ABSTRACT
INTRODUCTION AND HYPOTHESIS: The female pelvic floor muscles (PFM) play an important role in sexual function. We hypothesize that there is a relation between PFM strength and sexual function in women with and without sexual dysfunction. METHODS: Retrospective multicentric cross-sectional study including women with and without sexual dysfunction [Female Sexual Function Index (FSFI) cutoff point < 26.55], analyzed by age range, considering demographic, clinical, anthropometric and PFM strength [Modified Oxford Scale (MOS)] data. Chi-square, Mann-Whitney test and linear regression (ranks) were used, with 5% significance (SAS 9.4). RESULTS: Out of 1013 medical records, 982 women with an average age of 45.76 (± 15.25) were included in the study. Of these, 679 (69.14%) presented FSFI score < 26.55, while 303 (30.86%) presented FSFI ≥ 26.55. It was identified that the higher scores were among white women, < 45 years old, single, with higher education, family income > 4 minimum wages, body mass index < 25 kg/m2, lower parity, regular physical activity practitioner and higher PFM strength (MOS: 4-5). Desire, arousal, lubrication and orgasm domains were higher among women with MOS 4-5, while satisfaction and pain domains were higher among those with MOS 3-5. CONCLUSION: Demographic, clinical and anthropometric conditions can influence both PFM strength and female sexual function. Our findings demonstrate that women with higher PFM strength present fewer complaints about sexual dysfunction.
Subject(s)
Pelvic Floor , Sexual Dysfunction, Physiological , Cross-Sectional Studies , Female , Humans , Middle Aged , Muscle Strength/physiology , Pregnancy , Retrospective Studies , Sexual Dysfunction, Physiological/etiologyABSTRACT
Objetivo: Avaliar a efetividade da inserção de um programa de treinamento dos músculos do assoalho pélvico (TMAP) na Atenção Básica à Saúde (ABS) sobre os sintomas urinários e sobre a força muscular e atividade eletromiográfica em mulheres na pós-menopausa. Métodos: Ensaio clínico, randomizado com 42 mulheres na pós-menopausa divididas em dois grupos: Grupo tratado (GT) (n = 21) e Grupo Controle (GC) (n = 21). A avaliação foi realizada através dos questionários de sintomas urinários (ICIQ-UI SF e ICIQ-OAB), palpação digital, eletromiografia (EMG) dos músculos do assoalho pélvico (MAP) e escala analógica visual para satisfação do tratamento. O protocolo de tratamento consistiu de 12 sessões em grupo de 30 minutos. A análise estatística foi realizada pelo Teste de Comparação Múltipla de Tukey, Anova e Teste Perfil de Contrastes. Resultados: 85,72% das mulheres do GT aderiram ao tratamento. A satisfação foi significativamente melhor neste grupo (p < 0,001). No GT, houve decréscimo significativo dos sintomas de IU, com diferença entre o GT e o GC (ICIQ-UI-SF: p = 0,03; ICIQOAB: p = 0,002), diminuição do escore ICIQ-OAB (p < 0,001) e aumento tanto da força muscular avaliada por meio da palpação digital (p = 0,001) quanto da atividade eletromiográfica dos MAP (p = 0,003). Conclusão: A inserção do TMAP em um programa de atenção básica à saúde foi capaz de diminuir a incontinência urinária, além de aumentar a força muscular e atividade eletromiográfica dos músculos do assoalho pélvico em mulheres na pós-menopausa. (AU)
Aim: To evaluate the efficacy of a pelvic floor muscle training (PFMT) program on urinary symptoms, muscle strength and electromyographic activity in postmenopausal women in a Primary Health Care Center. Methods: A clinical, randomized study was conducted with 42 postmenopausal women, divided into two groups: Treatment Group (TG) (n = 21) and Control Group (CG) (n = 21). The evaluation was performed using digital palpation, pelvic floor electromyography (EMG), as well as the validated questionnaires: ICIQ-UI SF, ICIQ-OAB. The treatment protocol consisted of 12 group sessions, twice a week, with 30 minutes of duration each. The statistical analyses were performed using Anova, Tukey's Multiple Comparison Test and the Contrast Profile Test. Results: 85.72% of the women in TG adhered to the treatment. The satisfaction was significantly higher in this group (p < 0.001). In TG, there was a significant decrease in the UI symptoms (ICIQ UI-SF), with difference between the TG and CG (p = 0.03) and a decrease in ICIQ-OAB score (p < 0.001) and increase in the pelvic floor muscles strength assessed by digital palpation (p = 0.001) and electromyographic activity (p = 0.003). Conclusion: The insertion of the PFMT was able to decrease UI and to increase muscle strength and electromyographic activity in postmenopausal women. (AU)
Subject(s)
Humans , Female , Menopause , Pelvic Floor Disorders , Primary Health Care , Urinary Incontinence , Muscle Strength , Physical Therapy SpecialtyABSTRACT
INTRODUCTION AND HYPOTHESIS: This video's proposal was to present one of the pelvic floor muscle (PFM) training programs used in our research, and to study the effects of abdominopelvic kinesiotherapy on female PFM function. METHODS: A total of 82 women participated in this study, 11 nulliparous, 13 primiparous pregnant, 20 primiparous postpartum and 38 postmenopausal women, who were evaluated first by digital palpation, then by either electromyography or vaginal dynamometry to investigate their PFM strength, followed by ICIQ UI-SF and ICIQ-OAB to evaluate urinary symptoms. This intervention protocol lasted for 60 min, three times a week, with a total of 10 sessions, and was supervised by a physiotherapist, using a gym ball, according to Marques and collaborators. RESULTS: A significant increase in PFM strength was observed by digital palpation in all groups. This finding was confirmed by electromyography in both pregnant (p = 0.0001) and postpartum (p = 0.0001) groups, as well as in 20 of the 38 women from the postmenopausal group (p = 0.003) then by vaginal dynamometry (p = 0.02) in the rest of the women (18) from the same group, with a concomitant decrease in urinary symptoms (p < 0.05). CONCLUSION: The abdominopelvic kinesiotherapy program promotes an increase in pelvic floor muscle strength and a decrease in urinary symptoms.