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Studies using high quality methods are still needed to support evidence-based decisions regarding the use of AFOs for this population.

The pelvic floor (PF) provides support to all pelvic organs, as well as appropriately closure/opening mechanism of the urethra, vagina, and anus. Therefore, it is likely that female athletes involved in high-impact and in strong-effort activities are at risk for the occurrence of urinary incontinence (UI). This study aimed to investigate the occurrence of UI and other PF dysfunctions (PFD) [anal incontinence (AI), symptoms of constipation, dyspareunia, vaginal laxity, and pelvic organ prolapse] in 67 amateur athletes (AT) compared with a group 96 of nonathletes (NAT). An ad hoc survey based on questions from reliable and valid instruments was developed to investigate the occurrence of PFD symptoms. The risk of UI was higher in AT group (odds ratio: 2.90; 95% CI: 1.50-5.61), mostly among artistic gymnastics and trampoline, followed by swimming and judo athletes. Whereas, AT group reported less straining to evacuate (OR: 0.46; 95% CI: 0.22-0.96), manual assistance to defecate (OR: 0.24; 95% CI: 0.05-1.12), and a higher stool frequency (OR: 0.29; 95% CI: 0.13-0.64) than NAT group. The occurrence of loss of gas and sexual symptoms was high for both groups when compared with literature, although with no statistical difference between them. Pelvic organ prolapse was only reported by nonathletes. Athletes are at higher risk to develop UI, loss of gas, and sexual dysfunctions, either practicing high-impact or strong-effort activities. Thus, pelvic floor must be considered as an entity and addressed as well. Also, women involved in long-term high-impact and strengthening sports should be advised of the impact of such activities on pelvic floor function and offered preventive PFD strategies as well.

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Objective: To identify the sociodemographic and clinical profi le of women with urinary incontinence attended at a public urogynecological physical therapy service. Methods: In this retrospective cross-sectional descriptive study, the following information were gathered from the participants' hospital records and physical therapy evaluation forms: age, marital status, educational level, type of incontinence, risk factors, signs and symptoms, perineal function (Oxford scale) and quality of life (QoL). Descriptive statistics using frequency distributions and proportions were applied. Results: Data from 58 participants were considered. Most of them were between 40 and 59 years old (81%), were married (62%) and only had elementary education (79%). Mixed urinary incontinence was the most prevalent type (63%), followed by stress urinary incontinence (34%). Pregnancy (88%) and vaginal delivery (76%) were the most prevalent risk factors and the most prevalent symptom was urinary loss under stress (97%). Perineal function grade 2 was the most frequent type (41%) and the participants' quality of life distribution ranged between poor (10%), moderate (33%), good (28%) and excellent (24%). Conclusions:This study provides data that contribute towards ascertaining the profi le of the women with urinary incontinence who are attended in public services that offer urogynecological physical therapy. Furthermore, it may assist in developing preventive and rehabilitative interventions in such services.Key words: health profi le; urinary incontinence; physical therapy. ResumoObjetivo: Identifi car o perfi l de mulheres com incontinência urinária (IU) atendidas em um serviço público de Fisioterapia Uroginecológica, em relação a características sociodemográfi cas e clínicas. Materiais e métodos: Neste estudo descritivo transversal retrospectivo, por meio de prontuários e fi chas de avaliação fi sioterapêutica das participantes, os seguintes dados foram levantados: idade, estado civil, grau de instrução, tipo de incontinência, fatores de risco, sinais e sintomas, função perineal (escala de Oxford) e qualidade de vida (IQoL). Estatística descritiva, pela distribuição de freqüência e proporção, foi aplicada. Resultados: Dados de 58 participantes foram considerados. A maioria tinha idade entre 40 e 59 anos (81%), era casada (62%) e possuía grau de instrução fundamental (79%). A IU mista foi prevalente em 63% da amostra e a incontinência urinária de esforço (IUE) em 34%. Gestações (88%) e partos vaginais (76%) se destacaram como fatores de risco e o sintoma mais prevalente foi perda de urina ao esforço (97%). O grau 2 de função perineal foi o mais freqüente (41%) e a distribuição da qualidade de vida das participantes variou entre baixa (10%), moderada (33%), boa (28%) e ótima (24%). Conclusões: Este estudo oferece dados que contribuem para o conhecimento do perfi l das mulheres com IU atendidas em serviços públicos que prestam assistência fi sioterapêutica uroginecológica e, além disso, poderá auxiliar no desenvolvimento de interve...

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Aims: Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. Materials and Methods: A prospective study with women submitted to radical hysterectomy (RH) (n = 20), exclusive radiotherapy (RT) (n = 20) or chemoradiation (CT/RT) (n = 20) for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor muscle contraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05). Results: The groups were similar in stress urinary incontinence incidence (p = 0.56), urinary urgency (p = 0.44), urge incontinence (p = 0.54), nocturia (p = 0.53), incomplete bowel emptying (p = 0.76), bowel urgency (p = 0.12) and soilage (p = 0.43). The CT/ RT group presented a higher urinary frequency (p < 0.001) and diarrhea (p = 0.025). Patients in the RH group were more sexually active (p = 0.01) and experienced less dyspareunia (p = 0.021). Vaginal length was shorter in RT group (5.5 ± 1.9 cm) and CT/ RT(5.3 ± 1.5 cm) than in the RH group (7.4 ± 1.1 cm) (p < 0.001). Pelvic floor muscle contraction was similar (p = 0.302). Conclusions: RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.

Background: Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil. Objective: To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers. Methods: Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge. Results: Interventions reduced the amount (pad-test, p = 0.004; d = 0.13, 95% CI = −0.23 to 0.49) and frequency of urine loss (voiding diary, p = 0.003; d = 0.51, 95%CI = 0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p < 0.001; d = 1.26, 95%CI = 0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them.