Relationship Between Primary Dysmenorrhea and Biomechanical Characteristics of Lumbo-pelvic Region Among Female University Students

The WaLIDD score (Working ability, Location, Intensity, and Days of pain) is a clinical questionnaire used to evaluate the severity of dysmenorrhea (painful menstruation) and to predict the likelihood of a person needing medical leave. It evaluates the condition using four criteria, each scored from 0 to 3, yielding a total possible score ranging from 0 to 12 points.Low/Mild Score (0 to 4 points): Indicates no dysmenorrhea.Moderate Score (5 to 7 points): Indicates moderate dysmenorrhea.High Score (8 to 12 points): Indicates severe dysmenorrhea.

Pain intensity will be assessed using the Numerical Rating Scale (NRS), where participants rate their pain from 0 (no pain) to 10 (worst imaginable pain)

Pelvic tilt angle will be measured using a digital pelvic inclinometer by assessing the angle between the ASIS and PSIS landmarks in a standing position

The pressure biofeedback unit will be used to assess muscle activity.Subjects were asked to stand upright with pelvis and spine in neutral position and wear a lumbar support belt firmly around the abdomen. The anterior superior iliac spines (ASIS) of both sides were palpated and marked. The pressure bag was placed underneath the lumbar support one inch above the ASIS over the transversus abdominis muscle and PBU at was pumped to 70 mmHg. The participants were instructed to correctly perform abdominal drawing as much as possible and hold it for 5 seconds. For each participant 3 readings were taken, and the average of these readings was recorded.

The MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess oscillation frequency. it introduces an innovative and non-invasive approach for comprehensively characterizing the biomechanical and viscoelastic properties of muscles.The device is applied under constant preload (0.18 N) to pre-compress subcutaneous tissues, and it exerts a brief (15 milliseconds) mechanical tap at a pre-determined force (0.4 Newtons), followed by quick release, causing damped oscillations that are recorded by the testing probe. This device is portable, inexpensive, easy to use, and convenient for re-cording the biomechanical and viscoelastic stiffness of myofascial tissues relatively quickly.A higher oscillation frequency indicates higher muscle tone, while increased stiffness reflects greater resistance to force application.

The MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess muscle dynamic stiffness. it introduces an innovative and non-invasive approach for comprehensively characterizing the biomechanical and viscoelastic properties of muscles.The device is applied under constant preload (0.18 N) to pre-compress subcutaneous tissues, and it exerts a brief (15 milliseconds) mechanical tap at a pre-determined force (0.4 Newtons), followed by quick release, causing damped oscillations that are recorded by the testing probe. This device is portable, inexpensive, easy to use, and convenient for re-cording the biomechanical and viscoelastic stiffness of myofascial tissues relatively quickly.A higher dynamic stiffness indicates greater resistance to force application.

the MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess muscle elasticity. it quantifies the dissipation of mechanical energy (damping) during natural oscillations of a muscle. lower values signify higher elasticity (i.e., better ability to recover from deformation), while higher values suggest lower elasticity.

the MyotonPro (Myoton AS Tallinn, Estonia) device will be used to assess mechanical stree relaxation time with ms.It represents the duration of the muscle recovery process (or the relaxation time) from displacement.the higher tissue tension or stiffness, the faster tissue recovers its shape, meaning the lower the value.

the MyotonPro (Myoton AS Tallinn, Estonia) device will be used to viscoelastic properity. It represents the relationship between the time it takes for a tissue to undergo creep (gradual elongation) and the time it takes for it to recover or relax after being under constant deformation.Lower values: Indicate higher tissue tension, structural integrity, or increased stiffness (faster recovery).Higher values: Indicate greater viscoelasticity (slower recovery, more creep).