Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review.

Pelvic, perineal, and nervous lesions, which derive principally from pregnancy and childbirth, may lead to pelvic floor dysfunctions, such as organ prolapses and lesions in the nerves and muscles due to muscle expansion and physiology. It is estimated that 70% of women affected by this clinical picture have symptoms that do not respond to the classical treatments with antimuscarinic and anticholinergic drugs. Therefore, resorting to efficient alternatives and less invasive methods is necessary to assist this public health problem that predominantly affects the female population, which is more susceptible to the risk factors. This study aimed to perform an updated and comprehensive literature review focused on the effects of pelvic floor electrical stimulation, considering new perspectives such as a correlation between electric current and site of intervention and other molecular aspects, different from the present reviews that predominantly evaluate urodynamic aspects. For that purpose, PubMed and ScienceDirect databases were used to perform the search, and the Methodi ordinatio method was applied. With well-researched therapeutic effects, electrical stimulation induced promising results in histological, nervous, and molecular evaluations and spinal processes, which showed beneficial results and revealed new perspectives on ways to evoke responses in the lower urinary tract in a non-invasive way. Thus, it is possible to conclude that this type of intervention may be a non-invasive alternative to treat pelvic and perineal dysfunctions.

Electrical stimulation structurally affects the tissues of the rectum and anus of nulliparous rats.

Considering that the muscles of the anus perform a critical role in maintaining continence, losses in their structure can negatively affect the physiological control of the intestinal contents. Anorectal electro-stimulation (ARES) has been reported to have a positive effect on the functionality of treated patients, but how ARES affects the structural tissues of the anorectal segment remains unknown. Because the study of how ARES structurally affects human tissues is not possible, this study aimed to clarify these effects in a murine model, which has a similar anorectal segment (structure and physiology) to humans. For the descriptive and comparative study, randomly selected nulliparous adult Wistar rats (n = 5) were submitted to 30 anorectal sessions of ARES with a biphasic current (700 µs, 50 Hz from 2 to 4 mA). After treatment, the animals were euthanized, and the anorectal segments were dissected and processed for histopathological analysis. Our results showed that ARES increased the widths of the mucosal, submucosal and muscle layers of the rectum, as well as the number of leukocytes in the mucosa. ARES also caused hyperplasia of the smooth muscle of the internal anal sphincter and hypertrophy of the external anal sphincter muscle. In conclusion, our results showed that ARES had not only a positive effect on the structure (morphology) of all tissues associated with the rectum and anus but, more importantly, on the structural gain of the muscles (hyperplasia and hypertrophy), which could point to a functional gain of the anal sphincter, reinforcing the applicability of ARES as a non-invasive treatment for anal incontinence.

Efeito da acupuntura sobre dinamometria manual e a resistência muscular localizada de membros superiores em praticantes de exercício resistido / Effect of acupuncture on hand dinamometry and muscular localized resistance of practitioners upper limbs in resistance exercise

Estudo analítico transversal controlado não pareado que contou com 14 participantes do sexo masculino, selecionados por conveniência com idades entre 20 e 25 anos, praticantes de exercício resistido, divididos em dois grupos não pareados, sendo: um grupo sem intervenção por acupuntura (GC) e o outro grupo com intervenção com acupuntura (GE). O objetivo do presente estudo consistiu em avaliar o efeito da acupuntura sobre a resistência muscular localizada de membros superiores e a força de preensão palmar em praticantes de exercício resistido. Com relação à resistência muscular localizada, os resultados apontam aumento do número de repetições para os dois grupos, porém, não estatisticamente significativos e para força de preensão palmar, aumento para o GE e diminuição para o GC, também não estatisticamente significativas. Conclui-se que a pesquisa sobre a acupuntura, apresentada neste artigo, não se demonstrou eficaz para aumentar o rendimento dos sujeitos no teste de resistência muscular localizada e da força de preensão palmar.(AU)

Controlled cross-sectional analytical study unpaired that featured 14 male participants, selected by aged between 20 and 25 years, practitioners of resistance exercise, divided into two unpaired groups: one group without intervention by acupuncture (GC) and the other group with intervention acupuncture (GE). The aim of this study was to evaluate the effect of acupuncture on muscular endurance of upper limbs and the handgrip strength in practitioners of resistance exercise. With respect to muscular endurance, the results indicate an increase in the number of repetitions for the two groups, but not statistically significant and to grip strength, increase and decrease in GE and GC respectively, also not statistically significant. It is concluded that acupuncture in this study did not prove to be effective to increase the yield of the subjects in the muscular endurance test and grip strength.(AU)

Efeito da acupuntura na qualidade de vida e no tratamento da dor em pacientes com fibromialgia / Effect of acupuncture on quality of life and the treatment of pain in patients with fibromyalgia

A fibromialgia é uma síndrome reumática caracterizada por dor musculoesquelética crônica, não inflamatória, associada à fadiga, distúrbio do sono, rigidez matinal, disfunção cognitiva, ansiedade e depressão. O objetivo do estudo foi avaliar o efeito da acupuntura na atividade eletrodermal, na qualidade de vida e na redução da dor em indivíduos fibromiálgicos. Trata-se de uma série de casos com pacientes do gênero feminino e idade compreendida entre 35 e 58 anos. Foram avaliados 3 desfechos: a intensidade da dor, por meio da Escala Visual Analógica (EVA); a qualidade de vida, investigada pelo Questionário Sobre o Impacto da Fibromialgia (QIF); e a atividade eletrodermal, verificada por Ryodoraku. Como resultado, observou-se redução percentual da dor entre 34% a 63% na EVA, melhora em 7 dos 10 itens do QIF e aumento da eletropermeabilidade média do Ryodoraku, de 34,95±11,12 para 46±11,66. Conclui-se que a acupuntura promoveu melhoria dos sintomas em todas as participantes do estudo.(AU)

Fibromyalgia is a syndrome characterized by chronic musculoskeletal pain, non-inflammatory origin, associated with fatigue, sleep disturbance, morning stiffness, cognitive dysfunction, anxiety and depression. The aim of the study was to evaluate the effect of acupuncture on electrodermal activity, quality of life and reduction of pain in fibromyalgia subjects. This research relates to a series of cases with patients of the feminine gender and aged between 35-58 years. We evaluated three clinical outcomes: pain intensity, using the Visual Analogue Scale (VAS); quality of life through the Fibromyalgia Impact Questionnaire (FIQ); and electrodermal activity, verified by Ryodoraku. As a result it was observed percentage reduction in pain between 34% and 63% in VAS, improvement in 7 of the 10 items QIF, and increased electrodermal activity Ryodoraku average of 34.95 ± 11.12 to 46 ± 11.66. It is concluded that acupuncture promoted improvement of symptoms in all study participants.(AU)

Efeito da acupuntura na dor lombar: revisão de literatura / Effect of acupuncture in low back pain: Literature review

A lombalgia é o acometimento mais frequente da coluna vertebral, sendo uma das principais queixas e uma das causas mais comuns de incapacidade e morbidade. Diversos tipos de tratamento são usados no combate à dor lombar, porém, muitos pacientes não apresentam resultados com a medicina convencional. Entre os tratamentos não convencionais, a acupuntura é uma das principais alternativas para o alívio e cura dessa patologia. Com isso, o objetivo do trabalho é analisar a eficácia da acupuntura no tratamento da lombalgia, comparando-a com outros tratamentos. Para isso, realizou-se uma revisão bibliográfica com 21 estudos, randomizados, revisões de literatura e meta-análises, publicados entre os anos de 1999 e 2011, com o tema deste estudo. A acupuntura foi eficaz no tratamento da lombalgia crônica e seus resultados foram superiores aos de outros tratamentos. Sugerimos que mais estudos sejam feitos para a comprovação dos efeitos da acupuntura na lombalgia aguda.(AU)

Low back pain is the most frequent involvement of the spine, with a major complaint and one of the most common causes of disability and morbidity. Several types of treatment are used to combat back pain, but many patients do not present results with conventional medicine. Among the non-conventional treatments, acupuncture is one of the main alternatives for the relief and cure of this disease. Thus, the objective of this study is to analyze the effectiveness of acupuncture in the treatment of low back pain, comparing it with other treatments. To do so, was performed a literature review of 21 studies, randomized, literature reviews and metanalysis published between the years 1999 and 2011, with the theme of this study. Acupuncture was effective in treating chronic low back pain and its results were superior to other treatments. We suggest that further studies should be done to prove the effects of acupuncture on acute low back pain.(AU)

Análise dos efeitos da tens, cinesioterapia e o método Mackenzie para redução da dor em pacientes com lombalgia / Analysis of the effects of tens, kinesiotherapy and Mackenzie method for reduction of pain in patients with low back pain

O objetivo do estudo foi analisar os resultados entre o TENS acupuntura, cinesioterapia e o Método Mackenzie visando o alívio de dor em pacientes com lombalgia no Hospital Militar da Área de Brasília (HMAB). Trata-se de um estudo de caso comparativo longitudinal. Contou com a participação de 11 pacientes, sendo que no primeiro mês foram realizados o TENS e alongamentos para ambos os grupos; no segundo mês, o grupo estudo (GE) realizou a Método Mackenzie, e o grupo de controle (GC) realizou exercícios isométricos. O tratamento teve duração de 2 meses (16 sessões). Para a coleta de dados foram utilizados seis questionários e testes especiais. Verifi cou-se nos resultados do estudo que houve uma estatística signifi cativa (p<0.05) no pré e no pós-tratamento entre os pacientes. Logo, os resultados obtidos demonstraram que as terapias foram efi cazes para o alívio da dor tanto na pósterapia como na manutenção para as sessões seguintes.(AU)

Th e aim of the study was to analyze the results between the TENS acupuncture, exercise and Method Mackenzie aimed at relieving pain in patients with low back pain in the Military Hospital of Brasília Area (HMAB). Th is is a longitudinal comparative case study. With the participation of 11 patients of whom the fi rst month held the TENS and stretching for both groups, and in the second month, the study group (SG) held Mackenzie Method, and the control group (CG) performed isometric exercises. Th e treatment lasted for 2 months (16 sessions). To collect the data we used questionnaires and six special tests. Th e results of the study found that there was a statistically signifi cant (p <0.05) before and aft er treatment among patients. Th us, the results demonstrated that the therapy was eff ective in relieving pain aft er therapy both in maintenance and in the following sections.(AU)