II.

We found that incontinent athletes have greater PFM strength than continent athletes. This suggests that urinary incontinence in this population is not due to PFM weakness. The positive association between abdominal and PFM strengths in incontinent athletes may be due to frequent co-contraction between these muscle groups.

No abstract

RESUMOAtualmente, diversos estudos relatam incontinência urinária (IU) entre mulheres jovens nulíparas e fisicamente ativas. Contudo, alguns investigam a prevalência da IU de acordo com as modalidades esportivas, enquanto outros investigam a carga de treino. A finalidade do presente estudo foi verificar se a modalidade esportiva é mais determinante na prevalência de IU do que a carga de treino entre mulheres jovens nulíparas. Para esta revisão sistemática, três revisores independentes realizaram uma busca de publicações originais nas bases de dados PubMed, LILACS e SciELO, entre 1994 e 2015. Foram utilizadas como estratégia de busca as palavras-chave: urinary incontinence AND (physical activity OR women OR nulliparous OR athletes), registradas na MeSH e no DeCS. Foram incluídos apenas estudos originais publicados nas línguas português, inglês e espanhol, que verificaram a IU em mulheres nulíparas, atletas ou praticantes de atividade física. Foram selecionados 873 estudos, mas somente dez artigos satisfizeram os critérios de inclusão e exclusão. Todos os artigos foram do tipo transversal, dos quais quatro relacionaram a IU com as modalidades esportivas, cinco verificaram a carga de treino com a perda de urina e um estudo verificou ambos os aspectos. Foi encontrada uma alta taxa de prevalência de IU entre atletas. Parece haver evidência de que as atividades que exigem salto, aterrissagem longa e corrida são as mais propensas a provocar perda de urina. Além disso, a maior carga de treino parece estar associada com a quantidade de urina perdida. Esta revisão evidencia as altas taxas de IU em praticantes de grandes cargas de treinamento associadas a esportes com salto, especialmente entre atletas. Contudo, ainda não há resposta para qual fator esportivo é mais determinante para a perda de urina entre mulheres nulíparas.Descritores: diafragma da pelve; exercício; esportes; incontinência urinária; saúde da mulher. ABSTRACT

Aims To compare the strength of abdominal and pelvic floor muscles (PFM) between nulliparous female athletes (FAs) and non‐athletes (FNAs), to determine the frequency of urinary incontinence (UI) in these groups. Methods This cross‐sectional comparative study of nulliparous women included 39 professional FAs, who competed at the district level or above, and 34 FNAs. Participants underwent pelvic floor and abdominal muscle assessments. PFM function and strength were assessed using the modified Oxford scale and a manometer (PERINA 996‐2 QUARK). Abdominal muscle function and strength were assessed using a 4‐Pro isokinetic dynamometer. The International Consultation on Incontinence Questionnaire‐Short Form was used to assess UI symptoms among the athletes, and the International Physical Activity Questionnaire‐Short Form was used to establish the level of physical activity among the non‐athletes. Results The prevalence of UIs in the FAs was 53.8%, while that for FNAs was 35.3%. There was no association between being an athlete and having UI (p = 0.112). FAs were found to weigh more (p = 0.012) and have increased abdominal muscle strength (p = 0.014) and maximum voluntary PFM contraction as recorded by the manometer (p = 0.035), as well as a decreased PFM contraction endurance time (p = 0.025) than FNAs. Conclusion FAs had stronger abdominal muscles and PFM contraction, as assessed by a manometer, but less PFM endurance when compared to FNAs. Despite these differences, the prevalence of UI was similar between groups.

Background:The delivery pain is an unpleasant experience which may generate some insecurity for the woman. Thus, some methods of analgesia need to be studied in order to generate greater comfort for the woman during labor. Objective: to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) and cryotherapy (CRYO) on labor pain. Method/Design: quasi experimental study, randomized sample in two groups: TENS and CRYO. Pregnant women were selected in the Carmela Dutra Maternity (Florianópolis (SC), Brazil) according to inclusion criteria: women which are pregnant for the first time, age (18-40 years) and initial cervical dilatation of 4-5cm. The Visual Analogue Scale (VAS) was used to evaluate pain before and after each intervention. Results: 24 parturient women were studied (TENS = 11, CRYO = 13). In the TENS group, there was a significant result in pain relief after the first application (p = 0.002). VAS was reduced from 8 to 5.5, but not significant. In the CRYO group there was reduction of pain during the first application (p = 0.008), and in the second there was an increase in pain (p = 0.008). There was a significant difference between the techniques in the evaluation performed before the second application, with a lower value attributed to the CRYO group (p = 0.034). Conclusions: CRYO and TENS were effective in relieving pain during the first phase of the initial phase of labor. However, during the treatment, in the parturient women studied, there was maintenance of pain response by the CRYO group and decrease in the TENS group without reduction significant.

Introdução: Após um acidente vascular encefálico (AVE) pacientes passam por instituições de reabilitação, porém parte da recuperação ocorrerá no domicílio. Objetivos: Avaliar a adesão ao programa domiciliar para pacientes com sequelas de AVE. Métodos: Realizou-se avaliação clínica questionários em nove indivíduos com sequela pós-AVE. Em seguida, foi entregue e explicado o manual de orientações com exercícios domiciliares. Após 15 dias realizou-se contato telefônico para enfatizar a importância do seguimento das orientações e ao final de 30 dias realizou-se a reavaliação. Resultados: Em treze das dezessete tarefas os pacientes aderiram às orientações. Em 14 tarefas menos da metade dos pacientes realizou por mais de 80%. As barreiras mais citadas foram: dificuldade, dor e desmotivação. Os facilitadores foram: expectativa de recuperação e manual de orientações. Conclusão: Pacientes com sequela de AVE mostraram baixa adesão às orientações prescritas em domicílio, no entanto apresentaram melhora em relação à mobilidade após as orientações da fisioterapia.

Introduction: Breast cancer has a high prevalence among women. It is known that breast cancer survivors can undergo a several alterations due to the treatment, including sexual dysfunction. Objective: This study aimed to determine the incidence of sexual dysfunction in women after breast cancer surgery, and assess the relationship between sexual dysfunctions and pelvic floor muscles (PFM) contraction, as well to verify if hormone therapy caused long-term occurrence of PFM weakness or sexual dysfunction. Methods: The sample was composed by 26 women with 48.4 ± 6.8 years which using hormone therapy treatment at least six months. Data on sexual dysfunction were collected through the Female Sexual Function Index- FSFI questionnaire and a section composed by demographic information. Furthermore, the PFM contraction was assessed using the PERFECT scale. Results: The results demonstrated a high rate of sexual dysfunction (64.3%) and a weak PFM contraction (2.31±1.3) among the women. In addition, a long-term hormone therapy had a negative association with PFM endurance and with the orgasm and satisfaction domains of the FSFI questionnaire. Conclusion: women using hormone therapy after breast cancer surgery had a high rate of sexual dysfunction and the long-term treatment of hormone treatment can be associated with a worsening of orgasm and sexual satisfaction in these women. Also, the use at long-term of hormone therapy had a negative association with the PFM endurance.