RESUMO
BACKGROUND: Although aging is considered a risk factor for pelvic floor muscle dysfunction (PFMD), the effect of aging on the function of the pelvic floor muscles (PFM) remains unclear. OBJECTIVE: To compare PFM function and activity in nulliparous women in different age groups. METHODS: This was a cross-sectional study in which 70 women with ages between 18 and 69 years were divided into five age groups for evaluation. Initially, medical histories were taken, and then the PFM function was assessed using digital palpation (Modified Oxford Scale), manometry and surface electromyography (sEMG). The Kruskal-Wallis test was applied to check the differences between the groups. The Spearman correlation coefficient was used to verify the correlations between age and PFM function, manometry values and sEMG. A significance level of 5% was adopted. RESULTS: No significant differences were observed between the different age groups in PFM digital palpation, manometry values and sEMG. There was a low negative correlation between age root mean square and peak of sEMG signals. CONCLUSION: This study found no difference in PFM function and activity between nulliparous women in the five different age groups. Future long-term large prospective studies are required to confirm these findings.
Assuntos
Fatores Etários , Eletromiografia , Músculo Esquelético/fisiologia , Diafragma da Pelve/fisiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Manometria , Pessoa de Meia-Idade , Palpação , Paridade , Distúrbios do Assoalho Pélvico , Adulto JovemRESUMO
The objective of this study was to evaluate the relationship between aerobic capacity and pelvic floor muscles (PFM) function in adult women. Women aged 18 or over and without urinary dysfunction or other chronic diseases were eligible to participate. They completed the habitual physical activity (HPA) questionnaire, underwent a PFM functional evaluation by palpation and perineometry, and performed a submaximal (between 75 and 85% of maximum heart rate) cardiopulmonary exercise (CPX) test to determine the ventilatory anaerobic threshold (VAT). Forty-one women were included (35±16 years, 75% physically active, 17% very active, and 8% sedentary and 17% presented grade 1 PFM contraction, 31.8% grade 2, 26.8% grade 3, and 24.4% grade 4, according to the modified Oxford Scale). The average PFM contraction pressure obtained by perineometer was 53±26 cmH2O and the average oxygen consumption at VAT (VO2VAT) obtained from CPX was 14±2 mL·kg-1·min-1. Significant correlations were found between PFM contraction pressure and VO2VAT (r=0.55; P<0.001); between PFM contraction pressure and HPA score (r=0.38; P=0.02); between age and VO2VAT (r=-0.25; P=0.049); and between VO2VAT and HPA score (r=0.36; P=0.02). An age-adjusted multiple linear regression equation (R2=0.32) was derived to estimate VO2VAT from the contraction value obtained by perineometer, so that the PFM contraction pressure was able to predict VO2VAT. The equation was validated using data from another group of 20 healthy women (33±12 years; PFM contraction: 49±23 cmH2O) and no significant difference was found between actual VO2VAT and predicted VO2VAT (13.1±1.9 vs 13.8±2.0 mL·kg-1·min-1). In conclusion, PFM function is associated with aerobic capacity in healthy women and PFM contraction pressure may be used to estimate VO2VAT in this population.
Assuntos
Limiar Anaeróbio/fisiologia , Tolerância ao Exercício/fisiologia , Exercício Físico/fisiologia , Músculo Esquelético/fisiologia , Adulto , Fatores Etários , Antropometria , Estudos Transversais , Teste de Esforço , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Força Muscular/fisiologia , Consumo de Oxigênio/fisiologia , Diafragma da Pelve , Pressão , Valores de Referência , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To compare the effects of water-based and land-based physical therapy on postural control of older women with osteoporosis. METHODS: Thirty-six postmenopausal women with osteoporosis were allocated into two groups: land-based or water-based. Volunteers received 12 weeks of a supervised land-based or water-based physical therapy treatment. The outcome measure was postural control of the body during quiet standing on upright stance (eyes opened and closed), tandem and one-limb stance on a force plate. A two-way ANOVA with a Tukey HSD post-hoc test were used to highlight differences between pre- and post-intervention evaluations. Effect sizes were measured with Cohen d coefficient. For all variables, a level of 5% of significance was adopted. RESULTS: Significant improvements at tandem (p < 0.05, effect sizes from -0.67 to -1.35) and one-limb stance (p < 0.05, effect sizes from -0.76 to -1.03) for women carrying out water-based treatment were observed. Land-based treatment did not present significant improvement. CONCLUSIONS: Group-based water-based physical therapy treatment may be more effective than land-based therapy to improve postural control at one-limb stance in women with osteoporosis.
Assuntos
Osteoporose Pós-Menopausa/terapia , Modalidades de Fisioterapia , Pós-Menopausa , Equilíbrio Postural , Água , Idoso , Densidade Óssea , Terapia por Exercício/métodos , Feminino , HumanosRESUMO
The objective of this study was to evaluate the relationship between aerobic capacity and pelvic floor muscles (PFM) function in adult women. Women aged 18 or over and without urinary dysfunction or other chronic diseases were eligible to participate. They completed the habitual physical activity (HPA) questionnaire, underwent a PFM functional evaluation by palpation and perineometry, and performed a submaximal (between 75 and 85% of maximum heart rate) cardiopulmonary exercise (CPX) test to determine the ventilatory anaerobic threshold (VAT). Forty-one women were included (35±16 years, 75% physically active, 17% very active, and 8% sedentary and 17% presented grade 1 PFM contraction, 31.8% grade 2, 26.8% grade 3, and 24.4% grade 4, according to the modified Oxford Scale). The average PFM contraction pressure obtained by perineometer was 53±26 cmH2O and the average oxygen consumption at VAT (VO2VAT) obtained from CPX was 14±2 mL·kg-1·min-1. Significant correlations were found between PFM contraction pressure and VO2VAT (r=0.55; P<0.001); between PFM contraction pressure and HPA score (r=0.38; P=0.02); between age and VO2VAT (r=-0.25; P=0.049); and between VO2VAT and HPA score (r=0.36; P=0.02). An age-adjusted multiple linear regression equation (R2=0.32) was derived to estimate VO2VAT from the contraction value obtained by perineometer, so that the PFM contraction pressure was able to predict VO2VAT. The equation was validated using data from another group of 20 healthy women (33±12 years; PFM contraction: 49±23 cmH2O) and no significant difference was found between actual VO2VAT and predicted VO2VAT (13.1±1.9 vs 13.8±2.0 mL·kg-1·min-1). In conclusion, PFM function is associated with aerobic capacity in healthy women and PFM contraction pressure may be used to estimate VO2VAT in this population.
Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Limiar Anaeróbio/fisiologia , Exercício Físico/fisiologia , Tolerância ao Exercício/fisiologia , Músculo Esquelético/fisiologia , Consumo de Oxigênio/fisiologia , Pressão , Valores de Referência , Modelos Lineares , Antropometria , Estudos Transversais , Inquéritos e Questionários , Fatores Etários , Diafragma da Pelve , Estatísticas não Paramétricas , Teste de Esforço , Força Muscular/fisiologia , Contração Muscular/fisiologiaRESUMO
OBJECTIVE: The objective of this study was to evaluate the effects of surface electrical stimulation in elderly women with stress urinary incontinence (SUI) as compared to no treatment. MATERIALS AND METHODS: This randomized controlled pilot study included women over the age of 60 years, with at least one episode of stress urinary leakage during the previous month. Fourteen women were allocated according to a computer generated randomization list in two groups: surface electrical stimulation (SES), and control group (CG). The women in the SES group were treated with surface electrical stimulation using four electrodes, during six weeks with two weekly sessions of 20 minutes each. They were evaluated before and after treatment primary outcome, urinary leakage, and secondary outcomes, King's Health Questionnaire, pressure perineometry, and subjective satisfaction. RESULTS: For the urinary leakage, there was a significant decrease in SES group after treatment (P=.017). Significant differences were observed between the SES group and CG in the evaluation after treatment (P<.01; effect size: -1,38; 95% confidence interval from 1,18 to 14,14). No significant differences were observed in both groups for the outcome pelvic floor muscle pressure. In the evaluation of quality of life, a significant reduction of score in the gravity domain was observed for the SES group after treatment (P=.017). CONCLUSION: The results of this study showed that surface electrical stimulation in elderly women with SUI can be an effective method for the improvement of urinary leakage.
Assuntos
Terapia por Estimulação Elétrica/métodos , Incontinência Urinária por Estresse/terapia , Idoso , Feminino , Humanos , Projetos PilotoRESUMO
OBJECTIVE: To investigate the effect of vaginal cones and pelvic floor muscle training (PFTM) in postmenopausal women with stress urinary incontinence. METHODS: This randomized, controlled study included postmenopausal women, who complained of stress urinary incontinence. Forty-five women were allocated to three groups: a group given therapy with vaginal cones (n = 15), a group receiving therapy with PFTM (n = 15), and the control group (n = 15). Subjects in the intervention groups were treated for 6 weeks with twice-weekly sessions of 40 min. Women in the vaginal cone group carried out the pelvic floor muscle strengthening with vaginal cones. The control group did not receive any treatment during the corresponding time. They were evaluated before, at the end of treatment and 6 weeks after treatment completion for primary outcomes (1-h pad test for urinary loss and pelvic floor muscle pressure) and secondary outcomes (quality of life with King's Health Questionnaire, satisfaction with treatment, and continuity of training). RESULTS: For urinary leakage, there were statistical differences between the treated groups and the control group at the end of treatment and 6 weeks after treatment (all p < 0.01; effect size: vaginal cone group 20.97; PFMT group 20.96). The same behavior was shown for treatment with pelvic floor muscle pressure (all p < 0.01; effect size: vaginal cone group 22.58; PFMT group 21.68). There were no differences between the vaginal cone and PFMT groups in any of the evaluations. In outcomes for quality of life, significant differences were observed for incontinence impact and gravity domains when both treated groups were compared with the control group after treatment. Both groups reported similar satisfaction levels and the vaginal cone group demonstrated lower training continuity. CONCLUSION: Based on this study, there were similar positive results for treatment with the vaginal cone and pelvic floor muscle training for urinary leakage, pelvic floor muscle pressure and quality of life for postmenopausal women with stress urinary incontinence after 6 weeks.
Assuntos
Biorretroalimentação Psicológica , Terapia Passiva Contínua de Movimento , Exercícios de Alongamento Muscular/métodos , Pós-Menopausa , Incontinência Urinária por Estresse , Idoso , Biorretroalimentação Psicológica/instrumentação , Biorretroalimentação Psicológica/métodos , Protocolos Clínicos , Interpretação Estatística de Dados , Desenho de Equipamento , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Terapia Passiva Contínua de Movimento/instrumentação , Terapia Passiva Contínua de Movimento/métodos , Preferência do Paciente , Diafragma da Pelve/patologia , Diafragma da Pelve/fisiopatologia , Pós-Menopausa/fisiologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Resultado do Tratamento , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/patologia , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária por Estresse/terapiaRESUMO
OBJETIVOS: Comparar o impacto do tipo de incontinência urinária sobre a qualidade de vida em mulheres. MÉTODOS: Foram avaliados retrospectivamente 77 prontuários de mulheres incontinentes que realizaram tratamento fisioterapêutico entre fevereiro de 2005 a outubro de 2006. De acordo com os dados do exame urodinâmico, as mulheres foram classificadas em três grupos: incontinência urinária de esforço (IUE), hiperatividade vesical (HV) e incontinência urinária mista (IUM). As voluntárias responderam a uma anamnese com dados demográficos e ao King's Health Questionnaire, questionário específico para avaliação da qualidade de vida em indivíduos com incontinência urinária. RESULTADOS: A maioria das pacientes (44%) apresentou IUM. A idade das pacientes acometidas por HV foi significativamente maior se comparada à idade das pacientes dos demais grupos. As mulheres acometidas por IUM apresentaram um impacto negativo significativamente maior sobre a qualidade de vida (domínio percepção geral da saúde) e sobre a percepção de que a incontinência afeta de modo negativo a própria vida em comparação com as pacientes dos demais grupos. CONCLUSÃO: Este estudo indicou que pacientes com IUM apresentaram um maior impacto negativo sobre a qualidade de vida.
OBJECTIVES: To compare the impact of the type of urinary incontinence on women's quality of life. METHODS: A retrospective evaluation was conducted on the medical records of 77 incontinent women who underwent physical therapy treatment between February 2005 and October 2006. Based on the urodynamic test data, the women were classified into three groups: stress urinary incontinence (SUI), overactive bladder (OB) and mixed urinary incontinence (MUI). The subjects' history was taken, the women provided demographic data and they answered the King's Health Questionnaire, which is a specific questionnaire for assessing the quality of life among individuals with urinary incontinence. RESULTS: Most of the patients (44%) had MUI. The patients affected by OB were significantly older than the patients in the other groups. The negative impact of incontinence on quality of life (General Health Perception domain) and lifestyle was significantly greater among the women affected by MUI than among the patients in the other groups. CONCLUSION: This study indicated that the negative impact of incontinence on quality of life was greater among patients with MUI.
RESUMO
OBJETIVO: Foi avaliada a influência da Universidade Aberta da Terceira Idade - Fundação Educacional de São Carlos (UATI-FESC) e do Programa de Revitalização Geriátrica (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos. MÉTODO: Participaram deste estudo 70 indivíduos do primeiro ano da UATI e do REVT. Os critérios de inclusão foram ter 50 anos ou mais e ser capaz de preencher os questionários. A UATI é um programa interdisciplinar com seis disciplinas (uma vez por semana cada), três de atividades físicas: Tai Chi Chi Kung, Expressão Corporal, Fisioterapia e Promoção da Saúde; e três de promoção social e cultural: Educação Musical, Arte, Cidadania e Terceira Idade, além de atividades comemorativas e turismo cultural. O REVT teve 48 sessões de atividade física, três vezes por semana, com duração de 50-55 minutos cada. Todos os participantes foram avaliados por meio dos instrumentos de qualidade de vida World Health Organization Quality of Life (WHOQOL-bref) e Short-Form 36 - Medical Outcomes Study (SF36) no início e ao término da intervenção de 16 semanas. Para análise dos dados, foi utilizada ANOVA com medida repetida. RESULTADOS: Não houve diferença entre os grupos. Ambos os grupos apresentaram melhora significativa do nível de qualidade de vida de acordo com o resultado geral do WHOQOL-bref e também nos domínios psicológico, meio ambiente e questões iniciais: "Como você avaliaria sua qualidade de vida?" e "Quão satisfeito(a) você está com a sua saúde?" do WHOQOL-bref. Também houve melhora significativa do domínio Estado Geral de Saúde do SF36. Para os domínios Físico e Relações Sociais do WHOQOL-bref e outros domínios do SF36 não houve melhora significativa. CONCLUSÃO: Esses programas melhoraram a qualidade de vida segundo o WHOQOL-bref e EGS-SF36.
OBJECTIVE: The influence of the Open University of the Third Age (São Carlos Educational Foundation) (UATI-FESC) and the Geriatric Revitalization Program (REVT) on the quality of life of middle-aged and elderly adults was evaluated. METHOD: Seventy individuals in their first year at UATI and REVT participated in this study. The inclusion criteria were that the subjects had to be at least 50 years old and be capable of filling out questionnaires. UATI had an interdisciplinary program comprising six lectures (once a week each). Three were on physical activities: Tai Chi Chi Kung, Body Expression and Physical Therapy and Health Promotion; three on social and cultural promotion: Musical Education, Art and Citizenship in the Third Age; and there were also commemorative activities and cultural tourism. REVT had 48 physical activity sessions, three times a week, lasting 50-55 minutes each. All the participants were evaluated using the World Health Organization Quality-of-Life (WHOQOL-bref) and Short-Form 36 Medical Outcomes Study (SF36) questionnaires at baseline and at the end of the 16-week intervention. The data were analyzed using ANOVA with repeated measurements. RESULTS: There were no differences between the groups. Both groups showed significant improvement in quality of life according to the overall result from WHOQOL-bref and also in the Psychological and Environmental domains and the initial questions: "How would you rate your quality of life?" and "How satisfied are you with your health?", in WHOQOL-bref. There was also a significant improvement in the General Health domain of SF36. For the Physical and Social Relations domains of WHOQOL-bref and other domains of SF36, there was no significant improvement. CONCLUSIONS: These programs improved quality of life according to WHOQOL-bref and the General Health domain of SF36.