Effect of therapeutic strengthening versus stretching exercises on pain, pelvic floor function, and quality of life in women with endometriosis: Pilot study

Background: Endometriosis is associated with pelvic pain, functional limitations, and impaired quality of life. Physical therapy has emerged as a useful complementary alternative. Objective: To compare the results of two therapeutic exercise modalities combined with transcutaneous electrical nerve stimulation (TENS) regarding pain, pelvic floor function, and quality of life in women with endometriosis. Methods: Interventional study involving a prospective cohort of twelve patients with endometriosis. The intervention consisted of an eight-week program comprising two 55-minute sessions per week. In each session, all patients received 15 minutes of TENS followed by 40 minutes of specific therapeutic exercise: Group 1 (six patients) performed pelvic floor stretching exercises, and Group 2 (six patients) performed exercises to strengthen trunk stabilizing muscles. Three variables were evaluated at the beginning and end of the intervention: (1) intensity of chronic pelvic pain, dysmenorrhea, and dyspareunia using the Visual Analog Scale (VAS); (2) lumbopelvic function using the Active Straight Leg Raise (ASLR) test; and (3) quality of life using the short version (18 items) of the Endometriosis Health Profile (EHP) questionnaire. The Wilcoxon and Mann-Whitney U tests were applied (p < 0.05). Results: Group 1 showed a significant reduction in dysmenorrhea (p=0.027), while Group 2 showed significant improvement in lumbopelvic function (p=0.041). Both groups demonstrated a significant decrease in EHP scores (p=0.028), with no between-group differences. Conclusions: Both therapeutic exercise modalities combined with TENS showed improvement in pain, lumbopelvic function, and quality of life. Keywords: Endometriosis; Therapeutic exercise; Physiotherapy; Chronic pelvic pain; Dysmenorrhea; Pelvic floor.