WHODAS measurement properties for women with dysmenorrhea.

BACKGROUND: There is an association of dysmenorrhea with human functioning and disability. However, no patient-reported outcome measure has been developed to assess this construct in women with dysmenorrhea. WHODAS 2.0 has been recognized as an important generic patient-reported outcome information of physical function and disability. Thus, the aim of this study was to assess the measurement properties of the WHODAS 2.0 in women with dysmenorrhea. METHODS: This is an online and cross-sectional study conducted with Brazilian women aged 14 to 42 years with self-report of dysmenorrhea in the last three months. According to COSMIN, structural validity was evaluated by exploratory and confirmatory factor analysis; internal consistency by Cronbach's Alpha; measurement invariance by multigroup confirmatory factor analysis between geographic regions of Brazil; and construct validity by correlating WHODAS 2.0 to the Numerical Rating Scale for pain severity. RESULTS: One thousand three hundred and eighty-seven women (24.7 ± 6.5 years) with dysmenorrhea participated in the study. WHODAS 2.0 presented a single factor by exploratory factor analysis and adequate model by confirmatory factor analysis (CFI = 0.924, TLI = 0.900, RMSEA = 0.038), excellent internal consistence (α = 0.892) for all items and an invariancy across geographic regions (ΔCFI ≤ 0.01 and ΔRMSEA < 0.015). Correlation between WHODAS 2.0 and numerical rating scale was positive and moderate (r = 0.337). CONCLUSION: WHODAS 2.0 has a valid structure to assess functioning and disability related to dysmenorrhea in women.

The influence of the menstrual cup on female pelvic floor muscles variables: a prospective case series.

The aim was to assess and report the effects of menstrual cup on pelvic floor muscles (PFM) function and tone, as well as check the acceptability after a period of three menstrual cycles in healthy young women. The data collected in assessments and reassessments included the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS) questionnaire, evaluation of PFM function through PERFECT Scheme, PFM muscle tone, and PFM manometry (Peritron 9300®). A diary regarding the overall colletor acceptability and satisfaction was collected. Ten healthy young women completed the study. There was an improvement in the mean values of maximal voluntary contraction (MVC) (p = 0.032), a decrease in the vaginal resting pressure (VRP) (p = 0.05), and an increase in the number of repetitions of sustained muscle contractions (p = 0.042). Seven women reported some discomfort while using the vaginal cup only in the first cycle while three revealed discomfort during the whole experiment. This study provides preliminary case-based evidence that the use of the vaginal cup for a period of three menstrual cycles changes the VRP, MVC, and PFM tone, as well as improves the repetitions of PFM assessed by digital palpation. Moreover, the women reported the use of vaginal cup as a positive experience.

Assessment of abdominal and pelvic floor muscle function among continent and incontinent athletes.

INTRODUCTION AND HYPOTHESIS: Studies have shown that there is a co-contraction between the pelvic floor and abdominal muscles. This study aimed to evaluate pelvic floor and abdominal muscle function in continent and incontinent female athletes and to investigate the association between these muscle groups. METHODS: This was a cross-sectional study. Forty nulliparous professional female athletes who competed at the municipal level or above participated in this study. All participants underwent a pelvic floor muscle (PFM) and abdominal muscle assessment. PFM function and strength were assessed using the modified Oxford Scale and a perineometer. Abdominal muscle function and strength were assessed using a 4-Pro isokinetic dynamometer. To assess athletes' urinary continence, the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-UI-SF) was used. RESULTS: There was a positive association between PFM and abdominal muscle strength among the incontinent athletes (p = 0.006; r = 0.577). The incontinent athletes had greater PFM strength than the continent athletes (p = 0.02). There was no difference in abdominal muscle function between the groups. CONCLUSIONS: We found that incontinent athletes have greater PFM strength than continent athletes. This suggests that urinary incontinence in this population is not due to PFM weakness. The positive association between abdominal and PFM strengths in incontinent athletes may be due to frequent co-contraction between these muscle groups.

Female sexual function and urinary incontinence in nulliparous athletes: An exploratory study.

OBJECTIVES: To estimate the prevalence of Female Sexual Dysfunction (FSD) and Urinary Incontinence (UI) symptom in nulliparous athletes and analyze the risk factors for these dysfunctions. DESIGN: A cross-sectional study. SETTING: The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) and the Female Sexual Function Index (FSFI) were applied to assess the UI and the FSD. PARTICIPANTS: 50 athletes with ≥18 years old. RESULTS: We found a prevalence of 48% of UI and 44% of FSD among nulliparous athletes. The rate of athletes having concomitant FSD and UI was 24%. We found a significant difference between high and low impact sports in the ICIQ-UI-SF score (p = 0.028). Hours of training (p = 0.007; R2 = 0.21) was found to be a risk factor for UI. Incontinent athletes demonstrated a Relative Risk of 2.7 to develop sexual desire problem when compared to the continents (p = 0.04; 95% CIs: 1.50-4.89). CONCLUSIONS: This study found a high prevalence of both UI and FSD among nulliparous athletes. Furthermore, nulliparous athletes practicing high-impact modalities are the most susceptible to UI. The hours of training per day was considered a risk factor to develop UI, and incontinent athletes have more chances of showing difficulties in sexual desire.

Avaliação isocinética do membro inferior de atleta comamputação transtibial: estudo de caso / Isokinetic assessment of lower limb in an athlete with below-knee amputation:a case study

Objetivos: Avaliar os efeitos de um treinamento isocinético no pico de torque e na potência máxima dos músculos flexores e extensores dejoelho e quadril em um atleta amputado de membro inferior.Descrição do Caso: Avaliou-se um atleta de Triathlon com 27 anos de idade com amputação congênita do terço proximal da tíbia à direita,usuário de prótese de alta performance para corrida. Realizou-se perimetria de ambos os membros inferiores, mensuração do pico de torquee mensuração da potência máxima da musculatura flexora e extensora de joelho e quadril, por meio de um dinamômetro isocinético antes eapós duas semanas de treinamento com exercícios no isocinético. Comparando-se os dados da avaliação com os da reavaliação, através deanálise descritiva exploratória, observou-se que houve redução do coeficiente de variação das quatro repetições dos movimentos de flexãoe extensão de quadril e joelho de ambas as extremidades inferiores, identificando maior uniformidade nas curvas de torque na reavaliaçãoquando comparada à avaliação inicial.Conclusões: É fundamental um período de adaptação no dinamômetro isocinético em atletas com amputação de membro inferior, parafamiliarização na execução dos movimentos concêntricos e excêntricos. A ausência ou ineficiência dessa adaptação poderá comprometer osdados para a composição de protocolos de tratamento e/ou treinamento do atleta com amputação.

Aims: To evaluate the effects of isokinetic training on peak torque and maximum power of the flexor and extensor muscles of the knee andhip articulations in an athlete with lower limb amputationCase Description: We assessed a 27-year-old triathlete amputee, with congenital amputation of proximal third of right tibia and user ofhigh-performance prosthetics for running. The circumference of both lower limbs were measured, and an isokinetic dynamometer wasused to estimate the peak torque and maximum power of the flexor and extensor muscle groups of the knee and hip, before and aftertwo weeks of training with isokinetic exercises. There was a reduction in the coefficient of variation of all four repetitions of flexion andextension of hip and knee on both lower extremities, identifying a greater uniformity in torque curves on revaluation compared to the initialevaluation.Conclusions: Athletes with lower limb amputation should have an adjustment period with the isokinetic dynamometer in order to familiarizewith the execution of concentric and eccentric movements. The absence or inefficiency of this adaptation can compromise data collection forthe composition of protocols of treatment and / or training in amputee athletes.