title: Comparison of Reflexology and Connective Tissue Manipulation in Participants with Primary Dysmenorrhea.
abstract: OBJECTIVE
  The aim of this interventional correlational study is to compare the effects of foot reflexology (FR) and connective tissue manipulation (CTM) in subjects with primary dysmenorrhea.
  
  
  METHODS
  A total of 30 participants having primary dysmenorrhea completed the study. Data, including demographics (age, body-mass index), menstrual cycle (age at menarche, menstrual cycle duration, time since menarche, bleeding duration), and menstrual pain characteristics (intensity and duration of pain, type and amount of analgesics), were recorded. Effect of dysmenorrhea on participants' concentration in lessons and in sports and social activities was assessed by using the visual analog scale. Participants rated their menstruation-related symptom intensity through the Likert-type scale. FR was applied to 15 participants for 3 days a week and CTM was performed on 15 participants for 5 days a week. Treatments were performed during one cycle, which started at the third or fourth day of menstruation and continued till the onset of next menstruation. Assessments were performed before treatment (first menstruation), then after termination of the treatment because of the next menstruation's onset (second menstruation), and ∼1 month after at the consecutive menstrual period (third menstrual cycle).
  
  
  RESULTS
  Time-dependent changes in duration and intensity of pain along with analgesic amount show that both treatments provided significant improvements (p < 0.05) and no superiority existed between the groups (p > 0.05). A similar result was obtained in terms of time-dependent changes in concentration in lessons and difficulty in sports and social activities due to dysmenorrhea. Menstruation-related symptoms were found to be decreased after treatment and in the following cycle with both treatments (p < 0.05) where no difference existed between the groups (p > 0.05).
  
  
  CONCLUSIONS
  Both FR and CTM can be used in the treatment of primary dysmenorrhea and menstruation-related symptoms as these methods are free from the potentially adverse effects of analgesics, noninvasive, and easy to perform.
authors.affiliation: 1 Department of Physiotherapy and Rehabilitation, Tokat School of Health, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Funda
authors.initials: F
authors.lastname: Demirtürk
authors.affiliation: 2 Department of Midwifery, Tokat School of Health, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Zümrüt Yilar
authors.initials: ZY
authors.lastname: Erkek
authors.affiliation: 2 Department of Midwifery, Tokat School of Health, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Alparslan
authors.affiliation: 3 Department of Obstetrics and Gynaecology, Faculty of Medicine, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Fazlı
authors.initials: F
authors.lastname: Demirtürk
authors.affiliation: 4 Department of Biostatistics, Faculty of Medicine, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Osman
authors.initials: O
authors.lastname: Demir
authors.affiliation: 5 Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Gaziosmanpasa University , Tokat, Turkey .
authors.forename: Ahmet
authors.initials: A
authors.lastname: Inanir
mesh_terms: D000293:Adolescent; D000328:Adult; D004412:Dysmenorrhea / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008405:Massage; D026201:Musculoskeletal Manipulations; D012919:Social Behavior; D055815:Young Adult