RESUMO
BACKGROUND: The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women. OBJECTIVE: To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions. METHODS: The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined. RESULTS: No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women. CONCLUSION: The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.
Assuntos
Comparação Transcultural , Dismenorreia , Humanos , Dismenorreia/fisiopatologia , Brasil , Feminino , Inquéritos e Questionários , Reprodutibilidade dos Testes , PsicometriaRESUMO
BACKGROUND: There is an association of dysmenorrhea with human functioning and disability. However, no patient-reported outcome measure has been developed to assess this construct in women with dysmenorrhea. WHODAS 2.0 has been recognized as an important generic patient-reported outcome information of physical function and disability. Thus, the aim of this study was to assess the measurement properties of the WHODAS 2.0 in women with dysmenorrhea. METHODS: This is an online and cross-sectional study conducted with Brazilian women aged 14 to 42 years with self-report of dysmenorrhea in the last three months. According to COSMIN, structural validity was evaluated by exploratory and confirmatory factor analysis; internal consistency by Cronbach's Alpha; measurement invariance by multigroup confirmatory factor analysis between geographic regions of Brazil; and construct validity by correlating WHODAS 2.0 to the Numerical Rating Scale for pain severity. RESULTS: One thousand three hundred and eighty-seven women (24.7 ± 6.5 years) with dysmenorrhea participated in the study. WHODAS 2.0 presented a single factor by exploratory factor analysis and adequate model by confirmatory factor analysis (CFI = 0.924, TLI = 0.900, RMSEA = 0.038), excellent internal consistence (α = 0.892) for all items and an invariancy across geographic regions (ΔCFI ≤ 0.01 and ΔRMSEA < 0.015). Correlation between WHODAS 2.0 and numerical rating scale was positive and moderate (r = 0.337). CONCLUSION: WHODAS 2.0 has a valid structure to assess functioning and disability related to dysmenorrhea in women.
Assuntos
Avaliação da Deficiência , Dismenorreia , Humanos , Feminino , Estudos Transversais , Organização Mundial da Saúde , Reprodutibilidade dos Testes , Qualidade de Vida , PsicometriaRESUMO
Urinary incontinence (UI) in female athletes can impair their quality-of-life (QoL) and reduce their participation in sports. This review aims to evaluate the effect of pelvic floor muscle training (PFMT) in treating UI in women participating in high-impact sports. Furthermore, to assess the influence of PFMT on pelvic floor muscles (PFM) function and the UI impact on their QoL. For this purpose, a systematic review of randomized controlled trials (RCTs) and non-RCTs was performed. An electronic search was conducted on PubMed, EMBASE, SciELO, and Scopus. The quality of evidence was assessed using the PEDro and ROBINS-I scales. The Consensus on Exercise Reporting Template (CERT) was used to assess the quality of PFMT protocols. All studies were available in full-text including incontinent female participants who are practitioners of high-impact sports, investigating PFMT vs control groups(inactive) or undergoing other treatments. Three RCTs and two non-RCTs (104 participants) were analyzed. PFMT provided a significant improvement in UI symptoms with a reduction in the frequency (n=3) and the amount of UI (n=5). PFM function was assessed in three studies, and two found improvement in maximal contraction and one in vaginal resting pressure in favor of PFMT. None of the two studies that assessed QoL found a difference after PFMT intervention.
Assuntos
Esportes , Incontinência Urinária por Estresse , Incontinência Urinária , Feminino , Humanos , Diafragma da Pelve , Terapia por Exercício/métodos , Incontinência Urinária/terapia , Exercício Físico , Resultado do TratamentoRESUMO
The aim was to assess and report the effects of menstrual cup on pelvic floor muscles (PFM) function and tone, as well as check the acceptability after a period of three menstrual cycles in healthy young women. The data collected in assessments and reassessments included the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS) questionnaire, evaluation of PFM function through PERFECT Scheme, PFM muscle tone, and PFM manometry (Peritron 9300®). A diary regarding the overall colletor acceptability and satisfaction was collected. Ten healthy young women completed the study. There was an improvement in the mean values of maximal voluntary contraction (MVC) (p = 0.032), a decrease in the vaginal resting pressure (VRP) (p = 0.05), and an increase in the number of repetitions of sustained muscle contractions (p = 0.042). Seven women reported some discomfort while using the vaginal cup only in the first cycle while three revealed discomfort during the whole experiment. This study provides preliminary case-based evidence that the use of the vaginal cup for a period of three menstrual cycles changes the VRP, MVC, and PFM tone, as well as improves the repetitions of PFM assessed by digital palpation. Moreover, the women reported the use of vaginal cup as a positive experience.
Assuntos
Força Muscular , Diafragma da Pelve , Feminino , Humanos , Diafragma da Pelve/fisiologia , Força Muscular/fisiologia , Produtos de Higiene Menstrual , Contração Muscular/fisiologia , ManometriaRESUMO
INTRODUCTION AND HYPOTHESIS: Studies have shown that athletes have three times increased risk of urinary incontinence compared to non-athletes, in addition to anal incontinence and sexual dysfunction (SD). This study aimed to assess the sexual and pelvic floor muscle (PFM) functions and to compare these variables among female athlete runners with and without SD and to identify predictive factors that may be associated with sexual function among the athletes. METHODS: Cross-sectional study including 90 female runners, who ran ≥ 20 km/week for at least 6 months, had had sexual intercourse in the last 4 weeks and were > 18 years old. PFM function was assessed by vaginal palpation and manometry. Women also answered the International Consultation on Incontinence Questionnaire-Short Form to investigate presence of urinary incontinence. Sexual function was assessed by Female Sexual Function Index (FSFI); total scores ≤ 26.5 were considered to indicate SD. The scores of each FSFI domain and the total score were compared individually between each predictor using simple linear regression. In addition, multiple linear regression analysis was performed. RESULTS: Athletes with SD presented lower PFM strength. The results of the multiple linear regression analysis among all the predictor variables, FSFI domains and total score show that the Modified Oxford Scale is a predictor for the desire, excitation, lubrication, orgasm, pain and total score domains. CONCLUSIONS: Female runners with lower PFM strength presented worse sexual function regardless of age, parity, BMI and running practice time.
Assuntos
Corrida , Disfunções Sexuais Fisiológicas , Incontinência Urinária , Gravidez , Feminino , Humanos , Adolescente , Diafragma da Pelve , Estudos Transversais , Comportamento Sexual/fisiologia , Disfunções Sexuais Fisiológicas/etiologia , Inquéritos e QuestionáriosRESUMO
AIMS: To compare the effects of manual visceral therapy (MVT) associated with pelvic floor muscle training (PFMT) on urinary incontinence (UI) symptoms, vaginal resting pressure, and maximum voluntary contraction of the pelvic floor muscles (PFM). METHODS: A double-blinded randomized controlled trial of 5 weeks duration with two active intervention arms: PFMT + MVT and PFMT + manual sham therapy (MST). Participants were women over 18 years of age with complaint or diagnosis of UI symptoms. The primary outcome was the severity of UI symptoms, assessed by the International Consultation on Incontinence Questionnaire - Short Form. The secondary outcomes measures included the vaginal resting pressure and the maximum voluntary contraction of PFM assessed by digital manometry. RESULTS: Fifty-two incontinent women participated in the study. There was no significant difference between groups in UI symptoms (F (1.74, 86.9) = 0.406; p = 0.638), vaginal resting pressure (mean difference -1.5 cmH20 [95% confidence interval [CI] -4.5 to 1.5; p = 0.33]), and maximum voluntary contraction of PFM (median 0.0 cmH20 [25%-75% interquartile range 0.0-5.6; p = 0.12]) after the intervention period. CONCLUSIONS: Combining MVT with PFMT was not more effective than PFMT alone in reducing UI symptoms, in change vaginal resting pressure and maximum voluntary contraction of PFM. Due to the limitations of the study, further investigations are still needed to confirm these findings.
Assuntos
Incontinência Urinária por Estresse , Incontinência Urinária , Adolescente , Adulto , Terapia por Exercício , Feminino , Humanos , Diafragma da Pelve/fisiologia , Resultado do Tratamento , Incontinência Urinária/terapia , Incontinência Urinária por Estresse/terapiaRESUMO
AIMS: To compare the strength of abdominal and pelvic floor muscles (PFM) between nulliparous female athletes (FAs) and non-athletes (FNAs), to determine the frequency of urinary incontinence (UI) in these groups. METHODS: This cross-sectional comparative study of nulliparous women included 39 professional FAs, who competed at the district level or above, and 34 FNAs. Participants underwent pelvic floor and abdominal muscle assessments. PFM function and strength were assessed using the modified Oxford scale and a manometer (PERINA 996-2 QUARK). Abdominal muscle function and strength were assessed using a 4-Pro isokinetic dynamometer. The International Consultation on Incontinence Questionnaire-Short Form was used to assess UI symptoms among the athletes, and the International Physical Activity Questionnaire-Short Form was used to establish the level of physical activity among the non-athletes. RESULTS: The prevalence of UIs in the FAs was 53.8%, while that for FNAs was 35.3%. There was no association between being an athlete and having UI (p = 0.112). FAs were found to weigh more (p = 0.012) and have increased abdominal muscle strength (p = 0.014) and maximum voluntary PFM contraction as recorded by the manometer (p = 0.035), as well as a decreased PFM contraction endurance time (p = 0.025) than FNAs. CONCLUSION: FAs had stronger abdominal muscles and PFM contraction, as assessed by a manometer, but less PFM endurance when compared to FNAs. Despite these differences, the prevalence of UI was similar between groups.
Assuntos
Força Muscular , Diafragma da Pelve , Incontinência Urinária , Atletas , Estudos Transversais , Feminino , Humanos , Contração Muscular , Incontinência Urinária/epidemiologiaRESUMO
BACKGROUND: High-impact sports can cause dysfunction to the female pelvic floor that leads to the occurrence of stress urinary incontinence. OBJECTIVE: To identify and compare the presence of urine loss between professional and amateur female volleyball athletes during a competition. METHODS: A cross-sectional and comparative study was conducted on 75 volleyball athletes, including 30 amateurs and 45 professional athletes. Female athletes 18 years of age or older were included. Urine loss during the competition was evaluated by self-report and measured by a pad test (in grams). Day-to-day urinary incontinence was identified using the Urinary Distress Inventory 6 (UDI-6). Before the beginning of the game, the instruments were applied by individual interview for data collection and the pad was positioned. After the game, the pad was removed and weighed again. Descriptive and inferential statistics were used, with a significance level of 5%. RESULTS: Half of the professional (50.0%) and amateur (55.6%) athletes have symptoms of urine loss during a competition. Objective urine loss was higher among professional athletes (4.5 ± 1.4 g) compared to amateur athletes (3.8 ± 1.4 g). There was a significant difference (P < .001) in objective urine loss between symptomatic (mean = 5.41, standard deviation [SD] = 0.8) and asymptomatic professional athletes (mean = 3.40, SD = 1.3). CONCLUSION: Self-report of urinary incontinence during the competition was common among professional and amateur athletes. However, objective urine loss was significantly higher among professional athletes.
Assuntos
Incontinência Urinária , Voleibol , Adolescente , Adulto , Atletas , Estudos Transversais , Feminino , Humanos , Diafragma da PelveRESUMO
INTRODUCTION AND HYPOTHESIS: Studies 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. METHODS: This 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. RESULTS: There 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. CONCLUSIONS: We 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.
Assuntos
Força Muscular/fisiologia , Diafragma da Pelve/fisiologia , Incontinência Urinária/fisiopatologia , Adulto , Atletas , Estudos de Casos e Controles , Estudos Transversais , Exercício Físico/fisiologia , Feminino , Humanos , Contração Muscular/fisiologia , Inquéritos e Questionários , Torque , Adulto JovemRESUMO
BACKGROUND: 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. OBJECTIVES: To verify and quantify urine loss in nulliparous athletes during 1 hour of sports training using a modified pad test protocol. DESIGN: Cross-sectional. SETTING: Secondary, institutional practice. PARTICIPANTS: Nulliparous athletes (N = 104). METHODS: Athletes completed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) and underwent a maximal resistance test of the abdominal muscles followed by the new modified pad test during 1 hour of training. OUTCOMES: Presence or absence of UI was the dependent variable; the initial hypothesis was that high-impact activities could lead to the development of UI. RESULTS: Almost 52% of athletes (n = 54) self-reported UI according to the ICIQ-UI-SF score. Of athletes who reported stress or mixed UI (n = 32), only 43.7% (n = 14) had leakage during the training pad test. Interestingly, 24% of athletes (n = 12) who did not report UI had a positive pad test result. In total, 27.9% of athletes (n = 29) presented a positive pad test during the training. Mean urinary loss was 1.57 ± 0.4 g. CONCLUSION: Athletes did not seem to have a good knowledge of UI symptoms, and the modified pad test could be an alternative to quantify urine loss; however, it is necessary to perform accuracy tests. None of the athletes reported discomfort or decreased performance when performing the pad test. LEVEL OF EVIDENCE: II.