Prevalence of sarcopenia in older women with pelvic floor dysfunction.

BACKGROUND: Sarcopenia is a determinant of age-related skeletal muscle weakness. In this sense, it is believed that there may be a pathophysiological association between pelvic floor dysfunction (PFD) and sarcopenia; however, few articles investigating an association between these two pathologies have been published. OBJECTIVES: To identify the prevalence of sarcopenia in older women with PFD and verify the association between the severity of PFD and the severity of sarcopenia. METHODS: This cross-sectional study was undertaken in urogynaecology outpatient clinics in Fortaleza, Ceará, Brazil. Women with PFD aged ≥ 60 years were included. Women with cognitive impairments, amputations and/or limb fractures were excluded. Sociodemographic, anthropometric and PFD data were evaluated, and tests for measuring muscle strength, muscle mass and physical performance were performed. RESULTS: In total, 217 women were included in this study; of these, 121 (55.8%) presented without sarcopenia, 71 (32.7%) presented with probable sarcopenia, 23 (10.6%) presented with confirmed sarcopenia, and two (0.9%) presented with severe sarcopenia. Regarding sarcopenia related to PFD, a higher prevalence of probable sarcopenia was observed in women with urinary incontinence (UI) (n = 55, 77.5%). Confirmed sarcopenia was more prevalent in women with pelvic organ prolapse (POP) (n = 19, 82.6%); among these cases, most women had POP of the anterior, posterior and apical compartments (n = 8, 42.1%). All the women with severe sarcopenia had UI and POP and, considering the specific types of these dysfunctions, the prevalence of severe sarcopenia was 50.0% in the women with UI and POP of the anterior and apical wall. The most severe stages of POP were associated with sarcopenia (p = 0.002). CONCLUSION: The prevalence of sarcopenia in women with PFD was high. Healthcare providers who assist women with PFD should consider the possibility of assessing sarcopenia, especially when faced with more extensive POP in older women. The evaluation of sarcopenia may play a role in the management of women with PFD.

Continence App: Construction and validation of a mobile application for postnatal urinary incontinence prevention.

OBJECTIVE: Describing the Continence App development as an educational technology to promote adherence to pelvic floor muscle training and prevent urinary incontinence in postpartum women. STUDY DESIGN: Study of technological production carried out in two stages: construction and validation. The first happened in four steps: modeling, navigation project, abstract design of the interface and implementation. In the validation phase 22 experts (11 health experts and 11 from the information technology/computing/communication areas) and 22 puerperal women were invited to evaluate the content and appearance of the education application. The content validity was analyzed through the Content Validity Index and the appearance validity through 75% minimum agreement in the items evaluated. The study was conducted during 2016 and 2017. For the content validation, the judges evaluated the following aspects: concepts and definitions used in the application, possibility of comprehension by the target audience and form of presentation. In order to validate the appearance, the installation, execution of the functions, objectives, usability, interface, practicality and interaction with the user were evaluated. RESULTS: Most of health experts were physiotherapists (n = 07) and professionals with a PhD (n = 07). Regarding the CVI, 100% of the evaluated items obtained values of 0.86 or greater. Most of information technology/computing/communication experts were male (81.8%) and of the information technology area (63.6%). Except for "restart sessions", "ways of presenting suggestions", "user interaction" and "motivates questioning", all the other aspects received between 81.8% and 100% positive responses. All items evaluated by the target audience obtained a minimum of 94.3% positive responses from the participants. In this step, points for adjustment were identified in relation to the application content and interface, which were promptly corrected. CONCLUSIONS: The application has been validated for use in clinical practice as an educational technology to promote adherence to pelvic floor muscle training and prevention of urinary incontinence in postpartum women.