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Objective To assess the effect of pelvic patterns of proprioceptive neuromuscular facilitation (PNF‐concept) on pelvic floor muscles (PFM) recruitment, as well as the electromyographic activity of muscles synergic to the pelvic floor in healthy women. Methods Observational study conducted with 31 women aged between 18 and 35 years, with mean age of 23.3 ± 3.2 (22.1–24.4). PFM activity was monitored by surface electromyography during the combination of isotonics technique of four pelvic patterns of PNF‐concept (i.e., anterior elevation, posterior depression, anterior depression, and posterior elevation). The electromyographic signal was analyzed using root mean square amplitude. Two‐way repeated measures analysis of variance was performed to analyze differences in PFM activity between types of contraction (i.e., concentric, isometric, and eccentric) and the four pelvic patterns. Results PFM activity did not differ among the four pelvic pattens. However, PFM activity was significantly different between the combination of isotonics technique and baseline, F(1.6, 48.2) = 71.5; p < 0.000, with a large effect size (partial ƞ² = 0.705). Concentric (22.4 µV ± 1.1), isometric (17.3 µV ± 0.6), and eccentric (15 µV ± 0.5) contractions of combination of isotonics technique increased PFM activity compared with baseline (10.8 µV ± 0.4) in all pelvic patterns. By analyzing the electromyographic activity of the muscles synergistic to the pelvic floor, there is effect of the interaction of the type of contraction, the pelvic pattern of the PNF concept, and the synergistic muscles on the myoelectric activity of the external anal sphincter, F(3.2, 96.5) = 5.6; p < 0.000, with a large magnitude of effect (partial ƞ² = 0.15). In the anterior elevation pattern, the muscles synergistic to the pelvic floor present synergy in phase with the PFM, and in the posterior patterns there was a decrease in the activity level of all synergistic muscles, without changing the activity level of the PFM. Conclusion PFM activity did not differ among the four pelvic patterns of PNF‐concept. Nonetheless, the combination of isotonics technique showed a significant effect on PFM compared with baseline, with greater PFM activity during concentric contraction. Pelvic patterns of PNF‐concept may be used to increase PFM recruitment in young healthy women.

Introdução: A lesão medular acarreta em perda da independência funcional, autonomia e status social. Essa enorme mudança contribui para o aparecimento dos sintomas depressivos nessa população. Objetivo: Avaliar os sintomas depressivos e disfunção sexual em homens com lesão medular traumática, analisando a associação entre eles. Métodos: Estudo observacional, realizado com 44 homens com lesão medular traumática, idade entre 18 e 60 anos, tempo de lesão superior a um ano e vida sexual ativa. O grau de comprometimento neurológico foi avaliado através da versão revisada em 2011 da ASIA Impairment Scale, os sintomas depressivos através do Inventário de Depressão de Beck e a função sexual através do Índice Internacional de Função Erétil. Foram aplicadas técnicas de estatística descritiva e análise bivariada para verificar associação, utilizando um nível de significância de 0,05. Resultados: Os voluntários possuíam média de idade de 34,1 anos, e tempo médio de lesão de 7,7 anos. Todos os indivíduos da amostra tinham nível de lesão acima do segmento medular L2, sendo as incompletas as mais frequentes (68,2%). O tempo médio da última relação sexual foi de 56,5 dias e a frequência semanal de relação sexual foi a mais relatada (65,9%). Da amostra, apenas 17,6% tinham sintomas depressivos, sendo 6,8% com disforia e 6,8% apresentando sintomas leves a moderados. Não foi encontrada associação entre sintomas depressivos e disfunção sexual, exceto para o domínio da disfunção de satisfação geral (p=0,02). Conclusão: Não existe associação entre sintomas depressivos e disfunção sexual em homens com lesão medular crônica.

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Study Design. Observational study (Ethics Committee Number 973.648). Objective. Evaluating the social and clinical factors associated with sexual dysfunction in men with traumatic spinal cord injury, as well as predictive factors for sexual dysfunction. Summary of Background Data. Besides the motor and sensory loss, sexual function changes after spinal cord injury, ranging from decreased sexual desire to erectile disorders, orgasm, and ejaculation. Methods. Performed with 45 men, with traumatic spinal cord injury and sexually active. Sexual function was assessed by the International Index of Erectile Function and the level and degree of injury were determined following guidelines of International Standards for Neurological and Functional Examination Classification of Spinal Cord Injury. Bi and multivariate analysis was applied, with a 0.05 significance level. Results. Forty-five subjects with mean injury time of 7.5 years (CI 5.2–9.9) were evaluated. Having a fixed partner is a protective factor (OR: 0.25; 95% CI: 0.07–0.92) of erectile dysfunction. Sexual desire is associated with the fixed partner (OR: 0.12; 95% CI: 0.02–0.66), masturbation (OR: 0.13; 95% CI: 0.02–0.62), and sexual intercourse in the last month (OR: 0.13; 95% IC: 0.01–0.92). Ejaculation (OR: 0.01; 95% CI: 0.00–0.15) and erectile dysfunction (OR: 15.7; 95% CI: 1.38–178.58) are associated with orgasm. Psychogenic erection (OR: 0.07; 95% CI: 0.01–0.69), monthly frequency of sexual intercourse (OR: 11.3; 95% CI: 2.0–62.8), and orgasmic dysfunction (OR: 7.1; 95% CI: 1.1–44.8) are associated with satisfaction. Conclusion. Fixed partner, ejaculation, masturbation are protective factors for sexual dysfunction. Erectile dysfunction, orgasmic, and infrequent sex dysfunction are predictors of sexual dysfunction. Level of Evidence: 3

Objective: Identification of changes in functionality of women with migraine according to the International Classification of Functioning, Disability, and Health (ICF). Method: This is a qualitative study conducted in the format of focus group interviews, which included women between 18 and 55 years old diagnosed with migraine based on the criteria of the International Headache Society. The women were divided into groups with averages of two to four people and, guided by a moderator, they were encouraged to talk about the influence of migraine on performing the tasks to which they are exposed daily, taking into account the environment in which they are inserted. The categories that reached the 30% agreement cutoff point in the groups were approved. Results: There were 10 rounds of interviews, each with a focus group with an average of two to four people, totaling 29 women with a mean age of 35 years old (95% CI: 18 - 51). Eighteen categories were approved, four in the Body Function domain, four in the Body Structure domain, six categories in the Activity and Participation domain and four categories in the Environmental Factors domain. Conclusion: Women with migraine perceive lteration in functionality in all ICF domains, with the Activities and Participation domain presenting the most mentioned categories.

Traumatic brachial plexus injury (BPI) is one of the most disabling injuries of the upper extremity, often requiring specialized treatment and a prolonged rehabilitation period. This scoping review was carried out to identify and describe the physical therapy modalities applied in the rehabilitation of adult individuals with BPI. Electronic databases, gray literature, and reference lists were searched, and studies meeting the following eligibility criteria were included: (a) interventions including any physical therapy modality; (b) individuals age ≥18 years old; and (c) a clinical diagnosis of BPI. The literature search yielded 681 articles of which 49 met the inclusion criteria and had their outcomes, treatment parameters, and the differences between conservative and pre‐ and postoperative treatment phases analyzed. The most commonly used physical therapy interventions were in the subfields of kinesiotherapy (ie, involving range of motion exercises, muscle stretching, and strengthening), electrothermal and phototherapy, manual therapy, and sensory re‐education strategies. Although several physical therapy modalities were identified for the treatment of BPI in this scoping review, the combination of low levels of evidence and the identified gaps regarding the treatment parameters challenge the reproducibility of such treatments in clinical practice. Therefore, future controlled clinical trials with clearer treatment protocols for individuals with BPI are needed.

Background: There is evidence of the association between catastrophic pain and cerebral connectivity activation. However, the nature of such neural network changes, and brain regions that are most likely to be affected are still unknown.Objective: To summarize the data available in the literature regarding fMRI-detected brain changes in individuals with catastrophic pain.Methods: This review included searches across the following databases: Medline-via-PubMed, Web-of-Science and Scopus. We included: cross-sectional studies; fMRI studies using the catastrophic pain scale; and control groups with healthy individuals. We measure the quality evaluation of the selected studies using the New Castle-Ottawa Quality Assessment Scale.Results: In total, 339 articles were identified, and after the title and abstract selection, 11 references were selected for further evaluation. Unfortunately, seven works were excluded by the eligibility criteria. Thus, a total of four studies were included for qualitative analysis: two included migraine subjects; one fibromyalgia; and another temporomandibular dysfunction. The included articles presented moderate quality of evidence. Conclusions:In healthy subjects, repeated exposure to painful stimuli generates a specific perception of pain with increased functional connectivity and somatosensory network activity. This does not happen in high catastrophic scores patients, instead may acquire a pain-associated increased state of attention and the inability to direct their attention to other situations, leading to reduced pain modulation capacity. This review finds a change in functional connectivity during processes of rumination or negative pain perception in the anterior and posterior cingulate cortex, somatosensory cortex, medial prefrontal cortex, thalamus, insula, pre-cuneus, midbrain, and retrosplenial cortex.