Effects of Clinical Pilates on Pain and Quality of Life in Women With Dyspareunia

The Female Sexual Function Index (FSFI) is a Likert-type scale consisting of 19 items that evaluates female sexual dysfunction over the past four weeks. The scale assesses six domains: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort. The maximum raw total score is 95 and the minimum is 4; after applying domain-specific weighting coefficients, the total score ranges from 2 to 36. The weighting factors used for scoring are 0.6 for desire; 0.3 for arousal and lubrication; and 0.4 for orgasm, satisfaction, and pain/discomfort. A total score below 26.55 is defined as indicative of sexual dysfunction. Higher scores indicate better sexual function.

The Carol Postpartum Sexual Function and Dyspareunia Assessment Scale was developed to evaluate sexual function and the presence of dyspareunia in women who have resumed vaginal intercourse after vaginal delivery. The scale consists of a total of 11 items and classifies the severity of the disorder at different levels. The first seven items are rated using a five-point Likert scale: "never" (0 points), "almost never" (1 point), "sometimes" (2 points), "usually" (3 points), and "always" (4 points). The last four items assess pain intensity using a Numeric Rating Scale (NRS), with scores ranging from "no pain" (0 points) to "unbearable/maximum pain" (10 points).**

The Short Form-36 (SF-36) consists of 36 items and evaluates an individual's self-assessment across physical functioning, social functioning, role limitations (due to physical and emotional problems), mental health, vitality (energy), pain, and general perception of health. The assessment considers the previous four weeks. The SF-36 does not have absolute cutoff scores to define good or poor quality of life. However, according to commonly used classifications in the literature, scores are interpreted as follows: 80-100 indicates very good quality of life, 60-79 good, 40-59 moderate, and 0-39 poor quality of life.**

The Beck Depression Inventory (BDI) is a Likert-type scale developed by Beck to assess emotional, cognitive, and motivational components of depression. The scale evaluates symptoms over the past week and consists of 21 items. Each item has four response options ranging from 0 to 3. Total scores are interpreted as follows: 9 or below indicates "no depression," 10-16 indicates "mild depression," 17-23 indicates "moderate depression," and 24 or higher indicates "severe depression."**

The Body Image Scale was developed to assess individuals' satisfaction with their body image. It is a 10-item, five-point Likert-type scale with response options ranging from "1-Never," "2-Rarely," "3-Sometimes," "4-Often," to "5-Always." The total score ranges from 10 to 50, with lower scores indicating lower body satisfaction and higher scores indicating higher body satisfaction.**

The Rosenberg Self-Esteem Scale consists of 10 items and is designed to measure self-esteem. The items are scored using the Guttman method. On the scale, responses eligible for scoring are marked with an asterisk (*). Scoring is performed as follows: items 1, 2, and 3 are evaluated together; items 4 and 5 together; and items 9 and 10 together. If a respondent scores on any two of the first three items (2/3), they receive one point for that set. If a respondent selects any scoring response for either item 4 or 5, they receive one point for that set. Items 9 and 10 are evaluated in the same way as items 4 and 5. Items 6, 7, and 8 are scored individually. Therefore, the maximum total score is 6. Scores are interpreted as follows: 0-1 indicates high self-esteem, 2-4 indicates moderate self-esteem, and 5-6 indicates low self-esteem.**