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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 3  |  Page : 303-308

Effect of stretching exercises on menstrual pain among adolescent girls


1 Department of Nursing, National Institute of Medical Sciences (NIMS) University Rajasthan, Jaipur, Rajasthan 303121, India
2 Department of Nursing, BJ Government Medical College and Sassoon General Hospital, JPN Road, Railway Station Road, Pune- 411001, Maharashtra, India
3 Department of Directorate of Research, Krishna Institute of Medical Sciences, (Deemed to be University), Agashivnagar, Malkapur, Maharashtra 415539, India

Date of Submission21-Jun-2022
Date of Acceptance06-Jul-2022
Date of Web Publication29-Sep-2022

Correspondence Address:
Mrs. Vaishali Chandrakant Talekar
Department of Nursing, National Institute of Medical Sciences (NIMS) University Rajasthan, Jaipur, Rajasthan 303121
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_85_22

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  Abstract 

Background: Pain is an unpleasant, intense feeling. During menstruation, contraction of the uterus to expel the built-up lining. Prostaglandin hormone is responsible for the muscle contraction in the uterus, which causes press against the blood vessels around it. It leads to a cut-off oxygen supply to muscle tissue, which triggers pain. One of the treatments for primary dysmenorrhoea is regular exercise and relaxation techniques. Stretching exercises help to relieve pain by reducing stress, improving flexibility, and strengthening the muscle. This study aims to find out the effect of stretching exercises on menstrual pain among adolescent girls. Materials and Methods: A cross-sectional evaluative study was conducted among the adolescent girls of Selected schools in Navi Mumbai, India from October 2021 to February 2022 to analyze the relationship between stretching exercises and menstrual pain among adolescent girls. A numerical pain scale and a modified women’s health questionnaire were used to collect data from 100 adolescent girls. The non-probability purposive sampling technique was used to select adolescent girls. Statistical Analysis: SPSS 24.0, software was used to tabulate and analyze the data. Results: This study result shows that a maximum of girls from age of 15–17 years (48%). A total of 82% of girls experienced menstrual pain. After doing stretching exercises, girls reduced their total pretest mean score from 2.65 to 1.99 post-test mean score. Posttest menstrual symptoms were reduced than the pretest menstrual symptoms after 8 weeks of intervention, so it was proven that stretching exercises helped in reducing menstrual pain and coping with problems.(‘p-value was <0.0001. Conclusion: Menstrual pain was a common problem among adolescent girls in schools of Navi Mumbai, Maharashtra, India. Dysmenorrhea adversely affects school attendance in adolescents. Regular daily exercises were can help to reduce menstrual pain among adolescent girls.

Keywords: Adolescencegirls, dysmenorrhea, menstrual pain, stretching exercises


How to cite this article:
Talekar VC, Singh M, Kamble K, Mane DK. Effect of stretching exercises on menstrual pain among adolescent girls. MGM J Med Sci 2022;9:303-8

How to cite this URL:
Talekar VC, Singh M, Kamble K, Mane DK. Effect of stretching exercises on menstrual pain among adolescent girls. MGM J Med Sci [serial online] 2022 [cited 2022 Dec 7];9:303-8. Available from: http://www.mgmjms.com/text.asp?2022/9/3/303/357478




  Introduction Top


Sixteen percent of adolescent girls compromised the total world population. Out of a total 21.3% of adolescent girls were consist of the age group of 10–19 years. Gynecologists said that menstruation is the key to the health status of adolescent females. Menstrual disorders are the measure problems among girls.[1] Menstrual pain is the commonest problem during menstruation. Prostaglandin hormone is responsible for the muscle contraction in the uterus, which causes press against the blood vessels around it. It leads to a cut-off oxygen supply to muscle tissue, which triggers pain. The prostaglandin hormone level rises before the period starts. That’s why it is difficult to identify the cause of unbearable pain.[2] 72.8% of girls experienced menstrual pain.[3]

The worldwide prevalence of dysmenorrhea was 15.8 to 89.5% reported by the adolescent population. Researchers identified 93% of menstrual disorders 65% of premenstrual symptoms,43% of abnormal cycle length, 33% affected social, and 7.7% of academic schooling.[4]Menstrual pain is also found in college-going girls. Out of that, 84.2% reported dysmenorrhea. It was assessed by using a visual analog scale that 34.2% had severe pain, 36.6% identified moderate pain and 29.2% had mild pain.[5] However physical activity such as mild stretches can ease the pain of menstrual cramps.[6]Primary dysmenorrhea means pain without organic pathology. One of the treatments for primary dysmenorrhea is regular exercise and relaxation techniques. Cramps usually feel like a pain in the abdomen (belly), pelvis (hip area), lower back, and upper legs. Stretching exercises help to relieve pain by reducing stress, improving flexibility, and strengthening the muscle..[7] Sharma S et al. highlighted that 53.5% of girls were having dysmenorrhea.[8] A quasi-experimental study done by Reda and Tawheda[9] revealed that pain intensity (severe dysmenorrhea) for the studied group reduced from 37.5% during the pre-test to 12.5% during the post-test. The researchers also concluded that using two months of regular stretching exercises with usual menstrual care was effective for reducing the pain intensity of primary dysmenorrhea. Negi P, et al.[10] found that eating habits and physical activities directly affect menstrual health.

Hightower M.[11] communicated that menstrual pain is greater in women who participate in the study. When physical activities were increased adjust the metabolism leading to increase blood circulation. The main function of the lumbar spine was the adjust the force of the body. Stretching exercises helped in the lumbar stabilization.[12] Exercises will help to release the endorphins from the brain leading to an increase in the pain threshold and a rise in blood circulation causing to decrease in cramps. It has an analgesic effect on menstrual pain during menstruation.[13] In the research context, there are fewer studies done on their relation to menstrual pain and stretching exercises. Investigators were interested to find the relationship between stretching exercise and menstrual symptoms.


  Materials and methods Top


A quasi-experimental, one-group pretest-posttest design was used to conduct a study among the girls in Navi Mumbai, Maharashtra, India. A total of 100 adolescent girls were selected by the non-probability purposive sampling technique from the age group of 12–19 years. NPS (Numerical pain scale) was used to assess menstrual pain and a Modified women’s health questionnaire was used to assess the premenstrual symptoms. Stretching exercises were demonstrated and insist to do exercise thrice a week for 8 weeks. The stretching exercises included as forward bending which helps to reduce the abdominal cramp, ankle stretching exercises, to release stress, arm, and leg stretching exercises, reduce the stress on the back muscle, pelvic bridging with curl-up exercises to improve the pelvic and abdominal muscles strength, elbow forward bending and abdomen contracting exercises reduce the stress on abdominal low back or thigh muscles. Adolescent girls were not doing exercises during menstruation. Ethical approval was taken from the Institutional Ethics Committee and permission from MGM High School and Jr. College, Navi Mumbai, Maharashtra, India. Informed consent was taken by participants and their parents. Statistical Package for the Social Sciences (SPSS) 24.0 software was used for the analysis of data.


  Results Top


The data were processed and analyzed based on the objectives of the study. 100 enrolled adolescent girls age-wise distribution of adolescent girls 48 belonged to 15–17 years of age [Table 1]. A maximum of 72 girls belong to the nuclear family, 23 were from a joint family, and only 5 were from extended family. A maximum of 50 girls were having a normal weight BMI, 46 girls were underweight and only 4 girls were overweight. 52 girls were in the age of menarche 12–13 years. Out of 100 adolescent girls was reported 50 (3–4 days) duration of menstruation [Table 2]. 82 girls experienced menstrual pain. 36 girls reported irregular periods. The interval between two menstruations was reported as less than 28 days. [Table 3] represents pretest data showing that a maximum of 33 girls experienced moderate pain and 19 girls experienced severe pain during the first day of menstruation. Posttestdata revealed that a maximum of 69 girls had mild pain and only 2 girls experienced severe pain during the first day of menstruation. On the second and third day of menstruation adolescent girls experienced pretest mild pain 56 and posttest 57 responses for mild pain, with 23 girls having moderate pain. On the fourth and fifth day of menstruation, in the pretest 47 girls reported mild pain which increased during the posttest 51 girls experienced mild pain. The following results are shown in table and graph no. while comparing the data within the group pretest and posttest 1 mean (2.65) and SD (0.86) score was the same but there is a change found in posttest 2 mean (1.99) and SD (0.61) score during pain on the first day of menstruation at the level of significant P < 0.05 [Table 4] and [Figure 1]. Therefore, it is proven that Stretching exercises were effective in decreasing menstrual pain during menstruation among adolescent girls. The comparison of 6 different menstrual symptoms within-group among adolescent girls has been explained and differences were found significant (P < 0.05) [Table 5] and [Figure 2]. In premenstrual symptoms, the difference between pretest and posttest premenstrual symptoms was not significant (at the ‘p’= 0.069). The findings of Menstrual cycle patterns showed that the mean post-test scores (1.88) are lesser than the pretest (2.4) scores with ‘a p-value <0.0001. For menstruation knowledge, the post-test 2 mean score (1.89) is lesser than the pretest mean score (2.65) with the ‘p-value <0.0001. Additionally, the menstrual post-test mean pain score (1.85) was significantly reduced from than pretest mean score (2.35) at the level of significance ‘p-value was <0.0001. In terms of mid-cycle (Ovulation) symptoms, the post-test mean score (1.31) was lesser than the pretest mean score(1.73) with a ‘p-value was <0.0001. As per post menstruation symptoms, the stretching exercises were effective in decreasing menstrual symptoms except for the premenstrual symptoms during menstruation among the adolescent girls within the group at the level of significance ‘p-value was <0.0001.
Table 1: Distribution of adolescent girls as per socio-demographic data n = 100

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Table 2: Distribution of adolescent girls as per menstrual history n = 100

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Table 3: Distribution of Adolescent girls as per Pretest and posttest score regarding Characteristics of Menstrual pain. (n = 100)

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Table 4: Comparison of Means and Standard Deviations of Menstrual pain by Numerical Pain Scale among adolescent girls. (n = 100)

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Figure 1: Comparison of Means of Menstrual pain by Numerical Pain Scale among adolescent girls

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Table 5: Comparison of Means and Standard Deviations of Menstrual Symptoms assessed by using Modified Women’s Health questionnaire among adolescent girls. (n = 100)

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Figure 2: Comparison of Means of Menstrual symptoms by using Modified Women’s Health questionnaire among adolescent girls

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  Discussion Top


Menstrual pain occurs during menstruation in the lower abdomen characterized by a cramping sensation in the lower abdomen radiating from the backside to the front towards the upper thigh. When girls were doing stretching exercises they release the endorphins hormone which acts as a natural painkillers effect on a muscle cramp.[10] The present study aimed to assess the effect of stretching exercise on menstrual pain among adolescent girls. The overall comparative result revealed that In the Garhwal[10] region PMS was a common problem present among adolescent girls was 51%-69%. Adolescent girls may not be aware and less utilize health care services that have a significant direct connection to physical exercise and dietary habits. Those who have an impact on physical and social factors of adolescent girls.[14] The researchers identified the mean age of menarche as 12.8 ± 1.2 years and the median age was 13[15] Another study in the Ratnagiri district found that 13.7 years was the mean age of menarche.[16] Our study found that the mean age of menarche was 12.5years. In the previous study, the researcher identified menarcheal age as more than 13yrs, which was progressively reduced in the previous three decades observed in the studies of Pathak et al.[17] RapkinAJ[18] described that exercise and physical activity improve brain efficiency and inner feeling of joyfulness which improve physical and mental health and create a positive approach to life. Exercise and playing sports, help to reduce premenstrual symptoms. In the present study, menstrual pain score during menstruation was significantly reduced when the girls were doing regular stretching exercises thrice a week for 8 weeks at the level of significance ‘p-value was <0.0001. Also, menstrual symptoms such as pain, irregular bleeding, nausea vomiting, and feeling uneasiness like fatigue, weakness, cramps, etc were significantly decreased after doing regular exercises(P < 0.001). In controversy, there was no significant reduction seen in premenstrual symptoms (‘p’= 0.069). Whereas Ameneh S, et al.[19] found that if the girls were doing exercise twice a week it help to reduce premenstrual symptoms(P = 0.022). Researchers have proven that there was found a significant relationship between exercise and identified depression among adolescent girls (P = 0.010) and if physical exercise increase increases that reduces the depression rate among individuals. On another hand, researchers believe that doing regular sports or physical exercise will increase the Beta-endorphin level during the late luteal phase, it helps to create pain tolerance among individuals. Variation in sex hormone decreases the Beta-endorphin level.[20] A research study described that menstruation had an impact on quality school time because of 36% of pain symptoms, fear, foul smell or uneasiness, difficult movement, physical posture, etc.[21]Different studies also revealed that dysmenorrhea and PMS were experienced as the cause of the most stressful symptoms of school absenteeism or interruption in household activities among girls. According to the study result, it was proved that the stretching exercise significantly reduced menstrual pain and improved the coping ability during menstruation whereas improving the quality of life in adolescent girls(‘p-value was <0.0001)


  Conclusion Top


The study concludes that adolescent girls were having dysmenorrheal. The effect of 8 weekly programs of stretching exercises reduces the severity of the symptoms of dysmenorrhea menstrual disorders were a common problem among adolescent girls in schools of Navi Mumbai. The stretching exercises can help to reduce menstrual pain in adolescent girls. The daily exercise followed before your expected period will help you to ease your pain in your next cycle. The clinician, educators, and parents may adopt this stretching exercises program to decline the severity of dysmenorrhea menstrual disorders symptoms.

Limitation

  1. This study was not included cultural beliefs regarding menstruation, which may vary the result.


  2. This study excluded elite athletes but it did not segregate the different levels of physical activity.


  3. It was conducted only for 12–19 years of age group girls.


Ethical consideration

The Institutional Ethics Committee of National Institute of Medical Sciences, Jaipur, Rajasthan, India had reviewed the research project and approved undertaking the study protocol vide their letter no. NIMSUNI/IEC/2019/Ph.D./109 dated 29th July 2019.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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