Table of Contents    
ORIGINAL ARTICLE
Year : 2017  |  Volume : 8  |  Issue : 1  |  Page : 82-86  

Vestibular stimulation for management of premenstrual syndrome


1 Department of Physiology, Little Flower Institute of Medical Sciences and Research, Angamaly, Kerala, India
2 Department of Physiology, Saveetha Medical College, Saveetha University, Chennai, Tamil Nadu, India
3 Little Flower Medical Research Centre, Angamaly, Kerala, India

Date of Web Publication13-Jan-2017

Correspondence Address:
Joseph Kurien Mukkadan
Little Flower Medical Research Centre, Angamaly, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-9668.198365

Rights and Permissions
   Abstract 

Objectives: The present study was undertaken to observe the effectiveness of vestibular stimulation in the management of premenstrual syndrome (PMS). Materials and Methods: The present study was an experimental study; twenty female participants of age group 18–30 years were recruited in the present study. Conventional swing was used to administer vestibular stimulation. Variables were recorded before and after vestibular stimulation and compared. Results: Depression and stress scores are significantly decreased after 2 months of intervention. Anxiety scores decreased followed by vestibular stimulation. However, it is no statistically significant. Serum cortisol levels significantly decreased after 2 months of intervention. WHOQOL-BREF-transformed scores were not significantly changed followed by the intervention. However, psychological domain score (T2) and social relationships domain score (T3) were increased followed by intervention. Systolic blood pressure was significantly decreased after 2 months of intervention. No significant change was observed in diastolic pressure and pulse rate. Pain score was significantly decreased after 2 months of intervention. Mini mental status examination scores and spatial and verbal memory score were significantly improved followed by intervention. Conclusion: The present study provides preliminary evidence for implementing vestibular stimulation for management of PMS as a nonpharmacological therapy. Hence, we recommend further well-controlled, detailed studies in this area with higher sample size.

Keywords: Pain, physiological intervention, premenstrual syndrome, vestibular stimulation


How to cite this article:
Johny M, Kumar SS, Rajagopalan A, Mukkadan JK. Vestibular stimulation for management of premenstrual syndrome. J Nat Sc Biol Med 2017;8:82-6

How to cite this URL:
Johny M, Kumar SS, Rajagopalan A, Mukkadan JK. Vestibular stimulation for management of premenstrual syndrome. J Nat Sc Biol Med [serial online] 2017 [cited 2017 Jun 28];8:82-6. Available from: http://www.jnsbm.org/text.asp?2017/8/1/82/198365


   Introduction Top


According to National Institute of Mental Health, premenstrual syndrome (PMS) is defined as “the cyclic occurrence of symptoms that are of sufficient severity to interfere with some aspects of life and which appear with consistent and predictable relationship to menses.”[1] PMS is one of the most common health problems experienced by women in reproductive age.[2] Women with PMS experience psychological symptom bloating, weight gain, breast tenderness, swelling, aches and pains, lack of concentration, sleep disturbance, and change in eating patterns. Most of these symptoms are present in the luteal phase of cycle and cease around menstruation.[3] Although exact cause for PMS is not clear, existing literature supports that stress is the cause of PMS, and PMS can be labeled as stress-induced psychophysiological disorder.[4],[5],[6] Nutritional deficiencies and hormonal aberrations have also been suggested as causes of PMS.[7] Alternative therapies have been found to be more beneficial in the management of PMS as they are affordable and have limited side effects.[8]

Optimal vestibular stimulation is required throughout the life for homeostasis.[9],[10],[11],[12],[13],[14],[15] Vestibular stimulation by swinging on a swing was reported as an effective method for stress management in college students.[16] Vestibular stimulation inhibits the stress axes and brings to stress less condition; hence, we hypothesized that vestibular stimulation may be beneficial in relieving most of the symptoms of PMS.[17] The present study was undertaken to observe the effectiveness of vestibular stimulation in the management of PMS.


   Materials and Methods Top


Research design

The present experimental study was conducted at Department of Physiology, Little Flower Institute of Medical Sciences and Research Centre, Angamaly. In the present study, participants served as self-controls. After recording the baseline values in premenstrual period (7 days before menstruation) of menstrual cycle, vestibular stimulation was administered for 2 months. Postintervention values were recorded in the premenstrual period of the 1st and 2nd month. All the parameters were recorded at 9 am to avoid diurnal changes. The present study was conducted in consultation with the physician of Little Flower Hospital and Research Centre.

Participants, inclusion criteria, exclusion criteria

Twenty female participants of age group 18–30 were recruited in the present study after obtaining, voluntary, written, informed consent.

Inclusion criteria

  • Healthy females with PMS (PMS will be screened by using PMS questionnaire)[8],[18],[19]
  • Having regular menstrual cycles from 28 to 34 days
  • Willing participants.


Exclusion criteria

  • The participants with any physical problem (musculoskeletal), psychiatric illness, or on medication including contraceptives will be excluded from the study
  • Unwilling participants.


Vestibular stimulation

Vestibular stimulation was administered by making the participants swing on a swing, according to their comfort, as standardized by previous methods.[20]

Assessment of depression, anxiety, and stress

Depression, anxiety, stress scale-42 was used to assess depression, anxiety, and stress.[21]

Assessment of serum cortisol

Serum cortisol levels were assessed by chemiluminescent microparticle immunoassay ABBOTT method.

Assessment of autonomic parameters

Diamond digital sphygmomanometers (BPDG024) were used to record blood pressure, and pulse rate was recorded by using pulse oximeter (EDAN H100B).[10]

Assessment of pain score

Numerical pain score was used to assess the perception of the pain.[22]

Assessment of cognition

Spatial and verbal memory test and mini mental status examination (MMSE) were used to assess the cognition.[23],[24]

Assessment of quality of life

The WHOQOL BREF questionnaire is used to assess the quality of life.[25]

Statistical analysis

Data were analyzed by IBM SPSS Statistics for Windows, IBM Corp. Armonk, NY: Statistical tests used are one-way analysis of variance and Tukey's multiple comparison tests. P <0.05 was considered statistically significant.

Ethical consideration

The present study was approved by the institutional ethical committee of Little Flower Hospital and Research Centre, Angamaly. No; EC/3/2015.


   Results Top


Demographic characteristics are presented in [Table 1]. Depression and stress scores are significantly decreased after 2 months of intervention (P < 0.05) [Figure 1]. Anxiety scores decreased followed by vestibular stimulation. However, it is no statistically significant. Serum cortisol levels significantly decreased after 2 months of intervention (P < 0.001) [Figure 1]. WHOQOL BREF-transformed scores were not significantly changed followed by the intervention. However, psychological domain score (T2) and social relationships domain 8 score (T3) were increased followed by intervention [Figure 2]. Systolic blood pressure was significantly decreased after 2 months of intervention (P < 0.01). No significant change was observed in diastolic pressure and pulse rate [Figure 3]. Pain score was significantly decreased after 2 months of intervention (P < 0.001) [Figure 3]. MMSE scores and spatial and verbal memory score were significantly improved followed by intervention [Figure 4].
Table 1: Demographic characteristics (n=20)

Click here to view
Figure 1: Depression, anxiety, stress scores of participants before and after intervention (n = 20) (values expressed are mean ± standard deviation. *P < 0.05, **P < 0.01, ***P < 0.001. D0 - Baseline value in premenstrual period (7 days before menstruation, D1 - postintervention value in premenstrual period (7 days before menstruation), D2 - postintervention values in premenstrual period after 2 months (7 days before menstruation), serum cortisol values are expressed in μg/dL)

Click here to view
Figure 2: WHOQOL BREF score of participants before and after intervention (n = 20) (values expressed are mean ± standard deviation. *P < 0.05, **P < 0.01, ***P < 0.001. D0 - baseline value in premenstrual period (7 days before menstruation, D1 - postintervention value in premenstrual period (7 days before menstruation), D2 - postintervention values in premenstrual period after 2 months (7 days before menstruation)

Click here to view
Figure 3: Systolic, diastolic blood pressure, pulse rate, and pain score of the participants before and after intervention expressed in mm of Hg (n = 20) (values expressed are mean ± standard deviation. *P < 0.05, **P < 0.01, ***P < 0.001. D0 - baseline value in premenstrual period (7 days before menstruation, D1 - postintervention value in premenstrual period (7 days before menstruation), D2 - postintervention values in premenstrual period after 2 months (7 days before menstruation)

Click here to view
Figure 4: Spatial and verbal memory score, mini mental status examination score of the participants before and after intervention (n = 20) (values expressed are mean ± standard deviation. *P < 0.05, **P < 0.01, ***P < 0.001. D0 - preintervention score, D1 - postintervention score after 1 month of vestibular stimulation, D2 - postintervention score after 2 months of vestibular stimulation)

Click here to view



   Discussion Top


In the present study, conventional swing was used to provide vestibular stimulation. Vestibular stimulation by motion devices is used in ancient times as a treatment for madness.[26],[27] However, use of vestibular stimulation as analgesic agent is recent.[28] Vestibular stimulation reduced the symptoms of pain in migraine patients, amputees, and paraplegics. However, the degree of pain relief varied.[29] Ramachadran et al. reported that vestibular stimulation is an effective method of pain relief.[30] Vestibular stimulation may relieve pain by modulating somatosensory perception, through its connections with thalamic nuclei, its connection with raphe nuclei, and its connection with nucleus tractus solitaries.[31] Our study provides further evidence for analgesic effect of vestibular stimulation as we have observed significant decrease in the pain scores followed by vestibular stimulation. It was reported that vestibular stimulation relieves stress by inhibiting stress axes. Animal and human studies have reported decrease in cortisol levels followed by optimal vestibular stimulation.[32],[33],[34] Our results are in accordance with earlier studies as we have observed decrease in depression, stress scores as well as serum cortisol followed by vestibular stimulation. Research testified the anatomical connections between vestibular and autonomic nuclei.[35] Vestibular lesions found to cause autonomic abnormalities and optimal vestibular stimulation found to decrease heart rate and blood pressure within normal limits.[36] In the present study, we have observed significant decrease in systolic blood pressure but no significant change in diastolic pressure, which may be due to short duration of intervention.[37] It was reported that vestibular stimulation improves cognition and vestibular lesions cause's defects in memory.[38] We agree with earlier studies as we have observed significant improvement in spatial and verbal memory scores followed by vestibular stimulation. Earlier studies reported marginal increase in all the domains of WHOQOL BREF quality of life.[39] In the present study, psychological domain and social relationship domains showed marginal improvement.

Limitations

We have not maintained control group in this study and the sample size was small.


   Conclusion Top


The present study provides preliminary evidence for implementing vestibular stimulation for management of PMS as a nonpharmacological therapy. Hence, we recommend further well-controlled, detailed studies in this area with higher sample size.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Endicott J, Halbreich U, Schacht S, Nee J. Premenstrual changes and affective disorders. Psychosom Med 1981;43:519-29.  Back to cited text no. 1
    
2.
Grosz HJ. Correlates of premenstrual syndrome. Am J Psychiatry 1988;145:1482.  Back to cited text no. 2
    
3.
Wyatt KM, Dimmock PW, Jones PW, Shaughn O'Brien PM. Efficacy of Vitamin B-6 in the treatment of premenstrual syndrome: Systematic review. BMJ 1999;318:1375-81.  Back to cited text no. 3
    
4.
Peeke PM, Frishett S. The role of complementary and alternative therapies in women's mental health. Prim Care 2002;29:183-97.  Back to cited text no. 4
    
5.
Benson H, Frankel FH, Apfel R, Daniels MD, Schniewind HE, Nemiah JC, et al. Treatment of anxiety: A comparison of the usefulness of self-hypnosis and a meditational relaxation technique. An overview. Psychother Psychosom 1978;30:229-42.  Back to cited text no. 5
    
6.
Coppen A, Kessel N. Menstruation and personality. Br J Psychiatry 1963;109:711-21.  Back to cited text no. 6
    
7.
Reid RL, Yen SS. Premenstrual syndrome. Am J Obstet Gynecol 1981;139:185.  Back to cited text no. 7
    
8.
Sharma B, Misra R, Singh K, Sharma R, Archana. Comparative study of effect of anuloma-viloma (pranayam) and yogic asanas in premenstrual syndrome. Indian J Physiol Pharmacol 2013;57:384-9.  Back to cited text no. 8
    
9.
Sailesh KS. Vestibular balance of food intake. Int J Pharma and Bio Sci 2014;5:1069-73.  Back to cited text no. 9
    
10.
Sailesh KS, Archana R, Antony NJ, Mukkadan JK. Controlled vestibular stimulation: A physiological method of stress relief. J Clin Diagn Res 2014;8:BM01.  Back to cited text no. 10
    
11.
Sailesh KS, Archana R, Antony NJ, Mukkadan JK. You are never too old to swing. Res J Pharm Biol Chem Sci 2014;5:612-5.  Back to cited text no. 11
    
12.
Sailesh KS, Archana R, Antony NJ, Mukkadan JK. Thinking with your sixth sense. Res J Pharm Biol Chem Sci 2014;5:481-5.  Back to cited text no. 12
    
13.
Sailesh KS, Mukkadan JK. Psychoneuroimmuno modulation by controlled vestibular stimulation. J Clin Exp Res 2013;1:68-70.  Back to cited text no. 13
    
14.
Sailesh KS, Archana R, Antony NJ, Mukkadan JK. Controlled vestibular stimulation: Supplementary treatment for hypothyroidism. Res J Pharm Biol Chem Sci 2014;5;:1842-5.  Back to cited text no. 14
    
15.
Sailesh KS, Archana R, Mukkadan JK. Vestibular stimulation: A simple but effective intervention in diabetes care. J Nat Sci Biol Med 2015;6:321-3.  Back to cited text no. 15
    
16.
Sailesh KS, Archana R, Mukkadan JK. Impact of traditional vestibular stimulation on depression, anxiety, and stress in college students. Biomed Res 2016;27:297-9.  Back to cited text no. 16
    
17.
Sailesh KS, Archana R, Mukkadan JK. Controlled vestibular stimulation: A Traditional intervention for pre-menstrual syndrome. J Clin Biomed Sci 2014;4:362.  Back to cited text no. 17
    
18.
Moos RH. The development of a menstrual distress questionnaire. Psychosom Med 1968;30:853-67.  Back to cited text no. 18
    
19.
Mahajan KK, Maini BK. Study of symptoms associated with menstrual cycle in working women of Rohtak. Indian Med Gaz 1980;64:30-353.  Back to cited text no. 19
    
20.
Sailesh KS, Mukkadan JK. Controlled vestibular stimulation, standardization of a physiological method to release stress in college students. Indian J Physiol Pharmacol 2015;59:436-41.  Back to cited text no. 20
    
21.
Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scale. 2nd ed. Sydney: Psychology Foundation; 1995.  Back to cited text no. 21
    
22.
Bashir MS, Khade A, Borkar P, Saleem M, Lingaswamy V, Reddy D. A comparative study between different pain rating scales in patients of osteoarthritis. Indian J Physiol Pharmacol 2013;57:205-8.  Back to cited text no. 22
    
23.
Baddeley AD. Your Memory – A User's Guide. New York: Avery; 1993.  Back to cited text no. 23
    
24.
Naveen KV, Nagarathna R, Nagendra HR, Telles S. Yoga breathing through a particular nostril increases spatial memory scores without lateralized effects. Psychol Rep 1997;81:555-61.  Back to cited text no. 24
    
25.
Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med 1998;28:551-8.  Back to cited text no. 25
    
26.
Vieth GU. Versuch Einer Encyklopädie Der Leibesübungen. Berlin, Germany: Hartmann; 1795.  Back to cited text no. 26
    
27.
Jütte R. Schwindelerregend: Drehmaschinen in der vormodernen psychiatrie. In: Schönhammer R, editor. Körper, Dinge Und Bewegung: Der Gleichgewichtssinn in Materieller Kultur Und Ästhetik. Wien, Austria: Facultas; 2009. p. 128-39.  Back to cited text no. 27
    
28.
Grabherr L, Macauda G, Lenggenhager B. The moving history of vestibular stimulation as a therapeutic intervention. Multisens Res 2015;28:653-87.  Back to cited text no. 28
    
29.
Kolev O. How caloric vestibular irritation influences migraine attacks. Cephalalgia 1990;10:167-9.  Back to cited text no. 29
    
30.
Ramachandran VS, McGeoch PD, Williams L. Can vestibular caloric stimulation be used to treat Dejerine-Roussy Syndrome? Med Hypotheses 2007;69:486-8.  Back to cited text no. 30
    
31.
Sailesh KS, Jissa G, Mukkadan JK. Cancer pain relief by vestibular stimulation. Health Sci 2013;2:2319-4154.  Back to cited text no. 31
    
32.
Winter L, Kruger TH, Laurens J, Engler H, Schedlowski M, Straumann D, et al. Vestibular stimulation on a motion-simulator impacts on mood states. Front Psychol 2012;3:499.  Back to cited text no. 32
    
33.
Yoo KH. The effects of auditory and vestibular stimulation on stress hormones in preterm infants. J Korean Acad Fundam Nurs 2004;11:203-12.  Back to cited text no. 33
    
34.
Smitha KK, Dinesh KS, Mukkadan JK. Standardisation of controlled vestibular stimulation for optimal stress relief in albino Wistar rats. Pharma Innov J 2015;4:1-3.  Back to cited text no. 34
    
35.
Biaggioni I, Costa F, Kaufmann H. Vestibular influences on autonomic cardiovascular control in humans. J Vestib Res 1998;8:35-41.  Back to cited text no. 35
    
36.
Yates BJ, Bronstein AM. The effects of vestibular system lesions on autonomic regulation: Observations, mechanisms, and clinical implications. J Vestib Res 2005;15:119-29.  Back to cited text no. 36
    
37.
Gopinath A, Archana R, Sailesh KS, Mukkadan JK. Eff ect of caloric vestibular stimulation on memory. Int J Pharm Bio Sci 2015;6:(B)453-9.  Back to cited text no. 37
    
38.
Gurvich C, Maller JJ, Lithgow B, Haghgooie S, Kulkarni J. Vestibular insights into cognition and psychiatry. Brain Res 2013;1537:244-59.  Back to cited text no. 38
    
39.
Kumar SS, Rajagopalan A, Mukkadan JK. Vestibular stimulation for stress management in students. J Clin Diagn Res 2016;10:CC27-31.  Back to cited text no. 39
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
    Materials and Me...
   Results
   Discussion
   Conclusion
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed775    
    Printed5    
    Emailed0    
    PDF Downloaded72    
    Comments [Add]    

Recommend this journal