Effect of Lifestyle Modification on Obese Females With Primary Dysmenorrhea

The visual analogue scale will be used to measure menstrual pain intensity for both groups before and after treatment.it is a valid and reliable 10 cm line ranging from 0 to 10. 0 indicates no pain,10 indicates worst pain.

WaLIDD scale will be used to determine the severity of dysmenorrhea for each female in both groups by combining subjective (intensity/wong-baker, work ability) and objective (days of pain, location) manifestations for both groups. its score ranges between 0 and 3, and the final score ranges from 0 to 12 points. the higher the score, the greater the severity of dysmenorrhea.

the pressure algometer will be used to assess pain pressure threshold for all females in both groups before and after treatment on the following points: A-Two measurements 4cm from the umbilicus, bilaterally (points I and II) B-Two other measurements 4cm below the previous ones (points III and IV) C. A single measurement 4cm from the lower margin of the umbilicus (point V). D. Another single measurement into the medial side of the lumbar region below the fifth lumbar vertebra, corresponding to S2-S4 (point VI).

Weight and height measurement will be measured for each participant in both groups before and after the treatment to calculate her BMI according to the following equation:

BMI (kg/m2) = Weight (kg) / Height² (m2).

Waist hip circumference were taken for each woman in both groups before and after the treatment course for calculating waist and hip ratio (WHR) by dividing the waist circumference (WC) on hip circumference (HC). By the tape measurement, (WC) was measured at the narrowest circumference between xipho-sternum and the iliac crest at the end of gentle expiration. HC was measured at the maximum circumference at the level of femoral trochanter.

By using the modified Schober test, the participant will be asked to stand; the therapist will mark both posterior superior iliac spines (PSIS) and then will draw a horizontal line connecting the center of both marks. A second line will be marked 5 cm below the first line and a third line will be marked 10 cm above the first line. The participant will be instructed to flex forward as if attempting to touch her toes, then therapist will re-measure the distance between the top and bottom line. The increased distance along the tap due to lumbar flexion is normally about 6-7 cm (less than 5 cm should be considered abnormal)

The subjects will be asked to stand with lower back and upper buttocks exposed on the markings done by adhesive tape on the floor with a distance of 15 cm between feet.

The flexible ruler will be placed over the lumbar spinous process and the readings on the flexible ruler that intersected with the markings done on spinous processes will be noted.

The vertical line (L) will be drawn to connect the spinous processes T12 and S2 landmarks and will be labelled as A and B respectively. The deepest point of the curve will be identified by recording the steep of the curve and a perpendicular line (H) from the point to the line L will be drawn. The L and H lengths will be measured in cm The measurements will be recorded after removing the flexible ruler without changing the curve. Then, the outline of the curve will be traced from the readings for T12 to S2 spinous processes using a pencil along the flexible ruler onto the graph sheet its normal value is ranged between 20° and 45°.

It will be assessed before and after treatment program using Free online SF-36 score calculator. The SF-36 measures eight scales: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Component analyses showed that there are two distinct concepts measured by the SF-36: a physical dimension, represented by the Physical Component Summary (PCS), and a mental dimension, represented by the Mental Component Summary (MCS). Responses will be scored on a five point scale (from "very poor" to "very good"), where higher scores indicate better enjoyment and satisfaction with life. Scores will be added and presented as a percentage of the total maximum score. A percentage of total score of > 70 represents normal quality of life.