Soraia Cristina Tonon da Luz

Home exercises for pelvic floor in continent women one year after physical therapy treatment for urinary incontinence: an observational study

OBJECTIVES To describe the results of home exercise targeting the pelvic floor in continent women one year after the end of a physical therapy treatment for the following outcomes: functional assessment of the pelvic floor and urinary incontinence. METHODS This is an observational study that evaluated fifteen women one year after physical therapy treatment for Stress Urinary Incontinence (SUI). The outcomes for this study were: situations of urinary loss, use of daily protection, practice of home exercises for the pelvic floor, functional assessment of the pelvic floor (FAPF) and patient satisfaction. We also investigated some confounding variables such as hormonal status, number of vaginal deliveries and previous history of episiotomy. RESULTS One year after completion of physical therapy treatment, we observed that the FAPF median remained stable over time (Median=5, p=0.08). The presence of urinary incontinence was reported by 40% of women in the sample, however, was characterized as mild (i.e. not requiring the use of daily protection). There was also a significant association (p=0.001) between the completion of home exercises (twice or more per week) and the normal clinical status. Confounding variables, which could compromise the clinical status, showed no significant association with the outcomes (p≥0.05). CONCLUSION Home exercises contributed to the maintenance of continence following a physical therapy treatment.

A PERDA DE URINA É INFLUENCIADA PELA MODALIDADE ESPORTIVA OU PELA CARGA DE TREINO? UMA REVISÃO SISTEMÁTICA

En la actualidad, varios estudios senalan incontinencia urinaria (IU) entre las mujeres nuliparas jovenes y fisicamente activas. Sin embargo, algunos investigan la prevalencia de la IU segun las modalidades deportivas, mientras otros investigan la carga de entrenamiento. El proposito de este estudio fue verificar si la modalidad deportiva es mas decisiva en la prevalencia de la IU que la carga de entrenamiento entre las mujeres nuliparas jovenes. Para esta revision sistematica, tres revisores independientes realizaron una busqueda de las publicaciones originales en PubMed, LILACS y SciELO, entre 1994 y 2015. Se utilizaron como estrategia de busqueda las siguientes palabras clave: urinary incontinence AND (physical activity OR women OR nulliparous OR athletes), registradas en MeSH y DeCS. Se incluyeron solo los estudios originales publicados en los idiomas: portugues, ingles y espanol, que analizaron la IU en mujeres nuliparas, atletas o practicantes de actividad fisica. Se seleccionaron 873 estudios, pero solo diez articulos cumplieron los criterios de inclusion y exclusion. Todos los articulos fueron del tipo transversal, de los cuales cuatro relacionaron la IU con las modalidades deportivas, cinco analizaron la carga del entrenamiento con la perdida de orina y un estudio examino ambos aspectos. Se encontro una alta prevalencia de la IU entre los atletas. Parece haber evidencias de que las actividades que requieran saltar, largo aterrizaje y correr son las mas propensas a causar la perdida de orina. Ademas, la mayor carga de entrenamiento parece estar asociada con la cantidad de orina perdida. Esta revision destaca las altas tasas de IU en practicantes con grandes cargas de entrenamiento relacionadas con los deportes de salto, especialmente entre atletas. Sin embargo, todavia no hay respuesta sobre cual factor deportivo es mas decisivo para la perdida de orina en las mujeres nuliparas.

EFICÁCIA DA DINÂMICA DE GRUPO EM EDUCAÇÃO EM SAÚDE EM MULHERES COM INCONTINÊNCIA URINÁRIA

Introduction: Group dynamics is reported as a viable and cost-effective way to for promotion and health education among women. Objectives: Determine the level of knowledge about urinary incontinence among women who use the Public Health Network; verify the effectiveness of a health education protocol using group dynamics toward this population. Patients and Methods: We carried out a pilot study with application of a pre- and post-tests in six incontinent women. As a research instrument, we designed a health education and urinary incontinence questionnaires. We applied the questionnaires in late and immediate pre- and post-intervention periods. The meetings were based on an open group dynamics using lectures and recreational activities on topics related to urinary incontinence. Results: In the pre-intervention period, issues related to modifiable factors for the urinary incontinence treatment, as well as those related to the types of therapies used by physical therapists to treat incontinence of urine showed the highest percentage of error (83.3% of women). The participants showed a significant improvement in the level of knowledge regarding urinary incontinence from the pre-intervention moment to the immediate post-intervention moment (p = 0.005), as well as from the pre-intervention moment to the late post-intervention moment (p = 0.009). Conclusion: The present study showed that an open group dynamics using the proposed protocol was effective to improve the level of knowledge regarding urinary incontinence in women users of the Public Health Network in late and immediate post-intervention periods.

Quantification of Urinary Loss in Nulliparous Athletes During 1 Hour of Sports Training

Urinary incontinence (UI) is a pelvic floor dysfunction that can affect nulliparous female athletes because of the effect of sports activities on pelvic floor muscles.

Female sexual function and urinary incontinence in nulliparous athletes: An exploratory study

OBJECTIVES To estimate the prevalence of Female Sexual Dysfunction (FSD) and Urinary Incontinence (UI) symptom in nulliparous athletes and analyze the risk factors for these dysfunctions. DESIGN A cross-sectional study. SETTING The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) and the Female Sexual Function Index (FSFI) were applied to assess the UI and the FSD. PARTICIPANTS 50 athletes with ≥18 years old. RESULTS We found a prevalence of 48% of UI and 44% of FSD among nulliparous athletes. The rate of athletes having concomitant FSD and UI was 24%. We found a significant difference between high and low impact sports in the ICIQ-UI-SF score (p = 0.028). Hours of training (p = 0.007; R2 = 0.21) was found to be a risk factor for UI. Incontinent athletes demonstrated a Relative Risk of 2.7 to develop sexual desire problem when compared to the continents (p = 0.04; 95% CIs: 1.50-4.89). CONCLUSIONS This study found a high prevalence of both UI and FSD among nulliparous athletes. Furthermore, nulliparous athletes practicing high-impact modalities are the most susceptible to UI. The hours of training per day was considered a risk factor to develop UI, and incontinent athletes have more chances of showing difficulties in sexual desire.

The Role of Physiotherapy in Female Breast Cancer

Breast cancer is a prevalent disease in women and complications following breast cancer treatment are frequent, compromising health condition of this population. This chapter describes physiotherapy applied to motor and functional rehabilitation in women with breast cancer. The implementation of therapeutic activities is important for prevention and health promotion of these women, as for treatment, when changes are installed. Physiotherapy aims to assist the patient recovering the skills to perform daily life activities, wellness and quality-of-life during the whole treatment. It will present the main details for adequate evaluation, care and couseling, and proper physiotherapy to prevent pre- and post-operative complications.

Assessment of abdominal and pelvic floor muscle function among continent and incontinent athletes

Introduction and hypothesisStudies have shown that there is a co-contraction between the pelvic floor and abdominal muscles. This study aimed to evaluate pelvic floor and abdominal muscle function in continent and incontinent female athletes and to investigate the association between these muscle groups.MethodsThis was a cross-sectional study. Forty nulliparous professional female athletes who competed at the municipal level or above participated in this study. All participants underwent a pelvic floor muscle (PFM) and abdominal muscle assessment. PFM function and strength were assessed using the modified Oxford Scale and a perineometer. Abdominal muscle function and strength were assessed using a 4-Pro isokinetic dynamometer. To assess athletes’ urinary continence, the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-UI-SF) was used.ResultsThere was a positive association between PFM and abdominal muscle strength among the incontinent athletes (p = 0.006; r = 0.577). The incontinent athletes had greater PFM strength than the continent athletes (p = 0.02). There was no difference in abdominal muscle function between the groups.ConclusionsWe found that incontinent athletes have greater PFM strength than continent athletes. This suggests that urinary incontinence in this population is not due to PFM weakness. The positive association between abdominal and PFM strengths in incontinent athletes may be due to frequent co-contraction between these muscle groups.

IS URINE LOSS INFLUENCED BY TYPE OF SPORT OR TRAINING LOAD? A SYSTEMATIC REVIEW

En la actualidad, varios estudios senalan incontinencia urinaria (IU) entre las mujeres nuliparas jovenes y fisicamente activas. Sin embargo, algunos investigan la prevalencia de la IU segun las modalidades deportivas, mientras otros investigan la carga de entrenamiento. El proposito de este estudio fue verificar si la modalidad deportiva es mas decisiva en la prevalencia de la IU que la carga de entrenamiento entre las mujeres nuliparas jovenes. Para esta revision sistematica, tres revisores independientes realizaron una busqueda de las publicaciones originales en PubMed, LILACS y SciELO, entre 1994 y 2015. Se utilizaron como estrategia de busqueda las siguientes palabras clave: urinary incontinence AND (physical activity OR women OR nulliparous OR athletes), registradas en MeSH y DeCS. Se incluyeron solo los estudios originales publicados en los idiomas: portugues, ingles y espanol, que analizaron la IU en mujeres nuliparas, atletas o practicantes de actividad fisica. Se seleccionaron 873 estudios, pero solo diez articulos cumplieron los criterios de inclusion y exclusion. Todos los articulos fueron del tipo transversal, de los cuales cuatro relacionaron la IU con las modalidades deportivas, cinco analizaron la carga del entrenamiento con la perdida de orina y un estudio examino ambos aspectos. Se encontro una alta prevalencia de la IU entre los atletas. Parece haber evidencias de que las actividades que requieran saltar, largo aterrizaje y correr son las mas propensas a causar la perdida de orina. Ademas, la mayor carga de entrenamiento parece estar asociada con la cantidad de orina perdida. Esta revision destaca las altas tasas de IU en practicantes con grandes cargas de entrenamiento relacionadas con los deportes de salto, especialmente entre atletas. Sin embargo, todavia no hay respuesta sobre cual factor deportivo es mas decisivo para la perdida de orina en las mujeres nuliparas.

¿LA PÉRDIDA DE ORINA SE VE INFLUENCIADA POR LA MODALIDAD DEPORTIVA O POR LA CARGA DEL ENTRENAMIENTO? UNA REVISIÓN SISTEMÁTICA

En la actualidad, varios estudios senalan incontinencia urinaria (IU) entre las mujeres nuliparas jovenes y fisicamente activas. Sin embargo, algunos investigan la prevalencia de la IU segun las modalidades deportivas, mientras otros investigan la carga de entrenamiento. El proposito de este estudio fue verificar si la modalidad deportiva es mas decisiva en la prevalencia de la IU que la carga de entrenamiento entre las mujeres nuliparas jovenes. Para esta revision sistematica, tres revisores independientes realizaron una busqueda de las publicaciones originales en PubMed, LILACS y SciELO, entre 1994 y 2015. Se utilizaron como estrategia de busqueda las siguientes palabras clave: urinary incontinence AND (physical activity OR women OR nulliparous OR athletes), registradas en MeSH y DeCS. Se incluyeron solo los estudios originales publicados en los idiomas: portugues, ingles y espanol, que analizaron la IU en mujeres nuliparas, atletas o practicantes de actividad fisica. Se seleccionaron 873 estudios, pero solo diez articulos cumplieron los criterios de inclusion y exclusion. Todos los articulos fueron del tipo transversal, de los cuales cuatro relacionaron la IU con las modalidades deportivas, cinco analizaron la carga del entrenamiento con la perdida de orina y un estudio examino ambos aspectos. Se encontro una alta prevalencia de la IU entre los atletas. Parece haber evidencias de que las actividades que requieran saltar, largo aterrizaje y correr son las mas propensas a causar la perdida de orina. Ademas, la mayor carga de entrenamiento parece estar asociada con la cantidad de orina perdida. Esta revision destaca las altas tasas de IU en practicantes con grandes cargas de entrenamiento relacionadas con los deportes de salto, especialmente entre atletas. Sin embargo, todavia no hay respuesta sobre cual factor deportivo es mas decisivo para la perdida de orina en las mujeres nuliparas.

Intervenções fisioterapêuticas utilizadas em pessoas amputadas de membros inferiores pré e pós-protetização: uma revisão sistemática

Physical therapy interventions in amputee patient before and after the placement of a prosthesis are cited in a variety of physical therapy services, however, it is necessary to systematize evidence of rehabilitation protocols. Objective: The objective of this study was to add scientific evidence to guide the physical therapy practice in preand post-fitting of lower limb amputee. Method: We conducted a systematic review during the months of August to December 2014 in the databases Lilacs, Medline, Pedro, Pubmed, Scielo and Cochrane. Articles published from 2000 to the first half of 2014 were selected by key words in Portuguese, English and Spanish. Results: Six articles met the inclusion criteria, and only one was related to the pre-fitting stage highlighting the intervention: bandaging of the stump. The other interventions referred to the post-fitting stage as muscle force training, aerobic training, functional and gait. Conclusion: Few articles were found with scientific evidence related to major interventions pre and post prosthesis routinely used by the physiotherapist, which hinders the establishment of protocols and the reinforcement of the effectiveness of commonly described therapies.