Pelvic floor muscle function and EMG in nulliparous women of different ages: a cross-sectional study.

BACKGROUND: Although aging is considered a risk factor for pelvic floor muscle dysfunction (PFMD), the effect of aging on the function of the pelvic floor muscles (PFM) remains unclear. OBJECTIVE: To compare PFM function and activity in nulliparous women in different age groups. METHODS: This was a cross-sectional study in which 70 women with ages between 18 and 69 years were divided into five age groups for evaluation. Initially, medical histories were taken, and then the PFM function was assessed using digital palpation (Modified Oxford Scale), manometry and surface electromyography (sEMG). The Kruskal-Wallis test was applied to check the differences between the groups. The Spearman correlation coefficient was used to verify the correlations between age and PFM function, manometry values and sEMG. A significance level of 5% was adopted. RESULTS: No significant differences were observed between the different age groups in PFM digital palpation, manometry values and sEMG. There was a low negative correlation between age root mean square and peak of sEMG signals. CONCLUSION: This study found no difference in PFM function and activity between nulliparous women in the five different age groups. Future long-term large prospective studies are required to confirm these findings.

Relationship between aerobic capacity and pelvic floor muscles function: a cross-sectional study.

The objective of this study was to evaluate the relationship between aerobic capacity and pelvic floor muscles (PFM) function in adult women. Women aged 18 or over and without urinary dysfunction or other chronic diseases were eligible to participate. They completed the habitual physical activity (HPA) questionnaire, underwent a PFM functional evaluation by palpation and perineometry, and performed a submaximal (between 75 and 85% of maximum heart rate) cardiopulmonary exercise (CPX) test to determine the ventilatory anaerobic threshold (VAT). Forty-one women were included (35±16 years, 75% physically active, 17% very active, and 8% sedentary and 17% presented grade 1 PFM contraction, 31.8% grade 2, 26.8% grade 3, and 24.4% grade 4, according to the modified Oxford Scale). The average PFM contraction pressure obtained by perineometer was 53±26 cmH2O and the average oxygen consumption at VAT (VO2VAT) obtained from CPX was 14±2 mL·kg-1·min-1. Significant correlations were found between PFM contraction pressure and VO2VAT (r=0.55; P<0.001); between PFM contraction pressure and HPA score (r=0.38; P=0.02); between age and VO2VAT (r=-0.25; P=0.049); and between VO2VAT and HPA score (r=0.36; P=0.02). An age-adjusted multiple linear regression equation (R2=0.32) was derived to estimate VO2VAT from the contraction value obtained by perineometer, so that the PFM contraction pressure was able to predict VO2VAT. The equation was validated using data from another group of 20 healthy women (33±12 years; PFM contraction: 49±23 cmH2O) and no significant difference was found between actual VO2VAT and predicted VO2VAT (13.1±1.9 vs 13.8±2.0 mL·kg-1·min-1). In conclusion, PFM function is associated with aerobic capacity in healthy women and PFM contraction pressure may be used to estimate VO2VAT in this population.

Water- versus land-based treatment for postural control in postmenopausal osteoporotic women: a randomized, controlled trial.

OBJECTIVE: To compare the effects of water-based and land-based physical therapy on postural control of older women with osteoporosis. METHODS: Thirty-six postmenopausal women with osteoporosis were allocated into two groups: land-based or water-based. Volunteers received 12 weeks of a supervised land-based or water-based physical therapy treatment. The outcome measure was postural control of the body during quiet standing on upright stance (eyes opened and closed), tandem and one-limb stance on a force plate. A two-way ANOVA with a Tukey HSD post-hoc test were used to highlight differences between pre- and post-intervention evaluations. Effect sizes were measured with Cohen d coefficient. For all variables, a level of 5% of significance was adopted. RESULTS: Significant improvements at tandem (p < 0.05, effect sizes from -0.67 to -1.35) and one-limb stance (p < 0.05, effect sizes from -0.76 to -1.03) for women carrying out water-based treatment were observed. Land-based treatment did not present significant improvement. CONCLUSIONS: Group-based water-based physical therapy treatment may be more effective than land-based therapy to improve postural control at one-limb stance in women with osteoporosis.

Relationship between aerobic capacity and pelvic floor muscles function: a cross-sectional study

The objective of this study was to evaluate the relationship between aerobic capacity and pelvic floor muscles (PFM) function in adult women. Women aged 18 or over and without urinary dysfunction or other chronic diseases were eligible to participate. They completed the habitual physical activity (HPA) questionnaire, underwent a PFM functional evaluation by palpation and perineometry, and performed a submaximal (between 75 and 85% of maximum heart rate) cardiopulmonary exercise (CPX) test to determine the ventilatory anaerobic threshold (VAT). Forty-one women were included (35±16 years, 75% physically active, 17% very active, and 8% sedentary and 17% presented grade 1 PFM contraction, 31.8% grade 2, 26.8% grade 3, and 24.4% grade 4, according to the modified Oxford Scale). The average PFM contraction pressure obtained by perineometer was 53±26 cmH2O and the average oxygen consumption at VAT (VO2VAT) obtained from CPX was 14±2 mL·kg-1·min-1. Significant correlations were found between PFM contraction pressure and VO2VAT (r=0.55; P<0.001); between PFM contraction pressure and HPA score (r=0.38; P=0.02); between age and VO2VAT (r=-0.25; P=0.049); and between VO2VAT and HPA score (r=0.36; P=0.02). An age-adjusted multiple linear regression equation (R2=0.32) was derived to estimate VO2VAT from the contraction value obtained by perineometer, so that the PFM contraction pressure was able to predict VO2VAT. The equation was validated using data from another group of 20 healthy women (33±12 years; PFM contraction: 49±23 cmH2O) and no significant difference was found between actual VO2VAT and predicted VO2VAT (13.1±1.9 vs 13.8±2.0 mL·kg-1·min-1). In conclusion, PFM function is associated with aerobic capacity in healthy women and PFM contraction pressure may be used to estimate VO2VAT in this population.

Electromyographic activity of the pelvic floor muscles in the third trimester: comparison between primigravidae and secundigravidae.

OBJECTIVE: The objective was to compare the electromyographic activity of pelvic floor muscle (PFM) on third semester between primigravidae and secundigravidae who had previous vaginal delivery. DESIGN: Cross-sectional observational study. SAMPLE: Nineteen primigravidae and 21 secundigravidae between 34'h and 361 gestational weeks were evaluated. MATERIALS AND METHODS: Data collection consisted in assessing the PFMs activity by surface electromyography. MAIN OUTCOME MEASURES: The variables related to electromyographic assessment such peak and average on the rest, maximal voluntary contraction, and sustained contraction. RESULTS: There were no differences on electromyographic activity of PFMs between primigravidae and secondigravidae. However, a significant increase in body mass index and a negative correlation of the newborn weight with the peak value of electromyographic signal during maximal voluntary contraction were observed. CONCLUSIONS: The factors that can change the electromyographic activity pattern during pregnancy can be related to maternal body mass increased and newborn weight.

Efectos de la electroestimulación superficial en las mujeres mayores con incontinencia urinaria de esfuerzo: estudio piloto aleatorio controlado / Effects of Surface Electrical Stimulation in Older Women With Stress Urinary Incontinence: A Randomized Controlled Pilot Study

Objetivos: El objetivo de este estudio fue evaluar los efectos de la estimulación eléctrica de superficie en mujeres con incontinencia urinaria de esfuerzo (IUE) sin compararla con ningún tratamiento. Material y métodos: Este estudio piloto, aleatorio y controlado, incluyó mujeres mayores de 60 años con al menos un episodio de fuga de orina de esfuerzo durante el mes anterior. Catorce mujeres fueron distribuidas aleatoriamente en 2 grupos: estimulación eléctrica de superficie (EES) y grupo control (GC). Las mujeres en el grupo EES fueron tratadas con estimulación eléctrica de superficie con 4 electrodos durante 6 semanas, con 2 sesiones semanales de20 min. Fueron evaluadas antes y después del tratamiento para el resultado primario, la pérdida de orina, y para los secundarios, mediante el Cuestionario de Salud de King, presión de la contracción y la satisfacción subjetiva. Resultados: Para el escape de orina se observó una disminución significativa en el grupo EES después del tratamiento (p = 0,017). Se apreciaron diferencias significativas entre el grupo EES y GC en la evaluación después del tratamiento (p < 0,01; tamaño del efecto:−1,38,IC del 95% de 1,18 a 14,14). No se observaron diferencias significativas en ambos grupos para el resultado de presión de la contracción. En la calidad de vida se constató una reducción significativa de la puntuación en el dominio de la gravedad para el grupo EES después del tratamiento (p = 0,017).Conclusiones: Los resultados demostraron que la estimulación eléctrica de superficie en mujeres con IUE puede ser un método eficaz para la mejora de las pérdidas de orina (AU)

Objective: The objective of this study was to evaluate the effects of surface electrical stimulation in elderly women with stress urinary incontinence (SUI) as compared to no treatment. Materials and methods: This randomized controlled pilot study included women over the age of 60 years, with at least one episode of stress urinary leakage during the previous month. Fourteen women were allocated according to a computer generated randomization list in two groups: surface electrical stimulation (SES), and control group (CG). The women in the SES group were treated with surface electrical stimulation using four electrodes, during six weeks with two weekly sessions of 20 minutes each. They were evaluated before and after treatment primary outcome, urinary leakage, and secondary outcomes, King’s Health Questionnaire, pressure perineometry, and subjective satisfaction. Results: For the urinary leakage, there was a significant decrease in SES group after treatment (P = 0.017). Significant differences were observed between the SES group and CG in the evaluation after treatment (P <0 .01; effect size: -1,38; 95% confidence interval from 1,18 to 14,14). No significant differences were observed in both groups for the outcome pelvic floor muscle pressure. In the evaluation of quality of life, a significant reduction of score in the gravity domain was observed for the SES group after treatment (P = 0.017). Conclusion: The results of this study showed that surface electrical stimulation in elderly women with SUI can be an effective method for the improvement of urinary leakage (AU)

Adjustments in static and dynamic postural control during pregnancy and their relationship with quality of life: A descriptive study

Objective: The aim of this study was to evaluate static and dynamic postural control during the three trimesters of pregnancy and to check the quality of life in each trimester. Methods This is a descriptive study in which posturographic tests were applied in four still standing positions, for three trials, with a combination of different visual conditions and support base configurations. The variables of ground reaction force (GRF) were also analyzed during the gait stance phase through the force platform and the quality of life. The study included 20 non-pregnant women and 13 pregnant women during the gestational period. The variables analyzed were statokinesigram, time and value of the first and second peak and the valley of the vertical component of GRF, time and maximum and minimum value found in the anterior-posterior horizontal component. Results Compared to control group, pregnant women had larger center of pressure displacement areas, longer time in the first phase of weight acceptance, lower values of first and second peaks of the vertical component and lower maximum and minimum values of the anterior-posterior horizontal component of the GRF. With respect to quality of life, the physical domain was the most affected in the first trimester. Conclusion The results demonstrate that in the beginning of the pregnancy, the woman's body seems to already change postural control, and during the trimesters, there is a trend to reduction in postural stability (AU)

Objetivo: El objetivo de este estudio fue evaluar el control de la postura estática y dinámica durante los tres trimestres del embarazo y comprobar la calidad de vida en cada trimestre. Métodos: Se realizó un estudio descriptivo en el que las pruebas posturograficas se aplicaron en cuatro posiciones de pie, de tres ensayos, con una combinación de diferentes condiciones visuales y las configuraciones de base de apoyo, también se analizaron las variables de la fuerza de reacción del suelo (GRF) en la posición de marcha a través de la plataforma de fuerza, y la calidad de vida. El estudio incluyó 20 mujeres no embarazadas y 13 mujeres embarazadas durante el período gestacional. Las variables analizadas fueron: statokinesigram, el tiempo y el valor del primer pico y el segundo y el valle de la componente vertical de GRF, el tiempo y el valor máximo y mínimo de la componente horizontal antero-posterior. Resultados: En comparación con el grupo control, las mujeres embarazadas tenían más centro de las zonas de desplazamiento de presión, mayor tiempo en la primera fase de aceptación de peso, los valores más bajos de los primero y segundo picos de la componente vertical y menores valores máximos y mínimos de la horizontal antero-posterior componente de la GRF. Con respecto a la calidad de vida, el dominio físico fue el más afectado en el primer trimestre. Conclusión: Los resultados demuestran que, al principio del embarazo, el cuerpo de la mujer parece cambiar ya el control postural, y durante el trimestre hay una tendencia a la reducción en la estabilidad postural (AU)

[Effects of surface electrical stimulation in older women with stress urinary incontinence: a randomized controlled pilot study]. / Efectos de la electroestimulación superficial en las mujeres mayores con incontinencia urinaria de esfuerzo: estudio piloto aleatorio controlado.

OBJECTIVE: The objective of this study was to evaluate the effects of surface electrical stimulation in elderly women with stress urinary incontinence (SUI) as compared to no treatment. MATERIALS AND METHODS: This randomized controlled pilot study included women over the age of 60 years, with at least one episode of stress urinary leakage during the previous month. Fourteen women were allocated according to a computer generated randomization list in two groups: surface electrical stimulation (SES), and control group (CG). The women in the SES group were treated with surface electrical stimulation using four electrodes, during six weeks with two weekly sessions of 20 minutes each. They were evaluated before and after treatment primary outcome, urinary leakage, and secondary outcomes, King's Health Questionnaire, pressure perineometry, and subjective satisfaction. RESULTS: For the urinary leakage, there was a significant decrease in SES group after treatment (P=.017). Significant differences were observed between the SES group and CG in the evaluation after treatment (P<.01; effect size: -1,38; 95% confidence interval from 1,18 to 14,14). No significant differences were observed in both groups for the outcome pelvic floor muscle pressure. In the evaluation of quality of life, a significant reduction of score in the gravity domain was observed for the SES group after treatment (P=.017). CONCLUSION: The results of this study showed that surface electrical stimulation in elderly women with SUI can be an effective method for the improvement of urinary leakage.

Efectos del fortalecimiento del suelo pélvico en la calidad de vida de un grupo de mujeres con incontinencia urinaria: estudio aleatorizado controlado / Effects of Pelvic Floor Muscle Training on Quality of Life of a Group of Women With Urinary Incontinence: Randomized Controlled Trial

Objetivos: Evaluar los efectos de la kinesioterapia en un grupo de mujeres con incontinencia urinaria (IU) sobre la calidad de vida (CV), el nivel de presión y función de los músculos del suelo pélvico en mujeres con IU. Material y métodos: Estudio piloto aleatorizado controlado de 30 mujeres (edad: 60,87±05,09 años) que fueron evaluadas al inicio y después de 12 semanas de tratamiento. Se realizaron las siguientes evaluaciones: prueba de absorbente de una hora, presión y función de los músculos del suelo pélvico y el cuestionario King’s Health Questionnaire (KHQ). Las voluntarias fueron distribuidas aleatoriamente en dos grupos: kinesioterapia en grupo y grupo de control. El protocolo del grupo de kinesioterapia en grupo consistió en 12 sesiones, con una duración de una hora. Los datos fueron analizados usando las pruebas de Wilcoxon y Mann-Whitney. El nivel de significación fue del 5%.ResultadosEl tratamiento en grupo mostró una mejoría significativa en: la prueba de absorción de una hora (p=0,053); la función (p<0,006) y el nivel de la presión (p=0,0014) de contracción de los músculos del suelo pélvico y en algunos ámbitos del KHQ: el impacto de la incontinencia urinaria (p=0,034), las limitaciones en el desempeño de las tareas diarias (p=0,025), el sueño y la disposición (p=0,018), así como la gravedad (p=0,004). En el grupo de control no hubo diferencias significativas. Conclusiones: El protocolo para fortalecer los músculos del suelo pélvico en grupo fue eficaz para mejorar la IU, CV, función y presión de la contracción de los músculos del suelo pélvico (AU)

Objective: To evaluate the effects of Kinesiotherapy on function and level of pressure of pelvic floor muscle and quality of life (QOL) of a group of women with urinary incontinence (UI). Materials and methods: This is a randomized controlled pilot trial. Thirty women (age 60.87±9.05 years) were evaluated, before and after 12 weeks of treatment, for urinary loss, pelvic floor muscle function and pressure; and quality of life (QOL). Volunteers were randomly allocated into two groups: Kinesiotherapy Group and Control Group. The Kinesiotherapy Group protocol consisted of 12 1-hour sessions with exercises to strengthen pelvic floor muscle and information for UI. The Control Group did not receive any treatment during the corresponding time. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney test. The significance level was 5%.ResultsThe Kinesiotherapy Group presented a significant improvement in urinary loss (p=0.053), pelvic floor muscle function (p<0.006) and pressure (p=0.0014) and in some domains of King’s Health Questionnaire for QOL assessment: incontinence impact (p=0.034), limitations of daily activities (p=0.025), sleep and disposition (p=0.018) and also gravity domains (p=0.004). No differences were found in the control group for any variables. Conclusion: The protocol to strengthen the pelvic floor muscle used by the Kinesiotherapy Group was effective to improve the UI, QOL, function and pressure of pelvic floor muscle contraction (AU)

[Effects of pelvic floor muscle training on quality of life of a group of women with urinary incontinence: randomized controlled trial]. / Efectos del fortalecimiento del suelo pélvico en la calidad de vida de un grupo de mujeres con incontinencia urinaria: estudio aleatorizado controlado.

OBJECTIVE: To evaluate the effects of Kinesiotherapy on function and level of pressure of pelvic floor muscle and quality of life (QOL) of a group of women with urinary incontinence (UI). MATERIALS AND METHODS: This is a randomized controlled pilot trial. Thirty women (age 60.87±9.05 years) were evaluated, before and after 12 weeks of treatment, for urinary loss, pelvic floor muscle function and pressure; and quality of life (QOL). Volunteers were randomly allocated into two groups: Kinesiotherapy Group and Control Group. The Kinesiotherapy Group protocol consisted of 12 1-hour sessions with exercises to strengthen pelvic floor muscle and information for UI. The Control Group did not receive any treatment during the corresponding time. The data were analyzed by non-parametric Wilcoxon and Mann-Whitney test. The significance level was 5%. RESULTS: The Kinesiotherapy Group presented a significant improvement in urinary loss (p=0.053), pelvic floor muscle function (p<0.006) and pressure (p=0.0014) and in some domains of Kinǵs Health Questionnaire for QOL assessment: incontinence impact (p=0.034), limitations of daily activities (p=0.025), sleep and disposition (p=0.018) and also gravity domains (p=0.004). No differences were found in the control group for any variables. CONCLUSION: The protocol to strengthen the pelvic floor muscle used by the Kinesiotherapy Group was effective to improve the UI, QOL, function and pressure of pelvic floor muscle contraction.

Vaginal cone for postmenopausal women with stress urinary incontinence: randomized, controlled trial.

OBJECTIVE: To investigate the effect of vaginal cones and pelvic floor muscle training (PFTM) in postmenopausal women with stress urinary incontinence. METHODS: This randomized, controlled study included postmenopausal women, who complained of stress urinary incontinence. Forty-five women were allocated to three groups: a group given therapy with vaginal cones (n = 15), a group receiving therapy with PFTM (n = 15), and the control group (n = 15). Subjects in the intervention groups were treated for 6 weeks with twice-weekly sessions of 40 min. Women in the vaginal cone group carried out the pelvic floor muscle strengthening with vaginal cones. The control group did not receive any treatment during the corresponding time. They were evaluated before, at the end of treatment and 6 weeks after treatment completion for primary outcomes (1-h pad test for urinary loss and pelvic floor muscle pressure) and secondary outcomes (quality of life with King's Health Questionnaire, satisfaction with treatment, and continuity of training). RESULTS: For urinary leakage, there were statistical differences between the treated groups and the control group at the end of treatment and 6 weeks after treatment (all p < 0.01; effect size: vaginal cone group 20.97; PFMT group 20.96). The same behavior was shown for treatment with pelvic floor muscle pressure (all p < 0.01; effect size: vaginal cone group 22.58; PFMT group 21.68). There were no differences between the vaginal cone and PFMT groups in any of the evaluations. In outcomes for quality of life, significant differences were observed for incontinence impact and gravity domains when both treated groups were compared with the control group after treatment. Both groups reported similar satisfaction levels and the vaginal cone group demonstrated lower training continuity. CONCLUSION: Based on this study, there were similar positive results for treatment with the vaginal cone and pelvic floor muscle training for urinary leakage, pelvic floor muscle pressure and quality of life for postmenopausal women with stress urinary incontinence after 6 weeks.

Comparação da qualidade de vida nos diferentes tipos de incontinência urinária feminina / Comparison of quality of life for different types of female urinary incontinence

OBJETIVOS: Comparar o impacto do tipo de incontinência urinária sobre a qualidade de vida em mulheres. MÉTODOS: Foram avaliados retrospectivamente 77 prontuários de mulheres incontinentes que realizaram tratamento fisioterapêutico entre fevereiro de 2005 a outubro de 2006. De acordo com os dados do exame urodinâmico, as mulheres foram classificadas em três grupos: incontinência urinária de esforço (IUE), hiperatividade vesical (HV) e incontinência urinária mista (IUM). As voluntárias responderam a uma anamnese com dados demográficos e ao King's Health Questionnaire, questionário específico para avaliação da qualidade de vida em indivíduos com incontinência urinária. RESULTADOS: A maioria das pacientes (44%) apresentou IUM. A idade das pacientes acometidas por HV foi significativamente maior se comparada à idade das pacientes dos demais grupos. As mulheres acometidas por IUM apresentaram um impacto negativo significativamente maior sobre a qualidade de vida (domínio percepção geral da saúde) e sobre a percepção de que a incontinência afeta de modo negativo a própria vida em comparação com as pacientes dos demais grupos. CONCLUSÃO: Este estudo indicou que pacientes com IUM apresentaram um maior impacto negativo sobre a qualidade de vida.

OBJECTIVES: To compare the impact of the type of urinary incontinence on women's quality of life. METHODS: A retrospective evaluation was conducted on the medical records of 77 incontinent women who underwent physical therapy treatment between February 2005 and October 2006. Based on the urodynamic test data, the women were classified into three groups: stress urinary incontinence (SUI), overactive bladder (OB) and mixed urinary incontinence (MUI). The subjects' history was taken, the women provided demographic data and they answered the King's Health Questionnaire, which is a specific questionnaire for assessing the quality of life among individuals with urinary incontinence. RESULTS: Most of the patients (44%) had MUI. The patients affected by OB were significantly older than the patients in the other groups. The negative impact of incontinence on quality of life (General Health Perception domain) and lifestyle was significantly greater among the women affected by MUI than among the patients in the other groups. CONCLUSION: This study indicated that the negative impact of incontinence on quality of life was greater among patients with MUI.

Influência da universidade aberta da terceira idade (UATI) e do programa de revitalização (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos / Influence of the Open University for the Third Age (UATI) and the revitalization program (REVT) on quality of life in middle-aged and elderly adults

OBJETIVO: Foi avaliada a influência da Universidade Aberta da Terceira Idade - Fundação Educacional de São Carlos (UATI-FESC) e do Programa de Revitalização Geriátrica (REVT) sobre a qualidade de vida de adultos de meia-idade e idosos. MÉTODO: Participaram deste estudo 70 indivíduos do primeiro ano da UATI e do REVT. Os critérios de inclusão foram ter 50 anos ou mais e ser capaz de preencher os questionários. A UATI é um programa interdisciplinar com seis disciplinas (uma vez por semana cada), três de atividades físicas: Tai Chi Chi Kung, Expressão Corporal, Fisioterapia e Promoção da Saúde; e três de promoção social e cultural: Educação Musical, Arte, Cidadania e Terceira Idade, além de atividades comemorativas e turismo cultural. O REVT teve 48 sessões de atividade física, três vezes por semana, com duração de 50-55 minutos cada. Todos os participantes foram avaliados por meio dos instrumentos de qualidade de vida World Health Organization Quality of Life (WHOQOL-bref) e Short-Form 36 - Medical Outcomes Study (SF36) no início e ao término da intervenção de 16 semanas. Para análise dos dados, foi utilizada ANOVA com medida repetida. RESULTADOS: Não houve diferença entre os grupos. Ambos os grupos apresentaram melhora significativa do nível de qualidade de vida de acordo com o resultado geral do WHOQOL-bref e também nos domínios psicológico, meio ambiente e questões iniciais: "Como você avaliaria sua qualidade de vida?" e "Quão satisfeito(a) você está com a sua saúde?" do WHOQOL-bref. Também houve melhora significativa do domínio Estado Geral de Saúde do SF36. Para os domínios Físico e Relações Sociais do WHOQOL-bref e outros domínios do SF36 não houve melhora significativa. CONCLUSÃO: Esses programas melhoraram a qualidade de vida segundo o WHOQOL-bref e EGS-SF36.

OBJECTIVE: The influence of the Open University of the Third Age (São Carlos Educational Foundation) (UATI-FESC) and the Geriatric Revitalization Program (REVT) on the quality of life of middle-aged and elderly adults was evaluated. METHOD: Seventy individuals in their first year at UATI and REVT participated in this study. The inclusion criteria were that the subjects had to be at least 50 years old and be capable of filling out questionnaires. UATI had an interdisciplinary program comprising six lectures (once a week each). Three were on physical activities: Tai Chi Chi Kung, Body Expression and Physical Therapy and Health Promotion; three on social and cultural promotion: Musical Education, Art and Citizenship in the Third Age; and there were also commemorative activities and cultural tourism. REVT had 48 physical activity sessions, three times a week, lasting 50-55 minutes each. All the participants were evaluated using the World Health Organization Quality-of-Life (WHOQOL-bref) and Short-Form 36 Medical Outcomes Study (SF36) questionnaires at baseline and at the end of the 16-week intervention. The data were analyzed using ANOVA with repeated measurements. RESULTS: There were no differences between the groups. Both groups showed significant improvement in quality of life according to the overall result from WHOQOL-bref and also in the Psychological and Environmental domains and the initial questions: "How would you rate your quality of life?" and "How satisfied are you with your health?", in WHOQOL-bref. There was also a significant improvement in the General Health domain of SF36. For the Physical and Social Relations domains of WHOQOL-bref and other domains of SF36, there was no significant improvement. CONCLUSIONS: These programs improved quality of life according to WHOQOL-bref and the General Health domain of SF36.

Influence of a physical training program on muscle strength, balance and gait velocity among women with osteoporosis

OBJECTIVES: The trend towards increased life expectancy will certainly lead to increases in morbidity and mortality relating to osteoporosis. Because of the lack of well defined protocols on the intensity and frequency of easily performed physical exercises for Brazilian women, this study proposed to analyze the effects of a training program for ankle muscle strength, balance performance and gait velocity among women with a densitometric diagnosis of osteoporosis. METHODS: Twelve female volunteers (age 68.7 ± 2.7 years) underwent physical evaluation and subsequent reevaluation after twelve weeks. The physical activity program was guided by a physical therapist, who conducted 60-minute sessions, three times a week for twelve weeks. Each training session included some stretching exercises, strengthening exercises for the ankle dorsiflexor and plantar-flexor muscles, with 50 percent of 10-repetition maximum (10-RM), and balance training. RESULTS: The variables analyzed regarding balance index, gait velocity and muscle strength presented significant improvement (p < 0.05), as shown by the Wilcoxon non-parametric test. CONCLUSION: After the 12-week exercise program, the participants presented benefits in terms of their fitness. The results demonstrate that the training had a role in improving the condition of this group of patients, thus suggesting that this program was effective, easy to implement and safe for Brazilian women with osteoporosis. Therefore, it can be seen that physical activity programs are efficient in improving balance performance, gait velocity and ankle muscle strength among elderly women with osteoporosis.

OBJETIVOS: A tendência de aumento na expectativa de vida certamente representará incrementos na morbidade e na mortalidade em eventos relacionados a osteoporose. Devido à falta de protocolos bem definidos na intensidade e freqüência de exercícios físicos, que sejam fáceis de se realizarem, para mulheres brasileiras, este estudo propôs analisar os efeitos de um programa de treinamento na força muscular do tornozelo, no equilíbrio funcional e na velocidade da marcha de mulheres com diagnóstico densitométrico de osteoporose. MÉTODOS: Doze mulheres voluntárias (idade 68,7 ± 2,7) foram submetidas à avaliação física e, posteriormente, reavaliadas após doze semanas. O programa de atividade física foi orientado por um fisioterapeuta, que trabalhou 60 minutos, 3 vezes por semana, por doze semanas. Cada sessão de treinamento incluiu alguns exercícios de alongamento, fortalecimento muscular dos músculos flexores plantares e dorsiflexores do tornozelo, com 50 por cento de 10-repetições máximas (10-RM) e treino de equilíbrio. RESULTADOS: As variáveis relacionadas ao índice de equilíbrio, à velocidade da marcha e à força muscular apresentaram melhora significativa (p < 0,05), analisadas por meio do teste não paramétrico de Wilcoxon. CONCLUSÃO: Após as doze semanas de treinamento, foram observados benefícios no condicionamento das voluntárias. Os resultados demonstram que o treinamento proposto, teve influência na melhora desse grupo de pacientes, sugerindo que o programa foi efetivo, fácil e seguro para mulheres brasileiras portadoras de osteoporose. Portanto, programas de atividade física são eficientes para melhorar o equilíbrio funcional, a velocidade da marcha e a força muscular do tornozelo de mulheres idosas portadoras de osteoporose.

Efeitos de um programa de atividade física na postura hipercifótica torácica, na dorsalgia e na qualidade de vida de mulheres com osteoporose / Effects of a physical exercise program on the thoracic hyperkyphosis posture, on back pain and on quality of life in osteoporotic women

O objetivo deste estudo foi avaliar os efeitos de um programa de exercicios na postura hipercifotica toracica, na dorsalgia e na qualidade de vida dde mulhres com osteoporose. Sujeitos: 16 mulheres, com idade entre 65 e 75 anos. Os voluntarios foram submetidos a uma avaliacao fisica e a uma avaliacao do grau de cifose e responderam a questionarios para avaliar a dorsalgia, o Br-MPQ, e a qualidade de vida, o OPAQ. O programa foi composto de tres sessoes por semana (com 1 hora de duracao cada), durante 12 semanas. Os dados foram analisados estatisticamente pelo teste nao-parametrico de Wilcoxon. Foram observadas diferencas significativas(p=0,05) no grau de cifose (de 58,19o. +-14,83o. na avaliacao para 55o. +- 13,26o. na reavaliacao), diminuicao significativa na dorsalgia e melhora significativa da qualidade de vida. Os resultados encontrados permitem concluir que o programa de exercicios foi eficiente para melhorar a postura (com diminuicao do grau cifose), reduzir a dorsalgia e melhorar a qualidade de vida das mulheres osteoporoticas. Este estudo atingiu seu objetivo de desenvolver um programa de exercicios eficiente para melhorar alguns dos problemas fisicos presentes em individuos osteoporoticos