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Abstract Primary dysmenorrhea is a highly prevalent cyclical disorder among adolescent girls. It includes a constellation of mood, behavioral, and physical symptoms that become prevalent at the first day of menstruation and last during 72 hours. It is a complex health problem that affect the adolescent daily life and experience a reduction in self-confidence, social isolation, decline in academic achievement, and increase in school absents and loss of concentration. So, management of these symptoms becomes more necessary. Today, non-pharmacologic treatment is one of the most common methods of treating any kind of disease because, in addition to cost-effectiveness, it leaves fewer side effects than chemical drugs. Exercise practice are easy and effective in nursing practice to decrease pain and strength muscles, Kegel exercise help girls feel more confident and control while minimizing the distress caused by specific symptoms. As well as, they are inexpensive, straightforward, and simple to teach and perform. This study aimed to: Evaluate the effect of Kegel versus pelvic rocking exercise on primary dysmenorrhea intensity among adolescents at secondary female’s schools in al-Mafraq Jordanian city. To fulfill the study aim: A quasi experimental research design was used. Materials and method Setting: The study will be conducted at Al-Mafraq Jordan city governmental schools, in three directorates. Al Mafraq secondary females’ schools at Directorate of education for the Kasbah which include 302 female students. Umm AL- Jamal secondary comprehensive mixed school at Directorate of education for the northeastern badia region which includes 87 female students. And Gap gap comprehensive secondary school for girls at Directorate of education for the north western badia region which include 99 female students. Subjects: A convenience sample of 216 female students was selected to participate in the study according to the following inclusion criteria: had a history of regular menstrual cycle ranging from 21 to 35 days (mean 28 days), lasting from 3-7 days, suffer from either mild or moderate degree of primary dysmenorrhea, symptoms were restricted before or first menstrual cycle day, no prior history of gynecological disease, had no history of co-existing medical illness or psychiatric disorder, and take no medication or analgesics for pain during the study time. The selected subjects were equally assigned to either the Kegel exercise group (108) or the Pelvic Rocking exercise group (108). Tools used in this study: Three tools were used for data collection, tool I: Socio-demographic and Menstrual data structured interview schedule, tool II: The WALIDD primary dysmenorrhea intensity scale Collection of data consumed a period of 3 months from middle of October 2021 until the middle of January 2022. Data of tool I was collected from both groups through an interview schedule, which was conducted individually and in total privacy. The study subjects were divided into two group 108 Kegel exercise group and 108 Pelvic Rocking exercise group. The researcher interviewed each student individually for about 30 minutes during any day of the menstrual time (1-3 days of menses)to collect basic data and to assess the severity of dysmenorrhea and associative symptoms by using tool (I&II&III). The study groups receive the Kegel or Rocking exercise. The researcher starts to explain and demonstrate how to do both exercise using PowerPoint presentation & video, and demonstration of the tow exercise while the participant watching, after the completion of the explanation, each female student was asked to re-demonstrate it until the researcher ensures that the student was able to demonstrate the technique independently. The student was asked to practice the exercise for 8 weeks a long, 3 sessions per week, 2 sessions/ day, and each session lasting from 10 to 15 minutes with a break of 2 hours between each session. Under direct supervision of the researcher. Another test after 4 weeks and 8 weeks, they interviewed to reassess the severity of dysmenorrhea by using tool (I&II) (post-test). The main findings of the present study were: 1. Subject’s general characteristics Regarding the age it was found that the mean age among Kegel and rocking groups was (17.11 ± 0.84 & 17.11 ± 0.84) years, respectively. Around half (48.1% &55.6%) of the Kegel and Rocking exercise groups, respectively were at -Second secondary year. In addition, the majority of both groups (62%) were urban resident. Family income was enough from the point of view of approximately two thirds (66.7% and 54.6% respectively) among both groups. As regarding to their menstrual history Where, 75.0 % of the Kegel exercise group compared to slightly more than three- quarters (75.9%) of the pelvic Rocking exercise group had their first menstruation at 12 to< 14 years with mean ages (12.39 ± 1.01& 12.19 ± 0.82) in both groups respectively. 2. Intensity of dysmenorrhea Dysmenorrhea intensity were significantly decreased within both group before and after intervention (p <0.0001). Kegel exercise seemed to be more effective than pelvic Rocking in improving dysmenorrhea intensity. Effect size reflects Mild relation for Kegel exercise group (0.486) and Low relation in Pelvic Rocking exercise (0.250). 3. Frequency of retrospective Symptom After 4 and 8 weeks of applying both interventions a statistically significant differences were observed between Kegel and pelvic Rocking exercise groups in relation to the following items; loss of appetite, headaches, mood change back pain, leg pain,, work difficult, social activity, Stress and fun activity, in favor of Kegel group, while no statistically significant differences were detected between the two groups in relation to their concentration, dizziness, diarrhea and nausea and physical activity.4. Intensity of retrospective symptoms Statistically significant differences were observed between Kegel and pelvic Rocking exercise groups in relation to the following items; vomiting, loss of appetite, headaches, back pain, leg pain, physical activity, work difficult, social activity, Stress and fun activity, of Kegel group, while no statistically significant differences were detected between the two groups in relation to their concentration, mood change, dizziness, diarrhea and nausea. 5. Total score of Retrospective symptoms. The finding indicates the associative symptoms before intervention was mild associative symptoms among two thirds of Kegel and Pelvic Rocking exercise groups respectively and moderate associative symptoms in about one third of Kegel exercise group and 41.7% of pelvic Rocking exercise group respectively. After 4 weeks after application of intervention, the symptoms became mild in the majority 95.4 % of Kegel exercise group compared to 85.2% of Pelvic Rocking exercise group, moderate associative symptoms were 4.6 % of Kegel group compare to 14.8% of Pelvic Rocking exercise. after 8 weeks application of Kegel exercises an improvement in associative symptoms continued, the symptoms became mild in all of students with no moderate or severe symptoms compared to 95.4% mild and 4.6% moderate with no sever cases in Pelvic Rocking exercise group were reported, Accordingly, the differences between the two groups were statistically significant at 4 and 8 weeks after application the interventions. Also, effect size indicates Moderate relation in both group (0.745 &0.522) respectively. Recommendations Kegel exercise technique should be advocated as a non-pharmacological approach for management of primary dysmenorrhea. The curriculum of basic nursing / midwifery education as well as continuing education should include the Kegel exercise technique for management of primary dysmenorrhea Maternity nurses should encourage young women to practice Kegel exercise technique for 8 weeks to decrease primary dysmenorrhea. Kegel exercise technique should be practiced in schools and colleges for girls at regular basis. Future researches Replication of the present study under different circumstances (sampling, setting, measurement, and duration of intervention) to generalize the findings. Kegel exercise technique can be replicated among adult women with primary dysmenorrhea. |