Effect of Vaginal Stretching and Photobiomodulation on Chronic Pelvic Pain
and Sexual Function in Adult Women: A Randomized Clinical Trial
Pelvic Floor Disorders. Stretching Exercises. Physical Therapy
Modalities. Low-Level Light Therapy.
Introduction: Chronic pelvic pain (CPP) is a multifactorial pathology
affecting one in six adult women, characterized by persistent pelvic pain
associated with the involvement of the genitourinary, gastrointestinal,
and musculoskeletal systems. It is also linked to sexual dysfunction and
significant mood changes, directly impacting the reduction of quality of
life. Stretching is a therapeutic alternative for restoring the functional
integrity of the pelvic floor muscles. Concurrently, other strategies have
emerged as effective alternatives to support established protocols,
among which photobiomodulation (PBM) stands out. PBM involves the
emission of low-intensity light to modulate the inflammatory process and
tissue repair, providing analgesic effects on skeletal muscles and
alleviating symptoms related to female sexual dysfunction (FSD) and
CPP. Consequently, this study aims to analyze the association of
stretching with PBM in the treatment of CPP and FSD. Methods: This is
a prospective, randomized controlled trial to be conducted by a
specialized team from the Department of Physical Therapy at the
Federal University of Rio Grande do Norte (UFRN), located in Natal, Rio
Grande do Norte, Brazil. Female individuals aged 18 to 50 years, with
active sexual life, diagnosed with CPP, and reporting sexual dysfunction
complaints, will be recruited. Eligible participants will be coded and
randomized in a 1:1 allocation ratio into two blocks: control group with
stretching + intravaginal laser therapy with the device turned off, and
experimental group (EG) with stretching + intravaginal laser therapy with
the device on. Reassessments will occur after the 5th session, 10th
session, and three and six months after the last session. Pain
assessment will be measured using the Numerical Rating Scale, while
sexual function assessment will be conducted using the Female Sexual
Function Index (FSFI) questionnaire. The photobiomodulation device
used will be the Fluence Maxx HTM®. Expected Results and Impacts:
A positive outcome is anticipated in the reduction of CPP symptoms and
an improvement in the patients' sexual quality of life, enabling the
development of a standardized, safe, and effective protocol to be
applied in both laboratory and clinical practice.