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The effect of sacroiliac joint manual therapy on heart rate variability in women with primary dysmenorrhea
Physical Therapy Rehabilitation Science 2020;9:252-60
Published online December 30, 2020
© 2020 Korean Academy of Physical Therapy Rehabilitation Science.

Sun-Geon Parka , Seong-Hyeok Songb , Ji-Hye Jungb , Young-Lan Joob , You-Jin Yangc , Seungwon Leed,e

aDepartment of Physical Therapy, The Wells Clinic, Seoul, Republic of Korea
bDepartment of Physical Therapy, The Graduate School, Sahmyook University, Seoul, Republic of Korea
cDepartment of Physical Therapy, Gangwon-do Wonju Medical Center, Wonju, Republic of Korea
dDepartment of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, Seoul, Republic of Korea
eInstitute of SMART Rehabilitation, Sahmyook University, Seoul, Republic of Korea
Correspondence to: Seungwon Lee (ORCID
Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul 01795, Republic of Korea
Tel: 82-2-3399-1630 Fax: 82-2-3399-1639 E-mail:
Received November 1, 2020; Revised December 7, 2020; Accepted December 8, 2020.
cc This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: Disorder of the autonomic nervous system is considered to be the cause of primary dysmenorrhea. The spine has a close relationship with the autonomic nervous system, and the sacrum is mechanically and neurologically connected to the uterus through ligaments. Therefore, this study was conducted to check the effect on the autonomic nervous system through measurement of heart rate variability by applying manual therapy to the sacroiliac joints of subjects with primary dysmenorrhea and to suggest an effective treatment method for dysmenorrhea.
Design: Randomized controlled trial.
Methods: Thirty females with dysmenorrhea were assigned to either the manual therapy group and sham treatment group according to the random treatment method. The manual therapy was applied to the sacroiliac joints, and the sham treatment was only treated with the hands placed in the same position of the intervention. Heart rate variability and the Visual Analogue Scale (VAS) were measured on the day when menstruation began ±2. Interventions were performed between the groups, followed by a 5-minute break and then re-measurements were made.
Results: There were significant differences in autonomic balance and VAS scores in the manual therapy group before and after the intervention between groups (p<0.05). In the sham treatment group, there were significant differences in low frequency, autonomic balance, and VAS scores (p<0.05). There were significant differences in autonomic balance between groups (p<0.05).
Conclusions: In females with primary dysmenorrhea, manual therapy applied to the sacroiliac joint was found to be effective for a short time on autonomic activity.
Keywords : Dysmenorrhea, Heart rate variability, Musculoskeletal manipulations, Sacroiliac joint


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