Objective To evaluate the influence of strength exercises on remote pain sensitivity in women with endometriosis-related symptoms. Design A quasi-experimental study. Setting University Hospital, a tertiary health unit. Subjects Twenty-one women with endometriosis-related symptoms and 21 healthy women provided written informed consent. Methods The participants performed weekly exercise sessions on an extensor chair for four consecutive weeks. An electronic algometer was used to measure the pressure pain thresholds on the nondominant forearm. Heart rate and blood pressure were measured using a digital device. All measurements were taken before, immediately after, and 10 and 20 minutes after the exercise series. Results Women with endometriosis-related symptoms had lower pain thresholds. Pressure pain thresholds increased immediately after exercise in healthy women, returning to baseline level 20 minutes after exercise. Women with endometriosis-related symptoms did not present significant pressure pain threshold alterations after exercise. However, they had a higher heart rate and systolic, diastolic, and average blood pressure than healthy women at all the timepoints. There were no consistent correlations between pressure pain thresholds and heart rate or blood pressure. Conclusions The strength exercise regimen used in this study increased pain thresholds in healthy women but not in women with endometriosis-related painful symptoms. The maintenance or even worsening of pain perception after exercise in women with persistent pain, such as those with endometriosis, may limit their adherence to a physical training program, which in turn could prevent them from experiencing the long-term beneficial effects of exercise.
Introduction Adaptations of the maternal organism can adversely affect the lower urinary tract, leading to urinary symptoms with impact in quality of life (QoL). Objective To determine the prevalence of urinary symptoms and the impact of urinary incontinence (UI) on QoL during the last month of pregnancy. Methods Retrospective cross-sectional study, envolving 96 women in the immediate postpartum period personally interviewed about urinary symptoms and QoL during their last four weeks of gestation. Women were divided into two groups according to the number of pregnancies: G1 = 1 pregnancy (n = 41) and G2 = ≥ 2 pregnancies (n = 55). Those who reported the presence of stress urinary incontinence (SUI) and/or urge incontinence (UUI) were also administered the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Results The most common symptoms were nocturia (90.6%), urgency (82.3%), urinary frequency (71.9%) feeling of incomplete emptying (62.5%) and SUI and/or UUI (53.1%) with no differences between groups. Only the complaint of SUI in cough was significantly higher in G2 (p = 0.04). There was no difference on QoL between groups based on ICIQ-SF scores among those with UI (53.1%), however G1 reported serious impact and G2 very serious impact. Conclusion Almost all women reported some type of urinary symptom and the most prevalent were nocturia, urgency, pollakiuria, feeling of incomplete emptying and SUI and/or UUI. SUI was more prevalent among women with two or more pregnancies and during cough were significantly higher. Regardless of the number of pregnancies, the presence any type of UI had a negative impact on QoL.
A incontinência urinária (IU) é uma condição caracterizada pela perda involuntária de urina, um problema recorrente no puerpério e, consequentemente, gera um impacto negativo na qualidade de vida da mulher. A presente pesquisa teve por objetivo revisar na literatura quais abordagens fisioterapêuticas estão sendo utilizadas para tratamento da IUE no pós-parto. Para isso, realizou-se uma revisão sistemática de literatura, utilizando as bases de dados Pubmed, MedLine, BVS, SciELO e PEDro, tendo como base os descritores incontinência urinária, pós-parto e fisioterapia, e seus correspondentes em inglês: urinary incontinence, postpartum e physical therapy, combinados com o operador lógico AND. Após a aplicação dos critérios de elegibilidade, selecionou-se quatro (4) artigos, que apontaram que o treinamento muscular do assoalho pélvico (TMAP) é eficaz para a melhora da força e função da musculatura do local, e, portanto, mostrou-se um tratamento assertivo para a IU. Conclui-se que a fisioterapia é efetiva para o tratamento da incontinência urinária de esforço em mulheres no pós-parto, sendo recomendada a realização de novos estudos, com maior acurácia metodológica, para se comprovar o real efeito da fisioterapia.
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