Elizabel de Souza Ramalho Viana

Influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women.

[Purpose] The aim of the present study was to assess the influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women. [Subjects and Methods] This was an observational analytic cross-sectional study with a sample of 100 postmenopausal women, aged between 45 and 65 years, divided into three groups according to menopausal stage: hysterectomized and early and late postmenopause. Patients were assessed for sociodemographic and gyneco-obstetric factors and subjected to a muscle strength test and perineometry. Descriptive statistics, ANOVA, Kruskal-Wallis and multiple regression were applied. [Results] The results showed homogeneity in sociodemographic and anthropometric characteristics. There was no difference in pelvic floor muscle function among the three groups. Type of delivery, parity and physical activity level showed no influence on muscle function. [Conclusion] The findings demonstrate that parity, type of delivery, and physical activity level had no influence on pelvic floor muscle pressure in postmenopausal women. One hypothesis to explain these results is the fact that the decline in muscle function in postmenopausal women is related to the female aging process.

Modulação pela progesterona da sensibilidade dolorosa a estímulos mecânicos e isquêmicos em mulheres saudáveis e jovens

PURPOSE: to investigate the relationship between pain perception (experimental pain threshold and tolerance, in response to ischemia and pressure) in young and healthy young women and female sexual hormone seric levels (estradiol and progesterone). METHODS: 18 volunteers have participated of this study, during three consecutive menstrual cycles. A pressure algometer and a manual dynamometer have been used to measure painful responses to pressure and ischemia algesic stimuli. Blood has been collected for assessment of both hormonal and painful variables, during three menstrual cycles, whose characterization was based on daily oral temperature record, a diary of the menstrual cycles with the onset and end of each cycle, and on estradiol and progesterone plasmatic levels. The average for the algesic variables measured has been compared by analysis of variance (ANOVA) and the Tukey-Kramers post-test, among the menstrual cycle phases (follicular, periovulatory, early luteal, late luteal and menstrual). The Pearsons test has been used for correlation analysis between algesic and hormonal variables. Statistical significance has been defined as p<0.05. RESULTS: no significant change in pain parameters among the menstrual cycle phases has been observed. Nevertheless, there have been significant negative correlations between progesterone and ischemic threshold (r=-0.23; p<0.01), and pressure tolerance (r=-0.23; p<0.01) at the early luteal phase. CONCLUSIONS: these results indicate that the increase in progesterone levels correlates with a decrease of ischemic threshold and pressure tolerance, suggesting that progesterone plays a role in the pain modulation during the early luteal phase.

Avaliação da adaptação psicossocial na gravidez em gestantes brasileiras

PURPOSE to evaluate psychosocial adaptation to pregnancy by translating and cross-culturally adapting a specific assessment instrument to be used with Brazilian women. METHODS this was a cross-sectional observational study. the translation and cross-cultural adaptation and of the Prenatal Self-evaluation Questionnaire (PSeQ) was performed following all the required methodological steps. another questionnaire was applied to characterize the sociodemographic and clinical status of the pregnant women (n=36). Statistical analysis consisted of the determination of the mean and standard deviation (SD) and of absolute and relative frequency. the statistical test used for the analysis of internal consistency was Cronbachs alpha coefficient, using SPSS version 17.0. RESULTS the volunteers were of low socioeconomic status, aged on average 25.1 years ( 5.5), and had an average gestational age of 25.9 weeks ( 8.1). 58.3% of these volunteers had not planned their current pregnancy. the pretest showed that 75% of the pregnant women found the questionnaire easy to understand. Regarding the PSeQ instrument, the identification with the maternal role was the subcategory which showed the highest average, 24.8 ( 5.6), while the relationship with the mother had the lowest average 15.4 ( 7.7). the internal consistency ranged from 0.52 to 0.89. CONCLUSION the assessment of psychosocial adaptation to pregnancy in pregnant women is very important during the progress of pregnancy and permits intervention through obstetric-neonatal actions of promotion and prevention regarding the well-being of mother and child.

Gait variables comparison between pregnant women with and without lumbopelvic pain

BACKGROUND AND OBJECTIVES: The various gestational adaptations may lead to changes in the gait pattern. Also, the lumbopelvic pain in this period can impact the gait dynamics. The objective of this study was to compare gait variables between pregnant women with and without lumbopelvic pain, according to the gestational trimesters, and to compare the outcome variables between the second and third gestational trimesters. METHODS: Analytical and cross-sectional study with 277 pregnant women. They were divided into two groups, considering the gestational trimester as a grouping factor. Subsequently, the two groups were subdivided considering the absence or presence of lumbopelvic pain. All participants were submitted to the evaluation protocol: identification form, visual analog scale, and gait assessment using the Balance Master System®. RESULTS: The chronological age averages of the second and third-trimester groups were, respectively, 29.9±4.6 and 29.7±3.7 years. When comparing gait variables between pregnant women with and without lumbopelvic pain, a statistically significant difference was observed only for the gait velocity (p=0.04) in the third-trimester group. CONCLUSION: It is suggested that women in the third trimester with complaints of lumbopelvic pain have reduced gait velocity when compared to those without pain.

Associação entre função sexual, independência funcional e qualidade de vida em pacientes após acidente vascular encefálico

Este estudio de tipo observacional, cuantitativo, transversal tiene el objetivo de analizar la funcion sexual y comparar la calidad de vida y la independencia funcional entre los sujetos sexualmente activos e inactivos, acometidos por accidente cerebrovascular. Se contactaron a los sujetos por telefono y se agendo una cita con ellos segun la disponibilidad. Se les aplico a los participantes una encuesta de evaluacion para conocer sus datos sociodemograficos, habitos de vida, salud y funcion sexual, ademas del cuestionario abreviado de la evaluacion de la calidad de vida Whoqol-Bref y la escala de la medida de independencia funcional. De los 29 sujetos evaluados un 48,3% eran sexualmente activos. De estos, un 64,3% son hombres y un 35,7% mujeres. La mayoria de los participantes informaron que hubo una disminucion de la actividad sexual tras la enfermedad (64,3%), un 60% de las mujeres presentaron disfuncion sexual por el coeficiente sexual -version femenina, y un 77,7% de los hombres presentaron disfuncion erectil, evaluada por el Indice internacional de funcion erectil. Los sujetos sexualmente activos presentaron una mejor calidad de vida referente al dominio fisico (p=0,035), una mayor independencia funcional motora (p=0,005) y cognitiva (p=0,006) en comparacion a los que no tenian actividad sexual. Se concluye que gran parte de estos sujetos mantienen una vida sexual activa y que hay asociacion entre la practica de la actividad sexual a la independencia cognitiva y motora.

Comparação da qualidade de vida em gestantes com disfunção sexual

PURPOSE To investigate the relationship between sexual function and quality of life in pregnant women living in two cities of Northeastern Brazil. METHODS The sample consisted of 207 pregnant women. The data were collected through a questionnaire containing questions about socio-demographic, gynecological and obstetrical data, body and sexual knowledge. Quality of life was assessed by applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power). Sexual function was assessed using the Female Sexual Function Index (IFSF). Data were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon tests. RESULTS The pregnant women studied had a median age of 30 years (quartile 26-33 years) and were approximately at the 26th gestational week. A significant decrease in the monthly frequency of sexual relations of the couple was observed, with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual dysfunction was detected in 35.7% of the pregnant women studied, whose quality of life was lower when compared to women with unchanged sexual function (Z=-2.9; p=0.004). CONCLUSION The results of this study show that sexual dysfunction negatively affected the quality of life of pregnant women, and this should be an important aspect for review during prenatal consultations.PURPOSE: To investigate the relationship between sexual function and quality of life in pregnant women living in two cities of Northeastern Brazil. METHODS: The sample consisted of 207 pregnant women. The data were collected through a questionnaire containing questions about socio-demographic, gynecological and obstetrical data, body and sexual knowledge. Quality of life was assessed by applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power). Sexual function was assessed using the Female Sexual Function Index (IFSF). Data were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon tests. RESULTS: The pregnant women studied had a median age of 30 years (quartile 26-33 years) and were approximately at the 26th gestational week. A significant decrease in the monthly frequency of sexual relations of the couple was observed, with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual dysfunction was detected in 35.7% of the pregnant women studied, whose quality of life was lower when compared to women with unchanged sexual function (Z=-2.9; p=0.004). CONCLUSION: The results of this study show that sexual dysfunction negatively affected the quality of life of pregnant women, and this should be an important aspect for review during prenatal consultations.

Quality of sleep in pregnant woman with low back pain

Introduction Pregnancy is characterized by several changes in her body. These changes contribute to the emergence of low back pain, which may influence the quality of sleep during pregnancy. Objective To compare the quality of sleep among pregnant women with and without low back pain during pregnancy, examining the relationship between two variables. Materials methods Thirty volunteers aged between 19 and 36 years, divided into control group (CG – n = 16) and Study Group (SG – n = 14), residents in the cities of Natal, were evaluated in the second trimester of pregnancy. To sleep evaluation were used to index the Pittsburgh Sleep Quality and the Epworth Sleepiness Scale. Low back pain was evaluated using the pressure algometer, Visual Analogue Scale (VAS) and Oswestry Disability Index. Statistical analysis used the Shapiro Wilk test, Student’s T test for independent samples and Pearson correlation test. Results The mean gestational and chronological ages were 28.2 ± 3.4 years and 19.9 ± 3.7 weeks, respectively. Sleep quality was lower in SG (8.21 ± 4.8) when compared to CG (5.94 ± 1.7) and was statistically significant (P = 0.021). Analyzing the relationship between sleep quality and pain intensity, it was observed that the variables have a positive correlation between them (r = 0.372, P = 0.043). Conclusion Our findings indicate that sleep quality is decreased in women with low back pain compared to those without pain.