Başak ÇAVLICA, Bereket Selda YÜCEL, Nurten DARÇIN, İdil Tekin MİRZAİ, KORAY ERBÜYÜN

Profesyonel kadın voleybolcularda ağrı duyumunun menstrüel döngü ile ilişkisi

AMAÇ: Sportif aktivitenin, menstrüasyon sırasındaki ağrı algısını değiştirmesi konusu tartışmalıdır. Bu çalışmada, kadın sporcularda menstrüel döngünün farklı fazlarında dinlenim ve maksimal kardiyovasküler streslerin ağrı eşiği ve toleransına etkisi değerlendirildi. GEREÇ-YÖNTEM: Celal Bayar Üniversitesi Voleybol Takımı’nın profesyonel 13 oyuncusu gönüllü olarak çalışmaya katıldı. Dinlenim anında antropometrik ölçümleri ve sistolik-diyastolik kan basınçları ölçüldü; kollarının üst kısmına yerleştirilen manuel tansiyon manşonu yardımıyla yaratılan iskemik ağrı Vizüel Analog Skalası (VAS) ile değerlendirildi. Olguların menstrüel döngülerinin 2. (menstrüel faz) ve 14. günlerinde (ovulasyon fazı) aşamalı artan maksimal egzersiz testlerinde maksimal oksijen tüketimi (VO2), kan laktatı (KL), kalp atım hızı (KAH), algılanan yorgunluk miktarı (RPE) ölçümleri yapılırken her aşamada ağrı VAS ile derecelendirildi. BULGULAR: İstatistiksel analiz sonuçlarına göre dinlenim ağrı eşiği ve toleransı ovulasyon safhasında istatistiksel olarak daha düşük bulundu. Maksimal egzersiz sırasında VO2 ve KL değerleri menstrüel safhada ovulasyon safhasından daha fazla idi (p

Pain perception of professional volleyball players during different phases of menstruation

The main purpose of this study was to investigate pain perception of the professional volleyball players at rest and maximal cardiovascular stresses during different phases of menstruation. Thirteen volleyball players from Celal Bayar University were used as the participants of the study. At rest, anthropometric measurements, systolic and diastolic blood pressures were determined. Then, pain tolerance and pain threshold were measured by sphygmomanometer that placed upper part of the arm. Visual Analog Scales (VAS) was used to grade the pain. At the 2nd (menstrual phase) and 14th (ovulation phase) days of menstruation, oxygen consumption (VO2), heart rate (KA), blood lactate (KL) pain perception and rate of perceived exertion (RPE) were taken during two incremental maximal exercises testing. Statistical analysis of this study indicated that at rest pain tolerance and threshold values of the volleyball players were significantly higher during menstruation phase compare to ovulation phase. Also, VO2 and KL measurements taken at the high intensities during 2nd day of mensturation were statistically higher than that of measurements were done at 14th day of mensturation. Moreover, pain perception of the participants that was measured during 2nd day of menstruation was significantly lower than that of measurements during the 14th days of menstruation (p<0.05). According to results of regression analysis, RPE and KL were two dependent variables that were statistically related to pain perception during two different phases of menstruation. As a conclusion due to the decrease in pain perception, the intensity of the training could be increase during menstruation period.

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1. Ord P, Gijsbers K. Pain thresholds and tolerances of competitive rowers and their use of spontaneous self-generated pain-coping strategies. Percept Mot Skills 2003;97(3 Pt 2):1219-22.
2. Whitmarsh BG, Alderman RB. Role of psychological skills training in increasing athletic pain tolerance. The Sport Psychologist 1993;7:388-99.
3. Hoffmann P, Thorén P. Electric muscle stimulation in the hind leg of the spontaneously hypertensive rat induces a long-lasting fall in blood pressure. Acta Physiol Scand 1988;133:211-9.
4. Koltyn KF, Arbogast RW. Perception of pain after resistance exercise. Br J Sports Med. 1998;32:20-4.
5. Fillingim RB, Maixner W, Girdler SS, Light KC, Harris MB, Sheps DS, et al. Ischemic but not thermal pain sensitivity varies across the menstrual cycle. Psychosom Med 1997;59:512-20.
6. Goolkasian P. An ROC analysis of pain reactions in dysmenorrheic and nondysmenorrheic women. Percept Psychophys 1983;34:381-6.
7. Çakmaklı E, Sanioğlu A, Patlar S, Çakmakçı O, Çınar V. Menstrüasyonun anaerobik güce etkisi, spormetre. Beden Eğitimi ve Spor Bilimleri Dergisi 2005;3:145-49.
8. Hightower M. Effects of exercise participation on menstrual pain and symptoms. Women Health 1997;26:15-27.
9. Sivaslıoğlu AA. Kadın hastalıkları ve doğum bilgisi el kitabı. Ankara: Etmest Yayınevi; 2004. s. 116-22.
10. Bruce RA, Kusumi F, Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J 1973;85:546-62.
11. Tamer K. Sporda Fiziksel-Fizyolojik Performansın Ölçülmesi ve değerlendirilmesi. Ankara: Bağırgan Yayınevi; 2000. s. 143-5.
12. Erdinç S, Hamzaoğlu O, Özkan Ö, Balta E, Domaç M. Türkiye’de yetişkinlerin ağrı prevalansı. Ağrı 2001;13:2-3.
13. Arendt-Nielsen L, Yücel A. Induction and asssessment of experimental pain from human muscle. Ağrı 2000;12:4.
14. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377-81.
15. Smekal G, von Duvillard SP, Frigo P, Tegelhofer T, Pokan R, Hofmann P, et al. Menstrual cycle: no effect on exercise cardiorespiratory variables or blood lactate concentration. Med Sci Sports Exerc 2007;39:1098-106.
16. Dean TM, Perreault L, Mazzeo RS, Horton TJ. No effect of menstrual cycle phase on lactate threshold. J Appl Physiol 2003;95:2537-43.
17. Lloyd GW, Patel NR, McGing E, Cooper AF, Brennand-Roper D, Jackson G. Does angina vary with the menstrual cycle in women with premenopausal coronary artery disease? Heart 2000;84:189-92.
18. Iwamoto Y, Kubo J, Ito M. Variation in maximal voluntary contraction during the menstrual cycle. Jpn J Phys Fit Sports Med 2002;51:193-201.
19. Campbell SE, Febbraio MA. Effects of ovarian hormones on exercise metabolism. Curr Opin Clin Nutr Metab Care 2001;4:515-20.
20. Sarwar R, Niclos BB, Rutherford OM. Changes in muscle strength, relaxation rate and fatiguability during the human menstrual cycle. J Physiol 1996;493 (Pt 1):267-72.
21. Lebrun CM, McKenzie DC, Prior JC, Taunton JE. Effects of menstrual cycle phase on athletic performance. Med Sci Sports Exerc 1995;27:437-44.
22. Schoene RB, Robertson HT, Pierson DJ, Peterson AP. Respiratory drives and exercise in menstrual cycles of athletic and nonathletic women. J Appl Physiol 1981;50:1300-5.
23. Sambanis M, Kofotolis N, Kalogeropoulou E, Noussios G, Sambanis P, Kalogeropoulos J. A study of the effects on the ovarian cycle of athletic training in different sports. J Sports Med Phys Fitness 2003;43:398-403.
24. Şahin Ş: Ağrı ve Cinsiyet. 5. Ulusal Ağrı Kongresi 3-6 Ekim İstanbul: Ağrı Dergisi 1999; 11:4.
25. Okifuji A, Turk DC. Sex hormones and pain in regularly menstruating women with fibromyalgia syndrome. J Pain 2006;7:851-9.
26. Veith JL, Anderson J, Slade SA, Thompson P, Laugel GR, Getzlaf S. Plasma beta-endorphin, pain thresholds and anxiety levels across the human menstrual cycle. Physiol Behav 1984;32:31-4.
27. Berglund LA, Derendorf H, Simpkins JW. Desensitization of brain opiate receptor mechanisms by gonadal steroid treatments that stimulate luteinizing hormone secretion. Endocrinology 1988;122:2718-26.
28. Sternberg WF, Bokat C, Kass L, Alboyadjian A, Gracely RH. Sex-dependent components of the analgesia produced by athletic competition. J Pain 2001;2:65-74.
29. Deuster PA, Petrides JS, Singh A, Lucci EB, Chrousos GP, Gold PW. High intensity exercise promotes escape of adrenocorticotropin and cortisol from suppression by dexamethasone: sexually dimorphic responses. J Clin Endocrinol Metab 1998;83:3332-8.
30. Knardahl S: Psychophysiological Mechanisms of Pain in Computerwork: The Blood Vessel-Nociceptor Interaction Hypothesis. Work&Stres 2002;16:179-89.
31. Palmerud G, Sporrong H, Herberts P, Kadefors R. Consequences of trapezius relaxation on the distribution of shoulder muscle forces: an electromyographic study. J Electromyogr Kinesiol 1998;8:185-93.
32. Gissel H. Ca2+ accumulation and cell damage in skeletal muscle during low frequency stimulation. Eur J Appl Physiol 2000;83:175-80.
33. Gissel H, Clausen T. Excitation-induced Ca2+ uptake in rat skeletal muscle. Am J Physiol 1999;276(2 Pt 2):R331-9.
34. Hollander DB, Durand RJ, Trynicki JL, Larock D, Castracane VD, Hebert EP, et al. RPE, pain, and physiological adjustment to concentric and eccentric contractions. Med Sci Sports Exerc 2003;35:1017-25.
35. Viana Ede S, da Silva SB, de Sousa MB. Perception of ischemic and pressing pain in young women during menstrual cycle. Association with humor and cortisol levels. Acta Cir Bras 2005;20 Suppl 1:220-6.
36. Koltyn KF, Schultes SS. Psychological effects of an aerobic exercise session and a rest session following pregnancy. J Sports Med Phys Fitness 1997;37:287-91.