Simone Pereira

This video's proposal was to present one of the pelvic floor muscle (PFM) training programs used in our research, and to study the effects of abdominopelvic kinesiotherapy on female PFM function. A total of 82 women participated in this study, 11 nulliparous, 13 primiparous pregnant, 20 primiparous postpartum and 38 postmenopausal women, who were evaluated first by digital palpation, then by either electromyography or vaginal dynamometry to investigate their PFM strength, followed by ICIQ UI-SF and ICIQ-OAB to evaluate urinary symptoms. This intervention protocol lasted for 60 min, three times a week, with a total of 10 sessions, and was supervised by a physiotherapist, using a gym ball, according to Marques and collaborators. A significant increase in PFM strength was observed by digital palpation in all groups. This finding was confirmed by electromyography in both pregnant (p = 0.0001) and postpartum (p = 0.0001) groups, as well as in 20 of the 38 women from the postmenopausal group (p = 0.003) then by vaginal dynamometry (p = 0.02) in the rest of the women (18) from the same group, with a concomitant decrease in urinary symptoms (p < 0.05). The abdominopelvic kinesiotherapy program promotes an increase in pelvic floor muscle strength and a decrease in urinary symptoms.

The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance. A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. The intra and inter-raters' analyses showed good reliability for maximum strength (ICCintra-rater1=0.96, ICCintra-rater2=0.95, and ICCinter-rater=0.96), average strength (ICCintra-rater1=0.96, ICCintra-rater2=0.94, and ICCinter-rater=0.97), and endurance (ICCintra-rater1=0.88, ICCintra-rater2=0.86, and ICCinter-rater=0.92) dynamometric measurements. The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice.

This video's proposal was to present one of the pelvic floor muscle (PFM) training programs, used in our research, that we designed as a virtual reality intervention protocol and investigated its effects on PFM contractility. Two clinical, controlled and prospective studies were conducted, one with 19 nulliparous women without urinary symptoms, who were evaluated by both electromyography and digital palpation (DP) and another with 27 postmenopausal women with mixed urinary symptoms (assessed by both ICIQ UI-SF and ICIQ-OAB), evaluated by vaginal dynamometry and DP, with a total of 46 women in both studies. This protocol was designed so that the participant would play a video game, seated on a pressure base platform, while commanding it through her pelvic movements. Using a virtual reality game, five activities were performed during 30 min, twice a week, with a total of 10 sessions. A significant increase in PFM strength was found in both the nulliparous (p = 0.0001) and the postmenopausal (p = 0.0001) groups of women, as ascertained by DP. A significant increase in postmenopausal women's muscle strength and endurance assessed by dynamometry (p = 0.05) and a concomitant decrease in their urinary symptoms, were observed. This virtual reality program promoted an increase in PFM contractility and a decrease in postmenopausal urinary symptoms.

During pregnancy, hormonal change, increase in the body mass index and the pressure caused by the enlarged uterus over the bladder and pelvic floor, are some factors involved in lower urinary tract symptoms (LUTS). This study was made to evaluate the correlation between pregnancy and delivery way with LUTS. This open prospective study was carried out using the overactive bladder questionnaire short form (OABq-SF). A total of 60 patients enrolled this study. The mean age was 24 year, raging from 14 to 40 years. The patients were evaluated during the third trimester and 6 months after delivery. Statistical analysis of the OABq-SF scores was made using the Pearson method. Mean OABq-SF score during pregnancy was 35.2 and 6 months after delivery decreased to15. Quality of life was 82.9 during pregnancy and increased to 88.4 at 6 month after delivery. Patient's perception, that is correlation, was 55.02 (p=0.0001) during pregnancy and 36.1% (p=0.0046). Clinical correlation index was 6...

ABSTRACT Introduction and objective: During pregnancy, hormonal change, increase in the body mass index and the pressure caused by the enlarged uterus over the bladder and pelvic floor, are some factors involved in lower urinary tract symptoms (LUTS). This study was made to evaluate the correlation between pregnancy and delivery way with LUTS. Material and method: This open prospective study was carried out using the overactive bladder questionnaire short form (OABq-SF). A total of 60 patients enrolled this study. The mean age was 24 year, raging from 14 to 40 years. The patients were evaluated during the third trimester and 6 months after delivery. Statistical analysis of the OABq-SF scores was made using the Pearson method. Results: Mean OABq-SF score during pregnancy was 35.2 and 6 months after delivery decreased to15. Quality of life was 82.9 during pregnancy and increased to 88.4 at 6 month after delivery. Patient's perception, that is correlation, was 55.02 (p=0.0001) during pregnancy and 36.1% (p=0.0046). Clinical correlation index was 6.7%. Conclusions: Our study demonstrated that in spite of LUTS being more important during pregnancy, there is no significant clinical correlation in patient's perception.

The aim of this study was to simultaneously evaluate both transversus abdominis/internal oblique (Tra/IO) and pelvic floor muscles (PFM) during isometric exercises in nulliparous, pregnant, and postpartum women. The study included 81 women divided into four groups: (G1) nulliparous women without urinary symptoms (n = 20); (G2) primigravid pregnant women with gestational age ≥24 weeks (n = 25); (G3) primiparous postpartum women after vaginal delivery with right mediolateral episiotomy (n = 19); (G4) primiparous postpartum women after cesarean section delivery, with 40 to 60 days of postpartum (n = 17). The assessment consisted of simultaneous surface electromyography (EMGs) of the PFM and Tra/IO, during three isometric maximum voluntary contractions. Only nulliparous women presented significant simultaneous Tra/IO and PFM co-activation when asked to contract PFM (P = 0.0007) or Tra/IO (P = 0.00001). There is co-activation of the transversus abdominis/internal oblique and the pelvic floor muscles in young, asymptomatic nulliparous women. This pattern was modified in primigravid pregnant and primiparous postpartum women regardless of the delivery mode.

The continence mechanisms depend on the integrity of the pelvic floor muscles. It is therefore important to find simple, reliable, and safe methods to assess its contractility in a clinical setting. This study aims to investigate if digital palpation of the pelvic floor muscles presents correlation with its electromyographic activity. The sample consisted of 307 women with mean age of 23.93 years, including 39 nulliparous, 117 primigravid pregnant, 64 primiparous, in post-vaginal delivery, and 87 primiparous women, in post-cesarean section delivery. The assessment consisted of both digital palpation and surface electromyography. One, and the same, highly skilled and experienced physiotherapist, who was able to classify the different grades of contractility accurately, performed digital palpation using the Modified Oxford Grading Scale. Surface electromyography was performed using an intravaginal probe. For electromyography evaluation, three contractions of 5 sec each were recorded, and an average of three Root Mean squares was considered for analysis. Spearman's Coefficient, Jonckheere-Terpstra Test, Kruskal-Wallis as well as Dunn Test were used for statistical analysis. The strong correlation found between the two methods (P < 0.001) indicates that both digital palpation and electromyography can be used in everyday practice, both for clinical use and scientific research, although both have their specific limitations and requirements to avoid the risk of biases. There was a correlation between pelvic floor muscle contractility measured by surface electromyography and by digital palpation. Both methods can be used to validate data in research and clinical setting.

The objective of the present study was to evaluate the sexual function of pregnant women and to identify the potential variables associated with it. The study was conducted on 137 low-risk, sexually active pregnant women who filled out the Female Sexual Function Index (FSFI) questionnaire. Although 61% of the women assessed presented an FSFI score ≤26.5, they declared that they were satisfied with the emotional proximity to their partner, with their relationship, and with their sex life. A positive association was detected between sexual dysfunction and gestational age and a report of urinary incontinence and excessive weight gain in the current pregnancy.

Introduction and objectiveDuring pregnancy, hormonal change, increase in the body mass index and the pressure caused by the enlarged uterus over the bladder and pelvic floor, are some factors involved in lower urinary tract symptoms (LUTS). This study was made to evaluate the correlation between pregnancy and delivery way with LUTS.