy – Effect of whole body vibration versus high intensity interval training on interleukin-6 in obese post-menopausal women. Fizjoterapia Polska 2022; 22(2); 144-149

Abstract
Background. Menopause and aging affect the health of obese women, provoking accumulation of visceral adipose tissue (VAT) and inflammation. Obesity leads to major health problems, which increase the risk of debilitating diseases that lead to death. Thus, loss of weight and VAT are primary goals of treatment through modifications of dietary habits and exercise. Purpose of the study. This study was conducted to determine which is more effective on interleukin- 6 (IL-6) levels for obese post-menopausal women, whole body vibration training (WBVT) or high intensity interval training (HIIT). Subjects and methods. 45 post-menopausal obese women diagnosed with higher level of IL-6, their body mass index (BMI) > 30 kg/m2 and waist/hip ratio (W/H ratio) > 0.8 participated at this study. Women were divided randomly into 3 equal groups in numbers; Group (A) followed low caloric diet (1200 Cal), Group (B) received WBVT and Group (C) received HIIT. Both groups (B & C) followed the same low caloric diet as group (A). Evaluation was done before and after 3 months of treatment, through measuring weight, BMI, waist as well as hip circumferences, W/H ratio and IL-6 levels. Results. The three groups revealed statistically significant improvements (P < 0.05) in all parameters after treatment compared to baseline. Also, there were statistically differences between the 3 groups after treatment, with the group (B) more favorable than groups (A & C). Conclusion. WBVT is more effective than HIIT on reducing inflammation via reducing IL-6 level in obese post-menopausal women.
Key words:
obesity, menopause, whole body vibration exercise, high intensity interval training, interleukin-6
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Effect of cold and ultrasonic therapy on postural kyphosis in pre and post-menopausal women: A randomized controlled trial

Marwa M. Mahran, Soheir M. Elkosery, Mohamed H. Mustafa, Amel M. Yousef

Marwa M. Mahran, Soheir M. Elkosery, Mohamed H. Mustafa, Amel M. Yousef – Effect of cold and ultrasonic therapy on postural kyphosis in pre and post-menopausal women: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 20-25

Abstract
Background. Thoracic kyphosis is one of the manifestations of post-menopausal spinal osteoporosis so it is preferable to prevent incidence of kyphosis related to estrogen deficiency especially for premenopausal whose kyphosis start to be developed. Purpose. The aim of this study was to detect the effect of cold and ultrasonic therapy on postural kyphosis with middle back pain in pre and post-menopausal women. Materials and Methods. Sixty non-osteoporotic pre and post-menopausal women between the ages of 40 and 60 years, assigned randomly into 3 groups equal in numbers; each group consisted of 10 pre and 10 post-menopausal women; Group (A) received physiotherapy program followed by cold therapy, Group (B) received ultrasonic therapy followed by physiotherapy program, and Group (C) received ultrasonic then the physiotherapy program followed by cold therapy. The three groups followed the same physiotherapy program in form of strengthening, stretching and postural reeducation, three sessions per week for three months. The kyphotic index and pain were assessed by flexicurve ruler and visual analogue scale (VAS) respectively pre- and post-interventions. Results. Within the three groups (A, B & C) the kyphotic index and pain showed significant decrease (P < 0.0001) post treatment in both pre- and post-menopausal conditions, while they showed clinical improvement and non-significant difference (P > 0.05) when compared pre to post-menopause conditions in the pre- and post-treatment. The clinical improvement in the kyphotic index in group (A), (B) & (C) at pre as well as post-menopausal conditions were equal [(↓8.44% & ↓7.1%), (↓7.7% &↓8.12%) & (↓9.68% &↓11.08%)] and VAS were [ (↓32%&↓35%), (↓40% & 30%) & (↓37.55%, ↓31.57%)] respectively post treatment. Conclusion. Adding cold and ultrasound therapy to physiotherapy program have a clinical impact in reducing kyphosis and pain in pre- and post-menopausal women.
Key words:
cold, ultrasonic, menopause, kyphosis, flexicurve ruler
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Effect of aerobic exercise on inflammation and sex hormones in obese polycystic ovarian syndrome women: A randomized controlled study

Doaa A. Abd El Aziz, Fahima M. Oqeel, Magid M. Labib, Amel M. Yousef

Doaa A. Abd El Aziz, Fahima M. Oqeel, Magid M. Labib, Amel M. Yousef – Effect of aerobic exercise on inflammation and sex hormones in obese polycystic ovarian syndrome women: A randomized controlled study. Fizjoterapia Polska 2021; 21(4); 204-209

Abstract
Purpose. This study aimed to investigate the effect of aerobic exercise on inflammation and female sex hormones in obese PCOS women. Materials and methods. Forty volunteer obese PCOS women were participated in this study, their ages ranged from 20 to 35 years and body mass index (BMI) ranged from 30 to 34.9 kg/m2, they randomly divided into two equal groups in numbers; group A, followed diet control therapy and group B, participated in an aerobic exercise three times per week and followed the same diet control therapy as group A. Both groups were evaluated before and after therapy (12weeks) through measuring their BMI, C-reactive protein (CRP), luteinizing hormone (LH), follicular stimulating hormone (FSH), LH/FSH ratio and modified Ferryman–Gallwey (mFG) scoring system for hirsutism Results. showed that there was a statistically significant difference (P < 0.05) in both groups (A&B) in BMI, LH, FSH, LH/FSH ratio, CRP and mFG in favor to group (B) after therapy (12 weeks). Conclusions. revealed that aerobic exercises are effective in decreasing weight and inflammation which lead to improve fertility by improving female sex hormonal variables.
Key words:
Polycystic ovarian syndrome, Aerobic exercise, Follicular stimulating hormone, luteinizing hormone, C-reactive protein
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Additional Effect of Electrical Stimulation for Women with Stress Urinary Incontinence: Literature Review

Reem H. Abdelhady, Amel M. Yousef, Maya G. Aly

Reem H. Abdelhady, Amel M. Yousef, Maya G. Aly – Additional Effect of Electrical Stimulation for Women with Stress Urinary Incontinence: Literature Review. Fizjoterapia Polska 2021; 21(3); 80-85

Abstract
Aims. This narrative review aims to investigate the effect of adding electrical stimulation (ES) to pelvic floor muscles training (PFMT) in the management of stress urinary incontinence (SUI) in women. Also, this review aims to provide a framework for future research in order to formulate more comprehensive, lifestyle-centered guidelines for treating women with SUI. Methods. A literature search was conducted in PubMed, PEDro, Cochrane library, and Google Scholar databases using the keywords “Physical therapy modalities”, “Pelvic floor muscle training”, “Exercise”, “Electrical stimulation”, “Interferential”, “Pelvic floor disorders”, “Stress urinary incontinence” and “Women”. Reviewed literature was descriptively analyzed and summarized. Results. ES is effective in the treatment of the SUI comparing to control or placebo treatment, while there is a little evidence that support the use of ES as an additional treatment for women with SUI as studies showed high diversity of ES parameters used. Conclusion. Adding ES to PFMT may be helpful for women who find difficulty to voluntarily contract their pelvic floor muscles. More well-designed studies are needed to strength the evidence of using ES for treatment of women with SUI.
Key words:
electrical stimulation, pelvic floor exercises, stress urinary incontinence, women
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