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Lothery, Natasha D. "Muscle activation of the lumbar and hip extensors during the hyperextension and reverse hyperextension exercises." Virtual Press, 2004. http://liblink.bsu.edu/uhtbin/catkey/1306854.
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The purpose of this study was to investigate the differences in muscle activity of the lumbar and pelvic extensor muscles during the hyperextension and reverse hyperextension exercises. Fifteen healthy and weight-trained volunteers (8 women, 7 men) were recruited from a university setting. Electromyographic (EMG) activity of selected hip and trunk extensor muscles was recorded during the execution of a hyperextension and a reverse hyperextension. Three muscles were analyzed: lumbar erector spinae (ES), biceps femoris (BF) and gluteus maximus (GM). The amount of external load used by each individual was determined by equating the amount of torque produced at the hip joint for both exercises. Participants performed two trials of each exercise, and completed at least three repetitions within the eight-second data collection period. Peak integrated EMG (iEMG) activity was expressed as a percentage of maximal voluntary isometric contraction (%MVC). A two-way repeated measures analysis of variance (ANOVA) failed to demonstrate significant differences in %MVC activity between the two exercises, (p>0.05). A comparison of the hyperextension and reverse hyperextension exercises revealed that under similar loading conditions, there is no significant difference in muscle activity of the lumbar and hip extensor muscles.School of Physical Education
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Thubert, Thibault. "Impact d'un détournement d'attention sur les mécanismes neuromusculaires impliqués dans la contraction des muscles du plancher pelvien." Thesis, Paris 6, 2017. http://www.theses.fr/2017PA066178/document.
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But: L’attention semble avoir un impact sur le fonctionnement des muscles périnéaux.Matériels : L’activité électromyographique (EMG) du sphincter anal externe (SAE) a été receuillie au cours d’effort de contractions périnéales volontaires et reflexe (provoquées par la toux) réalisées en réponse à un stimulus au marteau reflexe chez des femmes volontaires saines avec et sans épreuve de charge cognitive (ECC). Le temps de réaction (RT1) correspondant à la latence entre le stimulus et le début d’activité EMG du SAE lors d’une contraction périnéale volontaire, le RT3, correspondant au temps de latence entre le début d’activité EMG du SAE et le début d’activité EMG des muscles intercostaux externes (ICE) lors d’un effort de toux, ont été mesurés. Après randomisation (1/2) 13 femmes ont bénéficié d’une rééducation en double tache (cognitivo-musculaire) et 26 femmes constituaient le groupe témoin. Ces mêmes paramètres ont été enregistrés avant et apres rééducation dans les deux groupes.Resultats: Une ECC provoque un allongement du RT1 par un facteur 3,98 (p<0,001). Une ECC entrainne une diminution de 29% de la contraction périnéale réflexe: RT3 était respectivement de -80.00 ms sans ECC contre -56,7 ms en cas d’ECC (r=0,7, p=0,0045). Dans le groupe « rééducation » le RT1 en présence d’une ECC passait de 461,1 à 290,7 ms (r=0,6, p=0,006) contre 370 à 343 ms dans le groupe témoin (r=0,9, p=NS). Le RT3 dans le groupe « rééducation » en absence d’une ECC passait de -68,5 à -127,8 ms (r=1,9, p=0,03) et en présence d’une ECC de -42,6 ms à -59,3 ms (r=1,4, p=0,04). Conclusion: Une rééducation specifique corrige les effets provoqués par une ECC sur la contraction périnéaleAims: Attention may be involved in pelvic floor muscles (PFM) Methods: The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded on healthy female volunteers, during voluntary and involuntary (induced by cough) PFM contraction, elicited by local stimulation, combined (or not) with a mental Distraction Task (DT). Reaction time (RT1), ie. the latency between stimulus and the onset of EAS EMG activity, RT3, ie. the latency between the onset of EAS EMG activity and the onset of External intercostal muscle (EIC) (cough) were measured. Following randomisation (2/1) 13 volunteers underwent dual task cognitive (an attentional test and PFM exercises) rehabilitation program and 26 were the control group (no specific instruction). RT1 and RT3 were recorded before and after the program in both group.Results: The mental distraction task led to a 3.98 times greater reaction time between stimulus and EAS EMG activation (RT1), (p<0.001). DT led to a 29% shorter anticipation of the involontary PFM contraction: RT3 were respectively -80.00 ms without a DT versus -56.67 ms with a DT (r=0.7, p=0.004). In the rehabilitation group RT1 in DT conditions decreased from 461.1 ms to 290.7 ms (r=0.6, p=0.006)vs 370 to 343 ms in the control group (r=0.9, p=NS). In the study group RT3 without a DT increased from −68.5 ms to −127.8 ms (r=1.89, p = 0.03) and from 42,6 ms to -59,3 ms with a DT (r= 1.4, p=0.04).Conclusions: A specific dual task rehabilitation can prevent the effect of DT on PFM contraction characteristics
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Cyr, Marie-Pierre. "Fonction des muscles du plancher pelvien chez les survivantes d’un cancer de l’endomètre atteintes de dyspareunie." Mémoire, Université de Sherbrooke, 2017. http://hdl.handle.net/11143/11576.
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Contexte : Le cancer de l'endomètre est le plus fréquent des cancers gynécologiques. Il a été
suggéré que les traitements oncologiques entraînent des dysfonctions des muscles du plancher pelvien. Ces dysfonctions pourraient contribuer au développement de conditions débilitantes comme la douleur lors des relations sexuelles (dyspareunie) qui atteint plus de la moitié des survivantes. Or, à l'heure actuelle, aucune étude n'a investigué la fonction des muscles du plancher pelvien en lien avec la dyspareunie chez des survivantes d'un cancer de l'endomètre. Objectifs : L'objectif principal vise à explorer les différences quant à la fonction des muscles du plancher pelvien entre des survivantes d'un cancer de l'endomètre atteintes de dyspareunie et des femmes
sans douleur ayant subi l'hystérectomie totale pour des raisons bénignes. L'objectif secondaire est d'explorer les différences entre les deux groupes quant aux variables urogynécologiques, sexuelles, psychologiques et sociales. Méthodologie : Dans cette étude comparative exploratoire bicentrique, des survivantes d'un cancer de l'endomètre atteintes de dyspareunie (n=7) et des femmes asymptomatiques (n=7) ont assisté à une séance d'évaluation menée par une physiothérapeute. Les deux groupes ont été équilibrés selon l'âge, l'indice de masse corporelle et le nombre d'accouchements par voie vaginale. La fonction des muscles du plancher pelvien, y compris le tonus, la force maximale, la vitesse de contraction, la coordination et l'endurance, a été évaluée à l'aide du spéculum dynamométrique. Des questionnaires validés ont permis d'évaluer les variables secondaires. Des tests de Mann-Whitney ont été employés pour comparer les deux groupes quant à la fonction des muscles du plancher pelvien et les variables urogynécologiques, sexuelles, psychologiques et sociales (!=0,050). Résultats : Concernant la fonction des muscles du plancher pelvien, les survivantes atteintes de dyspareunie ont démontré un tonus à une ouverture vaginale
minimale supérieur (p=0,018) et une endurance inférieure (p=0,048) aux femmes asymptomatiques. Les survivantes ont également présenté plus d'incontinence fécale (p=0,005) et une fonction sexuelle inférieure (p=0,004) comparativement aux femmes asymptomatiques. Aucune différence n'a été détectée pour les variables psychologiques et sociales. Conclusion : Les résultats de cette étude exploratoire suggèrent des dysfonctions des muscles du plancher pelvien, notamment un tonus supérieur et une endurance inférieure, chez les survivantes d'un cancer de l'endomètre atteintes de dyspareunie. D'autres études sont nécessaires afin de confirmer ces résultats. Ces constats préliminaires pourraient servir d'assises pour mieux comprendre les dysfonctions des muscles du plancher pelvien impliquées dans la dyspareunie chez cette population.Abstract : Context: Endometrial cancer is the most common cancer in gynecological cancers. Oncological treatments are suggested to cause pelvic floor muscle dysfunction that could contribute to the development of debilitating conditions such as pain during sexual intercourse (dyspareunia), which affects more than half of survivors. However, to date, no study investigated pelvic floor muscle function in relation to dyspareunia in endometrial cancer survivors. Objectives: The main objective is to explore differences in pelvic floor muscle function between endometrial cancer survivors with dyspareunia and women without pain who underwent a total hysterectomy for benign conditions. The secondary objective is to explore differences between the two groups on urogynecological, sexual, psychological and social variables. Methodology: In this exploratory, bicentric comparative study, endometrial cancer survivors with dyspareunia (n=7) and asymptomatic women (n=7) attended one evaluation session conducted by a physiotherapist. The two groups were balanced in terms of age, body mass index and number of vaginal deliveries. The pelvic floor muscle function, including tone, maximal strength, contraction speed, coordination and endurance, was assessed with the dynamometric speculum. Validated questionnaires were used to evaluate secondary variables. Mann-Whitney tests were used to compare the two groups on muscular, urogynecological, sexual, psychological and social variables (!=0.050). Results: Concerning pelvic floor muscle function, survivors with dyspareunia demonstrated higher tone at a minimal vaginal aperture (p=0.018) and lower endurance (p=0.048) compared to asymptomatic women. Survivors also presented more fecal incontinence (p=0.005) and lower sexual function (p=0.004) compared to asymptomatic women. No differences were detected for psychological and social variables. Conclusion: The results of this exploratory study suggest impaired pelvic floor muscle function, notably higher tone and lower endurance, in endometrial cancer survivors with dyspareunia. Further studies are needed to confirm these findings. This preliminary evidence can be used as empirical data to better understand pelvic floor muscle impairments implicated in dyspareunia in this population.
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Jassi, Fabrício José [UNESP]. "Análise do Comportamento Eletromiográfico dos Músculos Estabilizadores Primários e a Relação com a Capacidade Física Funcional de Indivíduos Assintomáticos." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/87328.
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jassi_fj_me_prud.pdf: 1543331 bytes, checksum: 8ed02d93a413e228c19bad39b3100681 (MD5)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Contextualização: Observa-se na literatura que indivíduos assintomáticos podem não apresentar pré-ativação muscular de estabilizadores primários e não há estudos que apontem para os motivos da alteração no tempo de início de ativação muscular nessa população. Além disso, estudos preliminares em nosso laboratório mostraram que indivíduos assintomáticos apresentaram alterações em testes físicos e funcionais relacionados à capacidade de estabilização da região lombo-pélvica. Objetivo: Estudar o comportamento de pré-ativação dos músculos transverso do abdome/oblíquo interno (TrA/OI) e multífido lombar (ML), a capacidade de estabilização lombo-pélvica e a relação entre ambos. Metodologia: Foram selecionados 27 voluntários assintomáticos de ambos os sexos, com idades entre 20 e 28 anos (média = 23,85 ±2,21). Os voluntários foram submetidos a Testes Físicos Funcionais (TFF) para avaliar a capacidade de estabilização lombo-pélvica (Testes de Coordenação e Equilíbrio, Flexibilidade, Resistência e Comprimento e Força) e à Determinação de início de ativação muscular do TrA/OI e ML por meio da eletromiografia de superfície (EMG-S) durante movimento rápido de flexão do membro superior. Resultados: Embora a pré-ativação tenha sido o comportamento mais freqüente a ausência de pré-ativação do TrA/OI e ML ocorreu para alguns voluntários, sendo mais freqüente no músculo TrA/OI (26.6%) do gênero feminino. Nos TFF nenhum voluntário da amostra conseguiu obter valores de normalidade em todos os testes realizados e aqueles com maior número de voluntários com alteração foram: teste de flexibilidade do reto femoral e espinhais lombares, teste de enrolamento repetitivo do tronco, teste estático de resistência das costas de Sorensen e o teste de comprimento e força para o glúteo máximo. Entretanto, somente o teste de enrolamento...
Contextualization: It is observed in the literature that asymptomatic individuals may not have muscular pre-activation of primary stabilizers and there are no studies that point to the reasons for the change in time of onset of the muscle activation in this population. Furthermore, preliminary studies in our laboratory showed that asymptomatic individuals presented alterations in physical and functional tests with relationship the capacity of lumbo-pelvic stabilization. Objective: The study of pre-activation behavior of transversus abdominis/internal oblique muscle (TrA/OI) and lumborum multifidus (ML), the lumbo-pelvic stabilization capacity and the relationship of both. Methodology: Were selected 27 asymptomatic individuals of both sexes, with age between 20 e 28 years (mean = 23,85 ±2,21). The volunteers were submitted to a Physical Functional Tests (FFT) to evaluate a lumbo-pelvic stabilization capacity (coordination tests, balance, flexibility, endurance, length and force) and the determination of muscle activation onset of the TrA/OI and ML with superficial electromyography (EMG-S) during fast flexion arm movement. Results: Although pre-activation has been a usual result, the pre-activation absent of TrA/OI and ML happened in some volunteers, being more frequent for TrA/OI (26.6%) in the female gender. At TFF neither volunteers of the sample get regular scores in all tests executed. Those tests with more number of alterations were: rectus femoris and spinal lumbar flexibility, Sorensen static back endurance, and length and force to gluteus maximus. However, only repetitive trunk curl test showed great sensibility and specificity value with the primary stabilizers behavior of pre-activation
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Pereira, Larissa Carvalho 1983. "Fatores que interferem na contratilidade dos músculos do assoalho pélvico e na sua coativação com os músculos transverso abdome/oblíquo interno durante o ciclo vital feminino = estudo eletromiográfico = Factors that interfere on the contractility of the pelvic floor muscle and in its coactivation with the transversus abdomen/internal oblique during the female life cycle : electromyographic study." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312549.
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Orientadores: Cássio Luís Zanettini Riccetto, Simone BotelhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O assoalho pélvico (AP) feminino é uma estrutura complexa e vulnerável, suscetível a uma série de alterações funcionais ao longo da vida. Ampliar o conhecimento sobre esta estrutura poderia prevenir ou mesmo tratar tais disfunções. Objetivo: (1) Avaliar e comparar a contratilidade dos músculos do assoalho pélvico (MAP) em diferentes fases do ciclo vital feminino: nuligestas; primigestas; puérperas primíparas; climatéricas e pós-menopausadas. (2) Correlacionar a contratilidade dos MAP e sua coativação a partir da contração dos músculos transverso abdome/oblique interno (TrA/OI) com os fatores: idade; prática de atividade física; gestação; Índice de Massa Corpórea (IMC); paridade; presença e severidade dos sintomas urinários. Métodos: 331 mulheres participaram do estudo e foram avaliadas através dos questionários: International Consultation on Incontinence Questionnaire - Short Form (ICIQ UI-SF) e International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) para estudo dos sintomas urinários e eletromiografia (EMG) dos MAP para avaliação da contratilidade. Destas mulheres 92 foram submetidas também à EMG dos músculos TrA/OI e analisadas de acordo com os fatores propostos para estudar a influenciar da contratilidade na coativação. Resultado: Entre os grupos estudados, as nuligestas apresentam maior contratilidade (46.59±16.83?V) dos MAP, seguido do grupo das primigestas (35.31±18.22?V), puérperas de parto cesariana (33.28±13.00?V), puérperas de parto vaginal (31.23±16.12?V), climatéricas (25.81±17.57?V) e pós menopausadas (21.23±15.11?V). Houve correlação negativa entre a contratilidade dos MAP e a idade (p<0.0001), paridade (p<0.0001), ICIQ-SF (p=0.0001) e ICIQ OAB (p=0.0006). Não foi verificada correlação entre MAP e IMC (p=0.1348) e as mulheres que praticam atividade físca apresentam maior contratilidade dos MAP (p=0.03). Sobre os fatores que podem interferir na coativação foram significativos: a gestação (p=0.01), prática de atividade física (p=0.03) e altos valores do escore do ICIQ IU SF (p<0.0001). Em análise multivariada a atividade física juntamente com ICIQ IU SF influenciaram a contratilidade dos MAP e TrA/OI (p<0.001). Conclusão: A contratilidade dos MAP durante o ciclo vital feminino apresenta-se na seguinte ordem decrescente: nuligestas, primigestas, primíparas pós parto cesariana, primíparas pós parto vaginal, climatéricas e pós menopausadas. Os MAP apresentam sua contratilidade correlacionada inversamente com a idade, paridade, e escores do ICIQ SF e ICIQ OAB. A coativação entre o TrA/OI e os MAP é influenciada diretamente pela atividade física, e inversamente pela gestação e ICIQ IU SF. Em análise multivariada, verificou-se que, conjuntamente, a coativação é influenciada diretamente pela prática de atividade física e inversamente pelo escore ICIQ IU SF
Abstract: The female pelvic floor (PF) is a complex and vulnerable structure, susceptible to a number of functional changes throughout life. Increasing the knowledge of this structure could prevent or even treat such disorders. Objective: (1) To evaluate and compare the contractility of the pelvic floor muscle (PFM) at different stages of the female life cycle: nulliparous; primigravidae; primiparous postpartum women; climacteric and menopause. (2) To correlate the contractility of the PFM and their coactivation from the contraction of the transversus abdomen muscles/ internal oblique (TrA/IO) with the following factors: age; physical activity; pregnancy; Body Mass Index (BMI); parity; presence and severity of urinary symptoms. Methods: 331 women were evaluated through questionnaires: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-UI SF) and International Consultation on Incontinence Questionnaire Overactive Bladder (OAB-ICIQ) for study of urinary symptoms and PFM electromyography (EMG) for contractility assessment. Of these women 92 were also submitted to the TrA EMG / IO muscles and analyzed according to the proposed factors to study the influence of contractility in coactivation. Results: Among the groups, the nulliparous have greater contractility (46.59 ± 16.83_V) of PFM, followed by the group of first pregnancy (35.31 ± 18.22_V), cesarean birth mothers (33.28 ± 13.00_V), vaginal birth mothers (31.23 ± 16.12_V), weather (25.81 ± 17.57_V) and postmenopausal (± 15.11_V 21:23). There was a negative correlation between the contractility of PFM and age (p <0.0001), parity (p <0.0001), ICIQ-SF (p = 0.0001) and ICIQ OAB (p = 0.0006). There was no correlation between the contractility of PFM and BMI (p = 0.1348). Women who practice physical activity have greater contractility of PFM About the factors that can interfere with coactivation were significant: pregnancy (p = 0.01), physical activity (p = 0.03) and high values of the ICIQ UI SF score (p<0.0001). In multivariate analysis, physical activity along with ICIQ UI SF influence the contractility of PFM and TrA/IO (p<0.001). Conclusion: The contractility of PFM during the female life cycle is presented in the following descending order: nulliparous, primiparous, primiparous after cesarean delivery, primiparous after vaginal delivery, climateric and postmenopausal. The PFM present their contractility inversely correlated with age, parity, and scores of ICIQ SF and ICIQ OAB. The co-activation between the TrA /IO and PFM is directly influenced by physical activity, and inversely by pregnancy and ICIQ UI SF. In multivariate analysis, it was found that, together, the co-activation is directly influenced by physical activity and inversely by ICIQ UI SF score
Doutorado
Fisiopatologia Cirúrgica
Doutora em Ciências
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Pereira, Larissa Carvalho 1983. "Impacto da gestação e do parto na sinergia entre os musculos transverso do abdome/obliquo interno e o assoalho pelvico = avaliação eletromiografica." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312345.
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Orientadores: Cassio Luiz Zanettini Riccetto, Simone Botelho PereiraDissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas
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Resumo: Introdução e objetivos: Os exercícios dos músculos do assoalho pélvico e do abdome devem ser minuciosamente avaliados e orientados para que, através da sinergia, haja aperfeiçoamento na qualidade dos exercícios e se conheça as reações desencadeadas durante a realização dos mesmos. É de grande importância entender a sinergia do recinto abdomino pélvico em diferentes fases da vida feminina, como na gestação e puerpério, pois, nestas fases surgem grandes alterações na musculatura abdominal e do assoalho pélvico, necessitando de maior atenção para que os exercícios sejam realmente eficazes. Sendo assim, este estudo observacional, teve como objetivo a avaliação eletromiográfica simultânea dos músculos transverso do abdome e do assoalho pélvico, durante exercícios comumente realizados por mulheres em fase gestacional e/ou puerperal. Métodos: Este estudo, clínico, prospectivo, observacional e controlado foi constituído de 81 mulheres, com idade média de 23,56 anos (DP=4,82), as quais foram divididas em quatro grupos: Grupo (A): 20 nulíparas; Grupo (B): 25 primigestas, com idade gestacional maior ou igual à 24 semanas; Grupo (C): 19 puérperas em fase remota (40 a 60 dias), pós parto vaginal; Grupo (D): 17 puérperas em fase remota (40 a 60 dias), pós parto cesariana. Inicialmente foi realizado a avaliação funcional do assoalho pélvico (AFA) e posteriormente o probe endovaginal foi posicionado. A atividade elétrica dos músculos abdominais e do assoalho pélvico foi registrada simultaneamente por eletromiografia de superfície. As contrações solicitadas do assoalho pélvico e do abdome foram máximas, voluntárias e repetidas três vezes, sendo as contrações do abdome do tipo isométrico e isotônico. Os resultados obtidos foram submetidos à análise de variância (ANOVA) com aplicação de Teste Contrastes Ortogonais através do programa estatístico "R", da R Development Core Team (2008). Os contrastes realizados foram: Contraste 1- Nulíparas versus demais grupos; Contraste 2- Gestantes versus Puérperas e Contraste 3- Puérperas pós parto vaginal versus Puérperas pós parto cesariana. O nível de significância adotado foi abaixo de 1%. Resultados: Durante os exercícios para o assoalho pélvico, foi mostrada significância da sinergia abdominal das mulheres nulíparas (p=0,0007) quando comparadas aos outros grupos. Os demais contrastes realizados para verificação da sinergia durante exercício do assoalho pélvico não apresentou significância (p=0,4509 e p=0,2786). Ao realizar o exercício abdominal do tipo isométrico, as nulíparas mostraram valores significativos ao serem comparadas aos demais grupos estudados (p=0,00001). Entretanto, quando os outros grupos foram comparados entre si, não houve significância (p=0,7949 e 0,9633). Quando solicitado o exercício abdominal isotônico, as nulíparas se mostraram sinérgicas quando comparadas às demais mulheres em fases específicas (p=0,00002) o que não ocorreu nas demais comparações (p=0,8355 e p=0,4662). Conclusão: Há sinergia entre os músculos transverso do abdome/oblíquo interno e o assoalho pélvico em mulheres, jovens, nulíparas e saudáveis. Mulheres em fase gestacional e puerperal remota não apresentam co-ativação dos músculos transverso do abdome/oblíquo interno e do assoalho pélvico, independente do tipo de parto e exercício solicitado
Abstract: Introduction and objectives: Pelvic floor and abdominal muscles exercises must be carefully evaluated and coached so that throughout synergy there can be improvement of the quality of the exercises as well as a greater knowledge of the reactions produced during their execution. It is of great importance to understand the synergy of the abdominal-pelvic area during the different stages of the women such as gestation and puerperium, since in those phases there are many and great alterations of the abdominal and pelvic floor muscles that require more attention during exercises executions resulting in real efficacy. This observational study had as objective to evaluate through simultaneous electromyography the transversus abdominis, obliquous internus and pelvic floor muscles during commonly used exercises performed by women in gestational and/or puerperal phases. Methods: This is a clinical, observational, prospective and controlled study which was composed of 81 women with a mean age of 23. 56 years old (SD=4,82) who were divided into 4 groups: Group (A): 20 nulliparous; Group (B): 25 primiparous with gestational age superior or equal to 24 weeks; Group(C): 19 in late puerperal phase (40-60 days) after vaginal delivery; Group (D): 17 in late puerperal phase (40- 60 days) after cesarean delivery. The Functional Pelvic Floor Evaluation (AFA) was made prior to the endovaginal probe positioning. The electric activity of the abdominal and pelvic floor muscles was simultaneously recorded through surface electromyography. The requested contractions of those muscles were maximum, voluntary and performed for three times, being both isometric and isotonic. The results were analyzed by ANOVA (analysis of variance) with Orthogonal Contrast Test using the statistic program "R" from R Development Core Team (2008). The used contrasts were: Contrast 1: Nulliparous versus other groups; Contrast 2-Pregnant versus Puerperals and 3-After Vaginal Delivery Puerperals versus After Cesarean Delivery Puerperals. The significance level was below 1%. Results: During exercises of the pelvic floor muscles, there was a synergic response of the abdominal muscles in the nulliparous group (p=0,0007) when compared to the other groups. There was no significance for the other contrasts regarding pelvic floor muscles exercises (p=0,4509 and p=0,2786). There were significant values for the nulliparous women during isometric abdominal exercise when compared to the other groups (p=0,00001). However when the other groups were compared among each other, there were no significant values (p=0,7949 and 0,9633). During isotonic abdominal exercise, the nulliparous women showed synergy when compared to the other women who were in specific stages (p=0,00002). It did no happen with other comparisons (p=0,8355 and p=0,4662). Conclusão: There is synergy among transversus abdominis, obliquous internus and pelvic floor muscles in young, nulliparous and healthy women. Pregnant and late puerperal women do not present co-activation of the transversus abdominis, obliquous internus and pelvic floor muscles, independently of the delivery mode
Mestrado
Pesquisa Experimental
Mestre em Cirurgia
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Brown, Cindy Christine. "Reliability of electromyography detection systems for the pelvic floor muscles." Thesis, Kingston, Ont. : [s.n.], 2007. http://hdl.handle.net/1974/948.
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Souza, Samantha de Miranda Ferreira 1984. "Treinamento dos músculos do assoalho pélvico de mulheres em idade reprodutiva = avaliação funcional e sexual = Pelvic floor muscles training of women in reproductive age: functional and sexual evaluation." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311585.
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Orientadores: Paulo César Giraldo, Rose Luce Gomes do AmaralDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: O treinamento dos músculos do assoalho pélvico (TMAP) é uma técnica amplamente utilizada pela fisioterapia com o objetivo de aumentar a força muscular, aumentar o fluxo sanguíneo local e a mobilidade pélvica, além de informar a mulher sobre a sua anatomia e melhorar a conscientização corporal. O treinamento com esse foco poderia influenciar de maneira positiva a função dos músculos do assoalho pélvico (MAP) e a função sexual feminina. Objetivo: Avaliar as funções muscular e sexual feminina pré e pós TMAP de mulheres em idade reprodutiva sem disfunção uroginecológica e/ou sexual. Métodos: Ensaio clínico incluindo 68 mulheres nulíparas em idade reprodutiva sem disfunção uroginecológica e/ou sexual. A função dos MAP foi mensurada pré e pós TMAP pelas pressões intravaginais, potencial eletromiográfico de superfície (sEMG) e palpação bidigital. A função sexual foi avaliada pré e pós TMAP pelo questionário Female Sexual Function Index (FSFI) que enfatiza seis domínios (desejo, excitação, lubrificação, orgasmo, satisfação sexual e dor). O TMAP foi realizado em grupo, uma vez por semana durante 8 semanas, com 45 minutos de duração, usando 11 diferentes posições. Para cada posição foram solicitadas 5 contrações tônicas sustentadas por 6 segundos com igual tempo de relaxamento entre cada contração e 5 contrações fásicas, totalizando 110 contrações a cada sessão. As voluntárias foram orientadas a realizar em casa 30 contrações todos os dias da semana. Resultados: Foram observadas diferenças significativas ao compararmos os valores máximos das avaliações das pressões intravaginais pré e pós TMAP das contrações fásicas 41,7±13,7 vs. 47±14 (p=0,0023), tônicas de 10 segundos 42,7±13,8 vs. 47,7±15 (p=0,0085) e tônicas de 60 segundos 42,1±13 vs. 47,5±14,5 (p=0,0013) respectivamente. Também foram observadas diferenças significativas nos valores máximos do sEMG das avaliações pré e pós TMAP das contrações fásicas 27,7±11,2 vs. 31,3±12,6 (p=0,0009), tônicas de 10 segundos 27,7±10,9 vs. 31,5±13,6 (p=0,0017), tônicas de 60 segundos 28,6±11,8 vs. 31,1±13 (p=0,0232) e tempo de contração em segundos 41,7±22,1 vs. 49,3±27,7 (p=0,0252) respectivamente. Foram encontradas diferenças significativas pré e pós TMAP no escore total do FSFI 29,8±3,7 vs. 31,9±2,7 (p<0,0001) e nos domínios desejo 4,4±0,9 vs. 4,7±0,8 (p=0,0076), excitação 4,8±0,8 vs. 5,2±0,5 (p=0,0001), lubrificação 5,2±0,8 vs. 5,5±0,5 (p=0,0140) e orgasmo 4,5±1,4 vs. 5,3±0,9 (p<0,0001) respectivamente. Conclusão: O TMAP aumenta a função dos MAP e melhora a função sexual de mulheres em idade reprodutiva sem disfunção uroginecológica e/ou sexual
Abstract: Introduction: Pelvic floor muscles training (PFMT) is a technique widely used for physical therapy in order to increase muscle strength, increase local blood flow and pelvic mobility and inform women about their anatomy and improve awareness body. Training with this focus could positively influence the function of the pelvic floor muscles (PFM) and female sexual function. Objective: To evaluate the muscular function and female sexual function pre and post PFMT of women of reproductive age without urogynecologic and/or sexual dysfunction. Methods: A clinical trial including 68 nulliparous women of reproductive age without urogynecologic and/or sexual dysfunction. The function of the PFM was measured before and after the PFMT intravaginal pressures, potential surface electromyography (sEMG) and palpation bidigital. Sexual function was assessed before and after the PFMT the survey Female Sexual Function Index (FSFI) that emphasizes six domains (desire, arousal, lubrication, orgasm, sexual satisfaction, and pain). The PMAT group was performed once a week for 8 weeks, with 45 minutes using 11 different positions. For each position were requested 5 tonic contractions sustained for 6 seconds with equal relaxation time between contractions and 5 phasic contractions, totaling 110 contractions each session. The volunteers were instructed to perform 30 contractions at home every day of the week. Results: Significant differences were observed when comparing the maximum rating of intravaginal pressure pre and post PFMT of phasic contractions 41.7±13.7 vs. 47±14 (p=0.0023), tonic contractions of 10 seconds 42.7±13.8 vs. 47.7±15 (p=0.0085) and tonic of 60 seconds 42.1±13 vs. 47.5±14.5 (p=0.0013) respectively. There were also significant differences in the maximum values of sEMG pre and post PFMT of phasic contractions 27.7±11.2 vs. 31.3±12.6 (p=0.0009), tonic contractions of 10 seconds 27.7±10.9 vs. 31.5±13.6 (p=0.0017), tonics of 60 seconds 28.6±11.8 vs. 31.1±13 (p=0.0232) and contraction time in seconds 41.7±22.1 vs. 49.3±27.7 (p=0.0252), respectively. There were significant differences pre and post PFMT in total score FSFI of 29.8±3.7 vs. 31.9±2.7 (p<0.0001) and in those areas desire 4.4±0.9 vs. 4.7±0.8 (p=0.0076), arousal 4.8±0.8 vs. 5.2±0.5 (p=0.0001), lubrication 5.2±0.8 vs. 5.5±0.5 (p=0.0140) and orgasm 4.5±1.4 vs. 5.3±0.9 (p<0.0001) respectively. Conclusion: The PFMT increases the function of PFM and improves sexual function in women of reproductive age without urogynecologic and/or sexual dysfunction
Mestrado
Fisiopatologia Ginecológica
Mestra em Ciências da Saúde
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Burnet, Evie Neff. "Frontal Plane Pelvic Drop in Runners: Causes and Clinical Implications." VCU Scholars Compass, 2008. http://hdl.handle.net/10156/1872.
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Basanelli, Renata. "Estudo eletromiografico de musculos da pelve na manutenção do equilibrio ortostatico." [s.n.], 1997. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289217.
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Orientadores: Heloisa Amelia de Lima Castro, Fausto BérzinDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicabaca
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Resumo: Este trabalho visa registrar a atividade eletromiográfica dos músculos íliocostallombar (ICL), glúteo máximo (GM), reto do abdome (RA) e reto da coxa (RC) na postura ereta relaxada normal e com as alterações provocadas por elevações nos calcanhares, como ocorre com uso de sapatos de salto, de 2,0, 4,0, 6,0 e 11,0 cm. Para registro dos exames utilizou-se um eletromiógrafo VIKING II de 8 canais, com eletrodos de superficie tipo Beckman, em 10 voluntários"do sexo masculino, na faixa etária entre 16 e 25 anos, sem nenhuma alteração postural considerada patológica. Esta condição foi respeitada com a obtenção da história clínica e exame fisico dos voluntários com uso de um espondilômetro. Os resultados, submetidos a . análise gráfica descritiva a partir da média dos valores de RMS e análise, estatística não paramétrica, mostram que: o m. ICL apresenta-se mais ativo nas posições em que os voluntários estão em pé relaxados sem elevação nos calcanhares e com elevação nos mesmos de 2 cm e menos ativo com os indivíduos utilizando 6 cm de altura de plataforma. O m. GM produziu atividade elétrica relativamente constante em todas as posições, sendo a maior na posição de 11,0 cm de plataforma e a menor com 4,0 cm. Com relação ao m. RC, nas plataformas 11,0 e 6,0 cm apresentou maior atividade ellétrica e a menor na plataforma 4,0 cm. O m. RA prod1J1Ziu atividade eletromiográfica média e crescente à medida em que a plataforma era aumentada de 0,0 para 2,0, depois 4,0, 6,0 e fmalmeNte 11,0 cm de altura. Com esses resultados analisados pudemos concluir que, dos milisculos estudados o mais ativo é o ICL e o menos solicitado é o GM, na postura ereta relaxada, sendo comprovada a importância de todos os músculos estudados nesta posição. A condição que exige menor consumo energético é com uso da plataforma (salto) de 4,0 cm, não sendo portanto a ausência de elevação (salto zero) a melhor para o descanso na, postura ortostática relaxada
Abstract: This task intends to registers the eleetromyographie aetivity of the muscles ilioeostalis lumbar (ICL), gluteus maximus (GM), reetus abdominis (RA) and reetus femoris (RF) in the normal upright postural relaxed and with the alterations provoked by rises on the heels, as it happens when wearing high heels shoes, of 2,0, 4,0, 6,0 e 11,0 eentimeters. For that utilized an eleetromyography VIKING 11 with 8 ehanels, with surfaee eleetrodes Beekman to registrate the eJÇames in 10 subjeets, between 16 and 25 yers old, with no postural ehange eonsidered pathologie. This eondition was respeeted with the obtainment of the elinieal history and phisieal exame of the subjéets using one espondilometer. The results, submeted the graphie analises deseriptive after the average of -the values RMS and statistie analyses no parametrie, show that, the m. ICL shows more aetive in the positions where the people are up relaxed without elevations in the heels and with elevation in 2 em and less aetive with the people wearing 6 em of high on the plataform. The m. GM produeed eleetrieal aetivity relatively eonstant in alI position, being the biggest in the positon 11,0 em of platform and the smalIest with 4,0 em. As for the m. RF, on the platform 11,0 and 6,0 em apresented more eleetrieal aetivity and the least on the platform with 4,0 em . The m. RA produeed eleetromygraphie aetivity average and crescent according to the platfmID was being elevated fi;om 0,0 to 2,0, after 4,0 and 6,0 and fmaIJy increased 11,0 cm of high. With these results analysed we could drow that, with the muscles studied the most active is the ICL and the less solicited is GM, in the upright postural relaxed, being confumed the importance of all; musdes studied in this position. The conditionthat require less energetic consume is with the use of platform with 4,0 cm, not being therefore the absence of elevation (zero) the best for the rest in upright position
Mestrado
Biologia e Patologia Buco-Dental
Mestre em Ciências
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Monteiro, Renan Lima. "Há diferença na atividade do músculo glúteo médio em diferentes posições de quadril durante o exercício inclinação da pelve?" Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-23112015-161510/.
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Exercícios de inclinação da pelve (\"pelvic drop\") são frequentemente utilizados para o fortalecimento do músculo glúteo médio com o objetivo de aumentar ou priorizar o seu recrutamento. No entanto, o efeito da rotação do quadril no desempenho da ação do glúteo médio é desconhecido. O objetivo do estudo foi avaliar o efeito da rotação do quadril no recrutamento do músculo glúteo médio, tensor da fascia lata e quadrado lombar. Dezessete sujeitos saudáveis executaram o exercício de inclinação pélvica com o rotação de quadril lateral (IPRL), medial (IPRM) e neutro (IPN). A atividade eletromiográfica dos músculos glúteo médio (GM), tensor da fáscia lata (TFL) e quadrado lombar (QL) foram avaliadas por meio da eletromiografia de superfície. Os resultados demonstraram aumento significativo na ativação do GM com rotação medial e posição neutra quando comparados com a rotação lateral. Em relação à rotação medial e neutra não houve diferença. A razão GM/TFL não foi diferente em nenhum dos posicionamentos analisados. Em relação à razão GM/QL houve um aumento significativo da ativação muscular em rotação medial e neutra. Exercícios de inclinação pélvica são mais eficientes para ativar o glúteo médio quando o quadril está em rotação medial e posição neutraPelvic drop exercises are often used to strengthen the gluteus medius muscle with the aim of increasing or prioritizing its recruitment. However, the effect of hip rotation on the performance of the action of the gluteus medius is unknown. The aim of the study was to evaluate the effect of hip rotation on the recruitment of the gluteus medius muscle, tensor fasciae latae and quadratus lumborum. Seventeen healthy subjects performed pelvic drop exercises with lateral (PDLR), medial (PDMR) and neutral (PDN) rotation of the hip. The electromyographic activity of the gluteus medius muscle (GM), tensor fasciae latae (TFL) and quadratus lumborum (QL) were evaluated using surface electromyography (sEMG). The results showed significant increases in activation of the GM with medial and neutral rotation compared with lateral rotation. There was no difference between medial and neutral rotation. The GM/TFL ratio was the same in all analyzed positions. Regarding the GM/QL ratio, there was a significant increase in muscle activation in the medial and neutral rotation. Pelvic drop exercises are more efficient for activating the gluteus medius when the hip is in medial rotation and neutral position
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Nyangoh, Timoh Krystel. "Musculature et innervation pelvi-périnéale en dissection anatomique assistée par ordinateur." Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLS128.
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Résumé : Introduction : Parmi les structures anatomiques impliqués dans la statique pelvienne, la continence urinaire et anale, le muscle élévateur de l’anus (MEA), le sphincter urétral (SU) et son innervation ont un rôle déterminant. Au cours de la grossesse, de l’accouchement par voie vaginale, de la chirurgie radicale pelvienne, des lésions des muscles du plancher pelvien ou de son innervation peuvent survenir. Ces lésions sont à l’origine de dysfonctions du plancher pelvien telle que le prolapsus uro-génital ou l’incontinence urinaire. Une meilleure connaissance de l’anatomie musculaire et nerveuse pelvi-périnéale est nécessaire pour diminuer la survenue et traiter ces troubles fonctionnels. Classiquement les muscles du plancher pelvien sont décrits comme entièrement striés sous contrôle somatique (nerf du MEA et/ou nerf pudendal (NP)). La dissection Anatomique Assisté par Ordinateur (DAAO) en utilisant des marqueurs nerveux et musculaires spécifiques peut aujourd’hui compléter les données établies par la dissection conventionnelle classique de sujets anatomiques.Objectif : L’objectif était de décrire l’innervation (origine, topographie, trajet, rapports, fonction) et la structure musculaire du MEA, de décrire l’innervation (origine, topographie, trajet, rapports, fonction) du sphincter urétral pour mettre en perspective les implications potentielles dans les dysfonctions du plancher pelvien.Méthodes : Nous avons étudié 9 fœtus humains (6 féminins et 3 masculins). Des coupes histologiques sériées de 5 µm d’épaisseur ont été effectuées dans les régions pelviennes de 7 fœtus âgés de 18 à 40 semaines de gestation. Pour chaque niveau de coupe, des lames ont été colorées puis traitées en immunohistochimie pour détecter : l’ensemble des fibres nerveuses (anticorps anti-protéine S100), les fibres autonomes cholinergiques (anti-VAChT), les fibres autonomes adrénergiques (anti-TH), les fibres autonomes nitrergiques (anti-nNOS), les fibres somatiques (anti-PMP 22), les fibres sensorielles (anti-CGRP), les fibres musculaires lisses (anti-SMA) et les fibres musculaires striées (anti-MYOG). Les coupes ont ensuite été numérisées par un scanner de haute résolution optique et les images ont été reconstruites en 3D avec le logiciel Winsurf®. Un fœtus additionnel a été entièrement destiné à réaliser de la microscopie électronique afin de confirmer nos résultats au niveau architectural musculaire.Résultats : Nous avons observé une innervation à la fois autonome (plexus hypogastrique inférieur (PHI)) et somatique (nerf du MEA et NP) du MEA. Nous avons individualisé des zones de cellules musculaires lisses au sein du plancher pelvien notamment de la partie médiane sous contrôle autonome (PHI) que nous nommons « compartiment médian musculaire lisse ».Nous avons systématisé le plancher pelvien musculaire en une zone médiale lisse sous contrôle nerveux autonome réalisant une interface entre les viscères pelviens, et une zone musculaire striée latérale sous contrôle nerveux somatique.Enfin, nous avons mis en évidence une double innervation à la fois somatique et autonome du sphincter urétral.Conclusion : La DAAO a permis de mettre en évidence une innervation pelvi-périnéale complexe avec l’intrication du système nerveux somatique et autonome. La fonction du contingent musculaire lisse pelvien reste à préciserAbstract : Levator ani muscle (LAM), urethral sphincter (US), and their innervation play a major role in pelvic status, urinary continence and anal continence. During pregnancy, vaginal delivery, pelvic radical surgery, damage of pelvic floor muscles or of their innervation may occur. These lesions are responsible for pelvic floor dysfunction such as urogenital prolapse or urinary incontinence. Better knowledge of pelvi-perineal muscle and nerve anatomy is needed to reduce the occurrence and treat these pelvic floor dysfunctions. Classically pelvic floor muscles are described as entirely striated under somatic control (levator ani nerve (LAN) and /or pudendal nerve (PN)). Computer Assisted Anatomical Dissection (CAAD) using specific nerve and muscle markers can nowadays complete data established by conventional dissection of anatomical subjects.The objective was to describe the innervation and the muscular structure of the levator ani muscle, to describe nerve supply of the urethral sphincter in order to better understand pelvic floor dysfunction.Methods : We studied nine human fetuses (6 female and 3 male). Serial histological sections of 5 μm of thickness were performed in the lumbar and pelvic regions of seven human fetuses aged 18 to 40 weeks of gestation. For each level, slides were stained and then treated in immunohistochemistry to detect: general nerve fibers (anti-protein S100), autonomic cholinergic fibers (anti-VAChT), autonomic adrenergic fibers (anti-tyrosine hydroxylase), autonomic nitrergic fibers (anti-nNOS), somatic nerve fibers (anti-peripheral myelin protein 22), sensory fibers (anti-CGRP), smooth muscle fibers (anti-SMA) and striated muscle fibers (anti-MYOG). The slides were then digitized by a high-resolution optical scanner and the images were reconstructed in 3D using the Winsurf® software. One fetus was entirely reserved for electronic microscopy in order to confirm our results.Results: We observed that LAM innervation is supplied by both autonomic (inferior hypogastric plexus (IHP)) and somatic (LAN and PN). We have individualized areas of smooth muscle cells in the pelvic floor, particularly the median part controlled by the autonomic system that we named “smooth muscle medial compartment”.We systematized within the pelvic floor muscle a smooth medial part under an autonomic nervous control as interface between the pelvic viscera and a lateral striated muscle part under somatic nervous control.Finally, we have demonstrated a dual innervation both somatic and autonomic sphincter urethral.Conclusion : CAAD has demonstrated complex pelvic-perineal innervation with the interaction of the somatic and autonomic nervous system. The function of the pelvic smooth muscle contingent remains to be clarified
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Alves, Fabiola Kenia 1987. "O efeito de um programa de treinamento dos músculos do assoalho pélvico realizado em grupo para mulheres na pós-menopausa = The effect of a pelvic floor muscle training performed in group to postmenopausal women." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313088.
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Orientadores: Simone Botelho Pereira, Cássio Luís Zanettini RiccettoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O processo de envelhecimento é um dos principais fatores de disfunções uroginecológicas. O treinamento dos músculos do assoalho pélvico (TMAP) é o método de primeira escolha para o tratamento de incontinência urinária e também recomendado para a prevenção e tratamento de prolapsos dos órgãos pélvicos. O objetivo deste estudo foi avaliar o efeito de um programa de TMAP em grupo sobre a contratilidade muscular em mulheres na pós-menopausa, assim como sobre a presença de sintomas urinários e prolapsos de órgãos genitais. Métodos. Foi realizado um ensaio clínico, randomizado, controlado e cego com 30 mulheres na pós-menopausa (idade média de 65.93 ±8.76 anos), divididas em dois grupos: Resumo: Grupo Tratado (n=18) e Grupo Controle (n=12). A avaliação foi realizada antes e após o tratamento em ambos os grupos e consistiu de palpação vaginal (Escala Modificada de Oxford), eletromiografia de superfície dos músculos do assoalho pélvico, avaliação da presença de prolapsos dos órgãos pélvicos e avaliação de sintomas miccionais e vaginais por meio da aplicação dos questionários validados: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-UI SF); International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) e International Consultation Questionnaire on Vaginal Symptoms (ICIQ-VS). O protocolo de tratamento consistiu de 12 sessões em grupo de 8-10 participantes, duas vezes na semana, por 30 minutos, totalizando seis semanas. Foram utilizados para análise estatística os Testes ANOVA, Teste de Comparação múltipla de Tukey, Teste de Wilcoxon e Teste Perfil de Contrastes. Resultados. A contratilidade dos músculos do assoalho pélvico aumentou significativamente depois do programa de treinamento tanto na eletromiografia (p=0.003) quanto na palpação digital (p=0.001). Houve decréscimo do escore do questionário ICIQ-OAB apenas no grupo tratado (p<0.001) com diferença significativa entre os grupos através do tempo (p=0.002). Houve decréscimo do escore do questionário ICIQ-UI SF com diferença significativa entre o grupo controle e o grupo tratado depois do tratamento (p=0.03). O grau do prolapso anterior também diminuiu apenas no grupo tratado (p=0.03). Não foram encontradas diferenças significativas no grau do prolapso posterior e no questionário ICIQ-VS. Conclusão. O programa de TMAP em grupo foi eficaz para o aumento da contratilidade muscular, diminuição da gravidade do prolapso de parede anterior e dos sintomas urinários em mulheres na pós-menopausa.
Abstract: Introduction. The aging process is one of the major reasons for urogynecological dysfunctions. Pelvic floor muscle training (PFMT) is the method chosen in the first place for the treatment of urinary incontinence, also indicated for the prevention and treatment of the pelvic organs' prolapses. The aim of this study was to evaluate the effects of a group pelvic floor muscle training program on post-menopausal women's pelvic floor muscle contractility , as well as on the presence of urinary symptoms and genital organ prolapses. Methods. A clinical, randomized, controlled and assessor-blinded study was conducted with 30 post-menopausal women (mean age 65.93 ±8.76 years), divided into two groups: Treatment Group (n=18) and Control Group (n=12). The evaluation was carried out using digital palpation (Modified Oxford Grading Scale), pelvic floor surface electromyography (sEMG), the Pop-Q System to evaluate the presence of pelvic organ prolapse using validated questionnaires: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-UI SF); International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and International Consultation Questionnaire on Vaginal Symptoms (ICIQ-VS). The treatment protocol consisted of 12 group sessions, with 8-10 participants, carried out by a physiotherapist (main investigator), twice a week, with 30 minutes of duration each, totaling six weeks. The statistical analysis was performed using ANOVA, Tukey¿s Multiple Comparison Test, McNemar¿s Test and the Contrast Profile Test. Results. The pelvic floor muscle contractility increased after the training program, assessed by sEMG (p=0.003) and by vaginal palpation (p=0.001). There was a decrease in the ICIQ-OAB scores only in the treated group's final evaluation (p<0.001) with a significant difference between the groups along the time (p=0.002). There was a decrease in the ICIQ-UI SF scores (p=0.03) between the treated and control groups after the treatment. There was a significant decrease in the anterior pelvic organ prolapse (p=0.03) in the treated group. No significant differences were found in the posterior pelvic organ prolapse and the ICIQ-VS scores. Conclusion. Group pelvic floor muscle training program is an effective way to increase the pelvic floor muscle contractility and to decrease the anterior pelvic organ prolapse as well as urinary symptoms in post-menopausal women.
Mestrado
Fisiopatologia Cirúrgica
Mestra em Ciências
14
Piassarolli, Virginia Pianessole 1983. "Treinamento muscular do assoalho pelvico nas disfuncões sexuais femininas." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312361.
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Orientadores: Ellen Hardy, Maria Jose Duarte OsisDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivo: avaliar o efeito do treinamento dos músculos do assoalho pélvico (MAP) nas disfunções sexuais femininas. Sujeitos e Métodos: realizou-se um ensaio clínico com 26 mulheres que apresentavam diagnóstico de disfunção sexual (transtorno de desejo sexual, transtorno de excitação, transtorno orgástico e dispareunia) no período de fevereiro de 2008 a maio de 2009. Foi administrado um questionário denominado FSFI (Female Sexual Function Índex) para verificar a função sexual. A contração dos músculos do assoalho pélvico foi avaliada por meio da palpação vaginal (bi-digital) e, em seguida, realizou-se uma eletromiografia de superfície para avaliar amplitudes de contração. Tais procedimentos ocorreram previamente, na metade e após o tratamento. As mulheres realizaram exercícios para os músculos do assoalho pélvico em diferentes posições, uma ou duas vezes por semana, totalizando 10 sessões de tratamento. Na análise das variáveis ao longo do tempo, utilizou-se o teste não-paramétrico e o Anova de Friedman, o teste de Bonferroni e o teste de correlação de Spearman. Adotou-se um nível de significância de p<0,05 para análise dos dados. Resultados: Observou-se uma melhora significativa (p<0,0001) dos escores de todos os domínios e do escore total do FSFI ao final do tratamento quando comparadas a avaliação inicial e intermediária. Em relação a eletromiografia de superfície, as amplitudes das contrações fásicas e tônicas aumentaram significativamente (p<0,0001) ao longo do tratamento. Houve também um aumento na força do assoalho pélvico, com 69% das mulheres apresentando grau 4 ou 5 na avaliação final. Ao final do tratamento, a maioria das participantes (18) recebeu alta por não mais apresentar queixas relativas à função sexual. Conclusão: O treinamento dos MAP resultou em melhora na força e nas amplitudes da eletromiografia, acompanhadas de aumento significativo nos escores de função sexual, o que indica que essa abordagem terapêutica pode ser utilizada com sucesso no tratamento das disfunções sexuais femininas
Abstract:Objective: To evaluate the effect of pelvic floor muscle training in female sexual dysfunctions. Subjects and Methods: 26 women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and dyspareunia) were enrolled in a clinical trial, between February 2008 and May 2009. To evaluate the sexual function we used Female Sexual Function Index (FSFI) questionnaire. Bi-digital palpation was applied to assess muscle strength and surface electromyography to contraction amplitudes. The assessment was carried out before, during (after five sessions) and at the end of the treatment (after 10 sessions). The women underwent pelvic floor muscle training, once or twice a week, for 10 sessions in different positions. To analysis during the follow-up period, non parametric's and ANOVA's Friedman test, Bonferroni test and Spearman Correlation test were applied. Results were considered statistically significant if p<0.05. Results: All FSFI scores were higher (p<0.0001) at the end of the treatment in comparison with the values observed before and in the middle of the treatment. Regarding surface electromyography, tonic and phasic contractions amplitudes significantly increased over time (p<0.0001). Pelvic floor strength also increased in 69% of the women who had 4 or 5 grade in final evaluation. Eighteen participants had a total improvement of sexual complaints at the end of the treatment. Conclusions: The pelvic floor muscle training improved strength and surface electromyography amplitudes while the sexual function scores increased. This indicates that physiotherapy approach may be successfully used in the female sexual dysfunctions treatment
Mestrado
Tocoginecologia
Mestre em Tocoginecologia
15
Sousa, Vanessa de Oliveira [UNESP]. "Avaliação comparativa da força muscular do assoalho pélvico em mulheres nulíparas e primigestas." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/88903.
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sousa_vo_me_botfm.pdf: 391073 bytes, checksum: 91c75cb9e4d3a632ca89a3c865031c0c (MD5)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
O objetivo desse estudo foi avaliar a força dos músculos do assoalho pélvico (AP) em nulíparas e primigestas utilizando a avaliação subjetiva e objetiva. 100 mulheres com idade entre 20 e 30 anos foram estudadas prospectivamente. As participantes foram distribuídas em dois grupos: Grupo G1 (n=50) composto por mulheres nulíparas voluntárias saudáveis sem disfunções urinárias, Grupo G2 (n=50) por primigestas. Dados demográficos, como atividade física, foram obtidos utilizando questionário clinico. Avaliação subjetiva dos músculos do AP foi feita por palpação digital vaginal em duas porções (anterior e posterior). A avaliação objetiva da força dos músculos do AP foi realizada utilizando um perineômetro portátil (Dynamed DM-01) em três diferentes posições: em decúbito dorsal com membros inferiores estendidos (P1), decúbito dorsal com membros inferiores fletidos (P2) e sentada (P3). Esses parâmetros foram avaliados em um só momento no grupo G1 e na 20ª, 36ª semana de gestação e após 45 dias do parto em G2. Em G2, 14 mulheres foram excluídas por perda de seguimento. A média de idade foi de 23 anos em G1 e 22 em G2 (p>0,05). 84% das mulheres em G1 e 80% em G2, relataram orgasmo (p>0,05). Em G1, 54% apresentaram constipação intestinal e 50% em G2 (p>0,05). A atividade sexual foi significativamente maior em G2 (97%) quando comparado a G1 (84%). Na porção anterior, a avaliação feita por palpação digital vaginal da contração dos músculos do AP foi considerada normal em 52% das nulíparas (G1), em 39%, 22% e 25% na 20ª, 36ª semana de gestação e 45 dias após o parto, respectivamente em G2. Na porção posterior, a palpação digital vaginal foi normal em 76% de G1, em 67%, 36% e 44%, na 20ª, 36ª semana de gestação e 45 dias após o parto, respectivamente, em G2. Houve diferença...
The aim of this study was to assess pelvic floor muscle (PFM) strength in nulliparous and primiparous using subjective and objective evaluation. 100 women with age between 20 and 30 years were prospectively studied . Participants were distributed into 2 groups: Group G1 (n = 50) composed by voluntary healthy nulliparous women without urinary complaints; Group G2 (n = 50) by primiparous females. Demographic data, such as physical activity, was obtained using clinical questionnaire. Subjective evaluation of pelvic floor muscle (PFM) was performed using transvaginal digital palpation (TDP) into 2 positions (anterior and posterior). Objective evaluation of PFM strength was assessed using a portable perineometer (DM 01 Dynamed) in three different positions: in lying position with straight limbs (P1), with bent limbs (P2) and sitting (P3). These parameters were recorded at one moment in group G1 and in 20th and 36th weeks during pregnancy and after 45 days of the delivery in G2.Results: In G2, 14 women were excluded due to the lost follow-up. The median of age was 23 years in G1 and 22, in G2 (p> 0.05). 84% of women in G1 and 80% in G2, reported orgasm (p> 0.05). In G1, 54% presented intestinal constipation and 50% in G2 (p>0.05). The sexual activity was significantly higher in G2 (97%) as compared to G1 (84%). In anterior position, the TDP evaluation of PFM contraction was considered normal in 52% of nuliparous (G1),and in 39%, 22% and 25%, at 20th and 36th week of pregnancy and 45 days afer delivery, respectively in G2. In posterior position, the TDP was normal in 76% of G1, and in 67%, 36% and 44%, at 20th and 36th week of pregnancy and 45 days afer delivery, respectively, in G2. There was a significant statical difference between all periods of evaluation as anterior as posterior position in G2 as compared to G1, except when ...(Complete abstract click electronic access below)
16
Darski, Caroline. "Associação entre a musculatura do assoalho pélvico e a função sexual de mulheres com diferentes tipos de incontinência urinária." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/151491.
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Introdução: Incontinência Urinária (IU) é comum na população feminina afetando um terço das mulheres adultas, podendo comprometer sua função sexual (FS). Ainda há controvérsia sobre o impacto da IU sobre a FS. A associação da FS e da funcionalidade da MAP é uma questão relevante que necessita aprofundamento. Objetivo: Comparar a FS de mulheres com Incontinência Urinária de Esforço (IUE) e Incontinência Urinária Mista (IUM), e correlacionar a funcionalidade da musculatura do assoalho pélvico (MAP) à FS destas mulheres. Método: Observacional e transversal, n=61 mulheres, de 30 a 70 anos que tiveram relação sexual nos últimos 12 meses. As participantes foram classificadas em dois grupos: IUE (n=22) E IUM (n=39). A avaliação foi constituída por ficha de anamnese, biofeedback pressórico, escala PERFECT, e questionário PISQ-12. A análise estatística foi realizada através do teste Shapiro-Wilk para verificar a normalidade dos dados. Para comparação dos dados foi utilizado o teste T de amostras independentes e o teste U de Mann-Whitney. Para correlação foi utilizado o teste de Correlação de Spearman. O nível de significância adotado foi de 5%. Resultados: Diferença significativa na paridade e duração da queixa entre os grupos; na comparação do escore total do PISQ-12 e no domínio físico; nos itens P e F da escala PERFECT. Não houve correlação significativa entre a CVM Média e o Escore Total PISQ-12. Conclusão: Não foi demonstrado correlação entre a função da MAP e a FS nos grupos. Porém, houve diferença significativa entre a FS nos grupos.Introduction: Urinary Incontinence (UI) is common among the female population. It affects one third of adult women and can compromise their sexual function (SF). There are still controversy about the impacts of UI on the SF. The association of the SF and the functionality of the pelvic floor muscles (PMF) is a relevant issue that needs to be better comprehended. Goal: Comparing the SF of women with Stress Urinary Incontinence (SUI) and Mixed Urinary Incontinence (MUI), and correlating these women’s PMF functionality to their SF. Method: Observational and cross-sectional, n=61 women aged 30 to 70 yo, who had had sexual relations in the last 12 months. The participants were divided into two groups: SUI (n=22) and MUI (n=39). The assessment consisted of the anamnesis record, pressure biofeedback, PERFECT scale and the PISQ-12 questionnaire. Statistical analysis was carried out using the Shapiro-Wilk test to verify the normality of the data. The independent t-test and the Mann-Whitney U test were used for data comparison. Spearman’s rank correlation was used to correlate data. The adopted level of significance was 5%. Results: Significant difference between the groups regarding the parity and duration of complaints; the PISQ-12 total score and the physical domain; the items Power-Pressure and Fast of the PERFECT scale. There was no significant correlation between the Maximum Voluntary Contraction (MVC) and the PISQ-12 total score. Conclusion: The tests did not find a correlation between the PFM functions and the SF in the groups. However, there was a significant difference in the SF between groups.
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Hannigan, James. "Neuromuscular Control of the Hip, Pelvis, and Trunk During Running." Thesis, University of Oregon, 2018. http://hdl.handle.net/1794/23111.
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Patellofemoral pain syndrome (PFPS) is the most common injury in runners and has a significant female sex bias. Current evidence suggests that several proximal factors, including hip muscle strength, hip muscle activation, and hip kinematics during running, play a large role in the development of PFPS, particularly in females. However, the relationships between these variables are unclear. A better understanding of these relationships in both males and females could help clinicians develop targeted interventions for this syndrome. Thus, this dissertation is comprised of four studies aimed to better understand the relationships between these risk factors.
The first study investigated whether there are any relationships between hip muscle strength and hip muscle activation during running. Overall, hip muscle strength and hip muscle activity during running do not appear to be strongly related.
The second study used a multiple regression approach to look for predictors of hip adduction and hip internal rotation during running. Sex was a significant predictor in both models, and running speed, static subtalar inversion range of motion, and gluteus maximus amplitude were significant predictors in the hip adduction model.
The third study examined the effect of decreasing hip abduction strength on running kinematics and hip muscle EMG. After the fatigue protocol, there were no changes in gluteus medius amplitude or timing, and no changes in hip kinematics during running. However, there were some changes in kinematics, particularly at the trunk, as well as differences in gluteus maximus and tensor fascia latae activation.
Finally, the fourth study used an alternative biomechanical method called continuous relative phase (CRP) to investigate the effect of sex and decreasing hip abduction strength on CRP variability at the hip. Decreasing hip abduction strength increased frontal plane CRP variability from 20-40% of stance phase, primarily in females, and females demonstrated less CRP variability than males in the frontal plane and transverse planes.
Overall, the results from this study improve our understanding of the relationships between hip strength, hip muscle activation, and hip kinematics during running in both males and females, which may have implications for knee injury rehabilitation strategies.
This dissertation includes unpublished co-authored material.
18
Bridger, Robert S. "Interrelationships between spinal and pelvic angles and hip muscle indices and their implications for workspace design." Doctoral thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/27182.
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The shape of the lumbar and thoracic spinal curves in healthy subjects, when standing and when adopting a variety of working positions, was investigated using angular measures. The hypothesis that spinal and pelvic posture is determined by body position was supported. The mechanism by which body position influences spinal and pelvic posture was investigated using angular indices of the lengths of the hip flexors and extensors. The hypothesis that hamstring stretch determines postural adaptation to sitting positions was not supported. A multivariate analysis revealed that an index of iliopsoas length was the best predictor of posterior pelvic tilt in a variety of sitting positions. A supplementary investigation was carried out using data on the range of motion of the pelvis in the different body positions and its relationship to the muscle length indices. The role of the hamstring muscles in sitting posture was clarified. Some electromyographic data is presented to further illustrate the effect of body position on the role of the hip and trunk muscles in posture. A replication of the main findings and an investigation of some of the practical implications of the work were carried out drawing attention to some mechanisms of postural stress, potential problems of increased lumbar lordosis and their cost-effective alleviation through workspace design. The provision of a footrest, for example, was found to have significant effects on lumbar and pelvic angles in standing as well as in sitting. Further research into standing posture in the workplace is indicated by these findings. Some hypotheses for future investigation are presented.
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Jassi, Fabrício José. "Análise do Comportamento Eletromiográfico dos Músculos Estabilizadores Primários e a Relação com a Capacidade Física Funcional de Indivíduos Assintomáticos /." Presidente Prudente : [s.n.], 2010. http://hdl.handle.net/11449/87328.
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Orientador: Rúben de Faria Negrão FilhoBanca: Carlos Marcelo Pastre
Banca: Amélia Pasqual Marques
Resumo: Contextualização: Observa-se na literatura que indivíduos assintomáticos podem não apresentar pré-ativação muscular de estabilizadores primários e não há estudos que apontem para os motivos da alteração no tempo de início de ativação muscular nessa população. Além disso, estudos preliminares em nosso laboratório mostraram que indivíduos assintomáticos apresentaram alterações em testes físicos e funcionais relacionados à capacidade de estabilização da região lombo-pélvica. Objetivo: Estudar o comportamento de pré-ativação dos músculos transverso do abdome/oblíquo interno (TrA/OI) e multífido lombar (ML), a capacidade de estabilização lombo-pélvica e a relação entre ambos. Metodologia: Foram selecionados 27 voluntários assintomáticos de ambos os sexos, com idades entre 20 e 28 anos (média = 23,85 ±2,21). Os voluntários foram submetidos a Testes Físicos Funcionais (TFF) para avaliar a capacidade de estabilização lombo-pélvica (Testes de Coordenação e Equilíbrio, Flexibilidade, Resistência e Comprimento e Força) e à Determinação de início de ativação muscular do TrA/OI e ML por meio da eletromiografia de superfície (EMG-S) durante movimento rápido de flexão do membro superior. Resultados: Embora a pré-ativação tenha sido o comportamento mais freqüente a ausência de pré-ativação do TrA/OI e ML ocorreu para alguns voluntários, sendo mais freqüente no músculo TrA/OI (26.6%) do gênero feminino. Nos TFF nenhum voluntário da amostra conseguiu obter valores de normalidade em todos os testes realizados e aqueles com maior número de voluntários com alteração foram: teste de flexibilidade do reto femoral e espinhais lombares, teste de enrolamento repetitivo do tronco, teste estático de resistência das costas de Sorensen e o teste de comprimento e força para o glúteo máximo. Entretanto, somente o teste de enrolamento... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Contextualization: It is observed in the literature that asymptomatic individuals may not have muscular pre-activation of primary stabilizers and there are no studies that point to the reasons for the change in time of onset of the muscle activation in this population. Furthermore, preliminary studies in our laboratory showed that asymptomatic individuals presented alterations in physical and functional tests with relationship the capacity of lumbo-pelvic stabilization. Objective: The study of pre-activation behavior of transversus abdominis/internal oblique muscle (TrA/OI) and lumborum multifidus (ML), the lumbo-pelvic stabilization capacity and the relationship of both. Methodology: Were selected 27 asymptomatic individuals of both sexes, with age between 20 e 28 years (mean = 23,85 ±2,21). The volunteers were submitted to a Physical Functional Tests (FFT) to evaluate a lumbo-pelvic stabilization capacity (coordination tests, balance, flexibility, endurance, length and force) and the determination of muscle activation onset of the TrA/OI and ML with superficial electromyography (EMG-S) during fast flexion arm movement. Results: Although pre-activation has been a usual result, the pre-activation absent of TrA/OI and ML happened in some volunteers, being more frequent for TrA/OI (26.6%) in the female gender. At TFF neither volunteers of the sample get regular scores in all tests executed. Those tests with more number of alterations were: rectus femoris and spinal lumbar flexibility, Sorensen static back endurance, and length and force to gluteus maximus. However, only repetitive trunk curl test showed great sensibility and specificity value with the primary stabilizers behavior of pre-activation
Mestre
20
Sousa, Vanessa de Oliveira. "Avaliação comparativa da força muscular do assoalho pélvico em mulheres nulíparas e primigestas /." Botucatu : [s.n.], 2009. http://hdl.handle.net/11449/88903.
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Resumo: O objetivo desse estudo foi avaliar a força dos músculos do assoalho pélvico (AP) em nulíparas e primigestas utilizando a avaliação subjetiva e objetiva. 100 mulheres com idade entre 20 e 30 anos foram estudadas prospectivamente. As participantes foram distribuídas em dois grupos: Grupo G1 (n=50) composto por mulheres nulíparas voluntárias saudáveis sem disfunções urinárias, Grupo G2 (n=50) por primigestas. Dados demográficos, como atividade física, foram obtidos utilizando questionário clinico. Avaliação subjetiva dos músculos do AP foi feita por palpação digital vaginal em duas porções (anterior e posterior). A avaliação objetiva da força dos músculos do AP foi realizada utilizando um perineômetro portátil (Dynamed DM-01) em três diferentes posições: em decúbito dorsal com membros inferiores estendidos (P1), decúbito dorsal com membros inferiores fletidos (P2) e sentada (P3). Esses parâmetros foram avaliados em um só momento no grupo G1 e na 20ª, 36ª semana de gestação e após 45 dias do parto em G2. Em G2, 14 mulheres foram excluídas por perda de seguimento. A média de idade foi de 23 anos em G1 e 22 em G2 (p>0,05). 84% das mulheres em G1 e 80% em G2, relataram orgasmo (p>0,05). Em G1, 54% apresentaram constipação intestinal e 50% em G2 (p>0,05). A atividade sexual foi significativamente maior em G2 (97%) quando comparado a G1 (84%). Na porção anterior, a avaliação feita por palpação digital vaginal da contração dos músculos do AP foi considerada normal em 52% das nulíparas (G1), em 39%, 22% e 25% na 20ª, 36ª semana de gestação e 45 dias após o parto, respectivamente em G2. Na porção posterior, a palpação digital vaginal foi normal em 76% de G1, em 67%, 36% e 44%, na 20ª, 36ª semana de gestação e 45 dias após o parto, respectivamente, em G2. Houve diferença... (Resumo completo, clicar acesso eletrônico abaixo)Abstract: The aim of this study was to assess pelvic floor muscle (PFM) strength in nulliparous and primiparous using subjective and objective evaluation. 100 women with age between 20 and 30 years were prospectively studied . Participants were distributed into 2 groups: Group G1 (n = 50) composed by voluntary healthy nulliparous women without urinary complaints; Group G2 (n = 50) by primiparous females. Demographic data, such as physical activity, was obtained using clinical questionnaire. Subjective evaluation of pelvic floor muscle (PFM) was performed using transvaginal digital palpation (TDP) into 2 positions (anterior and posterior). Objective evaluation of PFM strength was assessed using a portable perineometer (DM 01 Dynamed) in three different positions: in lying position with straight limbs (P1), with bent limbs (P2) and sitting (P3). These parameters were recorded at one moment in group G1 and in 20th and 36th weeks during pregnancy and after 45 days of the delivery in G2.Results: In G2, 14 women were excluded due to the lost follow-up. The median of age was 23 years in G1 and 22, in G2 (p> 0.05). 84% of women in G1 and 80% in G2, reported orgasm (p> 0.05). In G1, 54% presented intestinal constipation and 50% in G2 (p>0.05). The sexual activity was significantly higher in G2 (97%) as compared to G1 (84%). In anterior position, the TDP evaluation of PFM contraction was considered normal in 52% of nuliparous (G1),and in 39%, 22% and 25%, at 20th and 36th week of pregnancy and 45 days afer delivery, respectively in G2. In posterior position, the TDP was normal in 76% of G1, and in 67%, 36% and 44%, at 20th and 36th week of pregnancy and 45 days afer delivery, respectively, in G2. There was a significant statical difference between all periods of evaluation as anterior as posterior position in G2 as compared to G1, except when ...(Complete abstract click electronic access below)
Orientador: João Luiz Amaro
Coorientador: Mônica de Oliveira Orsi Gameiro
Banca: Carlos Trindade Filho
Banca: Carla Adelino Suaid
Mestre
21
Waterfield, Ann Elisabeth. "A community study of pelvic floor muscle function in women." Thesis, Exeter and Plymouth Peninsula Medical School, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.553764.
Full textAbstract:
Previous studies have indicated that pelvic floor muscle training supervised by a trained health care professional is beneficial, both as treatment and prevention of stress urinary incontinence. Currently there are few reports available in the literature that address pelvic floor muscle condition in the general population of women, and none which have investigated this group irrespective of continence status. However, it is known that verbal and written information are often insufficient for women to learn to contract their pelvic floor muscles correctly. The overall aims of this thesis were to ascertain by objective measurement what proportion of community dwelling women know how to and are able to voluntarily contract their pelvic floor muscles (PFM), and whether a nurse who had undertaken a short course training programme could effectively instruct women to increase strength, endurance and muscular co-ordination of the PFM. This might help to reduce one of the modifiable risk factors for incontinence and pelvic organ prolapse, namely pelvic floor muscle weakness. The first objective was to estimate the prevalence of pelvic floor muscle weakness in a community dwelling sample of women in both urban and rural areas of south west Devon and north east Cornwall, UK, who were attending their General Practice for routine health checks. The subjects were recruited from a general population and were not necessarily symptomatic of any incontinence or pelvic organ prolapse. The second objective was to investigate the relative importance of a number of specific factors (such as age, parity, body mass index etc.) that might be associated with pelvic floor muscle weakness in the sample of women. The key objective outcome measure was perineometry (vaginal squeeze pressure), focussing on pelvic floor muscle strength and endurance of contraction. In order to first assess a correct contraction, digital palpation (Modified Oxford Score) was used. Subjects with weak muscles, (scoring 2 or less) could be assigned to the second study. The final objective was to evaluate the effectiveness of an educational programme of PFMT delivered by Primary Care Nurses compared to a pelvic floor specialist nurse, or a control group with no training, over 3 months. The first study was a survey of pelvic floor muscle condition which investigated objectives 1 and 2. The second study, a randomised controlled trial of PFMT, addressed the final objective. In the survey, 762 women from a range of urban and rural General Practices, aged 19- 76 (mean age 46) were assessed. Forty four percent were found to have weak pelvic floor muscles (PFM). This declines further with age, increasing parity, body mass index, and obstetric factors such as having had a forceps delivery and/or episiotomy. The association of a weak pelvic floor with incontinence has also been confirmed. Although the majority of women knew of pelvic floor exercises (87%), few were practicing them at the time of the study .The greatest adverse effect on pelvic floor muscle strength was the transition from nulliparity to first childbirth. Generalized linear modelling was used to investigate the combined effects of multiple explanatory variables. Some women had strong muscles despite advancing age, obesity or grand multiparity. Those who were physically and sexually active had a significantly increased likelihood of strong PFM. Of the 337 women with weak PFM, 97 declined to take part in the second study. Two hundred and forty subjects were randomised to one of three groups (75 Control, 84 Practice nurse, 8\ Specialist nurse) for the RCT. Both treatment groups showed a significant increase in pelvic floor strength after 3 months' training, compared with Controls (p
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Soisson, Odette, Juliane Lube, Andresa Germano, Karl-Heinz Hammer, Christoph Josten, Freddy Sichting, Dirk Winkler, Thomas L. Milani, and Niels Hammer. "Pelvic belt effects on pelvic morphometry, muscle activity and body balance in patients with sacroiliac joint dysfunction." Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-167389.
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The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application.
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Mohd, Rasdi Hanif Farhan. "Impact of anterior load carriage on muscle fatigue, gait kinematics and pelvis-trunk coordination." Thesis, University of Southampton, 2018. https://eprints.soton.ac.uk/422206/.
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Background: Carrying is one of the most frequently performed activities of daily living, particularly in industrial settings. However, as the carrying activity involves a direct exposure to several biomechanical mechanisms that can potentially affect the musculoskeletal function of the lower back, a prolonged use of the activity may lead to low back pain (LBP). Therefore, the aim of this doctoral study was to investigate the impact of anterior load carriage on muscle fatigue, spatiotemporal parameters and 3D kinematics of gait, and pelvis-trunk coordination. Methods: This cross-sectional study involved 37 healthy people; 20 sedentary individuals and 17 manual workers. All participants were instructed to perform an isometric back endurance test and two gait conditions: 1) standard gait and 2) carrying gait whilst carrying a safe-maximum load (max-kg gait). The spatiotemporal parameters and 3D kinematics of gait, as well as the pelvis-trunk coordination during the activity were measured using the Vicon Motion Analysis System. The muscle fatigue during the activity was measured based on the slope of median frequency (MFslope) of surface electromyography (EMG). The differences between the sedentary and the manual groups in all parameters were examined. Results: During the Ito test, there was no significant difference in the isometric back endurance and muscle fatigue between the groups. During the carrying activity, the manual group was able to carry 4 kg heavier maximum load compared to the sedentary group. For the gait parameters, there was a significant effect of load condition (standard gait to max-kg gait) on cadence (increased by 10 steps/minute), stride length (reduced by 4 cm) and stride time (reduced by 0.09 seconds). For the gait kinematics, there was a significant effect of load condition during stance phase on the range of motion (ROM) of ankle (flexion-extension), left hip (flexion-extension, with significant interaction effect), pelvic tilt, left pelvic axial rotation and all trunk movements. For the pelvis-trunk coordination, there was a significant increase in the percentage of in-phase coordination across the activity in flexion-extension (11% increase in the manual group only), lateral flexion (10% increase in the manual group, 5% increase in the sedentary group but on the right side only) and axial rotation (23% increase on the right side only). Conclusion: The results suggested that both manual and sedentary groups demonstrated a similar pattern of changes in spatiotemporal parameters regardless of their maximum carrying load. However, the differences in gait kinematics and pelvis-trunk coordination between the groups may indicate common body strategies to adapt with a safe-maximum load limit. Therefore, this study had established a biomechanical baseline of anterior load carriage among healthy population that can be used to guide further research investigation on specific group of people or patients as a part of functional capacity evaluation.
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Semmen, Mahin. "Are Age-related Changes Evident in the Active and/or Passive Components of Pelvic Floor Muscle Force Outcomes in Nulliparous Women?" Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37717.
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Background: Age-related changes in pelvic floor muscle (PFM) biomechanics may contribute to urinary incontinence in older women; however, empirical evidence is scant. Purpose: This study aimed to understand the age-related changes in the biomechanical properties of the PFMs in women with no major risk factors for urinary incontinence. Methods: Thirty-three nulliparous women (20-64 years) were recruited to study active force, rate of force development, endurance, resistance to passive stretch and stiffness properties of the PFMs using an automated dynamometer. Separate regression analyses were performed to investigate the relationship between age and each outcome measure. Results: No significant relationships were observed between age and any of the outcome measures. Conclusion: The findings from this study do not support the presence of any age-related changes in PFM mechanics among women aged 20-64. Recruiting women over the age of 65 may be essential to detect age-related changes in PFM biomechanics in nulliparous women.
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Miller, Zachary Dalton. "Tensile Properties of Single Vaginal Smooth Muscle Cells." Thesis, Virginia Tech, 2018. http://hdl.handle.net/10919/83567.
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Improving treatment and prevention of pelvic organ prolapse, a disorder affecting up to half of parous women, requires thorough mechanical analysis of the vagina and other endopelvic structures at the cellular level. In this study, we tested single vaginal smooth muscle cells (SMCs) to quantify their elastic moduli. Cells were enzymatically isolated from vaginal walls of freshly sacrificed, virgin Long Evans rats and cultured using well-established methods. A custom-built experimental setup was used to perform tensile tests. Micropipettes were fabricated to serve as cantilever-type load cells, which were coated in cellular adhesive. Two pipettes applied tension to SMCs until adhesion between the cell and a pipette failed. During mechanical testing, images of SMCs were collected and translated into strain and stress. Specifically, force/stress data were calculated using Euler-Bernoulli Beam Theory and by making simplifying geometric assumptions. The average initial and total elastic moduli (mean ± SEM) for single vaginal SMCs were 6.06 ± 0.26 kPa and 5.4 ± 0.24 kPa, respectively, which is within the range reported for other types of SMCs, mainly airway and vascular, of various species. This protocol can and will be applied to further investigate mechanics of single cells from the pelvic region with independent variables such as parity, age, body mass index, and various stages of POP. Results of these experiments will provide critical information for improving current treatments like drug therapies, surgical procedures, medical grafts and implants, and preventative practices like stretching and exercise techniques.Master of Science
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Van, der Walt Ina. "An investigation of pelvic floor muscle strength and vaginal resting pressure in nulliparous women of different race groups." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4196.
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Thesis (MScPhysio (Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: The pelvic floor muscles (PFM) contribute to urinary continence and overactive PFM seem to be associated with pelvic pain syndrome (PPS). The literature indicates that ethnic differences regarding symptoms of urinary incontinence may exist. Research is needed to establish relationships between PFM function and symptoms reported by women of different ethnic groups. Objectives: To compare the PFM strength and endurance in black, white and coloured women. To investigate relationships between PFM strength, vaginal resting pressures, risk factors and symptoms associated with PFM dysfunction and PPS. Method: A cross-sectional study assessed the PFM strength and vaginal resting pressures of 122 nulliparous black (n=44), white (n=44) and coloured (n=34) university students. A self-developed questionnaire determined inclusion, demographic variables, factors affecting/factors associated with PFM strength and symptoms related to PPS. Maximum voluntary contraction pressure (cmH2O) and vaginal resting pressure (cmH2O) were measured with the Peritron TM 9300 (Cardio Design, Australia) used with the Camtech AS vaginal balloon sensor (Sandvika, Norway). Two sets of 3 maximum voluntary contractions of the PFM were recorded. Results: The mean age of the group was 22 ± 3.54 years and mean BMI of 23± 4.16 kg/m2. Black women (25 cmH2O ± 13.5) had significantly stronger PFM than white (p=0.02) or coloured (p<0.01) women, but no significant difference (p=0.78) in PFM strength existed between white (18.4 cmH2O ± 9.8) and coloured (15.6 cmH2O ± 8) women. In black women, PFM strength decreased significantly (p=0.02) between the sets, whereas no significant difference between sets was noted in the other ethnic groups. Increased PFM strength was associated with SUI (p=0.03) and amenorrhoea (p=0.01) and decreased PFM strength was associated with decreased frequency of bowel motion (p=0.01). In this sample, increased vaginal resting pressure was associated with menorrhagia (p=0.04). Conclusion: Black nulliparous women had stronger PFM than white and coloured women. There was no difference in PFM strength between white and coloured women. Endurance, as measured in this study, indicates that black women have decreased endurance of the PFM compared to white and coloured women. These findings inform the current research on ethnic differences in the prevalence of urinary incontinence. Preliminary data suggest that there was no relationship between vaginal resting pressures and symptoms of PPS and risk factors for PFM dysfunction, except for menorrhagia.
AFRIKAANSE OPSOMMING: Die bekkenvloer spiere (BVS) dra by tot urinêre kontinensie en ooraktiewe BVS kan moontlik geassosieer wees met pelviese pyn sindroom (PPS). Uit die literatuur blyk dit of daar etniese verskille bestaan in die simptome van urinere inkontinensie gerapporteer deur vroue. Navorsing is nodig om die verwantskap tussen BVS funksie en simptome wat deur pasiënte van verskillende etniese groepe gerapporteer word vas te stel. Doel: Om „n vergelyking te tref tussen BVS sterkte in swart, wit en kleurling vroue. Om vas te stel of daar assosiasies bestaan tussen BVS sterkte, rustende vaginale druklesings en risiko faktore en simptome geassosieer met bekkenvloer disfunksie en PPS. Metodologie: „n Dwarssnit studie het die BVS sterkte en rustende vaginale drukke van 122 nullipareuse swart (n=44), wit (n=44) en kleurling (n=34) universiteit studente geëvalueer. Insluiting, uitsluiting, demografiese veranderlikes, faktore wat kan affekteer/faktore geassosieer met BVS sterkte en simptome geassosier met PPS is deur „n self ontwikkelde vraelys geëvalueer. Maksimale willekeurige spiersametrekking drukke (cmH2O) en rustende vaginale drukke (cmH2O) was gemeet met „n Peritron™9300 perineometer (Cardio Design, Australië) wat saam „n vaginale ballon sensor (Camtech AS, Sandvika, Noorweë) gebruik is. Twee stelle van 3 maksimale willekeurige sametrekkings van die BVS was gemeet. Resultate: Die groep se gemiddelde ouderdom was 22±3.54 jaar en die gemiddelde liggaamsgewig indeks was 23±4.16kg/m2. Swart vroue (25 cmH2O ±13.5) het beduidend sterker BVS gehad as wit (p=0.02) en kleurling (p<0.01) vroue, maar daar was geen beduidende verskil (p=0.78) in BVS sterkte tussen wit (18.4 cmH2O ± 9.8) en kleurling (15.6 cmH2O ± 8) vroue nie. Die BVS sterkte in swart vroue het beduidend (p=0.02) verminder tussen die stelle, maar geen beduidende verskille was waargeneem in die ander etniese groepe tussen stelle. Verhoogde BVS sterkte was geassosieer met druklek (p=0.03), amenorrhoea (p=0.01) en verminderde BVS sterkte was geassosieer met verminderde frekwensie van opelyf (p=0.01). Verhoogde rustende vaginale drukke was geassosieer met menoragie in hierdie steekproef. Gevolgtrekking: Swart nullipareuse vroue het sterker BVS gehad as wit en kleurling vroue, Daar was geen verskil in BVS sterkte tussen wit en kleurling vroue nie. Uithouvermoë soos in hierdie studie getoets toon dat swart vroue verminderde uithouvermoë het i.v.m. wit en kleurling vroue. Hierdie bevindings dra by tot die huidige navorsing oor etniese verskille in die prevalensie van urinêre inkontinensie. Daar was geen verwantskap tussen vaginale rustende drukke en simptome van PPS en risiko faktore vir die ontwikkeling van bekkenvloer disfunksie, behalwe vir menoragie.
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Sjödahl, Jenny. "Pregnancy-related pelvic girdle pain and its relation to muscle function." Doctoral thesis, Linköpings universitet, Sjukgymnastik, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-60194.
Full textAbstract:
Pregnancy-related lumbopelvic pain affects approximately 50% of all pregnant women. For the majority the pain disappears during the first months after delivery; however, for a significant number of women, the pain is persistent, with little improvement for more than three months after delivery. Moreover, women who experience persistent lumbopelvic pain three months postpartum are at substantial risk for new episodes or for chronic lumbopelvic pain later in life. Hence, pregnancy-related lumbopelvic pain should be considered a major public health issue. In order to develop and offer specific treatment strategies, it is important to identify different subgroups of lumbopelvic pain based on different clinical presentations. Pelvic girdle pain (PGP) is one of the major subgroups of pain related to pregnancy. There is no consensus regarding the underlying mechanisms although instability in the pelvis has been proposed as one of the possible mechanism; thus, further studies are necessary to determine how to treat these women. The local lumbopelvic muscle system, including the pelvic floor muscles (PFM) is thought to contribute to the stabilization of the pelvis and they are also the target for many treatment strategies for lumbopelvic pain. The overall aim of this thesis was to improve rehabilitation for women with persistent postpartum PGP by investigating three areas, including: 1) the postural response of the PFM, 2) the effect of home-based specific stabilizing exercises (SSE) that target the local lumbopelvic muscle system and, 3) predictors for disability at 15 months postpartum. The thesis comprises three studies: A) a methodological study, B) an experimental study, and C) a clinical randomized controlled trial (RCT). The data is mainly based on muscle function, including recordings of electromyographic (EMG) activation, muscle endurance, and muscle strength. We also collected subjective ratings of disability, healthrelated quality of life, and pain. The methodological study showed that the designed protocol, which included limb movements performed at a comfortable speed in both standing and supine positions, was useful for detecting a postural response in the PFM. The experimental study demonstrated that women with persistent postpartum PGP and those free of pain exhibited a feed-forward mechanism in the PFM that responded in anticipation to leg lifts performed in a supine position. However, we cannot rule out the possibility that women with difficulties in transferring load between the trunk and legs (i.e., those with functional pelvic instability) might have a different postural response in the PFM. In the present study, one woman with persistent postpartum PGP failed to present a feed-forward mechanism in the PFM, in agreement with previous studies on other parameters of the PFM from other similar groups. The clinical RCT demonstrated that the concept of home-based SSE with visits every second week with the treating physiotherapist was not more effective than the clinical natural course for improving subjective ratings or muscle function in women with persistent postpartum PGP. A linear regression analysis revealed a complex picture that suggests that disability 15 months postpartum in women with persistent PGP could be partially predicted by two interaction effects comprising factors from different dimensions: biological, physical functioning, and self-rated function. The proposed association between muscle function and PGP was strengthen. New approaches are most likely needed to further identify subgroups of patients with persistent postpartum PGP that can be considered homogeneous for treatment.
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Aiello, Nathália Andreatti 1984. "Contração muscular do assoalho pélvico e incontinência urinária em primíparas após o parto vaginal espontâneo e fórcipe = Pelvic floor muscle contraction and urinary incontinence in primiparas with spontaneous and forceps delivery." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312596.
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Orientador: Eliana Martorano AmaralDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivo: Avaliar a influência do parto vaginal espontâneo ou instrumental por fórcipe na contração muscular do assoalho pélvico de primíparas e na incontinência urinária (IU). Métodos: Estudo de coorte prospectivo, realizado no Hospital Universitário da Faculdade de Medicina de Jundiaí (HU-FMJ). Foram selecionadas 133 primíparas, no puerpério imediato, com idade entre 18-35 anos, que tiveram parto vaginal com episiotomia espontâneo ou instrumental por fórcipe. A contração dos músculos do assoalho pélvico (MAP) foi avaliada 40-55 dias após o parto, por meio de eletromiografia de superfície - EMGs (avaliando-se tônus de base ¿ TB, contração voluntária máxima - CVM e contração sustentada média - CSM) e por graduação de força segundo Escala de Oxford Modificada (graus 0-5). Avaliou-se a presença de IU durante a gestação e puerpério, utilizando o Internacional Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Os métodos estatísticos utilizados foram teste de Qui-Quadrado (X2) ou exato de Fisher para comparar proporções e teste Mann Whitney para comparar médias. Resultados: A média de idade foi de 22,3 anos (±4,2), o IMC gestacional foi de 27,6 Kg/m2 (±5,1). Apenas 44 mulheres realizaram avaliação puerperal, sendo uma descontinuada, 72,1% submetidas ao parto vaginal (PV) e 27,9% ao parto fórcipe (PF). A ocorrência de laceração perineal foi mais frequente no grupo PF (33,3%) do que no grupo PV (3,2%), mas as complicações devidas à episiotomia foram relatadas em apenas 7,0% dos casos, todos no grupo PV. A prevalência de IU foi de 37,6% durante a gestação e 39,5% no puerpério, sendo 32,3% do grupo PV e 58,3% do grupo PF. Houve mais IU desencadeada no puerpério no grupo PF [RR=3,10 (IC=95% 1,16-8,28); p=0,0468]. O sintoma urinário predominantemente referido no puerpério em ambos os grupos foi a urgeincontinência (29,5%), e a média do escore ICIQ foi 2,3 (±3,8) para o grupo PV e 4,2 (±3,9) para o grupo PF, não havendo diferença significativa entre os grupos. Apresentaram grau reduzido de força muscular 66,7% das puérperas do grupo PF e 27,6% do grupo PV. Os valores médios encontrados para TB, CVM e CSM do grupo PV foram 4,6?V, 23,2?V e 16,8?V e do grupo PF 3,4?V, 14,2?V e 10,7?V, respectivamente, havendo diferença significativa para TB e CVM. Conclusão: Entre as mulheres do estudo em questão observou-se associação do parto fórcipe com a diminuição da função dos MAP 40-55 dias após o parto na graduação de força por palpação e parâmetros eletromiográficos de TB e CVM, sem associação com IU
Abstract: Objective: To evaluate the influence of the spontaneous or instrumental vaginal delivery by forceps in the muscular contraction of the pelvic floor of primiparas and urinary incontinence (UI). Methods: Prospective cohort study, carried out in the University Hospital of the Faculty of Medicine of Jundiaí (HU-FMJ). 133 primiparas in the immediate puerperium, aged between 18-35, that have had vaginal delivery with spontaneous or instrumental episiotomy by forceps were selected. The contraction of the pelvic floor muscles (PFM) was evaluated 40-55 days after delivery, by means of surface electromyography - EMGs (evaluating tonus of basis - TB, maximum voluntary contraction - MVC and average of sustained contraction - ASC) and by muscle strenght graduation according to the Modified Scale of Oxford (degrees 0-5). The presence of UI during pregnancy and puerperium was evaluated according to the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The statistical methods used were the Qui-Square test (X2) or the accurate Fisher indicator to compare ratio and the Mann Whitney test to compare averages. Results: The average age was 22,3 years old (±4,2), gestacional BMI was 27,6 Kg/m2 (±5,1). Only 44 women returned for the puerperal evaluation and one volunteer was discontinued, 72.1% gave birth via spontaneous vaginal delivery (VD) and 27.9% via instrumental vaginal delivery (FD). The occurrence of perineal laceration was more frequent in the FD group (33.3%) than in the VD group (3.2%), but complications due to episiotomy were reported in only 7.0% of the cases, all in the VD group. There were more UI triggered puerperium in the group PF [RR=3,10 (CI=95% 1,16-8,28); p=0,0468]. The prevalence of UI was of 37,6% during pregnancy and 39.5% in the puerperium, where 32,3% of the VD group and 58,3% in the FD group. The urinary symptom predominantly related in the puerperium in both groups was the urge incontinence (29.5%), and the average of the ICIQ score was 2,3 (±3,8) for the VD group and 4,2 (±3,9) for the FD group, without significant differences between the groups. Showed reduced degree of muscular strength 66,7% of the puerperal in the FD group and 27.6% of the VD group. The found average values for TB, MVC and SVC in the VD group was 4,6 ?V, 23,2?V and 16,8?V and in the FD group was 3,4 ?V, 14,2?V and 10,7?V, respectively, with significant difference for TB and MVC. Conclusion: Among the women of the study concerned noted an association of forceps delivery and the reduction of the function of MAP was observed 40-55 days after delivery in the graduation of muscle strenght for palpation and electromyographic parameters of TB and MVC, not associated with UI
Mestrado
Saúde Materna e Perinatal
Mestra em Ciências da Saúde
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Clark, Linnette. "Effect of transverse abdominus muscle activation on a pelvic muscle exercise program in women with stress urinary incontinence." Thesis, NSUWorks, 2008. https://nsuworks.nova.edu/hpd_pt_stuetd/12.
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Purpose: The literature indicates that normal healthy women can increase the strength of the pelvic floor muscles (PFMs) by simultaneously contracting the transverse abdominus (TrA) muscle. This study investigated the relationship of the PFMs and the TrA in women with stress urinary incontinence (SUI). Subjects: 15 women with SUI, verified by scores on the Questionnaire of Urinary Incontinence Diagnosis (QUID), were randomly assigned, blocked by age, into 2 exercise groups. The 6 women in the PFM only group had a mean age of 63 years and the 9 women in the PFM+TrA group had a mean age of 49 years. Method: For 2 weeks, all women were trained by rehabilitative ultrasound imaging (RUSI) to correctly contract the TrA or relax the TrA during a PFM contraction depending upon the group assignment. Each woman was examined using the PERFECT scheme and prescribed a patient-specific PFM exercise program. The exercise protocols required 6 weeks of supervised patient specific exercises. Data collection occurred at 3 time periods (before intervention, after intervention, and follow-up) and included: measurement of TrA thickness changes and PFM lift by RUSI, PFM strength and endurance with pressure perineometry, number of incontinence episodes and pad use from bladder diaries, and quality of life (QOL) measurements using the Incontinence Impact Questionnaire (IIQ) and the Patient Specific Functional Scale (PSFS). Results: MANOVA identified no significant difference after interventions between groups. All women significantly improved in PFM strength (PConclusion: PFM exercises done in isolation or with recruitment of the TrA increased PFM strength, endurance, lift and decreased incontinence in women with SUI. Recommendations: Women with SUI can benefit from physical therapists prescribing PFM exercises in isolation or in combination with TrA contractions.
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Barbosa, Angélica Mércia Pascon. "Efeito da via de parto na força muscular do assoalho pélvico, em primíparas /." Botucatu : [s.n.], 2004. http://hdl.handle.net/11449/95375.
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Orientador: Marilza Vieira Cunha RudgeResumo: Objetivo - Determinar a influência da via de parto na força muscular do assoalho pélvico (AP) de primíparas, 4 a 6 meses pósparto. Sujeitos e Métodos - Estudo clínico, de corte transversal, para avaliar a função da musculatura do AP pelo teste da AFA e perineômetro pneumático e classificada em: zero - ausência de contração muscular, um - contração leve, dois - contração moderada não sustentada por 6 segundos e, três - contração normal sustentada por 6 segundos. As 94 mulheres, tinham entre 20 e 30 anos, foram divididas em 3 grupos de acordo com a via de parto: I com 32 primíparas pós-parto vaginal; II com 32 primíparas pós-parto cesárea e III com 30 nulíparas que serviram como grupo controle. A variável independente foi a via de parto e a dependente a força muscular do AP(1). Resultados e conclusões - A mediana e o 1º e 3º quartís da força muscular do AP foram menores (p=0.01) pós-parto vaginal (2.0;1-2) e intermediária pós-parto cesárea (2.0; 2-3) em relação as nulíparas (3.0;2-3) pelo AFA e perineômetro. Aumentou o risco relativo(RR) de exame alterado da força da musculatura do AP pós-parto vaginal (RR=2.579 IC 95%=1.32-5.04 p=0.002); (RR=2.31 IC 95%=1.24- 4.32 p=0.005) e pós-cesárea (RR=1.56 IC 95% = 0.94-2.57 p=0.12); (RR=1.38 IC 95%=0.85-2.23 p=0.29) pela AFA e perineômetro. O parto vaginal diminuiu a força muscular do AP de primíparas e comparando com a cesárea e as nulíparas.
Abstract: Objective - To evaluate the influence of the route of delivery on pelvic floor (PF) muscle strength, in primiparous patients at 4 to 6 months after delivery. Subjects and methods - A cross-sectional study was undertaken among primiparous women at 4 to 6 months postpartum to evaluate the PF muscle strength by AFA test and pneumatic perineometer, classified in: zero - lack of muscle contraction; one - weak contraction; two - moderate contraction not sustained for 6 seconds and three - normal contraction sustained for 6 seconds. 94 enrolled patients were divided in three groups based upon prior delivery route: I) 32 vaginal delivery with singleton cephalic presentation; II) 32 cesarean delivery; and III) 30 nuliparous patients served as a control group. The independent variable was the route of delivery and the dependent one was the muscle strength of the PF. Data were subjected to Student t test to estimate the relative risk and the Kappa test(1). Results and conclusions - The three subgroups were comparable with respect to maternal age, weight, gestational age and newborn weight. The 1st and the 3rd quartiles of the route of delivery on PF muscle strength were lower (p=0.01) for vaginal delivery (n=32) (2.0;1- 2) and intermediate for cesarean (n=32) (2.0; 2-3) comparing to the nuliparous (3.0; 2-3) by AFA test and pneumatic perineometer. The altered PF muscle strength in primiparous were significantly lower in the vaginal delivery group (RR=2.58, CI 95%=1.32-5.04, p=0.002); (RR=2.31, CI 95%=1.24-4.32, p=0.005); and postcesarean (RR=1.56, CI 95% = 0.94- 2.57, p= 0.12); (RR=1.38, CI 95%=0.85-2.23, p=0.29). Vaginal delivery decreases PF muscle strength when compared with caesarean delivery and control.
Mestre
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Stephen, Catriona. "Adherence to pelvic floor muscle exercises and the role of smart phone apps." Thesis, University of the Highlands and Islands, 2015. https://pure.uhi.ac.uk/portal/en/studentthesis/adherence-to-pelvic-floor-muscle-exercises-and-the-role-of-smart-phone-apps(4337fb88-fbed-4fe5-991a-3d8309eed192).html.
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Urinary incontinence (UI) is a condition commonly experienced by women worldwide. Many women suffer in silence as they refrain from or delay seeking help. Pelvic Floor Muscle Exercises (PFME) have proven to be effective and are recommended as the first line of treatment. Regular exercise of the pelvic floor muscles can prevent symptoms developing. However, there is evidence of lack of motivation and poor adherence to exercises. The use of mobile phone applications have been suggested as an effective resource for health behaviour interventions, especially for sensitive or embarrassing conditions. A mixed methodology was used to gather evidence about the experience of community dwelling women in the North of Scotland over a three month period. Of the twenty three participants who completed a three month explanatory randomised controlled trial, fifteen participants exercised at least daily on average by the end of the trial. Of the fifteen who exercised at least daily, five continued average exercise of at least daily at the twelve month follow-up. Taking part in the study helped women to focus on the exercises and this had a positive impact on their adherence. Eleven out of the fifteen participants with incontinence experienced an improvement in their symptoms after twelve weeks. This had a positive impact on their quality of life. Of those who experienced UI, the women who had the biggest increase in level of exercise also had the biggest improvement in symptoms. Participants in the intervention group of the trial were provided with apps for PFME. Six out of the ten of intervention group participants who completed the trial reported that the apps were not useful and of the four who found them useful, their level of use was varied. The data from this study suggests that simply being provided with apps or equipment to use the apps cannot be linked to improved levels of participation in the study. This suggests that the provision of technology is insufficient in itself to engage with individuals in health behaviour change and has important implications for future service provision in continence promotion and mHealth.
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Paulitsch, Alessandra Fayh. "O Magic Circle aumenta a atividade eletromiográfica abdominal e a pressão intravaginal no exercício The Hundred do Método Pilates?" reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/103910.
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O Método Pilates parte do princípio da centralização, no qual todo movimento começa e é sustentado no centro do corpo, chamado de centro de força, ou, ainda, de powerhouse. Com a finalidade de ajudar o praticante do método a localizar o powerhouse, aumentar o controle e o recrutamento dos músculos que o compõem, Joseph Pilates criou o acessório Magic Circle, o qual consiste num aro flexível com aproximadamente 40 cm de diâmetro, utilizado, entre outras finalidades, para aumentar a atividade dos músculos abdominais em alguns exercícios do Método Pilates. O objetivo deste trabalho foi comparar a atividade eletromiográfica abdominal, bem como analisar a pressão intravaginal, nos exercícios The Hundred e The Hundred modificado, executados com e sem o acessório Magic Circle. Foram analisados, simultaneamente, o sinal eletromiográfico de superfície dos músculos reto abdominal, oblíquo externo, oblíquo interno e adutor longo, e a pressão intravaginal durante a execução dos exercícios The Hundred e The Hundred modificado com e sem a utilização do Magic Circle. Verificou-se uma maior atividade nos músculos abdominais apenas quando o Magic Circle foi utilizado em situações de instabilidade, enquanto a pressão intravaginal não foi afetada pelo uso do acessório. O Magic Circle pode ser recomendado para uma maior ativação da musculatura abdominal nas situações de maior instabilidade mecânica e não é recomendado quando se busca uma maior pressão intravaginal.The Pilates method is based on the centering principle, in which every movement starts and is supported by the center of the body, called strong core or powerhouse. In order to help the practitioner locate the powerhouse and increase the control and recruitment of its muscles, Joseph Pilates created the accessory Magic Circle, which consists of a flexible ring, approximately 40cm wide, used, among other purposes, to increase abdominal muscle activity in some exercises of the Pilates Method. The aim of this study was to compare the abdominal electromiographic activity, as well as to analyze intra-vaginal pressure in the exercises The Hundred and The Hundred modified, performed with and without the accessory Magic Circle. The study simultaneously analyzed the electomiographic signal on the surface of the rectus abdominis, external oblique, internal oblique, aductor longus, as well as intra-vaginal pressure during the performance of the exercises The Hundred and The Hundred modified with and without the use of the Magic Circle. There was higher activity on the abdominal muscles only when the Magic Circle was used in instability situations, while the intra-vaginal pressure was not affected by the use of the accessory. The Magic Circle can be recommended for higher activation of the abdominal muscles in mechanical instability situations and is not recommended when pursuing higher intravaginal pressure.
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Barbosa, Lia Janaina Ferla. "Função dos músculos do assoalho pélvico : comparação entre mulheres praticantes do método Pilates e sedentárias." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/108929.
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Pesquisas relacionadas os músculos do assoalho pélvico (MAP) tem ganhado espaço na última década principalmente quando se refere a alterações na sua função. A maioria das pesquisas encontradas na literatura diz respeito às disfunções dos MAP. É importante conhecer formas de condicionamento dessa musculatura que possa evitar a perda de função, seja por falta de exercícios os por alterações decorrentes do processo de envelhecimento. Sabe-se que em mulheres com disfunção o treinamento dos músculos do assoalho pélvico (TMAP) tem um efeito positivo na melhora da função desse grupo muscular o qual comumente é treinado isoladamente. Porém as formas de melhorar o condicionamento independente de um quadro de disfunção ainda são pouco investigadas, visto que mulheres não ingressam em um TMAP de forma preventiva. Já há registros de exercícios que podem gerar impacto negativo sobre a função dessa musculatura, como corrida e jump, mas não sobre exercícios que possam melhorar a função. A existência de um sinergismo entre os músculos profundos do tronco, em especial do transverso abdominal (TrA), e do assoalho pélvico (AP) é tema de estudos recentes e uma estratégia de prevenção seria a prática de exercício físico regular, que enfatize a coativação dos músculos abdominais e do AP. Assim, esta dissertação teve como foco de estudo identificar a presença ou não de sinergismo abdomino-pélvico em mulheres hígidas e também identificar se a função dos MAP de mulheres que praticam o Método Pilates diferem de sedentárias. O Método Pilates tem por objetivo melhorar o condicionamento de todos os grupos musculares que compõem o powerhouse, incluindo, portanto, TrA e os MAP. O primeiro estudo foi uma revisão sistemática das pesquisas que buscou identificar a presença de sinergismo em mulheres sem disfunções do assoalho pélvico. Tal revisão seguiu as recomendações propostas pela Colaboração Cochrane e a busca na literatura incluiu as bases MEDLINE, Cochrane CENTRAL e EMBASE, além de busca manual, do início das bases até agosto de 2013. Foram incluídos estudos observacionais transversais, com mulheres hígidas que foram avaliadas quanto à presença de sinergismo abdomino-pélvico. Foram incluídos 10 artigos e todos demonstraram a existência de sinergismo entre os músculos abdominais e músculos do assoalho pélvico (MAP) em mulheres hígidas nas posturas supina, sentada e em ortostase. O conhecimento desse sinergismo pode favorecer a proposição de estratégias de tratamento e prevenção das disfunções dos MAP feminino. O segundo estudo que compôs esta dissertação teve por objetivo verificar se existe diferença na função dos MAP entre mulheres praticantes do Método Pilates e sedentárias. O estudo foi observacional e transversal, com uma amostragem composta por mulheres praticantes do Método Pilates (GMP) e sedentárias (GS). O nível de significância e o poder estatístico foram fixados em 5% e 80%, respectivamente, e o tamanho da amostra foi de no mínimo 24 indivíduos para cada grupo - Grupo Método Pilates (GMP) e Grupo Sedentárias (GS). Para avaliação da função dos MAP utilizou-se a perineometria e a Escala PERFECT e uma Ficha de Anamnese. Foi utilizada estatística inferencial, sendo o nível de significância adotado menor ou igual a 0,05. Foram avaliadas um total de 60 mulheres, sendo 30 do GMP e 30 do GS. Este estudo demonstrou não haver diferença significativa entre o GMP e o GS em nenhuma das variáveis analisadas. Conclui-se que mulheres praticantes do Método Pilates não diferem de mulheres sedentárias em relação à função dos MAP.Searches related muscles of the pelvic floor (MAP) has gained ground over the last decade particularly when it comes to changes in its function. Most studies found in the literature with regard to disorders of MAP. It is important to know ways of conditioning these muscles which can prevent loss of function, either by lack of exercise for the changes resulting from the aging process. It is known that the dysfunction in women with pelvic floor training (PFMT) muscles have a positive effect on the improvement of the function of this muscle group which is commonly trained alone. But the ways to improve the fitness of an independent frame of dysfunction are still poorly investigated, since women do not enter into a TMAP preventively. Already there are reports of exercises that can have a negative impact on the function of these muscles, such as running and jump, but not about exercises that can improve function. The existence of a synergism between the deep trunk muscles, particularly the transversus abdominis (TrA), and pelvic floor (AP) is the subject of recent studies and a prevention strategy would be the practice of regular exercise that emphasizes coactivation abdominal muscles and the AP. Thus, this dissertation focused study to identify the presence or absence of abdominal-pelvic synergism in healthy women and to identify the function of the MAP of women who practice Pilates differ from sedentary. The Pilates method aims to improve the conditioning of all muscle groups that make up the powerhouse, including therefore TrA and MAP. The first study was a systematic review of research aimed at identifying the presence of synergism in women without pelvic floor dysfunction. This review followed the recommendations proposed by the Cochrane Collaboration and the literature search included the MEDLINE, EMBASE and Cochrane CENTRAL databases, and manual search, the start of the bases until August 2013 transversal observational studies were included, with healthy women who were evaluated for the presence of abdominal-pelvic synergism. 10 articles were included and all demonstrated the existence of synergism between the abdominal muscles and pelvic floor muscles (PFMs) in healthy women in the supine, sitting postures and standing positions. Knowledge of this synergism may favor the proposition of strategies for treatment and prevention of disorders of the female MAP. The second study that composed this dissertation aimed to verify whether there are differences in the function of MAP between practitioners of Pilates and sedentary women. The study was observational and cross-sectional, with a sample composed by practitioners of Pilates (GMP) and sedentary (GS) women. The significance level and statistical power were set at 5% and 80%, respectively, and the sample size was at least 24 subjects for each group - Group Pilates Method (GMP) and Sedentary Group (GS). To evaluate the role of MAP was used perineometry and Scale PERFECT and a sheet of Anamnesis. Inferential statistics were used, and the significance level less than or equal to 0.05. A total of 60 women, 30 and 30 of the GMP GS were evaluated. This study showed no significant difference between the GMP and the GS in any of the variables analyzed. It is concluded that women who practice Pilates Method not differ from sedentary women in relation to the function of MAP.
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Czyrnyj, Catriona. "UROKIN: A Novel Software for Kinematic Analysis of Urogenital Motion Using Transperineal Ultrasound Imaging." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36147.
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Dynamic transperineal ultrasound (TPUS) video allows for kinematic analysis of urogenital morphology and mobility, however, measures are often limited to peak displacements of anatomical landmarks and are vulnerable to error incurred by probe rotation during imaging. This thesis aimed to (1) develop an algorithm to calculate kinematic curves of urogenital landmark motion from TPUS video and to (2) investigate the error incurred in these kinematic measures due to in-plane ultrasound probe rotation. UROKIN, a semi-automated software, was developed and, as a proof of concept, was used to identify differences in urogenital kinematics during pelvic floor muscle maximum voluntary contractions between women with and without stress urinary incontinence. A mathematical model revealed that the error incurred by TPUS probe rotation in the x- (anterior-posterior) and y- (cranial-caudal) directions, was a factor of: r, the radius of rotation; Ɵ, the in-plane angular probe rotation; and α, the angular deviation between the anatomical planes and the coordinate system in which error was calculated. As an absolute measure, the error incurred by in-plane probe rotation is reduced to a factor of only r and Ɵ. Moving forward, UROKIN must be adapted to include findings from (1), and must be tested for validity and reliability.
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Pires, Telma Filipa Rodrigues Pereira. "Effects of pelvic floor muscles training on prevention and treatment of stress urinary incontinence in pregnant." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/16541.
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Mestrado em FisioterapiaIntroduction: Stress urinary incontinence (SUI) is the most common type of urinary incontinence (UI) in pregnant women and is known to have detrimental effects on the quality of life (QoL). Pelvic floor muscle training (PFMT) is considered the first-line treatment and prevention of SUI in pregnant women. Since there are few randomized controlled trial studies (RCT) in this population, it is important to check the effectiveness of another randomized protocol of the PFMT. Objectives: This study aimed to verify the effects of PFMT between the Intervention Group (IG) and the Control Group (CG) and exploring the effects with and without PFMT, in pregnant women. Methods: Participated in this RCT, pregnant women (aged 21-44 years), having been applied two questionnaires: King's Health Questionnaire (KHQ's) and Broome Pelvic Muscle self-efficacy Scale. The amount of urine was assessed using the modified pad test (20 minutes) and the muscular strength of the Pelvic Floor Muscles (PFM) was measured with Oxford Grading Scale. There were two moments of assessment, T1: 1st time of evaluation (pre- delivery) and T2: 2nd time of evaluation (6 weeks after delivery). The IG was added an exercise plan with duration of six weeks, applicable in Preparation for childbirth classes and at home exercise plan for 9 weeks. Results:The loss of urine, quantified by the Pad test significantly reduced, 0.86±0.83at T1 to 0.50±0.67at T2 in IG (p= 0.021). The degree of muscle contraction, measured by the Oxford Grading Scale, increased significantly in IG (p<0.001) from 3.59±0.85 to 4.82 ± 0:39 and did not change significantly in the CG (p=0.609). The total KHQ and severity of symptoms were observed significant improvements in both groups (p <0.05). As for the scale of Broome - Total scale women's IG improved significantly (p = 0.001 and p = 0.031, respectively) while in CG women no significant change (p> 0.05). Conclusion: PFMT can prevent and treat SUI, and recommend strength training of the PFM during pregnancy, two times per week for at least 6-9 weeks, making it extremely relevant for clinical practice.
Enquadramento: A Incontinência Urinária de Esforço (SUI) é o tipo mais comum em mulheres grávidas, tendo implicações prejudiciais para a qualidade de vida. O treino dos músculos do pavimento pélvico (PFMT) é considerado um tratamento de primeira linha para a SUI. Uma vez existirem poucos estudos randomizados controlados (RCT) nesta população, é importante verificar a eficácia de mais um protocolo randomizado de PFMT. Objetivos: Este estudo teve como objetivos verificar os efeitos do treino dos músculos do pavimento pélvico entre o grupo de intervenção (IG) e o grupo controle (CG) e explorar os efeitos com e sem treino dos músculos do pavimento pélvico, em mulheres grávidas. Métodos: Participaram neste RCT, mulheres grávidas (com idades compreendidas entre os 21-44 anos), tendo sido aplicados dois questionários: King´s Health Questionnaire (KHQ’s) e Broome Pelvic Muscle Self-Efficacy Scale. A quantidade de urina foi avaliada através do pad-test modificado (20minutos) e a força muscular dos músculos do pavimento pélvico (PFM) foi medida com o Oxford Grading Scale. Houve dois momentos de avaliação, a 1ª avaliação (T1), no período pré-parto e a 2ª avaliação (T2), 6 semanas após o parto. Ao IG foi acrescentado um plano de exercícios com duração de 6 semanas, aplicável nas aulas de preparação para o parto, com supervisão e um plano de exercícios ao domicílio, durante 9 semanas, sem supervisão. Resultados: A perda de urina, quantificada pelo pad test, reduziu significativamente, de 0.86±0,83 em T1 para 0.50±0.67 em T2 no IG (p = 0.021). O grau de contração muscular, avaliado pelo Oxford Grading Scale, aumentou significativamente no IG (p <0.001) de 3.59±0,85 para 4.82±0.39 e não sofreu alterações significativas no GC (p=0.609). No KHQ total e severidade dos sintomas observaram-se melhorias significativas em ambos os grupos (p <0,05). Quanto à escala de Broome – Total, as mulheres do IG melhoraram significativamente (p=0.001 e p=0.031, respetivamente) e nas mulheres do CG não se verificaram nenhumas alterações significativas (p> 0,05). Conclusão: O PFMT pode prevenir e tratar a SUI, e recomenda-se o treino da força do PFM durante a gravidez, 2 vezes por semana durante pelo menos 6-9 semanas, tornando-se de extrema relevância para a prática clínica.
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Silva, Valéria Regina 1983. "Comportamento dos músculos do assoalho pélvico e transverso do abdômen/oblíquo interno frente a dois programas de treinamento abdominopélvico em mulheres jovens nulíparas, continentes : estudo controlado, randomizado." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313089.
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Orientadores: Simone Botelho Pereira, Cássio Luís Zanettinni RiccettDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: A literatura recente tem investigado o efeito do treinamento abdominopélvico (TAP) como meio de prevenção e tratamento das disfunções do assoalho pélvico. Neste contexto, exercícios que promovam o treinamento muscular de forma global estão sendo explorados na pesquisa clinica. No presente estudo foram utilizados dois protocolos de TAP: um por meio de cinesioterapia e outro por meio de realidade virtual, a fim de investigar a interação dos músculos do compartimento abdominopélvico e, consequentemente, o comportamento dos músculos do assoalho pélvico (MAP) e Transverso do Abdômen (Tra) associado ao Obliquo Interno (OI), nas situações de contração voluntaria máxima (CVM), e de coativação. Objetivos: Investigar a atividade elétrica dos músculos do assoalho pélvico (MAP) e dos músculos abdominais (Tra/OI) frente a dois protocolos de treinamento: TAP Cinesioterapia (TAP CAP) e TAP Realidade Virtual (TAP RV); bem como identificar a presença de coativação entre os músculos. Pacientes e Métodos: Participaram desta pesquisa 47 mulheres jovens, nulíparas, continentes com idade média de 25,79 (±3,85) anos, divididas de forma randomizada em dois grupos: (G1) TAP_CAP (n=22) e (G2) TAP_RV (n=25). Os protocolos foram supervisionados por fisioterapeuta treinado, com duração de 30 minutos por sessão, três vezes por semana, totalizando 10 sessões. As mulheres foram avaliadas antes e após a realização dos protocolos, por meio de palpação digital (PD) dos MAP e eletromiografia (EMG) simultânea dos MAP e Tra/OI. Resultados: Os grupos apresentaram-se homogêneos quanto às condições sociodemográficas. Na avaliação por Palpação Digital observou-se aumento significativo na contratilidade dos MAP tanto no TAP_CAP (p=0,001) como no TAP_RV (p=0,0001), sem diferença entre os grupos (p=0,1). Em contrapartida, quando avaliado por EMG, não foi verificado diferença significativa na análise pré e pós- treinamento (p=0,05) em nenhum dos grupos. Ao solicitar a contração voluntária máxima do músculo Transverso do abdômen/ obliquo interno, para observação da coativação, observou-se resultado significativo (p=0,001) no grupo TAP RV após o treinamento. Entretanto, não foram encontrados resultados significativos no grupo TAP_CAP. Conclusão: O treinamento abdominopélvico por meio de realidade virtual proporcionou melhora da coativação dos músculos do assoalho pélvico em resposta à contração do Tra
Abstract: Introduction: Recent literature has investigated the abdominopelvic training effect (APT) effect as means of to prevent and treat pelvic floor dysfunction. In this context, globally muscle training exercises are being explored in clinical research. In the present study, two abdominopelvic protocols were used: by kinesiotherapy and by virtual reality, aiming to investigate the interaction of abdominopelvic enclosure muscles, and consequently, the behavior of the pelvic floor muscles (PFM) and transversus abdominis/internal obliquos (Tra/IO) muscle, in some peculiarly situations like maximum voluntary contraction (MVC) and coactivation. Aims: To investigate the pelvic floor and abdominal muscle¿s electrical activity using two training protocols: APT by kinesiotherapy (APT K) and APT by virtual reality (APT VR); as well as to indentify the presence of coactivation between these muscles. Patients and Methods: 47 young, nulliparous and continent women (mean age 25.79±3.85 years) participated in this study. They were randomly divided into two groups: (G1) APT_K (n=22) and (G2) APT_VR (n=25). The protocols were supervised by a physiotherapist, lasting 30 minutes per session, three times per week, during 10 sessions. The women were assessed before and after the completion of the protocols by digital palpation (DP) and electromyography (EMG) of simultaneous MAP and Tra/IO. Results: The groups were homogeneous in demographic conditions. There was a significant increase in PFM contractility in both APT_K (p = 0.001) and APT_VR (p=0.0001) groups when assessed by digital palpation, with no difference in the comparison between groups (p=0.1). In contrast, when measured by EMG, PFM electromyography activity did not showed a significant difference in pre and post training analysis (p=0.05). When requesting the Transverse / internal oblique maximum voluntary contraction, for observation of coactivation, a significant result (p=0.001) was observed in APT_VR group after training. However, no significant results were found in APT_K group. Conclusion: The abdominopelvic training by virtual reality showed an improvement in the coactivation of pelvic floor muscle contraction in response to Tra
Mestrado
Fisiopatologia Cirúrgica
Mestra em Ciências
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Ng, Sau-loi, and 吳秀來. "A randomised controlled trial study of the efficacy of intensive pre-operative pelvic floor muscle training to decrease post-prostatectomy urinary incontinence." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/198846.
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Background: Radical prostatectomy is the gold-standard treatment for clinically organ-confined cancer of the prostate. However, urinary incontinence and erectile dysfunction are major clinical problems, despite advances in surgical techniques. Pelvic floor muscle training is still the first-line treatment used to restore pelvic floor or bladder function after radical prostatectomy although its role is still inconclusive.
Objectives: To determine the benefit of starting pelvic floor muscle training three weeks before radical prostatectomy in order to find by the end of three months after surgery: (1) any degree of continence regained in the intervention group, measured by 24-hour and one-hour pad tests; (2) any positive improvement in the quality of life in that group.
Methods: Sixty-six eligible participants were randomised into either the intervention or the control group before radical prostatectomy. The former received three weeks’ pre-operative pelvic floor muscle training from an advanced practice nurse, while the latter received only standard care. Urine loss by 24-hour pad test was compared in the two groups as the primary outcome, and the questionnaires on incontinence impact, functional assessment on prostate cancer and potency satisfaction at one, two, three and six months after surgery were compared as secondary outcomes.
Results: The intervention group regained continence significantly (p=0.002) earlier than the control group at the end of three months after surgery, as measured by the 24-hour pad test. The intervention group also reported a significantly better quality of life in the questionnaire on ‘incontinence impact’ than the control group. Interestingly, the Functional Assessment of Cancer Therapy-Prostate questionnaire showed no statistical significant difference between the groups, despite significantly less urine loss in the intervention group, which also had a higher potency satisfaction score on the International Index of Erectile Function (p=0.005) by the end of three months after surgery.
Discussion: The present study found that three weeks’ pre-operative pelvic floor muscle training decreased the duration and severity of incontinence after radical prostatectomy, as measured by the 24-hour pad test of urine loss (in grams). Some other studies counted the number of pads used as the comparative data between the groups; however, there might be divergent findings in different studies. In one previous study of pelvic floor muscle training initiated two to four weeks before surgery but showing no benefit, it was found that patients received only one training session before surgery without further monitoring. A limitation of present study is that participants were followed-up for six months after surgery. It is possible that a longer period, perhaps one or two years, of post-prostatectomy follow-up might provide further important information.
Conclusions: This is the first comprehensive study in Hong Kong to examine the efficacy of three weeks’ pre-operative pelvic floor muscle training in reducing post-prostatectomy urinary incontinence, and to evaluate the continence-related quality of life and potency satisfaction of intervention and control groups. The results demonstrated that such training not only significantly hastens the recovery of urinary continence after surgery but also leads to a better continence-related quality of life and potency satisfaction in the intervention group.published_or_final_version
Nursing Studies
Doctoral
Doctor of Nursing
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Lima, Vanessa Morais. "Efeitos da penicilina G na pelve renal de ratos Wistar (Rattus norvegicus albinus) normais e diabéticos." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/10/10132/tde-09102013-180434/.
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A penicilina G é um dos antibióticos mais importantes. Além de possuir um baixo preço e comprovada eficácia de tratamento, mostra inúmeras possibilidades para a redução da morbidade e mortalidade por doenças infecciosas em todo o mundo. Como eventualmente este medicamento causa sequelas no parênquima renal e estruturas associadas, e sendo que a secreção da rede tubular renal contribui para a excreção da penicilina G, onde cerca de 60% do antibiótico é eliminado pela urina, nos propomos a fazer um estudo das principais alterações que possam ocorrer na pelve renal de ratos normais e ratos induzidos à diabetes. Este projeto tem o propósito de descrever e analisar as fibras colágenas, musculares lisas e elásticas da pelve renal de ratos wistar observando alterações estruturais e ultraestruturais dos grupos experimentais quando comparados ao grupo controle com relação ao uso da penicilina G. Os ratos foram divididos em 4 grupos, ratos Wistar normais (N); ratos Wistar tratados com penicilina G (NP); ratos Wistar induzidos à diabetes (D); ratos Wistar diabéticos com penicilina G (DP). Os ratos dos grupos D e DP foram induzidos ao diabetes por aloxano. A região da pelve renal com representação das fibras foi coletada e reduzida em pequenos fragmentos. Os cortes obtidos foram utilizados para Microscopia Eletrônica de Transmissão e corados pelos seguintes métodos para Microscopia Óptica: Hematoxilina Férrica para evidenciação de fibras elásticas; Resorcina fucsina para evidenciação de fibras elásticas e elaunínicas; Resorcina fucsina após oxidação com solução aquosa a 1% de oxona para evidenciação de fibras elásticas, elaunínicas e oxitalânicas; Azan para evidenciação do componente colágeno e muscular lisa; Picrosírius para observação do componente colágeno (especificamente tipo I e III); e Hematoxilina e Eosina, para evidenciação do componente celular. A análise microscópica e a histomorfometria mostraram que a Penicilina G altera os componentes fibrosos da pelve renal, fazendo com que as áreas de fibras musculares lisas e de colágeno tipo III fossem aumentadas e as fibras elásticas maduras diminuídas (neste caso, apenas entre N e NP). O Diabetes mellitus mostrou-se como uma doença metabólica também capaz de alterar a morfologia da pelve, fazendo com que a área de fibras musculares lisas aumentasse, a área de colágeno tipo I e a quantidade de fibras elásticas maduras e elaunínicas diminuísse e as oxitalânicas aumentassem, além de um notável aumento na quantidade de mitocôndrias. Podemos inferir que a antibioticoterapia feita pela penicilina G e o diabetes, provocam diferenças estruturais e ultraestruturais na pelve renal dos ratos Wistar, principalmente na organização dos componentes fibrosos elástico, muscular e colágeno.Penicillin G is the most important antibiotics. Besides having a low cost and proven effectiveness of treatment, it shows great possibilities for reducing morbidity and mortality from infectious diseases worldwide. As this medicine may cause sequelae in the renal parenchyma and associated structures, and since the net renal tubular secretion contributes to the excretion of penicillin G, where about 60% of the antibiotic is eliminated in urine, this study aims to investigate the main structural and ultrastructural changes occurring in the kidney of normal and diabetes rats. Thus, this project aims to describe and analyze the collagen fibers, smooth muscle and elastic fibers of the renal pelvis of Wistar rats, comparing control and penicillin G-treated animals. The animals were divided into 4 groups, normal rats (N), Wistar rats treated with penicillin G (NP); rats induced diabetes (D), diabetic Wistar rats with penicillin G (DP). The diabetes was induced in groups D and DP by alloxan. The fibrotic region of the renal pelvis was collected and reduced into small fragments. The sections were used for the transmission electron microscopy and stained by the following methods for optic microscopic: Iron Hematoxylin for disclosure of elastic fibers; Resorcin fuchsin for disclosure of elastic and elauninic fibers; Resorcin fuchsin after oxidation with 1% aqueous solution of oxone for disclosure of elastic, elauninic and oxytalan fibers; Azan evidencing the collagen and smooth muscle components; Picrosirius for observation of the collagen component (specifically type I and III); and Hematoxylin and Eosin, to show the cellular component. Microscopic and histomorphometry analysis showed that penicillin G alters the fibrous components of the renal pelvis, increasing areas of smooth muscle fibers and collagen type III deposition and decreasing mature elastic fibers (in this case, only between N and NP). Diabetes mellitus proved to be a metabolic disease also able to alter the morphology of the pelvis, leading to the augmentation of smooth muscle fiber area. Moreover, the area of type I collagen and the amount of mature elastic and elauninic fibers were diminished, while oxytalan fibers increased, together with a remarkable increase in the number of mitochondria. We can infer that the antibiotic therapy made by penicillin G and the diabetes, cause structural and ultrastructural differences in the renal pelvis of rats, mainly in the organization of elastic fiber, muscular and collagen components.
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Brooks, Kaylee. "Characteristics Predictive of Successful Pelvic Floor Muscle Training Outcomes Among Women with Stress Urinary Incontinence." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36667.
Full textAbstract:
Physiotherapist-supervised pelvic floor muscle (PFM) training is the recommended first-line treatment for women with stress urinary incontinence (SUI); however, only up to 50% of women are cured with this treatment. The primary objective of this study was to develop a predictive model of successful physiotherapy intervention outcomes among women with SUI using predictors that are accessible to clinicians. The secondary objective of this study was to run a preliminary investigation of morphologic differences between women with SUI who were cured with a physiotherapy intervention and those who were not cured, using a subset of ultrasound
imaging data. Seventy-nine women with SUI were assessed at baseline on measures of demographic data (i.e. age, body mass index, etc.), 3-day bladder diary, 30-minute standardized pad test, clinical assessments of PFM strength and tone, and transperineal ultrasound assessments of PFM morphology. Women then attended a 12-week physiotherapy intervention and returned for a follow-up assessment. The multivariate logistic regression model was significant (p < .001) with two predictors: baseline ICIQ-FLUTS UI subscale (SUI severity; p = .01) and parity (p = .06). A significant ROC curve for the ICIQ-FLUTS UI subscale (p ˂ .01) predicts physiotherapy intervention outcomes with 55.6% sensitivity and 80.8% specificity at a cut-off score of 7.50. Women most likely to be cured with a physiotherapy intervention were those with lower scores on the ICIQ-FLUTS UI subscale and those who have given birth to fewer children. Significant differences were found in a subset of data between women with SUI who are cured with the physiotherapy intervention and women who are not cured on morphologic measures in standing of bladder neck height at peak cough (p = .03), descent of the bladder neck during maximal Valsalva maneuver (MVM; p = .04), levator hiatus circumference at rest (p = .03) and at maximal voluntary contraction in both standing and supine (MVC; p = .01; p = .03). Variables that were trending towards significance included bladder neck height in standing at rest, levator plate length (LPL) at maximal excursion during a cough and MVM in standing, and mid-urethral wall cross-sectional area. These significant differences indicate potential value in using ultrasound imaging outcomes as predictors of a cure with physiotherapy intervention in future models, and a combination of demographic, clinical, and morphologic variables may build a
more robust predictive model.
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Chen, Shu-Yueh. "A causal model : factors influencing pelvic muscle exercise adherence among Taiwanese women with urinary incontinence /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7355.
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Chan, Fun-yee, and 陳芬怡. "An evidence-based pelvic floor muscle training program to prevent urinary incontinence for patients following radical prostatectomy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581376.
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Rodriguez, Kelly. "HIP MUSCLE STRENGTH AND PELVIC OBLIQUITY IN COLLEGIATE FEMALES DURING WALKING AND STAIR DESCENT TASKS." UKnowledge, 2009. http://uknowledge.uky.edu/gradschool_theses/616.
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The goals of the pelvis include maintaining the center of mass of the body, assisting in foot clearance and absorb forces from the lower extremities using muscles and ligaments to stabilize the joint. A better understanding of the influence of muscle strength on controlling pelvic obliquity in a healthy population will help in understanding low back pain and overuse lower extremity injuries. Thirteen females (22 ±2 yrs) participated in isokinetic strength testing of the hip abductors, adductors, internal rotators and external rotators on a Biodex dynamometer. The subjects also underwent gait analysis during self selected pace walking and stair descent. For each muscle group subjects were divided into weaker and stronger groups based on the mean. Independent t-test revealed a significantly greater amount of pelvic obliquity in the stronger group for abductors, adductors, and internal rotators during stair descent. Subjects may be compensating for more pelvic obliquity with less movement of the hip, knee and ankle. During walking weaker external rotators was the only muscle group that significantly increased pelvic obliquity. Our study supports the finding of other studies that the external rotators contribute to pelvic stabilization during walking (Powers, 2003).
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Yip, Clare. "The contribution of pelvic muscle and ligament weaknesses to the development of stress urinary incontinence." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/37905.
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The symptoms of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) are incited by strenuous activities, such as a valsalva maneuver, cough or lifting heavy objects. SUI is characterized by weakened bladder neck support and urine leakage. POP is characterized by the displacement of pelvic organs into the vaginal space. In women, the symptoms of SUI and POP often coexist, yet their relationship remains ambiguous. The POP-related defects that are relevant to SUI are unknown and are yet to be examined. Damages in pelvic floor muscles and cardinal and uterosacral ligaments are potential defects leading to SUI, since they are commonly found in SUI patients with POP symptoms. These defects can be objectively evaluated using Pelvic Muscle Strength test and Pelvic Organ Prolapse Quantification (POPQ) test. This study aims to explore the contribution of pelvic muscle and ligament weaknesses to the development of SUI by developing a biomechanical model of a female pelvic support system. The model simulates the behavior of a pelvic system during a valsalva maneuver, and it incorporates muscle strength score and POPQ points. Patient data were collected and implemented into the model to estimate the material parameters that describe the stiffness properties of the vaginal and ligament tissues for clinical patients. Using the model with parameters, the effect of varied degree of muscular and ligament weaknesses on the changes in the bladder neck and apical vaginal supports were assessed for the patients.
The estimated vaginal and ligament parameters were shown to vary, illustrating the diverse material properties of pelvic tissues in individuals. In modeling, simulated conditions of defective muscles and ligaments were demonstrated to contribute to bladder neck and vaginal apex prolapse, consistent with the clinical conditions of POP; alternatively, simulated conditions of restored muscular and ligament supports were shown to help re-establish both bladder neck and vaginal apex supports. The results exhibit the impact of compromise of pelvic muscles and ligaments on the development of SUI and vaginal apex prolapse and suggest a mechanism of how pelvic muscles and vaginal apex rehabilitation impact SUI and vaginal apex supports in patients with coexisting POP symptoms.
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Dorey, Grace Francis. "Evaluation of pelvic floor muscle exercises and manometric biofeedback in the management of erectile dysfunction." Thesis, University of the West of England, Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271042.
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Lovegrove, Jones Ruth Cerian. "Dynamic evaluation of female pelvic floor muscle function using 2D ultrasound and image processing methods." Thesis, University of Southampton, 2010. https://eprints.soton.ac.uk/157609/.
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The aim of this study was to define new quantitative parameters of dynamic Pelvic Floor Muscle (PFM) function using 2D transperineal (TP) ultrasound imaging combined with image processing methods (IPM). Ultrasound and digital vaginal data were obtained from a volunteer convenience sample of 23 continent and 9 Stress Urinary Incontinent (SUI) women recruited from the San Francisco Bay Area community, California, U.S.A. Two methods of IPM were used; speckle tracking for measuring displacement of the ano-rectal angle (ARA) and symphysis pubis (SP); and segmentation IPM for measuring displacement of the urethra. Good to excellent inter and intra observer reliability was established for processing the ultrasound images on stored audio-visual imaging files (AVI). Intraclass correlation coefficient (ICC) values: 0.61 to 0.99; 95% confidence intervals (CI) 0.08→0.84 to 0.97→0.99; standard error of measurement (SEM) 0.01to 0.25 cm. There was good agreement between measures on Bland and Altman analysis: mean difference 0.06 to -0.21 cm; 95% CI 0.02→0.45cm to -0.01→0.20cm. Validity of the IPM was confirmed with digital palpation, and furthermore indicated good sensitivity and specificity. Technical and methodological limitations of the IPM, and suggestions for future studies were discussed. Several research questions were addressed using TP ultrasound combined with IPM that enabled the dynamic evaluation of pelvic floor (PF) displacement throughout an entire manoeuvre, rather than limiting the quantification from static images at rest to the end of the manoeuvre. In this way, IPM determined unique quantitative data regarding the automatic displacement, velocity and acceleration of the ARA and urethra during a cough, Valsalva, voluntary PFM contraction, The Knack and a Transversus Abdominis contraction. During automatic events that raised intra-abdominal pressure (IAP), normal PFM function produced timely compression of the PF and additional external support to the urethra, reducing the displacement, velocity, and acceleration. In women with SUI, who have weaker urethral attachments, this shortening contraction did not occur; consequently, the urethra of women with SUI moved further and faster for a longer duration. Caution regarding the generalisability of this study is warranted due to the small number of women in the SUI group and the significant difference in parity between groups. However this non-invasive physiological measurement tool demonstrated a new way of assessing the PFM. It is envisaged that this study will provide the foundation for future studies with larger parity matched populations and eventually improve the rehabilitation of women with SUI and other PF disorders.
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Hallam, S. M. "Enhancing self-efficacy and pelvic floor muscle exercise adherence through sEMG biofeedback : a randomised study." Thesis, University of Salford, 2012. http://usir.salford.ac.uk/33239/.
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Background Pelvic floor muscle exercises are a recommended first-line treatment for stress urinary incontinence (SUI) in women (NICE, 2006). Poor adherence to pelvic floor muscle exercises (PFME) is a recognised problem which has the potential to compromise successful treatment (Bø, 1995; Alewijnse et al., 2001). Biofeedback is thought to help motivate PFME practice but so far this has not been evaluated in a randomised study. Aim This study tests the hypothesis that use of clinic-based sEMG biofeedback improves women’s motivation to exercise (PFME adherence) by increasing pelvic floor muscle exercise self-efficacy, an important construct in pelvic floor muscle exercise adherence behaviour. Method After ensuring that they are able to make an informed decision to participate, a sample of sixty women referred for physiotherapy treatment of SUI between December 2008 and February 2010, gave consent to participate in the study. They were randomised into one of two groups. Thirty one women received clinic-based sEMG biofeedback in addition to the usual care, twenty nine received the usual care. Each participant attended clinic twice in a three month treatment period. Women were also asked to adhere to a daily home exercise programme (HEP). The primary outcome was pelvic floor muscle exercise self-efficacy. PFME self-efficacy and HEP adherence, were assessed by means of self-completed questionnaires. Results Ten women dropped out of the study before completion. Both groups improved on all outcomes, but no significant difference was found between the groups in terms of self-efficacy levels or exercise adherence rates. PFME recall was more accurate in the intervention group receiving clinic-based sEMG biofeedback. A positive and significant relationship was confirmed between PFME self-efficacy and PFME adherence. These findings are discussed in respect to the concept of self-efficacy and behavioural change. xi xii Conclusion In the short term, clinic-based sEMG biofeedback does not increase PFME self-efficacy or HEP practice beyond that achieved through instruction using vaginal palpation. These findings refute the belief that monitoring with sEMG biofeedback improves self-efficacy or women’s motivation to adhere to a HEP, but does suggest that biofeedback may be a useful adjunct to teaching PFME.
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Aranchipe, Magda da Silva. "Ensaio clínico randomizado empregando eletroestimulação do nervo tibial e treinamento da musculatura do assoalho pélvico no tratamento da bexiga hiperativa, incontinência urinária de urgência e mista." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/139743.
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Introdução: Atualmente, a primeira linha de tratamento para bexiga hiperativa (BH), incontinência urinária de urgência (IUU) e incontinência urinária mista (IUM), envolve medicação, treinamento da musculatura do assoalho pélvico (TMAP) e terapia comportamental. Outra abordagem que vem apresentando resultados positivos no tratamento dessas disfunções é a eletroestimulação do nervo tibial (ENT). Objetivo: Comparar a efetividade das técnicas de ENT e TMAP no tratamento da BH, IUU e IUM, e validar um equipamento portátil para aplicação domiciliar de ENT. Métodos: O estudo apresenta delineamento de Ensaio Clínico Randomizado tipo cross-over. A amostra foi composta por 40 mulheres acima de 18 anos com diagnóstico de BH, IUU e IUM. As participantes foram randomizadas em dois grupos: grupo ENT, iniciou a pesquisa realizando eletroestimulação, e o grupo TMAP, iniciou a pesquisa realizando exercícios pélvicos padronizados, ambos de forma domiciliar. Após 8 semanas, as participantes trocaram suas abordagens terapêuticas, totalizando 16 semanas. Todas foram submetidas a uma anamnese e avaliadas em três momentos por meio dos questionários Índice da Severidade da Incontinência (ISI), King´s Health Questionnarie (KHQ) e dados do diário miccional (DM). Resultados: Para todas as variáveis, o grupo ENT apresentou resultados estatisticamente significativos após a intervenção quando comparado ao grupo TMAP (p<0,05). Conclusão: Os dados apresentados indicam maior efetividade da ENT quando comparados ao TMAP após intervenção domiciliar. Com isto, acredita-se que o aparelho desenvolvido pelo Serviço de Engenharia Biomédica do Hospital de Clínicas de Porto Alegre (SEB/HCPA) possa ser uma alternativa de tratamento da BH, IUU e IUM, validando o equipamento para uso clínico.Introduction: The first-line therapy in overactive bladder (OAB), urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI) presently involves drug treatment, pelvic floor muscle training (PFMT) and behavioral intervention (BI). An approach that has shown positive results in the treatment of these dysfunctions is the electrical stimulation of the tibial nerve (TNES). Objective: To compare the effectiveness of TNES and PFMT for treatment of OAB, UUI and MUI, and validate a portable TNES unit designed for home use. Methods: Randomized, crossover clinical trial. The sample consisted of 40 women older than 18 with OAB, UUI and MUI. Participants were randomly assigned to two groups: TNES group, which started the experiment undergoing electrical stimulation, and PFMT group, which started the experiment doing standardized pelvic exercises, both at home. After 8 weeks, the groups exchanged their initial therapeutic approach for the other, thus totalizing 16 weeks of treatment. All the subjects underwent anamnesis and assessment in three different moments with the use of Incontinence Severity Index (ISI), King´s Health Questionnaire (KHQ) and data from a voiding diary (VD). Results: For all the variables, TNES group presented statistically significant results after intervention in comparison to PFMT group (p<0.05). Conclusion: Data have evidenced greater effectiveness of TNES as compared with PFMT after intervention. The device designed by the Department of Biomedical Engineering of Hospital de Clinicas de Porto Alegre (SEB/HCPA) may be an alternative for the treatment of OAB, UUI and MUI, and could have its validation established for clinical practice.
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Bertotto, Adriane. "Ensaio clínico randomizado e controlado : técnicas de treinamento do assoalho pélvico com e sem biofeedback eletromiográfico em mulheres na pós-menopausa com incontinência urinária de esforço." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/116771.
Full textAbstract:
Introdução: Ensaio clínico randomizado e controlado com o propósito de comparar a eficácia da técnica de treinamento dos músculos do assoalho pélvico (TMAP) com ou sem biofeedback eletromiográfico (BFE) e a qualidade de vida (QV) em mulheres com queixas de perda urinária aos esforços. Métodos: Após seleção, as mulheres pós-menopáusicas com Incontinência Urinária de Esforço (IUE) foram randomizadas e alocadas em três grupos: grupo controle (GC), grupo treinamento assoalho pélvico (GTMAP) e grupo treinamento assoalho pélvico + biofeedback (GTMAP+BIO) Após a coleta de dados demográficos, antropométricos e gestacionais aplicou-se o questionário de qualidade de vida (QV) o International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) e a escala de OXFORD. Foi realizada a avaliação eletromiográfica do repouso inicial e final, presença de contração automática durante a tosse, contração voluntária máxima (CVM) e tempo de sustentação da contração, antes e depois da intervenção do GC, GTMAP e GTMAP+BIO. A intervenção no GTMAP e GTMAP+BIO foi de 20 minutos por dia, 2 vezes por semana, durante 4 semanas. Resultados: O estudo foi concluído com 45 mulheres. Houve aumento significativo nos grupos GTMAP e GTMAP+BIO no incremento da força muscular na OXFORD, na contração automática durante a tosse, na CVM, no tempo de sustentação e no ICIQ-SF em relação ao GC e na comparação ao tempo basal e pós-tratamento. O grupo GTMAP+BIO, quando comparado ao GTMAP, foi superior no incremento na força muscular na escala de OXFORD, na contração automática durante a tosse, na CVM e no tempo de sustentação (p<0.05). Considerações finais: O TMAP foi eficaz para a amostra estudada, porém, foi superior na adição do Biofeedback Eletromiográfico (BFE), sendo recomendado a utilização do TMAP associado ao BFE para pacientes com Incontinência Urinária de Esforço.Introduction: This randomized controlled trial sought to compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (EMG-BF) and quality of life in women with stress urinary incontinence (SUI). Methods: Postmenopausal women with SUI were randomly allocated across three groups: control, pelvic floor muscle exercises (PFME), and PFME + biofeedback (PFME+BF). Demographic, anthropometric and gestational data were collected and the ICIQ-SF QoL questionnaire and Oxford grading scale were administered. Before and after the study intervention, women in all groups underwent EMG assessment to evaluate initial and final baseline, presence of automatic contraction while coughing (“the Knack”), maximum voluntary contraction (MVC), and duration of endurance contraction. In the PFME and PFME+BF groups, the duration of intervention was 20 min/day, twice weekly for 4 weeks. Results: The study involved 45 women. The PFME and PFME+BF groups exhibited significant increases in muscle strength (Oxford scale), automatic contraction while coughing, MVC, duration of endurance contraction, and ICIQ-SF as compared to controls and when comparing baseline vs. post-treatment. PFME+BF was associated with significantly superior improvement of muscle strength, automatic contraction while coughing, MVC, and duration of endurance contraction as compared to PFME alone (p<0.05). Conclusion: PFME was effective in this sample, but superior results were achieved when EMG-BF was added. We recommend that PFME+BF be offered to women with SUI.
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Tadaravičiūtė, Rūta. "Dubens dugno raumenų lavinimo kineziterapijos metodais efektyvumas moterims su įtampos šlapimo nelaikymu." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060509_183248-66827.
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Object of the study. Pelvic floor muscles strength and endurance of women with stress urinary incontinence.
Problem of the study. The actuality of urinary incontinence remains in Lithuania, not only because of it’s prevalance, but also because women are not able to find appropriate help and incorrect treatment methods are applied.
Aim of the study. To evaluate the efficiency of physical therapy methods for the pelvic floor muscle re-education in women with stress urinary incontinence.
Objectives. To evaluate the efficiency of Kegel and combined methods for the pelvic floor muscle re-education in women with stress urinary incontinence, to compare the efficiency of Kegel and combined methods for the pelvic floor muscle re-education in women with stress urinary incontinence.
Methods. The objective pelvic floor muscle maximum strenght and endurance in 24 female were measured using pelvic floor muscle function measurement apparatus „Pelvexiser“ and chronometer. The subjects were interviewed about urinary incontinence symptoms‘ severity and urinary incontinence occurrence during provocative tests. Research data was analysed using SPSS 10,0 for Windows.
Results. Muscle function assessment after treatment showed that in both groups pelvic muscles strenght and endurance improved significantly. After treatment a majority of women in Kegel group indicated the severity of their symptoms as moderatley problematic, the majority of women in combined method group reported only minor symptoms... [to full text]
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Gutke, Annelie. "Pelvic Girdle Pain and Lumbar Pain in relation to pregnancy." Doctoral thesis, Linköping : Univ, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med998s.pdf.
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