Dual-Task Postural Stability in Women With Premstrual Syndrome: A Within-Subject Comparative Study

Among women of reproductive age, premenstrual syndrome (PMS) is a common condition. Recent evidence indicates that approximately 20-30% of women experience PMS, highlighting its substantial global impact and confirming that a considerable proportion of women are affected by clinically relevant symptoms [1,2]. Estimates suggest that about half of women experience PMS. Fatigue, discomfort, impatience, and trouble concentrating are among the physical, emotional, and cognitive symptoms of PMS that can significantly interfere with day-to-day functioning [3, 4]. In addition to these well-known consequences that may affect balance and postural control, an increasing amount of evidence suggests that PMS may also affect neuromuscular systems and cognitive function [5].

40 women with regular menstrual cycles and premenstrual symptoms were enrolled. Participants were assessed during the PMS phase, identified 5-7 days before menstruation, and the non-PMS follicular phase (days 7-10). PMS symptom severity was assessed using the 40-item Premenstrual Syndrome Scale (PMSS).

Dual-task postural performance was assessed using the Biodex Balance System during static and dynamic conditions. Participants stood barefoot without holding the handrails while performing forward and reverse spelling tasks. Three 30-second trials were performed at Biodex stability levels 6-8, with adequate rest between trials.

Primary outcomes included static and dynamic OSI, APSI, and MLSI, while PMS severity was the secondary outcome. Paired *t*-tests and Cohen's *d* were used to compare the two phases, and Pearson's correlation assessed the relationship between PMS severity and postural stability.

Inclusion criteria

• Regular menstrual cycles (19-25 days).
• Presence of premenstrual symptoms identified through menstrual cycle tracking and self-reported symptom reporting.
• No use of hormonal contraceptives.
• No history of neurological, musculoskeletal, vestibular, or cognitive disorders.

Exclusion criteria

• Lower-limb injury within the previous six months.
• Diagnosed psychiatric or neurological conditions.
• Use of medications affecting balance or cognitive performance.
• Presence of dysmenorrhea symptoms.