Muscle contraction Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):10-15
DOI 10.1590/S0100-72032013000100003
PURPOSES: To investigate the effect of an individualized and supervised exercise program for the pelvic floor muscles (PFM) in the postpartum period of multiparous women, and to verify the correlation between two methods used to assess PFM strength. METHODS: An open clinical trial was performed with puerperal, multiparous women aged 18 to 35 years. The sample consisted of 23 puerperal women divided into two groups: Intervention Group (IG, n=11) and Control Group (CG, n=12). The puerperal women in IG participated in an eight-week PFM exercise program, twice a week. The puerperal women in CG did not receive any recommendations regarding exercise. PFM strength was assessed using digital vaginal palpation and a perineometer. The statistical analysis was performed using the following tests: Fisher's exact, c², Student's t, Kolmogorov-Smirnov for two samples, and Pearson's correlation coefficient. Significance was defined as p<0.05. RESULTS: The participants' mean age was 24±4.5 years in IG and 25.3±4 years in CG (p=0.4). After the exercise program, a significant difference was found between the groups in both modalities of muscle strength assessment (p<0.001). The two muscle strength assessment methods showed a significant correlation in both assessments (1st assessment: r=0.889, p<0.001; 2nd assessment: r=0.925, p<0.001). CONCLUSIONS: The exercise program promoted a significant improvement in PFM strength. Good correlation was observed between digital vaginal palpation and a perineometer, which indicates that vaginal palpation can be used in clinical practice, since it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. the use of a perioneometer.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):10-15
DOI 10.1590/S0100-72032013000100003
PURPOSES: To investigate the effect of an individualized and supervised exercise program for the pelvic floor muscles (PFM) in the postpartum period of multiparous women, and to verify the correlation between two methods used to assess PFM strength. METHODS: An open clinical trial was performed with puerperal, multiparous women aged 18 to 35 years. The sample consisted of 23 puerperal women divided into two groups: Intervention Group (IG, n=11) and Control Group (CG, n=12). The puerperal women in IG participated in an eight-week PFM exercise program, twice a week. The puerperal women in CG did not receive any recommendations regarding exercise. PFM strength was assessed using digital vaginal palpation and a perineometer. The statistical analysis was performed using the following tests: Fisher's exact, c², Student's t, Kolmogorov-Smirnov for two samples, and Pearson's correlation coefficient. Significance was defined as p<0.05. RESULTS: The participants' mean age was 24±4.5 years in IG and 25.3±4 years in CG (p=0.4). After the exercise program, a significant difference was found between the groups in both modalities of muscle strength assessment (p<0.001). The two muscle strength assessment methods showed a significant correlation in both assessments (1st assessment: r=0.889, p<0.001; 2nd assessment: r=0.925, p<0.001). CONCLUSIONS: The exercise program promoted a significant improvement in PFM strength. Good correlation was observed between digital vaginal palpation and a perineometer, which indicates that vaginal palpation can be used in clinical practice, since it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. the use of a perioneometer.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(11):505-510
DOI 10.1590/S0100-72032012001100005
PURPOSE: To investigate the effect of adding biofeedback (BF) to the training of pelvic floor muscles (PFMT) for the treatment of stress urinary incontinence (SUI). METHODS: A prospective pilot study, randomized and controlled with women with SUI without sphincter deficiency, detected by urodynamic study and who performed the correct PFM contraction. Women with neuromuscular disorders and grade III and IV genital prolapse were excluded. Forty women were randomized into a Control Group and BF Group. The PFMT protocol with BF equipment consisted of three sets of ten slow contractions (tonic), with a holding time of six to eight seconds at each contraction followed by a rest period of equal duration. After each sustained contraction, they performed three to four fast contractions (phasic) in the supine and standing position twice a week, for a total of 12 sessions. We evaluated the effect of adding BF to PFMT on quality of life using King's Health Questionnaire (KHQ) regarding urinary symptoms based on a voiding diary and regarding the function of pelvic floor muscles by digital palpation. The evaluation was performed initially and after 12 treatment sessions. Data are reported as mean and standard deviation. The Mann-Whitney test was used for the analysis of homogeneity and to determine differences between groups, and the Wilcoxon test was used to determine possible differences between the times of observation, with the level of significance set at 0.05. RESULTS: A significant decrease in the scores of the domains assessed by the KHQ was observed in the comparison between groups, except for the general health domain (BF Group: 32.8±26.9 versus Control Group: 48.4±29.5, p<0.13). Accordingly, there was improvement in PFM function after treatment in the BF Group, regarding power (4.3±0.8, p= 0.001), endurance (6.0±2.2, p<0.001) and fast (9.3±1.9, p=0.001). When comparing the groups, the BF Group showed a positive result regarding power (BF Group 4.3±0.8 versus Control Group 2.5±0.9, p<0.001), endurance (6.0±2.2 BF Group versus Control Group 2.7±1.9, p<0.001) and fast (BF Group 9.3±1.9 versus Control Group 4.6 ± 3.2, p<0.001). Reduction of nocturnal urinary frequency (1.2±1.2 versus 0.7±0.9, p=0.02) and of effort urine loss (1.5±1.4 versus 0.6±0.8, p=0.001) was observed in the BF Group. CONCLUSION: The addition of BF to the PFMT for the treatment of SUI, applied according to the protocol described, improved PFM function, reduced urinary symptoms, and improved of the quality of life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(11):505-510
DOI 10.1590/S0100-72032012001100005
PURPOSE: To investigate the effect of adding biofeedback (BF) to the training of pelvic floor muscles (PFMT) for the treatment of stress urinary incontinence (SUI). METHODS: A prospective pilot study, randomized and controlled with women with SUI without sphincter deficiency, detected by urodynamic study and who performed the correct PFM contraction. Women with neuromuscular disorders and grade III and IV genital prolapse were excluded. Forty women were randomized into a Control Group and BF Group. The PFMT protocol with BF equipment consisted of three sets of ten slow contractions (tonic), with a holding time of six to eight seconds at each contraction followed by a rest period of equal duration. After each sustained contraction, they performed three to four fast contractions (phasic) in the supine and standing position twice a week, for a total of 12 sessions. We evaluated the effect of adding BF to PFMT on quality of life using King's Health Questionnaire (KHQ) regarding urinary symptoms based on a voiding diary and regarding the function of pelvic floor muscles by digital palpation. The evaluation was performed initially and after 12 treatment sessions. Data are reported as mean and standard deviation. The Mann-Whitney test was used for the analysis of homogeneity and to determine differences between groups, and the Wilcoxon test was used to determine possible differences between the times of observation, with the level of significance set at 0.05. RESULTS: A significant decrease in the scores of the domains assessed by the KHQ was observed in the comparison between groups, except for the general health domain (BF Group: 32.8±26.9 versus Control Group: 48.4±29.5, p<0.13). Accordingly, there was improvement in PFM function after treatment in the BF Group, regarding power (4.3±0.8, p= 0.001), endurance (6.0±2.2, p<0.001) and fast (9.3±1.9, p=0.001). When comparing the groups, the BF Group showed a positive result regarding power (BF Group 4.3±0.8 versus Control Group 2.5±0.9, p<0.001), endurance (6.0±2.2 BF Group versus Control Group 2.7±1.9, p<0.001) and fast (BF Group 9.3±1.9 versus Control Group 4.6 ± 3.2, p<0.001). Reduction of nocturnal urinary frequency (1.2±1.2 versus 0.7±0.9, p=0.02) and of effort urine loss (1.5±1.4 versus 0.6±0.8, p=0.001) was observed in the BF Group. CONCLUSION: The addition of BF to the PFMT for the treatment of SUI, applied according to the protocol described, improved PFM function, reduced urinary symptoms, and improved of the quality of life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):134-140
DOI 10.1590/S0100-72032007000300004
PURPOSE: to compare women's quality of life (QoL) before and after physical therapy treatment for stress urinary incontinence (SUI). METHODS: an uncontrolled clinical trial of 26 women, who had mainly complaints of SUI. Post-menopausal women with overactive bladder, cystocele >grade II and previous surgical/conservative treatments were excluded from the study. The physiotherapy treatment relied on 12 individual pelvic floor exercises assisted by electromyographyc-biofeedback sessions. A total of 200 contractions were carried out, divided in phasic (quick) and tonic (slow). The tool used to evaluate QoL was the King's Health Questionnaire (KHQ), before and after the treatment. RESULTS: there was a decrease in the urinary symptoms, particularly in urinary frequency, nocturia, urgency and urinary incontinence. Regarding the QoL, there was a significant improvement in the following domain scores: general health perception (49.0±24.0 versus 26.9±15.7; p=0.0015), incontinence impact (78.2±28.2 versus 32.1±30.5; p=0.001), activity limitation (75.0±28.2 versus 13.5±22.6; p<0.001), physical limitation (72.4±29.4 versus 15.4±24.5; p<0.001), social limitations (38.3±28.6 versus 6.4±14.5; p<0.001), emotions (59.0±33.8 versus 14.1±24.7; p=0.0001, sleep/energy (34.0±23.8 versus 6.4±16.4; p=0.001) and severity measures (66.9±19.6 versus 22.3±24.2; p<0.001), except for personal relationships (60.5±33.9 versus 41.7±16.7; p=0.0679). CONCLUSIONS: there was an improvement in several aspects of women's QoL treated by physiotherapy, when evaluated with a specific tool, the KHQ.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):134-140
DOI 10.1590/S0100-72032007000300004
PURPOSE: to compare women's quality of life (QoL) before and after physical therapy treatment for stress urinary incontinence (SUI). METHODS: an uncontrolled clinical trial of 26 women, who had mainly complaints of SUI. Post-menopausal women with overactive bladder, cystocele >grade II and previous surgical/conservative treatments were excluded from the study. The physiotherapy treatment relied on 12 individual pelvic floor exercises assisted by electromyographyc-biofeedback sessions. A total of 200 contractions were carried out, divided in phasic (quick) and tonic (slow). The tool used to evaluate QoL was the King's Health Questionnaire (KHQ), before and after the treatment. RESULTS: there was a decrease in the urinary symptoms, particularly in urinary frequency, nocturia, urgency and urinary incontinence. Regarding the QoL, there was a significant improvement in the following domain scores: general health perception (49.0±24.0 versus 26.9±15.7; p=0.0015), incontinence impact (78.2±28.2 versus 32.1±30.5; p=0.001), activity limitation (75.0±28.2 versus 13.5±22.6; p<0.001), physical limitation (72.4±29.4 versus 15.4±24.5; p<0.001), social limitations (38.3±28.6 versus 6.4±14.5; p<0.001), emotions (59.0±33.8 versus 14.1±24.7; p=0.0001, sleep/energy (34.0±23.8 versus 6.4±16.4; p=0.001) and severity measures (66.9±19.6 versus 22.3±24.2; p<0.001), except for personal relationships (60.5±33.9 versus 41.7±16.7; p=0.0679). CONCLUSIONS: there was an improvement in several aspects of women's QoL treated by physiotherapy, when evaluated with a specific tool, the KHQ.