Low-Value Practices for Pelvic Floor Dysfunction-Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women's Health: Observational Study.

INTRODUCTION AND HYPOTHESIS: The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor. METHODS: A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil. RESULTS: The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication. CONCLUSIONS: The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.

Sleep disorders and regular physical exercise in primary health care: an observational study / Distúrbios do sono e exercício físico regular na atenção primária à saúde: estudo observacional

Physical exercise is currently considered a non-pharmacological alternative to improve sleep quality, but due to the lack of knowledge of some professionals, it is not widely used for this purpose. Thus, the objective of this study was to compare sleep quality, the presence of sleep disorders and insomnia, and the quality of life in patients who practice regular physical exercise (PG) and those who did not practice regular physical exercise (NPG), attended in Basic Health Units (BHUs) in the municipality of Divinópolis, Minas Gerais, Brazil. The study was a cross-sectional observational study carried out with 49 patients recruited from BHUs in the city of Divinópolis, Minas Gerais. They were divided into two groups constituted by those who practiced regular physical exercise (PG) and those who did not practice regular physical exercise (NPG), and then evaluated for sleep quality and the presence of sleep disorders, perception of insomnia, and quality of life addressed according to the respective questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index and SF-36 Quality of Life Questionnaire. When comparing the groups, there was a statistically significant difference regarding the items good sleep quality, presence of severe insomnia, general health status, social aspects and mental health. Thus, it is suggested that patients who practiced regular physical exercise attended in BHUs have a higher prevalence of good sleep quality, lower rate of severe in-somnia and better quality of life

O exercício físico é considerado atualmente como alternativa não farmacológica para melhora da qualidade do sono, porém pela falta de conhecimento de alguns profissionais o mesmo não é muito utilizado para essa finalidade. Dessa forma, o objetivo deste estudo foi comparar a qualidade do sono, a presença de distúrbios do sono e insônia, e a qualidade de vida em pacientes praticantes de exercício físico regular (PEFR) e não praticantes de exercício físico regular (NPEFR), assistidos em UBS ́s do município de Divinópolis, Minas Gerais. O estudo foi do tipo observacional transversal, realizado com 49 pacientes recrutados a partir de Unidades Básicas de Saúde (UBS ́s) do município de Divinópolis, Minas Gerais. Foram divididos em dois grupos, os PEFR e NPEFR, e em seguida avaliados quanto a qualidade e presença de distúrbios do sono, percepção da insônia, e qualidade de vida, abordados de acordo com os respectivos questionários: Índice de Qualidade de Sono de Pittsburgh (IQSP), Índice de Gravidade de Insônia e Questionário de Qualidade de Vida SF-36. Quando comparado os grupos, houve diferença estatisticamente significativa quanto aos itens boa qualidade do sono, presença de insônia severa, qualidade de vida sob os domínios estado geral de saúde, aspectos sociais e saúde mental. Desta forma, sugere-se que os pacientes que praticam exercício físico regular assistidos em UBS's apresentam maior prevalência de boa qualidade do sono, menor índice de insônia severa e melhor qualidade de vida